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WHAT IS VETERINARY ACUPUNCTURE?
Veterinary acupuncture is a healing art and science. It is based on the ancient theories of Traditional Chinese Medicine (TMC) which views each animal as a unique energetic being - not a catalogue of signs and symptoms. It has also received numerous contributions from modern scientific theories and research. As with many other veterinary treatment modalities, the purpose of acupuncture is to strengthen and stimulate the body's own adaptive-homeostatic mechanisms (physiological equilibrium). Treatment is facilitated by influencing precise points on or near the surface of a patient's body known as acupuncture points are related to specific internal organs and body functions.
Traditionally, fine solid metallic needles are inserted into acupuncture points. Stainless steel, gold, and silver needles are commonly used. There are also several other methods of stimulation (sedating or tonifying) animal acupuncture points (See Contemporary Veterinary Acupuncture below).
THE HISTORY OF VETERINARY ACUPUNCTURE
Human acupuncture is considered to have been practiced for several thousands of years; archaeological evidence suggests as early as 3000 years B.C. One of the earliest written documents "The Yellow Emperor's Classic of International Medicine" is dated 400-200 B.C. This record discusses the use of acupuncture in remarkable detail. It even explains that blood is controlled by the heart and flows continuously through the body - 2000 years before this was discovered by Western Medicine.
The use of acupuncture in animals appears to have been used nearly as long as in humans. Government veterinarians treated livestock in the Chow Dynasty, 2303 B.C. Since then, it has been practiced continuously in China. Camels, horses and swine were among the species of particular importance during this era.
Veterinary acupuncture was practiced in France in the 1700's and early 1800's, having been introduced by Jesuits returning from China. The use of acupuncture in animals fell into disuse in Europe before modern veterinary medicine arrived in America.
During the past 20 years, a handful of veterinarians in France, Germany and Austria began transposing human acupuncture to animals. Although these early "modern" efforts progressed slowly, the results were encouraging. In the 1970's, after China was politically opened to the West, there began an active dialogue between veterinarians from China and the United States. Since this time, veterinary acupuncture in the Western world has rapidly developed into useful and progressive clinical discipline.
In this country, much of the pioneering in veterinary acupuncture was done by individuals associated with the National Association of Veterinary Acupuncture (NAVA). The NAVA was sponsored by the UCLA Pain Clinic. Since 1974, the principal focus of veterinary acupuncture has been the International Veterinary Acupuncture Society (IVAS). Veterinarians affiliating with IVAS represent at least 12 nationalities, numerous academic institutions, as well as a wide spectrum of practice interests. The society has endeavored to establish high standards for veterinary acupuncture through its post graduate educational programs and accreditation examinations.
In addition, the IVAS has encouraged dialogue with both human medical and veterinary disciplines which share common interests, i.e. immunology, neurology, and surgery. The IVAS has also maintained direct liaison with veterinary and medical schools in both the Peoples Republic of China and the Republic of China.
HOW DOES ACUPUNCTURE WORK
Traditional Chinese Medicine describes an orderly system or network of interconnecting channels and meridians which exist in predictable locations throughout the body. There are 14 major meridians which conduct the flow of qi (chi). Qi is thought of as energy - a life sustaining vital force that regulates body functions as it circulates continuously through the meridian system. In order to maintain a state of wellness, however, it is essential that the qi energy flows in a smooth, harmonious and unobstructed manner. Internally the major meridians connect and communicate with specific organs.
Most illnesses and injuries are either caused by or accompanied by disturbances in the flow and balance of qi. Disorders in the function of qi can be influenced by treating acupuncture points. Most acupuncture points are located at a specific anatomical site where a meridian comes near the body surface. Humans are generally considered to have 365 classical acupuncture points associated with the major meridians. Domestic animals have acupuncture points that correlate closely with humans. Although most of these points are used in modern veterinary acupuncture, it is interesting to note that some domestic animals have points not found in people. Most points vary from 1.5 to 3.0 mm in diameter and are characterized as having a high electrical conductivity compared to surrounding skin.
The behavior and function of qi is described by the time honored theories of TCM. These theories are the traditional basis for enabling a veterinary acupuncturist to identify, localize and characterize specific patterns of energetic disharmonies in animals. Examples if these theories are the yin-yang theory, the five element theory and the eight principals (ba-gang).
