Written by a Medical Acupuncture for Veterinarians course graduate. Author’s name available upon request. Signed release obtained from client/author/4391.
A French Bulldog with presenting complaints of inappetance, abnormal hind limb gait, fecal incontinence, and an unwillingness to jump was referred for acupuncture treatment and showed a significant improvement in clinical signs.
Zhoc is a 7 year old, male neutered French Bulldog who presented to his primary care veterinarian on 5/20/16 with complaints of inappetance, abnormal hind limb gait, fecal incontinence, and an unwillingness to jump up on furniture. The owners declined diagnostics at that time, but his clinical signs improved only slightly after being prescribed carprofen and tramadol. He presented for a recheck examination on 5/26/16. A complete blood count, serum chemistry, neurologic exam, and spinal radiographs were performed and were within normal limits. His primary care veterinarian then referred him for acupuncture.
Physical Examination and Clinical Assessments
On 5/27/17, Zhoc’s physical and neurologic exams were within normal limits. He was slightly short-strided on the right hind limb during gait analysis. A myofascial examination revealed trigger points in the right longissimus dorsi at the level of the lumbar vertebra and in the right gluteals, tenderness to palpation of the thoracolumbar fascia, and reluctance to caudally extend the right hind limb.
Medical Decision Making
Acupuncture points were selected to treat the trigger points in the longissimus and gluteal muscles, decrease pain in the thoracolumbar fascia, and stimulate the sacral spinal nerves. It was suspected that lower back and pelvic soft tissue pain was responsible for the right hind limb gait abnormality and reluctance to assume a normal posture for defecation. Points were also selected for calming, anti-inflammatory, and immune-modulating effects.
Acupuncture treatment on 5/27/16 consisted of GV 14, GV 20, Bai Hui, GV 1, and GV T as well as BL 10, BL 22, BL 23, BL 25, BL 27, BL 28, BL 35 and ST 36 bilaterally. using Seirin J-type 0.16mm dry needles. Needles were left in place for 10 minutes. The owners were instructed to continue controlled exercise with Zhoc by leash walking and preventing him from jumping up on furniture. A second treatment was performed on 6/6/16 using the same points with Seirin J-type 0.16mm dry needles for 10 minutes. A third acupuncture treatment was performed on 6/13/16 using the same points. However, at this treatment 0.2mm Seirin J-type needles were used at BL 23, BL 25, and BL 27 bilaterally. Electroacupuncture was performed using a Pantheon 4c.Pro with electrodes attached to BL 23 and BL 27 bilaterally. A continuous stimulation was applied for 5 minutes at a frequency of 2 Hz.
Outcomes, Discussions, and References
In the days following his first acupuncture treatment, Zhoc’s owner reported that he resumed defecating normally, had no more accidents in the house, and regained his appetite. At the time of his second treatment, the trigger points in his longissimus and gluteal muscles were gone, although some tenderness on palpation remained. When he presented for his third visit, Zhoc had a normal gait and no tenderness on palpation of his back. Systematic reviews in the medical literature have shown acupuncture to be an effective treatment modality for fecal incontinence1 and acute low back pain2 in humans. This case report suggests that acupuncture is also a promising treatment option for these conditions in the dog.
- Thin NN et al. Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence. Br J Surg. 2013 Oct;100(11):1430-47.
2. Lee JH et al. Acupuncture for acute low back pain: a systematic review. Clin J Pain.