Narda G. Robinson, DO, DVM, DABMA, FAAMA
CLINICIANS BRIEF – INTEGRATIVE MEDICINE
|APRIL 2005|PEER REVIEWED
What Is “Acupuncture”?
Most often, the term acupuncture refers to the insertion of thin metal acupuncture needles into specific sites on the body for treatment or prevention of diseases and pain. However, it may also refer to other types of stimulation of these same sites, such as injection of fluid (e.g., vitamin B12) into a point, called “aquapuncture”; electrical stimulation of an acupuncture needle, called “electro-acupuncture”; low-level laser light stimulation, called “laser acupuncture”; or local heating with a smoldering herb, called “moxibustion.” Some veterinarians perform “gold bead implantation,” which is potentially risky and unsupported by controlled research studies,
as discussed below.
Why & When to Try Acupuncture
In considering acupuncture for a patient, there are two main questions to be considered:
- Is there a valid physiologic justification for suggesting acupuncture to the client?
- Does evidence support use of acupuncture for this clinical condition?
Being familiar with the types of physiologic changes acupuncture produces allows one to better assess whether it is suitable for a given problem in a particular patient. Studies involving functional brain imaging reveal changes in thalamic, cerebellar, and cortical function that may relate to endocrinologic, autonomic, circulatory, and mental-emotional improvements. Endogenous opioid peptides (e.g., endorphins) and monoamines (e.g., serotonin and norepinephrine) play a prominent role in analgesic relief resulting from electro-acupuncture. Additional relaxation of muscle tension comes about by the ability of acupuncture to reduce the output of α-motor neurons.
Research evidence for acupuncture in humans is strong and continually increasing. A quick search on PubMed (www.pubmed.com) using the words “acupuncture” and the disease process of interest will probably return a long list of references. While many of the studies done overseas lack rigor and controlled conditions, well-done studies showing benefits do exist for a wide range of disorders, including musculoskeletal problems, gastrointestinal and hepatobiliary disorders, and neurologic dysfunction
Be aware that there are veterinarian acupuncturists who refuse to treat animals that are receiving concurrent treatment with steroid medications or opioids, mistakenly believing that these products will negate the effects of treatment. Others may not treat an animal with cancer, based on the unsubstantiated fear that acupuncture will promote metastasis because of its beneficial effects on circulation. In fact, acupuncture provides important advantages to oncology patients, including pain reduction, elimination of nausea, and improved glandular function following radiation therapy.3
A cat with an acupunture needle on the top of its head, in a point called Governor Vessel 20, that is used for calming.
- Gold bead implants became popular in the 1980s in veterinary acupuncture as a form of “permanent acupuncture.” This technique involves implanting fragments of gold jeweler’s wire, gold-plated pellets, or magnets. The most common applications include arthritis, degenerative myelopathy, wobbler’s syndrome, and epilepsy. While some advocates claim up to 98% success with gold bead implantation in conditions such as hip dysplasia, two double-blind, controlled studies evaluating the effectiveness of gold bead implants found no benefit over placebo.4,5Risks of gold bead implantation include migration of the metal fragments into the nervous system, infection6 (especially if nonsterile beads are used7), and cellulitis.8,9
- “Color” acupuncture involves the practitioner shining colored lights on acupuncture points. “Sound” acupuncture or “meridian therapy” involves using tuning forks or “specific sound frequencies.” These and other spin-offs of acupuncture do not have physiologic, evidential, or historical studies to back them. Practitioners should consider using them carefully as the American Veterinary Medical Law Association’s White Paper on the Law and Complementary and Alternative Veterinary Medicine states that “All veterinarians-conventional and C.A.V.M.-must use scientifically reliable treatments and therapies.”10
- Diagnostic techniques that involve applied kinesiology refer to procedures in which the practitioner tests the strength of the client (referred to as an “energy conduit”) while simultaneously touching the patient to pick up “transmitted” diagnostic information. These techniques do not have scientific research support, especially when performed with the client or practitioner as a diagnostic “surrogate” for the actual patient.
What Information to Supply
Veterinarian acupuncturists require the same amount and type of historical, physical, and diagnostic information as any other veterinary specialist would. They should be supplied with a complete list of all supplements and medications that the owner is giving the pet. Some of these may be prescribed by the referring veterinarian but the owner should also be encouraged to be all-inclusive when supplying this information for both the primary veterinarian and the acupuncturist.
Treating a patient that recently had an amputation for cancer. This photo shows that acupuncture can and should be relaxing for the animal (as well as the provider).
What to Ask for
Expect the same sort of feedback from a veterinary acupuncturist that you would from any other veterinary specialist, including a preliminary treatment schedule and outcome goals. The acupuncturist should be able to describe her or his assessment and treatment of the patient in clear, unambiguous terms.
Patient Outcomes & Length of Treatment
A typical trial period of acupuncture involves a “start-up” routine of twice- or once-weekly treatments (twice-weekly is preferred) for a total of four sessions. Some veterinary acupuncturists require clients to initially commit to at least eight sessions. Patients that are likely to respond favorably to acupuncture usually do so within the first few treatments; however, at first the benefits may last only 1 to 2 days. The goal is to build a cumulative and longer-lasting effect by delivering frequent sessions at the outset. Once a satisfactory level of improvement occurs, the acupuncturist will usually increase the time interval between sessions to that which allows sustained improvement with the fewest treatments.
Chronic problems often require longer start-up times, and patients may need prolonged and perhaps lifelong maintenance (e.g., monthly) treatment for severe dysfunction. Acute illness or pain and swelling from recent trauma or surgery usually resolve more quickly-perhaps with only a few treatments.
If a new problem develops while the patient is under the care of the veterinary acupuncturist, he or she should alert the referring veterinarian and ensure that the patient returns to the primary care provider for further workup. Any herbal, nutraceutical, homeopathic, or other recommendations made by the acupuncturist should be discussed with the primary care veterinarian before instituting, especially in cases in which herb-drug interactions may result.