Written by a Medial Acupuncture for Veterinarians course graduate. Author’s name available upon request. Signed release obtained from client/author/4998.
This case describes the use of acupuncture on a French bulldog diagnosed with chronic pain associated with hemivertebrae, lumbar spondylosis and hip dysplasia. She exhibited steady improvement in her mobility and decrease in pain level with each session. Stella’s movement has dramatically improved and her pain appears to be under control with regular acupuncture sessions.
History and Presentation:
Stella is a 7 year old, spayed female French bulldog who presented to the clinic for difficulty walking. Prior to arriving at the clinic she spent 2 days limping on her right rear leg. Stella was radiographically diagnosed in 2014 with significant hip dysplasia bilaterally, hemivertebrae at L3 and L4 vertebrae and ventral lumbar spondylosis. The owners found it difficult to administer oral medications, which prevented Stella from getting pain medication on a regular schedule.
Physical Examination and Clinical Assessment:
During her physical examination she displayed a significant lameness in both rear legs, short stepping, and a stiff gait. She also displayed tension and ropey bands in her caudal cervical and shoulder areas. She demonstrated a sever amount of pain when touched over her sacrum and both coxofemoral joints. Moreover, she exhibited a decreased range of motion on both coxofemoral joints; no neurologic deficits were noted.
At the conclusion of her physical examination, it was determined that she displayed clinical signs that are consistent with previous diagnosis of hip dysplasia.
Her cervical tension and pain was likely due to compensation for the hind limb pain.
Medical Decision Making:
Stella’s owner stated she had difficulty administering oral medications therefore oral medication sent home was limited and acupuncture, laser and adequan injections were initially recommended weekly. Over time laser and adequan treatment wasn’t practical due to financial constraints.
Stella’s acupuncture treatments focused on addressing pain and trigger point pathology. Initial treatment was accomplished using Seirin 0.20 mm x 30 mm needles for 10 minutes. GV-14 and GV-20 were placed first for their parasympathetic affects and BL-10 and GB-21 were used to address neck and shoulder tension. Bai Hui and GB-30 were also used to treat her lumbosacral and pelvic limb pain. The patient displayed a strong pain reaction to these points and further hind limb manipulation was ceased for this treatment. A class IV therapy laser was used for ten minutes over the lumbosacral and coxofemoral areas. Her second acupuncture treatment was very similar to her first and the same points were used. During her third treatment she displayed more tension and pain in the mid lumbar spin and less pain over the coxofemoral joints. To treat this increase in pain BL-19, 21, 25, and GB-29 were added to her treatment. Lumbar and hip points were treated with 0.16 mm needles to reduce pain reaction on insertion. Her fourth treatment, only 0.16 mm needles were used because of favorable reactions in her third treatment. BL-11 was used to treat shoulder tension while BL-17 was used her mid thoracic spinal trigger points. Also BL-54 was added for hip and sciatic pain and ST-36 for inflammation and pelvic limb pain. Finally, BL-40 was added to address any sciatic pain from the hip dysplasia.
Outcome, Discussion and References:
Stella had a lot of pain in both hips that appeared to improve after each treatment. However, as her hip pain became controlled, pain in her lumbar spine became more evident. During her most recent treatment she displayed minimal pain over the hips, mid lumbar trigger points, and a normal gait. Stella remained reactive to caudally placed needles allowing me to better understand the need for specific needle selection for each patient. Having better understanding now how she would react to treatment, I would’ve treated more peripheral rear limb points from the beginning. This process would’ve allowed for earlier treatment of hip pain, without directly stimulating the most painful regions. Despite the restriction in treatment she displayed continuous improvement at each visit. Multiple studies have demonstrated the effectiveness of acupuncture; this case demonstrates the potential effectiveness of acupuncture treatments in treating chronic pain due to hip dysplasia and concurrent hemivertebrae. Further studies would be encouraged to fully demonstrate the usefulness in managing chronic pain associated specifically with hip dysplasia.
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