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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/4990.

A 7 year old female spayed Devon Rex was treated for feline idiopathic cystitis with acupuncture.

Pixel, a 7 year old female spayed Devon Rex, first presented for hematuria, pollakiuria, and stranguria in late October 2016.  She had a previous history of presumed inflammatory bowel disease and was being treated with 1mg/kg prednisolone every other day, as well as a prescription diet.  She had never experienced urinary signs before.

On physical exam she was anxious, alert, and responsive.  She had mild dental disease. Thoracic auscultation was unremarkable.  Her kidneys were smooth and non-painful, and her bladder was very small.  Her vulva appeared moderately inflamed. She seemed somewhat uncomfortable on palpation of her caudal abdomen.  The remainder of her physical exam was unremarkable.

A urine sample could not be collected due to her very small bladder.  Based on her age, lack of previous urinary signs, and the steroid -medication, the top differential was a urinary tract infection.  Other possible causes were feline idiopathic cystitis/feline urologic syndrome, uroliths, a polyp, or neoplasia.   Problems identified included:  anxiety, pain, and small, frequent urinations.  Pixel received acupuncture at points GV14, BL 23, BL 52, and BL 28.  GV 14 was selected as a point to introduce her to acupuncture, and it seemed well tolerated.  The other points were used to neuromodulate her bladder inflammation. She was sent home with antibiotics and buprenorphine, and told to recheck if clinical signs did not improve within 48 hours.

Pixel re-presented about two weeks later with recurrence of small, frequent, blood-tinged urinations and straining to urinate.  Her owner reported that her clinical signs had resolved 2-3 days after her first visit, but then recurred.  Pixel’s physical exam was essentially unchanged, although she seemed a bit calmer and less anxious. Her bladder was again very small.  Radiographs were taken, and no stones were seen.  She received SQ fluids and was kept until a urine sample could be obtained. A urinalysis and urine culture and sensitivity were sent out.  Pixel was treated for presumed feline urologic syndrome- she received acupuncture at BL 23, BL 52, and BL 28.  She accepted these points well, but then reached her limit and did not want any further needling.  She was sent home with buprenorphine, with further antibiotics to be prescribed only if indicated by the culture and sensitivity. Her owners were instructed to purchase a Feliway diffuser , increase water intake, and work on providing a calm, enriched environment.

The urine culture showed no growth.  At home, Pixel’s clinical signs improved, and then returned within 3 weeks.  She was seen frequently straining to urinate, producing only a few drops of red urine.  She returned to the hospital, and an abdominal ultrasound was performed by a radiologist.  Immediately prior to the ultrasound Pixel received acupuncture to help calm her and decrease bladder inflammation.  She received dry needling at points KI 3, SP 6, BL 23, BL 28, GV 14 and GV 20.  She remained very calm for her ultrasound and needed no sedation.  The ultrasound revealed normal kidneys.  Her bladder had sludge/debris and appeared inflamed.  Her intestines were mildly thickened, with normal wall layering.  An additional urine culture was obtained, which showed no bacterial growth.

Outcome:

Pixel is receiving ongoing care for feline interstitial cystitis/feline urologic syndrome.  I would like to begin regular acupuncture to decrease her inflammation and anxiety and better manage her cystitis and inflammatory bowel disease.  Good points for the future would be KI 3, SP 6, ST 36, HT 7, GV 20, BL 23, BL 28, and CV 3.  Due to the patient’s temperment, I am not sure she would feel comfortable with needling of CV 3, but this area could be massaged.  Her family is working on enrichment and decreasing her stress at home.  Pixel has a safe refuge away from the other animals in the house, and a ceramic water fountain to increase her water consumption.  She continues to eat Royal Canin rabbit and green pea canned and dry foods.  At this time she has been off of prednisolone for 3 weeks, and has not had any GI signs. She has shown improvement in her anxiety, and her last episode of urinary signs was in early December.

References:  The use of acupuncture to aid therapy of idiopathic lower urinary tract disease in cats.  LH Giovaninni  Cienc. Rural [online, Google translated from Portuguese]. 2010, vol.40, n.3, pp.712-71