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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. A2017028

Old Mixed Breed Dog Sinonasal Carcinoma

Abstract: Lucky was diagnosed with a sinonasal carcinoma in February 2017. Acupuncture was started in May with the goals of improving his sinonasal symptoms and supporting his immune function while on anti-cancer therapy. He was anxious during treatments but tolerated them well.

History and Presentation: Lucky is an 11 year old Mix Breed Dog who was diagnosed with sinonasal carcinoma in February 2017, He received treatment with IMRT (intensity modulated radiation therapy), 18 fractions completed 3/3/17, and oral Palladia. He developed moist desquamation and KCS secondary to RT which had resolved prior to him starting acupuncture. He continued to have signs of rhinitis at the start of acupuncture: mild epistaxis, sneezing, post-nasal drip. No other relevant medical history

Physical Examination and Clinical Assessments: Alopecia of frontal/nasal area secondary to RT. Normal tear production. Occasional sneezing with blood. Neurology exam was normal: no deficits, no orthopedic disease found or reported in the history. He was also found to have significant myofascial pain along his T/L spine (more severe on the left).

Medical Decision Making: My treatment goals were to focus on treating sinus issues/inflammation, to support Lucky’s immune system as his local immunity has been altered by radiation therapy. His ocular side effects resolved prior to starting acupuncture so this was not a primary focus.

Differential Diagnoses: T/L myofascial discomfort- suspect local pain/nerve entrapment/tight fascia, no evidence of internal organ dysfunction on blood work, no evidence of orthopedic or neurologic disease, could be tense from persistent sneezing secondary to rhinitis.

Definitive (or putative) Diagnosis (or Diagnoses): Sinonasal carcinoma, treated with definitive radiation therapy, on-going treatment with Palladia, mild rhinitis/sinusitis, T/L myofascial discomfort as above.

Acupuncture Treatments:
5/10/17- GV-14, GV-20, Bai-Hai, LU-1 bil, LI-4 R, LI-10 bil, LI-11 L, ST-36 bil, PC-6 bil, HT-7 R, BL-10, 12,13,21 bil; could not place distal limb pts or pts on face
5/18/17- GV-14, GV-20, Bai-Hai, LU-1 bil, LI-10 and LI-11 bil, ST-36 bil, LU-7 bilat, BL-10, 12-14 bil, BL-23 and 25 bilat, local trigger point along bladder line near BL-23; could not place distal limb pts or pts on face
5/25/17- GV-14, GV-20, Bai-Hai, LU-1 bil, LI-10 and LI-11 bil, ST-36 bil, BL-10, 12-13 bil, BL-21, 23,25 bilat, local trigger point along L out bladder line (3 needles);, LI-4 R, KI-3/BL-60 bilat, PC-6 bilat, LR-3 bilat, SI-19 bilat.
5/31/17- sensitivity cranial thoracic with TP near BL 13-15 and BL 21-23. AP Treatment: GV-14, GV-20, Bai-Hui, LU-1 bil, LI-10 and LI-11 bil, ST-36 bil, BL-10, 12-15 bil, BL-21, 23,25 bilat, local trigger point along outer bladder line bilateral, KI-3/BL-60 bilat, BL-40, SI-19 bilat, GB-29,30/BL-54 bilat. Could not place distal limb points today.

Outcomes, Discussions, and References: Lucky will now go to treatment every 2-3 weeks and continue on Palladia. Thus far, he has not required antibiotics for his rhinitis. Aside from alopecia he does not have any RT effects and has been tolerating his Palladia. His owner reports that he is “acting like a puppy again”.

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