Select Page

 

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

Abstract

Acupuncture treatment for chronic shifting leg lameness in 18-year-old paint mare. Successful pain relief with acupuncture after two treatments. Resolution of lameness with further corrective shoeing.

History Presentation

Maddy is an18-year-old paint horse mare presenting for chronic bilateral hindlimb lameness for four months duration. Karen noticed that Maddy had a very short stridden the backend when she was brought in from the pasture this spring. She has been pastured in a dirt lot without shoes for the winter. She eats a diet of grass hay supplemented with equine senior grain and horse guard.

Physical Examination and Clinical Assessments

On presentation, Maddy was bright alert and responsive. Lameness evaluation showed a grade 3/5 lameness bilaterally on the pelvic limbs, worse on the right. Flexion tests did not increase the severity of the lameness. There was no swelling, inflammation, or heat on palpation of the pelvic or thoracic limbs. Digital pulses were palpable but within normal limits.

TMJ joints palpated within normal limits bilaterally and there was no pain or discomfort on flexion, extension, and palpation of the cervical vertebrae. Thoracic limbs flexed and extended within normal limits. Myofascial palpation indicated a trigger point in the left deltoid.

Myofascial palpation indicated moderate back pain along the left lumbar spine extending from T-11 to the proximal sacrum, Severe back pain on the right side extending from T-13 to coxofemoral joint. Bilateral tenderness to palpation along the semimembrinosus and semitendinosus muscles, worse on the right side. Maddy was reluctant to lift her hind limbs and flexion and extension of both pelvic limbs was reduced.

Tail flexed and extended within normal limits.

Medical Decision Making

Maddy tolerated her treatment well settling into the treatment and falling asleep. She sold well for 20 minutes despite a hail storm starting and the barn becoming loud.

Next treatment should be similar if she responds well to this. We may consider adding E-stim if she continues to tolerate the needling well.

Please consider a formal lameness evaluation by your primary care veterinarian to further localize the source of her discomfort.

Acupuncture Treatment

Treatment protocol 5/13/16:
Bai Hui (permission pt anxiety, hip, pelvic limb) LI-16 (anxiety)

GB-21 (permission pt), 29 (hip/pelvic limb), 30 (hip/pelvic limb), 34 (hip/pelvic limb)

BL-25 (pelvic limb), 26 (pelvic limb), 27 (pelvic limb), 36 (pelvic limb), 40 (pelvic limb), 54 (hip/pelvic limb) into left deltoid trigger point

Needles in for a 20-minute treatment, no E-stim this visit

5/21/16

Myofascial palpation indicated moderate tenderness over thoracic and lumbar spine. Positive for pain on palpation of hip triad bilaterally. Flexion of pelvic limb reduced bilaterally worse on right. No pain on palpating of thoracic limbs.

Bai Hui (permission pt anxiety, hip, pelvic limb) LI-16 (anxiety)

GB-21 (permission pt), 29 (hip/pelvic limb), 30 (hip/pelvic limb), 34 (hip/pelvic limb)

BL-25 (pelvic limb), 26 (pelvic limb), 27 (pelvic limb), 36 (pelvic limb), 40 (pelvic limb), 54 (hip/pelvic limb)

Maddy tolerated her treatment well today. She has a scheduled lameness evaluation with an equine specialist next week.

Outcomes, Discussions

Maddy’s lameness evaluation localized lameness to her hooves as a result of imbalanced trimming. A consultation with a specialty farrier is being pursued. Radiographs of all limbs reviled skeletal structure is within normal limits. These results indicate that Maddy’s back and hip pain are most likely compensatory to the primary lameness issue in her hooves. Corrective shoeing along with continued acupuncture for pain relief are recommended.

Maddy’s lameness was evaluated as resolved. She is back to trail riding with continued corrective shoeing. No lameness issues are present as of this date.

Lesson

Acupuncture is great for helping to manage pain but sometimes there is a larger underlying cause that cannot be fixed with acupuncture. Always investigate the whole picture and find the root of the cause of the pain.