Before an animal can be treated, a TCM diagnosis is made. This is accomplished through a systemic process of evaluating a patient by observing, touching, listening and inquiring (history, behavior, etc.). The TCM diagnosis, in turn, is the basis for planning or prescribing therapy. A single acupuncture point of a group of points is selected to correct a patients specific energetic excesses and/or deficiencies. The acupuncture needle acts, in effect, like an opener and a closer of doors… or gates, somewhat like locks on a waterway. The needle summons or permits (pushes or pulls) energy from one pathway to another. Through this process it is the intention of acupuncture to correct energetic disturbances and allow the body to govern and regulate itself in a normal manner. The patient, in effect, heals itself, not through palliation or suppression, but by correcting what is fundamentally wrong.
ACUPUNCTURE AND WESTERN CULTURE
In the recent past, the Western world has not known how to accept acupuncture. Culturally, it has not always been easy or comfortable to deal with. The oriental view of health and illness contrasts sharply with the occidental. In addition, many facets of acupuncture have not been able to be immediately explained in tangible terms of Western thought and experience. Many Western authorities viewed acupuncture not only with skepticism, but disdain. Unable to understand "how it works" it was often characterized as being "unscientific" and presumed to operate through the power of suggestion. It was essentially dismissed as a curious and antiquated form of poetic folk medicine.
Culturally, a lot has happened since 1968. Our collective experience since then has told us, in effect, that it is alright to look seriously at acupuncture… thoughts and concepts need not be rejected just because they are not of occidental origin. IN fact, we have culturally recognized that we owe it to ourselves to learn about this subject - to see how it applies to us and our animals. After all it is the most thoroughly field tested form of medical treatment known.
Today, acupuncture must be taken seriously. There have now been several years of clinical experience by Western practitioners applying acupuncture to a wide variety of scientific knowledge concerning acupuncture. This experience and knowledge have established acupuncture as a valid modality for both human and veterinary therapy.
HOW DOES ACUPUNCTURE WORK - A WESTERN PERSPECTIVE
Scientific investigations have given some important insights into how acupuncture works. The following summarize some of the current scientific theories concerning acupuncture. It is important to recognize, however, that so far no single modern theory can, by itself, explain all the phenomena associated with acupuncture healing.
1.) Bioeletric theory - This theory suggests that the basis of coordinating and regulating biological processes is to be found in physics - in an electrical dimension - not chemistry. This concept recognizes that polarized electric-like energy fields exist in and around animal bodies and, more particularly, around each cell. Further, these electric fields are associated with a network of circuits that continuously conduct minute amounts of direct current through the body. This current is conducted by cells forming an entirely different conduction system - the perineural cells, located around nerve fibers. Unlike nerve cells, the perineural cells conduct current by a process known as semi-conduction, which is somewhat slower than ordinary motor or sensory nerve impulses.
This bioelectric current is responsive to minute electromagnetic forces and is responsible for initiating, coordinating and regulating many body functions. It is also very susceptible to influence by external electromagnetic fields.
In this context, acupuncture points are analogous to amplifiers; the meridians serve as conductors and the qi is comparable to bioelectricity. Acupuncture needles, according to this theory, electrically affect the body's bioelectricity in a beneficial way, assisting the body to return to a condition where is can resume regulating itself in a normal manner.
2.) Humeral theory - This theory suggests that the way acupuncture works is by releasing specific chemical substances into the blood and other body fluids. For example, some acupuncture points, when stimulated, release potent morphine-like substances which can alleviate pain. The most well studied category of hypoalgesic (pain reducing) humeral substances are the endorphins.
Acupuncture is known to be capable of stimulating the immune system. Antibodies are produced in greater quantity. White blood cells are not only released in greater numbers, but function more effectively (phagocytosis) during microbial infections. In addition, acupuncture can be effective in treating many allergic-like reactions, as well as harmful inflammatory reactions, i.e. autoimmune disease and fever. There is strong evidence that this is possible because humeral substances are released following acupuncture treatment.
Other humeral factors associated with acupuncture treatment are neurotransmitters such as serotonin and epinephrine, and hormones such as cortisol and thyroxin.
