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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/4900.

Abstract:

Shiva, a 24 year old heavy Warmblood presents with a stiff neck to the left side after a paravenous injection with Finadyne about 6 month ago. She experienced an immense swelling midway of her left jugular vein and wasn’t able to bend her neck to the left for about 4 months. Since about 2 months, she is able to move it a slight bit to the left and with the dry needling therapy she is almost back to normal.

History Presentation:

Shiva, the 24 year old heavy Warmblood, has been used to pull a carriage in eastern Germany. She was reluctant to pull after the heavy inflammation around her left jugular vein about 6 month ago. She has been treated with heparin creme for about 4 weeks in February without changing muscle stiffness. Her owners were asking me, if I could treat the stiffness of her neck to give her a better quality of life and bring her back to work.

Physical examination and Clinical Assessments:

On her physical examination she presents BAR, interested and calm. She carries heavy horseshoes typical for carriage horses. Most of the time she grazes on a large pasture with 3 other horses. She has difficulties bending the neck to the left shoulder, slight difficulties to the left front hoof but is able to raise the head normally. I can see a slight stiffness to the right and she needs a bigger circle when she walks in a left bend. There are no obvious neurological deficits.

On the myofascial examination I can find a very tender m. brachiocephalicus and and sternocephalicus muscles especially on the left side but also slightly on the right side. I can see a reaction when I try to palpate deeper into the m. rhomboideus and splenius. There are some trigger points around the upper neck in the area of BL 10. At the beginning she reacted on palpation of the lumbosacral region and gluteal muscles which improved with the treatment.

Medical decision making:

Shiva is still needed to pull a carriage so the main goal is to get her relatively pain free with an increased range of motion of her neck. I will treat her neck and back to release some of the muscle tension.

Acupuncture treatment:

The treatment plan involves the main acupuncture points relating to tense muscles around the neck and shoulders as well as the lumbar region. On some warmer days she reacted to the needles like flies would sting her.

I used red and blue Seirins without electroacupuncture or laser (reason: I don’t have one or the other). She has been needled every 3-4 days for about 2 weeks. She also got walked in smaller circles every now and then.

Acupuncture points:

The following points have been used in almost every session (depended on the ‘fly’ status);

LI 16 – local pain and well accepted

LI 17 – local trigger point

LI 18 – close to the area of the old thrombophlebitis area

ST 10 – close to problem area, stiff neck

SI 11 and 12 – tender areas

SI 16 – tender, trigger point, stiff neck

TH 16 – neck pain

GB 21 – local trigger point

BL 10 – tender, trigger point

BL 11 and 12 – local trigger points

BL 23 and 25 and 54 – tender lumbar region

Bai Hui – lumbosacral tenderness

Outcomes:

Shiva’s condition improved after about 3 treatments. She was able to bend her neck further to the left and after about 2 weeks she was willing to pull the carriage again with more enthusiasm.

Discussion:

With this case I learned, that horses need a calm and fly-free area for best relaxation and acupuncture results. Electroacupuncture and laser would have also been a good addition to speed up the comfort and healing. There will always remain a slight stiffness to the left due to the scar tissue but the comfort has improved.