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Written by a Medical Acupuncture for Veterinarians Course Graduate. Author’s name available upon request. Signed release obtained from client/author/4911.

Abstract

This case report is about a horse that was presented for back pain and behavioral issues. It describes the acupuncture treatments and positive clinical response of this horse to the treatment.

An eight-year-old Quarter horse mare was presented for back pain. The owner had acquired the horse only a couple months earlier. Little history was known, except that the horse had tendinitis of its left front leg, which was supposedly healed, but no precise diagnostic had been made. Other past medical history was unknown. The owner was planning to do barrel racing with the horse, but had noticed that the mare seemed sensitive on its back. The owner also reported behavioral issues when the horse was being manipulated on the left. The mare would avoid contact and pull away.

Physical Examination

On physical examination, no lameness was found, but the mare reacted positively to the flexion of both hind legs, worse on the left side. The neurologic examination and rest of the physical examination were normal. The myofascial palpation evaluation revealed that the horse was painful at ST-7 when pressure was applied bilaterally. The mare was also tense and very painful in her cranial neck on both sides, worse on the left. The patient had a lot of trigger points in the neck and had a taut band cranial to the scapulas on both sides. The horse was painful from BL -17 to BL-20 and at BL-52 on both sides, worse on the left. Finally, the mare was also painful at BL-54 and GB-29 on both sides and had a lot of trigger points in the gluteal region.

Treatment

The goal of the treatment was to make the patient more comfortable and help with behavioral problems. Because the tenderness in the cranial neck and at ST-7 was thought to be primarily caused by a rear-end problem, the acupuncture treatment was focused primarily on helping gluteal and pelvic limb pain. The second focus of the acupuncture treatment was to release the tension in the cranial neck. The acupuncture treatment was also elaborated to release trigger points and taut bands, as well as improve local blood flow in the neck, along the back and near the pelvis and gluteal muscles. Another focus of the treatment was to induce neuromodulation to provide analgesia in this horse, by stimulating the release of proteins and neurotransmitters, such as serotonin and endorphins. Finally, the treatment had to be agreeable for the horse, non-painful, and relaxing. For that reason, few needles were used during the first acupuncture treatment to make sure the horse would tolerate it, and needles were not directly applied to the more painful areas. As the acupuncture treatments started to be effective and the horse became less painful, it was possible to increase the number of needles placed per treatment and aim for more painful areas. The patient’s tolerance was good. When a needle seemed uncomfortable, it was removed promptly.

The acupuncture treatments always started with some calming points, which include LI-16, GB-21, GV-14, and Bai Hui. GB-21 was also used to help release the taut bands near that point. Bai Hui was used for its calming effect, but also for its effect on back, lumbosacral, and pelvic limb pain. Needles were applied bilaterally to ST-7 to help relieve local pain. BL-54 and GB-29 were used to help with hip and gluteal pain. The first acupuncture treatment was stopped at that point after the mare reacted negatively to a needle placement on its neck. That needle was removed, and the horse was able to enjoy the end of the treatment. For the second and third treatments, it was possible to needle more points. The previous points were all needled again, but it was possible to also needle some neck points. BL-10, SI-16, LI-17, and two cervical trigger points were needled bilaterally to release cervical pain and tension. BL-25, BL-26, BL-27, and BL-28 were needled bilaterally to help with lumbosacral, back, and pelvic limb pain. Finally, BL-14 was needled, but the horse had such strong muscle contractions that the needles fell out only one minute after being placed. The acupuncture treatments occurred weekly for three consecutive weeks. Only dry needling was used because the horse would not allow electroacupuncture. After the second treatment, the owner was taught to massage the horse’s neck daily. Ideally, some bladder points along the back of the horse and some distal limb points would have been needled, but this was not possible with this patient.

Improvement in this horse was almost immediate. The owner reported better behavior the week following the first treatment. On the myofascial palpation examination before the second treatment, the horse was much more comfortable in the neck, and it was possible to needle the cervical region, which was impossible the week before because it caused too much pain. By the third treatment, the horse would gladly present its neck for the treatment and would want to be scratched on the left side of its neck, while before the mare would avoid total contact. Because no other treatment modalities were used, the outcome is clearly a response to acupuncture. No adverse effects of acupuncture were noticed in this patient. The acupuncture treatment in this mare resolved the behavioral issues reported by the owner and contributed to making the horse more comfortable.

Discussion and Outcomes

After seeing such an improvement following only three acupuncture sessions, it is clear that acupuncture is often underestimated, as is pain when it comes to behavioral issues. Pain is often undetected in our domestic animals, highlighting the importance of a good myofascial palpation examination. Furthermore, myofascial pain does not always respond well to standard medications, such as analgesics and anti-inflammatory drugs, while acupuncture is a beneficial tool. The article, Equine   Acupuncture:   Incorporation   into   Lameness   Diagnosis   and   Treatment1, explains how acupuncture is an interesting tool for treatment, but also for diagnostic purposes. Another interesting article about the treatment of painful horses with acupuncture is, Acupuncture Treatment of Pain along the Gall Bladder Meridian in 15 Horses2. In conclusion, acupuncture is a very useful tool to help painful horses, as was demonstrated by this case report.

References
1. Schoen AM. ‘Equine Acupuncture: Incorporation into Lameness Diagnosis and Treatment’. AAEP Proceedings, 2000, vol. 46; 80-83.

2. Still J. ‘Acupuncture Treatment of Pain along the Gall Bladder Meridian in 15 Horses’. Journal of Acupuncture and Meridian Studies, 2015, vol. 8; 259-263.