3.) Neurophysiologic theory - This theory is based on the hypotheses that acupuncture works because there is a physical relationship between acupuncture points and peripheral nerves.
It is well known that there are a greater number of neuroreceptors (nerve endings that transmit information such as pain, heat or pressure) at or near most acupuncture sites. In addition, most acupuncture points have a close physical relationship peripheral nerves. For example, acupuncture points are often located where nerves attach to major muscles, bones, tendons, or blood vessels.
Properly placed acupuncture needles, therefore, are thought to communicate directly with specific neuroreceptors, which in turn send a specific message through the body's autonomic nervous system.
This neurologic message ultimately modifies the mechanisms which ordinarily regulate and control an animal's physiology. Knowing which acupuncture point to is more or less like knowing what neurological switches to turn on or off in the animals nervous system in order to help make it well, i.e. inhibit pain, increase cardiac output, suppress the cough reflex or stimulate bone healing.
Today, in the United States, practicing veterinarians utilize acupuncture in a wide variety of clinical settings. Some accept only cases referred by other veterinarians, i.g. equine lameness. Most utilize acupuncture as a part of their day to day practice; both traditional and holistic. This includes dogs, cats, horses, cattle, sheep, swine, and avian species.
Except for few select treatments, a considerable amount of specialized knowledge is required in order to practice veterinary acupuncture satisfactory. Of approximately 300 veterinary acupuncturists in the U.S. today, half have received post graduate training and have been certified by the International Society of Veterinary Acupuncturists. Certification requires understanding of the principles and practice of TMC as well as integration of current scientific theories with knowledge of acupuncture into Western clinical veterinary medicine. The IVAS emphasizes the importance of acupuncturists making both a Western and TCM diagnosis for each patient.
There are several different approaches and methodologies for treating animals with acupuncture. Instead of inserting fine sterile metallic needle into acupuncture points, there are occasions where heat my be more appropriate (moxibustion). Manual pressure (acupressure), low voltage electricity (electroacupuncture) and sound (sonopuncture) also have particular applications. In some circumstances, very small sterile gold or silver beads are surgically implanted in the precise site of acupuncture points. The use of light as in the case of lasers can be very effective. In the case of "aquapuncture", a small volume of sterile liquid, such as vitamin B12 is injected into acupuncture points, particularly when a period of prolonged stimulation is indicated.
Simply stated, veterinary acupuncture today involves combining the principles of classical Chinese medicine into a western scientific and clinical background. This integration process has had numerous positive consequences including the stimulation of a dynamic and rapidly progressing clinical discipline. It has contributed to the depth and perspective of the veterinary profession as a whole as well as producing alternatives and choices available to the animal owning public.
Most states in the U.S. require a license to practice veterinary medicine as a prerequisite to practicing veterinary acupuncture. Some states require further evidence of post graduate training and/or certification.
SOME RECENT INNOVATIONS
During recent decades, two of the more significant applications of acupuncture in animals are auricular therapy, and EAV. Auricular therapy involves the use of a rather extensive pattern of acupuncture points located specifically on animal's ears. These auricular points are used for both diagnosis and treatment.
EAV or Electroacupuncture According to Voll was developed by Rhinhart Voll, a German Physician. This very useful clinical tool is based on the predictable ways in response to various disease conditions. By measuring the electrical skin resistance over acupuncture points, several kinds of useful information can be obtained concerning the condition and function of each individual acupuncture meridian - information that quantifies, qualifies, and localizes a patient's energetic disturbances. This methodology can also information which can strongly suggest what specific substances (environmental, medicinal, and nutritional) offend or benefit the body'd effort to restore harmony and balance to its acupuncture meridian system. In effect, it permits the veterinarian to as an animal's body what substances it will accept as being capable of helping it become well.
INDICATIONS FOR VETERINARY ACUPUNCTURE
Acupuncture is known to have good therapeutic effect in a wide variety of animal diseases. Although pain moderation is an important application in veterinary acupuncture, it has much wider applications. It is generally considered to be a beneficial for most functional disorders. It is also efficacious for numerous structural disorders as well. Besides therapy, acupuncture is useful in clinical practice as a diagnostic aid. Many clinical conditions can be differentiated and localized with the use of manual examinations or instruments. Even when acupuncture is indicated, it must be weighed in contest with alternatives. In addition, the owner's objectives, preferences and personal values must be carefully considered.
