Written by a CuraCore Veterinary Medical Acupuncture course graduate. Signed release obtained from client/author. 4S2019027

Abstract: This report shows complete recovery from an acute onset of neck pain, lumbosacral pain, and anorexia in a 7.5 year old FS Maltese Mix named Josie. After three acupuncture treatments, Josie regained complete range of motion in her neck and her anorexia had resolved.

History: Josie is a 7.5 YO FS Maltese Mix that was presented to RRVH on 10/9/19 for a 3 day history of yelping in pain and decreased activity. Starting 10/8/19 she became anorexic and was not interested in her food which prompted owners to bring her in. She is otherwise healthy and UTD on all her vaccinations. No previous pertinent medical history. She is the only dog in the household, and she does like to play rough with the owners. On Trifexis for Flea/HW preventative. Not on any other medications.

Presenting PE:
Attitude: QAR
Weight: 6.25lbs
Temp: 102.0F
Pulse: 128
Resp: 28
CRT: <2 seconds; MM Pink/Moist

Josie was QAR and shaking upon presentation. On myofascial palpation exam, she showed trigger points in her cervical muscles and reaction to palpation of her lumbosacral region. Using peanut butter to encourage her to move her head up, down, left, and right, she showed limited range of motion ventrally and to the right. She did not show any delayed conscious proprioception in any of her limbs. She had a “hunched” or kyphotic appearance to her mid spine, and was not super motivated to walk. All other aspects of her physical exam were unremarkable.

Radiographs of the spine showed slight narrowing of IVD spaces L4-L6 on lateral but not repeatable on v/d. The abdomen visible on radiographs showed a full colon and an empty gastric lumen and empty small bowel loops.
All other radiographic findings were within normal limits.

Problem List:
Cervical pain
Lumbosacral pain
Anorexia

Differential Diagnosis:
Cervical/Lumbosacral Pain: ischemia, diskospondylitis, nerve sheath tumor or other cancerous tumor, osteoarthritis, intervertebral disc disease (IVDD), inflammation secondary to overuse, congenital vertebral abnormality, immune mediated polyarthropathy, trauma from jumping on/off furniture or playing with other dogs, myofascial restriction in neck and in thoracolumbar spine

Anorexia: secondary to systemic illness, nausea, megaesophagus, upper respiratory infection, ileus, periodontal disease, anxiety, pain, neoplasia, myofascial restriction in neck

Putative Diagnosis:
Based on radiographic interpretation, physical exam, myofascial exam, and history it was suspected that Josie had IVDD or soft tissue myofascial restriction in the neck and back. It was suspected that her acute onset of anorexia was due to cervical pain and not wanting to lower head to food bowl.

IMG_1738

Josie Initial presentation away and toward     Josie Initial presentation     Josie initial Side

Medical Acupuncture and Related Therapy:
Medical Therapy:
Gabapentin 100mg capsule PO BID for 7 days
Meloxicam 0.3mg PO SID for 5 days

10/9: Red SEIRIN® GV 20, GV 14, and Bai hui
Light green SEIRIN® BL 10, Inner bladder line (BL 20, 21, 22, 23, 25) and ST 36 (left side). Patient reacted and did not let me place ST 36 on the right side. Also placed light green SEIRIN®’s in trigger points in neck. Patient did well, fed peanut butter throughout. Next session would like to focus more on cervical pain (patient not wanting to turn head to the right). Will also want to add in electroacupuncture next session.

10/17: Red SEIRIN® GV 20, GV 14, and Bai hui
Light green SEIRIN® BL 10, Inner bladder line (BL 20, 21, 22, 23, 25).
Slightly reactive when placing at bladder 23/25 (trigger point)
Electroacupuncture bilaterally from BL 20 to BL 25 (Frequency S and .5/1 CH 2-3)
Patient did well, fed peanut butter throughout. Still tender on palpation along lumbosacral area of spine. Used peanut butter and patient was able to turn head almost all the way to the right, readily bent neck down to eat, up and to the left. Cervical range of motion seemed significantly improved at this visit. Was shaking/a little nervous at first, but warmed up with peanut butter and was very comfortable and wagging tail/licking my face by the end of the visit.

10/24: Red SEIRIN® GV 20, GV 14, and Bai hui
Light green SEIRIN® BL 10, Inner bladder line (BL 20, 21, 22, 23, 25).
Slightly reactive when placing at BL 23/25
Electroacupuncture bilaterally from BL 20 to BL 25 (Frequency S and .5/1 CH 2-3)
Patient did extremely well this visit. Cervical range of motion was back to normal, and she did not hesitate to turn head in every direction. Also seemed much more relaxed this visit. Wagging tail and greeted me with licks the second I walked into the room.

Josie Final away and toward Josie Final Side Josie final treatment needles Josie Final TX

Outcomes and Discussion:
Josie was a very rewarding case and shows how acupuncture can be a great adjunct treatment in acute and chronic injuries. She responded beautifully after every session, and has not needed to come in for any additional sessions since completing her last one. Owners report she is doing great at home. Full cervical range of motion has returned, however owners now keep her food and water bowl slightly elevated to help her eat and drink without having to overreach with her neck to help prevent further straining injury. She is no longer on medical pain management.

References:
Curacore Integrative Medicine and Education Center. Medical Acupuncture for Veterinarians:Canine Point Mini-Manual.

Lindsey M. Fry, DVM, Susan M. Neary, DVM, Joseph Sharrock, DVM, Jessica K. Rychel, DVM, DACVSMR. Acupuncture for analgesia in veterinary medicine. Topics in Companion Animal Medicine. 2014; Volume 29, Issue 2. 35-42. Science Direct.