Written by a Medical Acupuncture for Veterinarians course graduate. Author’s name available upon request. Signed release obtained from client/author/4994.
Rhonda is a 13 year old AQHA broodmare with carpal arthritis and bone chips. She is pregnant so is being maintained with Back on Track carpal boots, acupuncture and Previcox until she can go for surgery. Frequent (at least 1x/week) acupuncture allows for a decrease by approximately half Previcox.
Rhonda is a 13 year old AQHA broodmare that was shown competitively as a young horse but has been retired as a broodmare for approximately 4 years. She has degenerative joint disease in both her carpi with bone chips as well. She is kept comfortable with Back on Track carpal boots and long term Previcox use until she foals and can go for surgery to remove the bone chips.
PE and Clinical Assessment:
Rhonda has a normal physical exam other than swelling in both carpal joints. On myofascial exam, she has myofascial restriction and trigger points along her neck, specifically in her omotransversarius, brachiocephalicus, trapezius, triceps and biceps muscle groups bilateral. She has corresponding myofascial restriction along her back from T18 to her sacrum. She has a normal neurological exam.
Medical Decision Making:
Rhonda takes some time to warm up to strangers so my main focus for all my treatments is to improve her PSNS input and decrease SNS input. The other main goal is to increase her comfort level in her carpal joints while she is heavily pregnant to keep her Previcox dosing at the lowest dose possible. To accomplish this goal I wanted to place needles along his tight myofascia in his back as to encourage relaxation of myofascia and muscles and release any nerves that might be impinged due to the restriction. I also wanted to place local points around the carpus to improve local circulation and decrease the inflammation and help remodulate the hyper-responsive pain fibers to provide long term pain relief.
On the first visit, I only used dry needling with a combination of 0.20 and 0.22 needles. I used Bai Hui, GV 14 and LI 16 bilaterally as my first combination to see how she would respond to needling. Within 5 minutes, Rhonda had lowered her head and was licking her lips so I placed LU 7, LI 6, HT 7 and PC 6 for the carpal pain and BL 14-18, 25 and 27 bilaterally to help loosen up restrictions. This was tolerated well for about 20 minutes. The second treatment was performed 5 days later and the same points as the initial treatment were used plus trigger points in her triceps and brachiocephalicus. Rhonda reacted negatively to the trigger point needles so they were removed having only been there for less than 5 minutes. On the third treatment, I tried to perform e-stim and this was not tolerated well; Rhonda was anxious and seemed bothered by the electrical stimulation so that was discontinued.
Outcomes, Discussions and References:
I believe Rhonda responded well to her acupuncture treatments. Qualitatively she seems more comfortable and is not pacing in her pasture anymore. Her pain and stiffness also decreased over the sessions. Quantitatively she has decreased her Previcox dosing by half and still been comfortable. I believe this is evidence that I achieved neuromodulation with acupuncture and improved Rhonda’s overall SNS overdrive that was her normal. I think using the Previcox dosing during her acupuncture treatments and afterwards can be used to indicate her decrease in chronic pain1. The owner is also very happy with the outcome of using acupuncture on Rhonda. There were no adverse events