Written by a Medical Acupuncture for Veterinarians course graduate. Author’s name available upon request. Signed release obtained from client/author/4988.
Working sport horses, specifically those competing in dressage and hunter/jumper classes, are strong athletic animals, but even the most physically fit and well cared for horse can sustain an injury. Injuries can range from life-threatening fractures to constant, low-grade muscle soreness. No matter the injury, it has a negative effect on the animal’s health, well-being, and ability to do its job. Depending on the diagnosis, acupuncture could be included in a patient’s treatment plan. This case involves a horse with severe back pain that was alleviated with the use of acupuncture.
History and Presentation:
“Prada” is a 10-year-old bay mare who is in-training and stabled at a large hunter/jumper barn in San Diego. The owner/trainer has had her for two years and has always felt her back seemed to be sore but it never inhibited her from working until four months ago. At that time the mare was asked to increase her work level. With the increase in work, the trainer noticed the mare protecting her back more than usual. She started to resist being tacked up, having the girth tightened, would brace herself when the rider mounted her, and would feel lame under saddle when asked to trot for 10-15 minutes until she seemed to work out of it. The mare was given time off and the saddle was re-fitted but it did not improve the overall long-term comfort of the mare.
Physical Examination and Clinical Assessments:
A full clinical workup was performed five months ago and the mare was found to have positive hind flexions and was severely sore to palpation of her thoracic and lumbar areas of her back. A neurologic evaluation was performed and no deficits were noted. At that time it was decided to inject the distal intertarsal and tarsometatarsal joints bilaterally with steroids and hyaluronic acid as well as inject her back musculature with a combination of steroids and vitamin B complex. The trainer reported a significant increase in the mare’s comfort that lasted about three weeks. At that time another clinical evaluation was performed and although the mare was sound and had negative flexions, her back was once again very sore to palpation. Initially, multiple points along the bladder line were sensitive on myofascial palpation examination. Based on the mare’s history and the positive response to having her back treated, acupuncture was offered and the owner/trainer agreed to the treatment plan.
Medical Decision Making:
At the time of the first acupuncture appointment, points along the bladder line were extremely sensitive to finger palpation. The most sensitive points initially were along the thoracic and thoracolumbar regions of the back. After those areas were treated during the first session, the sensitivity then moved caudally and during the second appointment the thoracolumbar and lumbar regions were most sensitive. At the third appointment, the mare’s sensitivity again moved caudally and included the lumbar and lumbosacral regions. By the fourth appointment the greatest sensitivity found was in the lumbosacral and pelvic regions. Throughout her treatments, the head, neck, and forelimbs were not found to be sensitive to palpation.
The mare received once-weekly acupuncture treatments for a total of four treatments. The following is a list of points that were found to be sensitive to palpation and treated at that particular time:
11/23/16: Bladder (BL) 10, BL 11, BL 13, BL 14, BL 15, BL 16 (All of these points were needled bilaterally)
11/30/16: BL 16, BL 17, BL 18, BL 19, BL 20 (All of these points were needled bilaterally)
12/7/16: BL 21, BL 23, BL 24, BL 25, BL 26, Stomach (ST) 36, Gallbladder (GB) 29, GB 30, BL 54
(All of these points were needled bilaterally); electroacupuncture was used for fifteen minutes on the BL points
12/14/16: BL 27, BL 28, BL 29, BL 30, BL 40, BL 26, GB 29, GB 30, BL 54 (All of these points were needled bilaterally); electroacupunture was used for fifteen minutes on the BL points
*Please note that at each appointment the following points were needled first (in addition to the points listed above): GB 21 (bilaterally), Large Intestine 16 (bilaterally), Governor Vessel 14 and Bai Hui.
Outcomes, Discussions, and References:
Not only has acupuncture increased the overall comfort of this mare, but she truly enjoys her acupuncture appointments. She is usually a mare who pins her ears when someone walks by and becomes agitated when made to stand in the crossties for long periods of time. However, she completely relaxes and stands quiet and sedated-like in the crossties while she is being needled. Her bottom lip will droop, her eyes will tear, and she will stand quiet even when the hay cart comes by. She also tends to lie down and sleep in her stall after her appointments. The owner/trainer has stayed very objective in her evaluation of the mare’s progress yet has been very impressed with how the mare has responded and how she continues to improve with each appointment. After the fourth appointment, the owner plans to see how long the positive effects of acupuncture last on the mare before she schedules additional appointments. The mare did not receive any medication during her treatment course that would have altered the positive results seen. With her responding so well I am very excited to offer acupuncture for several other patients with chronic back pain.
Dunkel B, Pfau T, Fiske-Jackson A, Veres-Nyeki KO, Fairhurst H, Jackson K, Chang YM, Bolt DM. “A pilot study of the effects of acupuncture treatment on objective and subjective gait parameters in horses.” Vet Anaesth Analg (2016 Mar): n. pag. Web. 9 Nov. 2016. https://www.ncbi.nlm.nih.gov/pubmed/26946316>.
Robinson, Narda. “Acupuncture For Pain.” Veterinary Practice News (2009 April): n. pag. Web. 11 Nov. 2016. <http://www.veterinarypracticenews.com/April-2009/Acupuncture-For-Pain/>.