Written by a Medical Acupuncture for Veterinarians Course Graduate. Author’s name available upon request. Signed release obtained from client/author/4952.
Bailey, a 12-year-old MN Labrador Retriever, presented for acupuncture treatments for recent development of hindlimb weakness and neurologic deficits in both hindlimbs likely attributable to thoracolumbar disc disease. Bailey had also recently developed symptoms consistent with laryngeal paralysis. The patient was treated once or twice weekly with a combination of acupuncture, electroacupuncuture, and k Laser treatments. He responded favorably to therapy. The owner reports that the symptoms of laryngeal paralysis nearly completely resolved and that overall the pet is more comfortable in both hind limbs and pet is able to ambulate much better.
Bailey developed hindlimb weakness and atrophy approximately six months prior to his first acupuncture treatment. The owners also reported that Bailey developed loud, stertorous breathing consistent with laryngeal paralysis symptoms within 2 months of the first acupuncture treatment. Bailey has a two-year history of chronic diarrhea, which is controlled with alternating Tylan powder and metronidazole. He also was diagnosed with immune mediated neutropenia two years ago, which has been controlled with cyclosporine. He also has a long history of skin allergies that have been controlled with low dose prednisone. Due to the side effects of the prednisone, the prednisone was discontinued. After a seven-day washout from prednisone, Bailey was started on Rimadyl. Bailey had also been on long term tramadol, but owners did not think that this was helping. Therefore, tramadol was stopped and gabapentin was started. He also receives every other week generic adequan injections.
On physical exam, Bailey was bright and alert, heart rate, respiratory rate, and temperature were normal. He had loud stertorous breathing consistent with laryngeal paralysis. He was ataxic in the hindlimbs, very weak and needed assistance to stand from lying down. Myofascial palpation revealed marked tension along latissimus dorsi muscles bilaterally and triceps tension. Both rear legs demonstrated moderate quadriceps atrophy and tension, adductor muscles, semitendinou,s and semimembranous muscles bilaterally demonstrated moderate tension on palpation. Pet had conscious proprioceptive deficits in both hindlimbs with the right being worse. The muscle atrophy also appeared slightly more pronounced on the right rear leg. The longissimus and iliocostalis muscles revealed tension from T10 extending along the lumbar spine. The tension in this area was less pronounced than along the latissimus dorsi muscles.
Bailey has been treated with a combination of acupuncture, electroacupuncture and laser for three months. For the first three weeks, Bailey was treated three times weekly and the frequency of treatments lessened each week. Maintenance therapy for Bailey was initiated after six weeks and Bailey is now treated every five to seven days. Owner reports that Bailey will develop increased hindlimb weakness if he goes longer than one week between treatments.
Acupuncture treatments included the following points: GV-14, BL-15 bilaterally, trigger points along latissiumus dorsi bilaterally, BL 20, 21, 22, 23, 25, 27, 29, bilaterally, Bai Hau, GVT, ST-34 and ST-36 right leg only; hip triad-right side(GB 29 and 30 and BL-54), bafeng right; and CV-22 and ST-9 bilaterally. DBC SPRING10 needles-0.20 x 30 mm were used on all points. Applied electroacupuncture for 15 minutes from BL 21-25 bilaterally (mixed setting 1 and 100, setting 1). K Laser was also applied to the thoracolumbar spine and acupuncture laser setting was used on CV 22 and 23.
The acupuncture points were chosen to address back pain and inflammation that resulted in decreased hind limb mobility, hind limb weakness, and conscious proprioceptive deficits that affected the right hind limb more severely; laryngeal paralysis, chronic diarrhea and immune system dysfunction. The Bladder line points 20, 21 and 25 and ST 36 were chosen to address digestive issues by neuromodulating the thoracic, thoracolumbar, and lumbar spinal nerves that branch to the digestive organs. Bladder points 22, 23, 25, 27 and 29, bafeng points, Bai Hau and ST-34 and ST-36 were chosen to address back pain, decrease inflammation and improve mobility by neuromodulating the thoracic, thoracolumbar and lumbar spinal nerves as well as by providing feedback to the central nervous system, most specifically the nucleus tractus solitarius. The points CV-22 and ST-9 were chosen to the cervicothoracic and specifically the vagus and recurrent laryngeal nerves to improve function of the laryngeal cartilages to decrease laryngeal paralysis symptoms. The hip triad points were chosen on the right side consistently as the right pelvic limb displayed more weakness and discomfort on myofascial palpation. Bladder 15 and trigger points along the latissimus dorsi were chosen to address myofascial tension in this area. GV-14 and ST-36 were chosen to improve parasympathetic tone and improve immune function. Laser has been used to add additional pain relief and decrease inflammation.
Over the last four months, numerous medications have been tried to improve Bailey’s comfort and ability to walk. Until acupuncture, electrical stimulation and laser were applied, Bailey had limited improvement. Owners report that on the sixth day after his treatments, Bailey starts to decline, has difficulty rising and can stay standing for shorter periods of time. Given that all medications are the same during that time, it is believed that his positive response is due to these alternative treatments. Bailey has also shown an improvement in the laryngeal paralysis symptoms. These symptoms lessened after the first acupuncture treatment. They have never completely resolved, but definitely are less. Bailey’s digestive issues have continued to wax and wane and he is still on alternating tylan and metronidazole to keep his stools normal. Bailey continues to be monitored for his Immune Mediate Neutropenia and remains on cyclosporine.
Bailey is a good example of how acupuncture, electrical stimulation and laser therapy can be used to treat dogs with suspected thoracolumbar disc disease. Studies have shown that dogs receiving acupuncture as a treatment for thoracolumbar disc disease do have improvement in ability to ambulate and that dogs are in less pain as a result of treatment1. Furthermore, studies have shown that electroacupuncture has been more successful than decompressive surgery for recovery of ambulation and improvement in neurologic deficits2. Studies such as these support the use of alternative therapies such as acupuncture, electrical acupuncture and laser therapy. These therapies are very effective at treating dogs with disc disease and should be considered as viable treatment options.
1 Still, J. Acupuncture treatment of thoracolumbar disc disease: A study of 35 cases. Companion Animal Practice. January 1988; 2(1):19-24.
2 Janssens LA, de Prins, EM. Treatment of thoracolumbar disk disease in dogs by means of acupuncture: A comparison of two techniques. J Am Anim Hosp Assoc. 1989 Mar-Apr; 25(2):169-174