Written by a Medical Acupuncture for Veterinarians Course Graduate. Author’s name available upon request. Signed release obtained from client/author.
Picasso, a 10-year-old German Shepherd presents with occasional weakness in his hind legs, especially his right hind leg. It seems to be a chronic issue since about four years. He has a lick granuloma on his right metatarsus and left hip.
For about two-three days post acupuncture, there is visible improvement of his gait and comfort. His back legs are stronger, and he is not interested in the lick granulomas for about three-four days.
Picasso is living on a farm in Dohna, Germany. He was diagnosed with Anaplasmosis in 2010 and treated with Doxycycline for a couple of months. His titer stays relatively high. During the last three years, he had three episodes of hind leg paresis after walking. In April 2016, he has been sitting down during longer walks and needed about 15 minutes before he was able to continue. Suspected diagnosis is cauda equina syndrome, Degenerative Myelopathie, moderate Hipdisplasia, or lameness due to anaplasmosis. His symptoms are almost gone under a course of Doxycycline. Since he has a lot of trouble during and after an anesthesia, he hasn’t been x-rayed for HD nor has had an MRI. He has been treated twice by a chiropractic last year with success – he was able to walk freely for about two weeks post treatment. He is getting a low dose dexamethasone due to the anaplasmosis.
Physical Examination and Clinical Assessments
At each treatment, he presents BAR and very happy, he comes running with little jumps. His reflexes are normal, the Ortolani test is negative, and no pain reaction on hip extension. After longer walks, his proprioception is slightly delayed.
On the myofascial examination, I can find sore neck muscles, tense biceps, very sore back muscles especially in the lumbar region, sore quadriceps bilateral, bilateral prominent stifles – drawer test negative, no history of cruciate injury but could be possible. As a differential diagnosis polyarthritis from anaplasmosis.
Medical Decision Making
Picasso’s quality of life changes as soon as he experiences times of stiffness and pain. Since there is no direct diagnosis for Degenerative Myelopathie and no chance to get proper x-rays, the goal is to increase the days of comfort with the help of acupuncture.
The treatment plan involves the main acupuncture points relating to tense muscles around the hips and lumbar region, as well as the neck and shoulder region. When there were trigger points present, I treated them if accepted.
I used blue and red Seirins without electroacupuncture or laser (reason: I don’t have one or the other). He has been needled every three-four days for about three weeks.
The following points have been used in each session:
Yintang – good relaxation, kept his head down and rested relaxed
Bai Hui – against hip pain
Bafeng – sensitive on some days
BL 23 25 26 27 – very sensitives muscles, tolerates well
BL-40 – against pelvic limb pain and paresis
ST-36 – pelvic limb dysfunction
SI-12 – trigger point
SI-3 – used a the 3rd time for neck pain
GB 29 30 31 – trigger points, hips pain, neurologic dysfunction
LI-3 – lick granuloma, needles also around lesion
GV-14 – neck pain
Picasso presented almost pain free for two-three days after treatment. Due to management, we were not able to treat him more frequently. He also stopped licking his granulomas during this timeframe.
In this case, electroacupuncture would speed up the progress of healing. More frequent treatments, swimming, and massage would also improve the outcome. We will continue the treatments to achieve longer periods of comfort.