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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/4933.

Abstract

Z’lyska is a 12 ½-year-old spayed German Shepard. Her owner wanted to pursue acupuncture to assist her in being more comfortable, mobile, and improve her quality of life.  Z’lyska can no longer get up the stairs and cannot take walks with her owner. On physical exam, Z’lyska appears lame on all four limbs. She is very slow to rise with reduced range of motion in both hindlimbs. Trigger points and taut bands were detected in multiple areas. For her front limbs particularly, laser therapy and massage were used following her acupuncture treatments.  For each treatment, we completed as many points as Z’lyska would allow, focusing mainly on the hind limbs, back, and shoulders, using Hwato 0.2mm needles. As time and treatment has gone on, the owner has reported being able to take short walks with her.  She is even doing better with stairs, wanting to play in the water, and has an easier time getting up. I have discovered that acupuncture can give patients extra quality time with their owners and vice versa. Acupuncture can be used as an additional modality particularly for arthritis and chronic pain.

History Presentation

Z’lyska presented to me in July of 2016 as a referral from her primary veterinarian. Z’lyska’s owner wanted to pursue acupuncture to assist her in being more comfortable, mobile, and improve her quality of life.  She had been slowing down for several months and wasn’t able to do things as she used to, according to her owner. Z’lyska can no longer get up the stairs and cannot take walks with her. Her primary veterinarian has her on Novox (Carprofen), Glucosamine, and chondroitin as well as fish oil on a daily basis. Her owner was seeing little to no improvement with these medications. The decision was approaching that her quality of life may not be good and her owner was considering euthanasia. However, Z’lyska’s owner was not ready to give up on her and wanted to give some alternative therapies a try, particularly acupuncture.

Physical Examination

On physical exam, Z’lyska is overweight with moderate to heavy dental calculus and seems lame on all four limbs. She is pruritic but does have fleas. She has moderate to severe hyperextension of the carpi and mild hyperextension of the tarsi. She is very slow to rise with reduced range of motion in both hindlimbs. Her conscious proprioception is slow but present in the hind limbs, normal in the front limbs. Her owner does report times of her falling and is unsure if it is weakness or ataxia. Elbows and carpi are thickened bilaterally and painful on manipulation. Trigger points detected in both triceps and several areas on palpation of her thoracolumbar spine. Taut bands are palpated over shoulders and just caudal to them. She also seems to be tense in her neck. Z’lyska’s owner has done radiographs. According to the previous radiographs she was found to have spondylosis throughout her vertebra and osteoarthritis in her hips. Due to her age the owner did not want to do any further work up. She just wants to keep her comfortable and give her a better quality of life.

Medical Decision Making

Based on physical and myofascial exam, Z’lyska had a lot of areas that needed help. She was not tolerable of any needles near her neck, face or front limbs. Other methods were needed to work on those areas. For her front limbs particularly, laser therapy and massage were used following her acupuncture treatments. For each treatment we did as many points as Z’lyska would allow, focusing mainly on the hindlimbs, back, and shoulders. Acupuncturing these points facilitated the connective tissue restriction to be reduced, which allowed better activity of the nerves, vessels and lymphatics. It was important to facilitate analgesia, aid in proprioception, and influence the circulation.

Acupuncture Treatment

When planning her treatment for acupuncture, focus was mainly put on her hind limbs, back, and shoulders if she would allow it. For her first treatment Blue 0.2mm Seirin needles were used but after that, Hwato 0.2mm needles were used. For her back pain and trigger points over her shoulders included the use of the Bladder line. Typical points were BL 13-15, 17-23, 27-28. In addition to this Bai Hui and GV-14 master points were added. In addition, for her shoulder and trigger points in her triceps, SI 11-12 and SI-9 (bilaterally) were used. Due to her temperament these points were not always executed. For her hind limbs the following points were used bilaterally:  BL-54, BL-60/KI-3, GB 29-31, ST 35-36. Most points were dry needled. However, e-stim. was used mostly on BL-54 to BL-60 bilaterally and BL 23 to 28 bilaterally. After each acupuncture session massage and laser therapy were done, mainly focusing on the front limbs. Initially Z’lyska came once weekly for three weeks and is now coming every other week on a regular basis.

Outcome

Shortly after starting acupuncture, Z’lyska’s owner stated that she was noticing subtle changes in her. She began to desire to walk more and even had interest in playing. As time and treatment has gone on the owner has reported being able to take short walks with her. She is even doing better with stairs, wanting to play in the water, and has an easier time getting up. As she came in for her visits she seemed to be walking with more ease and is able to rise easier. Also, her owner purchased some braces for her front limbs to help with the hyperextension in her carpi and this has further improved her quality of life. These changes in Z’lyska are related to the acupuncture and laser therapy as nothing else in her regimen has changed.  Z’lyska’s owner is very happy with how she has responded to acupuncture and has given this patient more quality time with her owner, for which she is very grateful.

I have discovered that acupuncture can give patients extra quality time with their owners and vice versa. Acupuncture can be used as an additional modality, particularly for arthritis and chronic pain. Some owners do not want or their pets are not able to take certain medications and this is another way to give these pets pain relief and quality of life. Acupuncture studies have shown ratings of pain intensity also decreased significantly after treatment with acupuncture (2). There appears to be good support for the hypothesis that one or two sessions of combined acupuncture and massage therapy provides immediate short-term improvement in dogs’ comfort and mobility, as demonstrated by owner observed changes in play behavior, walking, trotting, jumping, descending stairs, rising from a lying position, and stiffness after rest or following exercise (1). Most of these changes as mentioned above were also noted in Z’lyska’s case by either myself or her owner.

1.      Lane D., Hill S. Effectiveness of combined acupuncture and manual therapy relative to no treatment for canine musculoskeletal pain. Can Vet J 2016;57:407–414

2.      Norrbrink C., Lundeberg T. Acupuncture and massage therapy for neuropathic pain following spinal cord injury: an exploratory study. Acupunct Med 2011;29:108–115.