It is interesting to note that not all conditions respond equally well when compared between species of domestic animals. In dogs and cats it can be especially useful for many neurologic and gastrointestinal conditions.
Generally speaking, indications for acupuncture therapy fall into three categories. First, it may be a primary therapy. In this instance, acupuncture is considered to be the method of choice or is selected as a principal modality of therapy. Second, it may be more appropriate to utilize acupuncture as supportive of adjunctive therapy. Third, acupuncture may be viewed as a back-up or alternative therapy when standard treatments are inadequate.
It not unusual to use acupuncture in conjunction with other therapeutic modalities and methods of supportive care. It can be used simultaneously with many traditional Western therapies. It is especially useful in bridging the gap between medicine and surgery. In addition, it is compatible with many nontraditional and holistic approaches to veterinary care such as homeopathy and chiropractic.
There are clearly circumstances where acupuncture would be useless or even contradicted (see Limitations and Contradictions of Acupuncture, below). It is not intended to replace other modalities when they are appropriate. Knowing when and how to integrate acupuncture with the overall management of an animal's injury or illness requires considerable clinical skill and discretion. If your animal has a compound leg fracture, he/she needs orthopedic surgery. Nonetheless, post operative acupuncture minimizes post operative pain, facilitates a quicker return to function, as well as lessens post operative arthritis
The following are examples of some of the clinical conditions where veterinary acupuncture may be appropriate
A. Gastrointestinal disorders: esophageal hypo motility, gastritis,
Rumen atony, gastroenteritis, colitis, mega colon, rectal prolepses,
Chronic idiopathic diarrhea or vomiting.
B. Respiratory problems: rhinitis, sinusitis, laryngitis epistaxis,
Bronchial asthma, chronic coughing, pneumonia.
C. Neurological disorders: trigeminal neuralgia, peripheral
Nerve paralysis, nysyagmus, vestibular syndrome, torticollis.
Non degenerative myelopathies, epilepsy, stroke, deafness,
D. Musculoskeletal disorders: chronic degenerative joint
Disease, intervertbral disc disease, spondylosis, spondylothesis,
Hip dysplasia, disunited anconeal process, tendonitis, sprains,
Muscle spasms e.g. trapezius spasm.
E. Reproductive, endocrine, and metabolic disorders: ovarian
Cysts, dystocia, retained placenta, uterine prolapse, mastitis,
Udder edema, milk fever, hepatitis, jaundice.
F. Immunosupportive and allergic disorders
G. Dermatologic disorders: lick granulomas, sensory nervo-
Dermatitis, allergic dermatitis.
H. Urinary disorders: incontinence, cystilis, urine retention
I. Emergencies: cardiac arrest, respiratory arrest.
IS ACUPUNCTURE FOR YOUR ANIMAL?
If you are considering acupuncture for your animal, what would you expect when you consult with a veterinary acupuncturist?
1. A careful history of the sequence of signs and symptoms your animals condition will be obtained. In some cases, previous x-rays and laboratory
Data may be important if not essential
2. Your animal will be examined and physical findings recorded.
3. A diagnosis should be established, or a plan outlined to confirm a tentative
4. The veterinarian will discuss with you your animal's candidacy for
Acupuncture. If it is indicated, the following topics should be
Included: a proposed schedule of treatments or a plan of therapy
An explanation of the prognosis, possible sequelea, estimated
Fees and a review of the alternatives. He/she will also indicate
Any preliminary steps or supportive care that may be indicated
In conjunction with acupuncture therapy.
5. If you have been referred to a veterinary acupuncturist by another
Veterinarian, you should expect that your regular veterinarian will
Be kept informed by the acupuncturist.
For some conditions, one treatment is all that is necessary. This is not usually the case. Typically acupuncture therapy requires multiple treatments. Five to six is common, and for some long-standing problems, sometimes up to ten or twelve treatments. Often convincing signs of improvement will be observed after the second or third treatment. However, it is important to know that how completely an animals recovers does not necessarily correspond to how fast improvement is noted. Many kinds of illnesses require persistence in order for acupuncture to work.
