Written by a Medical Acupuncture for Veterinarians Course Graduate. Author’s name available upon request. Signed release obtained from client/author.
This case study examines a geriatric pony receiving his first acupuncture session. He was treated for chronic pain in the front end per his owner’s request. Dry needling technique was solely used, and the patient handled the treatment moderately well for his first time. The owner reported that she noticed some improvement in flexibility and attitude in the following few days.
History and Presentation
Buster Snell is a 26-year-old POA gelding. He has a history of Grade 3 lameness in both front limbs that started about 10 years ago when he retired from showing. He spent four years as a therapeutic riding horse with special needs children where he performed minor walking exercises that did not cause him discomfort. In 2011, he was diagnosed with chronic uveitis and blindness. He was returned to his original owner because the therapeutic riding academy could no longer use him for liability reasons. He has been a pasture pet ever since.
Physical Exam and Clinical Assessment
On physical Exam, Buster is bright, alert, and responsive. He has microphthalmia, corneal opacity, and blindness OU. His cranial nerves are otherwise WNL. He has a stiff, arthritic gait when walking and is moderately lame when trotting. He has muscle soreness and taut bands across the Caudodorsal cervical spine, both shoulders bilaterally across the Supraspinatus and infraspinatus muscles, as well as the right triceps and mid to caudal lumbar epaxial muscles. Oral, thoracic auscultation, derm, neuro, and lymph node systems were all within normal limits. No laboratory or imaging diagnostics were performed.
Medical Decision Making
Since this was the first acupuncture session for Buster, I decided to start with calming points. From there, I addressed trigger points in both shoulders based on myofascial palpation. I used massage and acupressure before placing each needle to test his reaction to the pressure and minimize startling him. The goal for this first session was to see how Buster reacted to the needles, provide some pain relief into trigger points, and stimulate nerves in and around the shoulder focusing on the caudal cervical region and infraspinatus and supraspinatus muscles.
Red Seirin (0.16x30mm) needles were used to dry needle the patient. Needles were placed in Bai Hui, GV-14, SI-11 (bilaterally), SI-12 (bilaterally), SI-9 (right only), and trigger point located at SI-16 on the right side. At this point, Buster became minorly agitated, and I decided to end my needling session. The needles stayed in approximately 25 minutes b4wv8fe.
Outcomes, Discussions, and References
Buster’s owner reported that he seemed to be a little slower than usual that evening, but his attitude and energy level improved noticeably the following day. The owner reported that he seemed to be willing to bend to the left more in her observation of him while being led. He has not had any additional treatments or medications, but he could benefit from laser and massage to his trigger points. He would also benefit from Adequan injections for his arthritis. No adverse reactions were noted.
This case was my first equine acupuncture patient. I grew up with horses, but have not practiced equine medicine since vet school. Equine anatomy is quite different from canine and feline anatomy, so some adjustments had to be made in my technique to keep the patient, owner, and myself safe. In addition, I would like to add in electroacupuncture to my treatments as three sessions of electroacupuncture were found to effectively reduce thoracolumbar pain in horses, and phenylbutazone did not have the same effect (Xia, Colahan, Ott, 2005). In addition, local trigger points may need to be stimulated with a higher frequency, while points farther away from painful areas may do better being stimulated with a lower frequency (Xie, et al, 2001).
Xie, H., Colahan, P., Ott, E.A. Evaluation of Electroacupuncture Treatment of Horses with Chronic Thoracolumbar Pain. JAVMA (2005). DOI: 10.2460/javma.2005.227.281
Xie, H., Ott, E., Harkin, J., Tobin, T., Colahan, P., Johnson, M. Influence of Electroacupuncture on Pain Threshold in Horses and Its Mode of Action. Journal of Equine Veterinary Science. (Dec, 2001).