Written by a Medical Acupuncture for Veterinarians course graduate. Signed release obtained from client/author. 4384
Mona presented for acute hind limb paresis and was nearly normal by her third acupuncture treatment
History and Presentation:
Mona is an 11 year old SF Rottweiler mix with a history of hip dysplasia and cruciate disease in both stifles that presented for acute pelvic limb paresis on 5/18/17
Physical Examination and Clinical Assessments:
Patient presented with severe kyphosis of the T/L junction, absent conscious proprioception and superficial pain bilaterally and intact deep pain bilaterally in the pelvic limbs. Musculoskeletal exam revealed severe pain from T11-L4, along with muscle tension in the trapezius.
Medical Decision Making:
Neurologic consultation was recommended, however the owner declined and elected medical treatment of spinal chord injury. Prednisone, tramadol, methocarbamol and strict rest were all prescribed.
Acupuncture was started the day of presentation with the goals of addressing the kyphosis on physical exam to release muscle tension, stimulating the nerves of the pelvic limbs to initiate healing around the defect, aiding in autonomic reset to expedite healing, and addressing any trigger point pathology along the forelimbs to help patient comfort during healing
Based on age and presentation, Neoplasia, IVDD, or a vascular event were our top rule outs
Definitive (or Putative) Diagnosis (or Diagnoses):
Treated as IVDD based on presentation, knowing other differentials have not been ruled out without imaging
Treatments were initiated every third day due to the severity of the neurologic event, Treatment protocols were based on physical, musculoskeletal and neurologic examination. Dry needling is the only modality available at our clinic and was therefore all that was used on this patient outside of amateur massage performed after each acupuncture session.
5/18/17- ST36, GV 20, GV 14, LI 4, Bai hui, bafeng in both hind limbs, hip triads bilaterally, Inner BL line points spanning entire area of kyphosis, triceps trigger points. Recommended passive range of motion to owner
5/22/18- GV 20, GV 14, Bai hui, Inner and outer bladder line points spanning severe kyphosis, BL 60, SI 10, SI 11, BL 10- added on Gabapentin for improved pain management. Recommended adding on short, controlled walks to owner, and discussed referral for laser therapy, owner declined.
5/25/18- GV14, Bai hui, BL lines along kyphosis- inner only, ST 36, SP10, BL 40 (R only) one bafeng point in each hind limb, SI 11, SI12, SI 9
Outcomes, Discussions, and References:
Patient markedly improved after first session of acupuncture. By the third session CP had nearly improved to normal and visits were extended to every 7 days. Mona is now being seen once monthly for management of her OA of her hips and stifles.
The combination of medical and adjunctive therapies accelerated healing in this patient. Additionally, acupuncture is now a part of her arthritis management regimen and markedly has improved her quality of life.