Written by a Medical Acupuncture for Veterinarians course graduate. Signed release obtained from client/author. A2017059

Abstract: Eclipse has been treated with acupuncture as part of her wellness program for the past 8 years. She has a long history of medical issues, including a severe left hind hock injury and undiagnosed acute onset hindlimb ataxia. I took over her care in 2015, 2016 and 2017 saw Eclipse face a number of significant health issues, including a severe gastric impaction and persistent gastric atony. She became solely reliant on our regular treatments when she developed reactions to her promotility medication. The acupuncture treatments provided significant results and improvement in her gastric motility, preventing any further gastric impaction prior to her euthanasia for acute enteritis in April 2017.

History: Eclipse, a 21 year old Hanoverian mare, presented in November 2016 for mild colic signs, she was diagnosed with a severe gastric impaction. She was treated aggressively with oral fluids, Coke, and promotility agent Bethanocol in hospital, along with daily acupuncture treatments to encourage gastric motility. Upon discharge, she received weekly-biweekly treatments. These became critical to managing her gastric motility and comfort level as she developed side effects to her Bethanocol, which was discontinued. During her recovery and management from her gastric impaction, difficulties in providing her intense diet management schedule meant she was moved to a number of different farms over the next few months. During this time we also dealt with stress related gastric ulcers, which were treated with Gastroguard as well as acupuncture. She has been retired since then and lived a wonderful life as an extremely well loved soul-mate to her owner. She received regular joint supplements (Legend, Adequan) to keep her comfortable. Her schedule was immaculately regulated for her maximal comfort and her owner was intense in her observations of Eclipses well-being. Eclipse also profited from her owners use of crystal therapy to encourage her maximal mental and physical health.

Physical Exam: Eclipse was a very bossy mare with a huge personality, she was always a bit overweight (BCS 6/9), however after her gastric impaction she maintained a lighter BCS 5/9 that was critically monitored to ensure she was getting her appropriate caloric intake. Her vital parameters were within normal limits. Her left tibiotarsal joint markedly distended with a mild varus stance due to weakness. She maintained a Grade 2 hindlimb ataxia since 2011.

Medical Decision Making: Initially our treatments had been to maintain overall comfort, however after her gastric impaction our primary goal switched to improving gastric motility. Eclipse generally handled her acupuncture treatments well, however it took several sessions to slowly introduce new points and distal limb points were not able to be used for safety reasons.

Differential and Definitive Diagnoses: Primary diagnoses were poor gastric motility, grade 2 hindlimb ataxia of unknown confirmed origin and marked left tibiotarsal effusion. She was consistently reactive over her neck (right more so than left), BL 13, thoracolumbar junction, and gluteal muscles.

Acupuncture Treatments: Eclipse was treated intensively with dry needle acupuncture treatments while in hospital (daily). Once she was discharged she was treated on a weekly-twice weekly basis, depending on how her owner felt she was doing, until her death. Her treatments would vary depending on how reactive she was that day. When I took over her acupuncture care, it was exceedingly difficult to treat anything behind her TL junction safely. She responded very well and I was able to quickly treat her more extensively.
– Bai Hui
– GV12 – Stomach Mu points
– Left and Right GB21
– Left and Right LI17, LI17a
– Left and Right ST25 – GI motility
– Left and Right ST36 – GI motility, immunomodulation
– Left and Right BL10 – cervical trigger points
– Left and Right BL13
– Left and Right BL 20/21 (Stomach Shu point)/22/25/26/27 – GI dysfunction, appetite stimulant
– Left and Right LR14
– CV14 – stress, stomach
+/- Left and Right LR13
+/- Left and Right PC1 – local tension
+/- Left and Right PC6 – cranial GI tract
+/- Left and Right ST10
+/- GV24 – stress
– Attempted SP6 a few times – very reactive, aborted

Outcomes, Discussions, References: Eclipses’ gastric motility problems were managed successfully in preventing further gastric impaction. She maintained a strong appetite until April 2017 she became mildly innappetant, mildly more ataxic, significant reduction in manure production and aggressive wall chewing behaviour. Over the next 3 days acupuncture treatments would rouse her appetite temporarily but she was admitted to the hospital and diagnostics confirmed severe small intestinal ileus and pyloric wall thickening. Given the multitude of problems Eclipse faced, her owner made the difficult decision to euthanize her and donate her body to the university for students to benefit from what she could teach them. On post mortem, she was confirmed to have an intracranial nerve sheath tumor of the trigeminal ganglia compressing the pons and midbrain. She also had moderate eosinophilic enteritis of the small intestine and a suspect displacement of the pylorus.

 


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