By Ed Boldt, Jr., DVM, Reprinted from Miniature Donkey Talk
The use of
"complementary" therapies continues to increase in veterinary
practice. While there are myriad modalities that fall within this broad term,
the two most utilized are veterinary acupuncture and chiropractic (sometimes
referred to as manual therapy). It is felt that as more of the population turn
to complementary therapies for their own health care, those individuals then
seek out such therapies for their animals. It should be stressed that the term
"complementary" is the correct term for the use of veterinary
acupuncture and chiropractic. These therapies complement our
conventional/routine veterinary care. They are an adjunct, not a replacement.
This
demonstration is intended to inform you of what veterinary acupuncture and
chiropractic are, when they may be utilized to help your horse, and who you
should look to for these services.
What are acupuncture and chiropractic therapies?
Acupuncture involves the
insertion of a needle through the skin at predetermined sites (acupuncture
points) for the treatment or prevention of disease, including pain. Acupuncture
is only one of the therapies that come under the heading of Traditional Chinese
Medicine (TCM). The other TCM therapy most often used in veterinary medicine is
herbal therapy, using Chinese herbs and herbal compounds.
Besides the use
of solid, typically stainless steel needles, other means of stimulating the
acupuncture points can be used. The effects of acupuncture therapy cannot be
explained in terms of a single mechanism, but rather a series of interactions
between the nervous system, the endocrine system, and the immune system.
Anatomical examination of classical acupuncture points has shown that most of
the acupuncture points are associated with certain anatomic structures of the
nervous system. Acupuncture needling causes micro trauma that in turn causes a
local inflammatory effect. This inflammatory effect results in an increased
local tissue immune response, improved local tissue blood flow, and muscle and
tissue relaxation. Some acupuncture points are known as "trigger
points." These are tender areas found in skeletal muscle associated with a
tight band or knot in the muscle. The principle trigger points in a muscle are
located at its center in the motor endplate zone. This is where the nerve ends
in a muscle and causes the muscle to contract. Besides using acupuncture points
for treatment purposes, reactivity of acupuncture points can aid in diagnosis.
When palpated, these points might show some sensitivity if there is a problem
at that point, or with the acupuncture meridian or pathway that is associated
with the point.
Chiropractic
care focuses on the health and proper function of the spinal column, however,
the pelvis, limbs, and head are also considered. Chiropractic uses controlled
forces applied to specific joints or anatomic regions to cause a therapeutic
response due to induced changes in joint structures, muscle function and
neurological reflexes. The common principle in all chiropractic theory is that
joint dysfunction affects the normal neurological balance found in healthy
individuals. The spinal column should be considered from the standpoint of a
"motor unit." This consists of two adjacent vertebrae and all their
associated soft tissue structures — muscles and ligaments, nerves, blood
vessels, and all the contents of the intervertebral space. Any disruption to
the normal function of the motor unit is defined as a "vertebral
subluxation complex." Adjustments are then done to correct this disruption
and restore normal joint motion. From a chiropractic standpoint, there is no
"bone out of place."
Acupuncture techniques
Dry Needling
This is the use of the typical
"Chinese" or acupuncture needle. The needle consists of a solid shaft
with a handle. Needles vary in length (0.5 to 6 inches) and diameter (0.25 mm
to 0.75 mm). The smaller needles are used in the lower limbs, feet, head and
ear, while the larger needles are commonly used in the neck, back, and upper
limbs. The needles may be disposable or reusable via sterilization. Needles
with wire handles are used for moxibustion (described below). Most disposable
needles now have plastic handles. They may or may not come with an insertion
tube that aids in placing the needle through the skin.
Aquapuncture
This is the injection of a fluid
into the acupuncture point. While initially treating the point with acupuncture
(needle being placed through the skin into the point), this process also leaves
behind a liquid that continues to stimulate/treat the point with pressure (due
to displacement of tissue by the fluid) and/or irritation over a period of time
as it is absorbed. The most commonly used fluid is Vitamin B-12. Some
veterinarians who are acupuncturists may inject medications into an acupuncture
point to try to combine the effect of both the acupuncture and the medication.