Perhaps even more than with traditional veterinary care, you should recognize that the veterinary care is very personal - as are your priorities, values and philosophy. Therefore, you should feel comfortable in being very direct in asking questions or discussing the rational of any proposed treatment. Be certain that acupuncture is not a panacea. It is important to become informed about veterinary acupuncture and select a veterinarian in whose skill and judgment you can have confidence in.
WHAT TO EXPECT AT THE TIME OF TREATMENT
Ordinarily, pain and discomfort associated with acupuncture treatment is conspicuously absent or minimal. In fact, there is typically far less discomfort associated with an acupuncture treatment than with an ordinary vaccination or hypodermic injection.
Occasionally, there is a brief moment of sensitivity as an acupuncture needle penetrates the skin in certain sensitive areas. Once the needles are in place, most animals relax. Some will even fall asleep during treatment.
The duration of a treatment may vary from 10 seconds to 30 minutes. For many conditions, patients are treated one to three times a week for four to six weeks. A positive response may be noticed after one or two treatments. In some cases, improvement may not be observed until the fifth or sixth treatment.
Owners are often requested, or at least invited, to be present. Exceptions may be procedures that are particularly time consuming or that require special scheduling.
LIMITATIONS AND CONTRADITCTIONS IN VETERINARY ACUPUNCTURE
A. Pregnant animals not ready for labor are ordinarily not candidates for acupuncture.
B. Certain drugs can significantly alter the effects of acupuncture treatment, such as tranquilizers, narcotics, steroids or anticonvulsant drugs. You need to carefully review with your veterinarian all prescription and non-prescription medications your animal may currently or recently be taken.
C. Animals with high fevers may not be candidates for acupuncture treatment. Bacterial infections should ordinarily be treated with an appropriate antibiotic. Concomitant acupuncture, however, can often shorten discomfort and accelerate the resolution process.
D. There are limits on how far a degenerative disease process can progress and still be able to be arrested or reversed by acupuncture. Some diseases should not be treated by acupuncture except for supportive therapy and symptomatic relief.
E. Acupuncture is not considered to be a primary therapy for cancer or malignancies. It is not considered efficacious as a cancer cure.
BEFORE AND AFTER TREATMENT
To enhance the benefit of therapy, the following are important:
1.) Avoid feeding, unusual exertion, heavy exercise, or bathing immediately before or after your animal's treatment.
2.) Plan your schedule so your animal can get some rest following a treatment so that his/her body can obtain the maximum benefit of treatment.
3.) Continue taking any prescription medicines exactly as directed by your veterinarian.
4.) Carefully observe your animal after each treatment. It is possible for a wide variety of changes to occur. Some may be transient and others sustained - some rather subtle and others quite obvious. For example, there may be a period of change in alertness or emotions - changes such as tranquility, relaxation, modified sleep patterns, increased sociability, eagerness or simply "feeling more like his/her usual self". Other changes may include differences in activity, appearance, appetite, as well as bowel and urinary habits. Do not be concerned if you recognize such events. They are important in the healing process and you should allow time for them to run their course. If you feel there is deterioration in your animal's condition, or if you have a question, you should contact the veterinarian who is managing your animal's acupuncture care. Such details are valuable in evaluation and planning the course of treatment.
5.) The principles underlying veterinary acupuncture ultimately rely upon the patient's own energies. Nothing can replace appropriate nutrition, regular and prudent exercise (except when contradicted), and adequate rest. In addition, the owners own positive attitude toward wellness is very important in the success of your pet's treatment and healing.
POSSIBLE SIDE EFFECTS AND COMPLICATIONS
Acupuncture is one of the safest veterinary therapies when practices by a competent acupuncturist. Compared to most other modalities, adverse effects are rare. The following side effects, however, may occur:
1.) Rebound effect: This is the worsening of symptoms for up to 72 hours following a treatment, followed by improvement. This is unusual and probably occurs in less than 5% of all patients. This usually is taken to be a good sign, however, because these individuals often do very well following the rebound.
2.) Depending upon the treatment, an animal can experience either excess energy or fatigue for up to 48 hours.
3.) Rarely, a needle can break while in the skin and subcutaneous tissue. This could require minor surgery to remove it if other methods fail.
4.) Needles injuries to underlying organs can occur but these are very rare. Sometimes a hematoma can occur if a blood vessel is punctured.