Written by a Medical Acupuncture for Veterinarians course graduate.Signed release obtained from client/author. A2017018
Abstract: Kippy is a 12 year-old spayed female Pembroke Welsh Corgi that has increased orthopedic pain due to arthritis, increased anxiety, and has started urinating in the house. Her owner sought integrated medicine to address all three issues following the recommendation of another veterinarian to place her on NSAIDS for her arthritis, anti-anxiety medication, and could find no medical reason for the increased urination in the house. Following the initiation of acupuncture she became more relaxed, was able to move with more freedom, and stopped the inappropriate urination.
History and Presentation: Kippy is 12-year-old spayed female Pembroke Welsh Corgi that presented to be for an integrative approach to her increased orthopedic pain secondary to aging, increased anxiety, and intentional urination in the house over the last month. Kippy has had no previous illness or serious injuries. She is currently on no medications. She is a ranch dog and spends time inside and outside. There are two other dogs in the house.
Physical Examination and Clinical Assessments: Kippy had recently been presented to her rDVM for concerns about the urination in the house. A CBC/CHEM/UA were performed and no abnormalities were noted. With no signs of cystitis and signs of incontinence the house soiling was chalked up to previously diagnosed anxiety. The referring also confirmed suspicions of the owner that Kippy was slowing down due to osteoarthritis in her shoulders and hips. The referring offered to place Kippy on Rimadyl and alprazolam. The owner chose to look into acupuncture therapy due to the side effects noted with both medications. Due to Kippy’s anxiety we chose to perform acupuncture at the owner’s home allowing the pet to be in a comfortable, familiar environment. On myofascial examination Kippy was found to have significant tightness and trigger points along her neck, shoulders, back especially in the lumbar area and her quadriceps.
Medical Decision Making: My acupuncture approach focused on reducing Kippy’s anxiety along with addressing her orthopedic pain. I chose points that would decrease her sympathetic input and would support the muscles supporting her shoulder joints, lumbar region, and hips.
Treatment began with needles placed in points to reduce anxiety and progress depended on Kippy’s tolerance level. Electroacupuncture would only be initiated once it was determined that Kippy was comfortable and not experiencing anxiety secondary to the treatment.
Differential Diagnoses: anxiety and osteoarthritis of shoulder, hip and likely discospondylosis of the lumbar regions based off of assessment of behavior, physical examination and myofascial examination
Definitive (or Putative) Diagnosis (or Diagnoses): anxiety and osteoarthritis of shoulder, hip and likely discospondylosis of the lumbar regions based off of physical examination and myofascial examination. No radiographs were taken to confirm diagnosis of osteoarthritis.
Treatment l: GV 20, HT3, HT7, ST36, Baihui
Treatment 2: GV 20, HT3, HT7, ST36, Baihui, LU7, SB local neck trigger points, LUI
Treat ment 3: GV 20, HT3, HT7, ST36, Baihui, LU7, SB, LUI, LUS, SP6, BL 23, BL25, BL27, BL28, GB 29, OB30, BL53
The points chosen to begin with focused on treating Kippy’s anxiety in efforts to keep her calm and comfortable. Only 5 points were used initially with the thought that as she became increasingly more comfortable with subsequent treatments that we could further address her osteoarthritis. Only dry needling was performed and needles were left as long as Kippy would allow which was approximately I0-15 minutes. Treatments were initially spread 5 days apart and currently she is on an every 3 week treatment plan. Kippy’ s owners have incorporated myofascial massage into Kippy’s daily routine usually at night when sitting on the couch.
Outcomes, Discussions, and References: Kippy seems to have improved both mentally and physically. She has fewer episodes of anxiety and has become more affectionate towards her house mates and owners and has stopped urinating in the house. She has also started spending a greater amount of time outside with the owners throughout the day and appears to move with less restriction. As Kippy was prescribed no medication her improvements can be directly correlated to her acupuncture and massage treatments.