This is done with antibiotics and hormonal medications, as well as with
homeopathic solutions such as Zeel and Traumeel. Trigger points and
"ashi" points may also be injected. I typically use 25 gauge, 1.5
inch hypodermic needles, but for some points, 3 to 6 inch spinal needles may be
used.
Electrostimulation/Electroacupuncture
This procedure involves attaching
electrodes to the acupuncture needles and applying a pulsating electrical
current to them. Stimulation can be achieved by varying the frequency,
intensity and type of electronic pulse used on the acupuncture points. Research
has shown that there are varying physiological responses to different types and
frequencies of electronic pulses applied to acupuncture points. I utilize
electroacupuncture primarily for neurological conditions such as facial nerve
and radial nerve paralysis, and for non-responsive pain, especially in the
lumbar area.
Moxibustion
This involves the burning of an
herb either on an acupuncture point (direct moxibustion) in order to stimulate
that point. The herb used (Artemisia vulgaris) is commonly called
"mugwort." In horses, the most commonly used technique is
"indirect moxibustion." Indirect moxibustion is done by holding a
burning moxa stick 1/2 to 1 inch above the acupuncture point or by attaching a
moxa to an acupuncture needle allowing the heat to be transferred down the
needle into the acupuncture point. It is mostly used to treat chronic muscular
and arthritic pain. It has also been used on lower back points when treating
equine reproductive disorders and for use around chronic wounds to promote
healing.
Hemoacupuncture
This is a procedure whereby the
acupuncture point is bled with a hypodermic needle using a technique similar to
the one in humans where a finger is pricked for a blood sample. It is most
commonly used in the treatment of acupuncture points in the coronary band area
("Ting Point Therapy") and other points on the extremities (head,
legs, tail). There are TCM implications as to the characteristics of the blood
that comes out. I mainly use Hemoacupuncture with cases of laminities and as a
distal treatment.
Cold Laser/Infra-red (IR)
Stimulator
These units can be useful in
stimulating acupuncture points that are difficult to treat any other way. In
the equine, this is most commonly seen in the treatment of points on the
extremities (head, legs). Caution should be taken with the use of lasers as
damage to the eye can occur. The use of Infrared Stimulators such as the CEFCO
model can be safely used for eye conditions and is especially useful with
corneal ulcers.
Equine Acupuncture and Chiropractic Exam — What's Going On
As with any examination, I begin
by getting a history on the horse. I especially want to know exactly what the
horse is used for and at what level (weekend rodeos vs. PRCA; training level
dressage vs. Prix St. George; occasional riding vs. full-time training, etc.).
I then ask the handler to walk the horse in a straight line away and back. I
want to watch how the horse tracks, as well as how the horse carries its head
and neck, and how the pelvis moves. Does the horse carry its tail to the side?
Does on hip move higher than the other one? Is there a "hunter's
bump" or high tuber sacrale? I then begin examining the horse on the left
(near) side at the head and work my way to the tail. I palpate acupuncture
points along the meridians (channels) and will do chiropractic motion palpation
as I go along. I will then do the right (off) side in exactly the same manner.
I check for any sensitivity at certain acupuncture points that can aid in
suggesting other areas of the horse to examine. I motion palpate the horse to
check for any decrease in the range of motion and flexibility of the spine and
pelvis, and for any sensitivity to the motion palpation. At this time, if I
feel I need to see the horse move either on a lunge line or with a rider up, I
have that done. I may then re-examine the horse to see if there is any change
in either acupuncture point reactivity or motion palpation. If I need to
examine the horse with hoof testers or do flexion exams I will do that. Once I
have determined which acupuncture points are reactive, and what areas show
decreased motion, I will then discuss with the owner my findings. We discuss if
further conventional diagnostics are needed and treatment options. If we agree
that acupuncture and chiropractic treatment are warranted, I then begin to
actually treat the horse. If we agree that conventional diagnostics or
treatments are needed, I refer the owner back to their routine veterinarian.
For information on veterinary
acupuncture and veterinary chiropractic contact:
The International Veterinary
Acupuncture Society
PO Box 271395, Fort Collins, CO
80527
(970) 266-0666
(970) 266-0777 (fax)
The American Veterinary
Chiropractic Association
442154 E 140th Rd., Bluejacket,
OK 74333
(918) 784-2231
(918) 784-2675 fax
