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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/4977.

Abstract:

Geriatric dog presented  acutely non-weight bearing on the right hind leg. Previous history of  degenerative joint disease in the hips, lumbar spine and cervical pain.

Dramatic pain relief following first acupuncture session, and continued improvement thereafter.

History/Presentation:

Phoebe an 11 yr old retriever who presented for acutely crying all weekend and for not using her right hind limb. She had a previous history of lumbar and cervical pain in 9/16 which resolved with pain medication and laser therapy. Her radiographs showed spondylosis L1-L7 in her lumbar spine, degenerative joint disease (DJD) of both hips, and mild DJD in her shoulders. Phoebe has been on Meloxicam and Tramadol as well as Actistatin (a glucosamine supplement) since 9/16.

Phoebe was hit by a car in 4/07 and had a fractured right ileum with subsequent surgical repair using a bone plate.

Physical exam:

Phoebe was holding up her right hind leg, and wanting to lay down. She was tender in her longissimus and ileocostalis paraspinal lumbar musculature bilaterally from L2-L6 which were also atrophied. I could not even touch her right hip or she cried. Her left hip and sacrum were palpably sore. She had muscle wasting in her hind legs. Her patellar reflexes were normal and conscious proprioception was normal. No ataxia upon walking. Phoebe had some taught bands in her right omotransversarius muscle and cervical trapezius muscle and her right shoulder  as well. Phoebe also has a 3″x2″ chronic lick granuloma on her right hind metatarsal area.

Medical Decision Making:

Phoebe’s hip dysplasia and previous fractured ileum are causing her to avoid the pain of walking by compensating and bearing more weight with her front legs and supporting her hind end with her lumbar spinal muscles. This is causing strain patterns in her lumbar spine, paraspinal muscles and thoracolumbar spinal nerves, her right front leg, cervical and shoulder muscles, cervicothoracic spinal nerves and brachial plexus nerves that innervate the upper shoulder.  I chose points to help alleviate the strain patterns in her back, thoracolumbar spinal nerves, right front leg, using the brachial plexus and cervicothoracic spinal nerves, and points to treat the origin of the hip, gluteal muscle and sciatic nerve pain and the sacral nerves for the sacral pain.

Acupuncture Treatment:

The treatment plan was to treat Phoebe weekly with dry needling and Laser therapy. Points included: GV20 for calming and GV14 and LI16 (right) as a points for the front limb. Bilateral points;  BL 20, 21, 22,23,25 for lumbar pain, and BL 27 and 28 and Baihui for hind limb and sacral pain. The hips were too painful to treat more than a few points, so I used GB 29, GB30 and BL54.  BL 60 was used as a distal limb point.

Circle the dragon technique was used to treat the lick granuloma.

Outcomes, Discussions and References:

Phoebe had a dramatic response to pain relief after the first treatment. She got up after her treatment and was literally running. Her previously 5/5 lame right hind leg was now a 1/5. She has continued to improve so much so her owner is not bringing her in for her rechecks as often as I would like. I did encourage her owner to massage her back 3 times a week and take Phoebe on leash walks daily. An underwater treadmill would be ideal for strengthening her hind legs but is not available.

I learned how effective acupuncture can be. Phoebe had already been on traditional pain medication, and it wasn’t until we did acupuncture/laser therapy on her that she experienced dramatic pain relief.

I would like to see studies done on the effectiveness of acupuncture/laser therapy combined as opposed to acupuncture alone.

References:

  1. Effectiveness of combined acupuncture and manual therapy relative to no treatment for canine musculoskeletal pain. Can Vet J. Lane DM, Hill SA.
  2. 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc. 2015 Mar-Apr;51(2):67-84 Epstein m, Rodan I, Griffenhagen G,

Kadrlik J, Petty M, Robertson S, Simpson W.

  1. Acupuncture as an adjunct therapy for osteoarthritis in chimpanzees (Pantroglodytes)

J Am Assoc Lab Anim Sci 2013 Jul;52(4):475-80 Magden ER, Haller RL, Theile EJ, Buchl SJ, Lambeth SP, Schapiro SJ.