As alternative medicine and treatments become more widely available in human medicine, our clients are seeking the same options for their pets. Alternative therapies such as acupuncture, herbal medicine, chiropractics and homeopathy are all becoming more widely available to our patients. Acupuncture is the technique of piercing the skin with very thin needles at precise, predetermined foci to prevent or treat disease. Its history, neurophysiology and applications will be reviewed in this article.
The History of Acupuncture
Acupuncture has been most closely associated with ancient China and remains part of Traditional Chinese Medicine (TCM). The earliest known reference to acupuncture is found in the book Huangdi Nei Jing, estimated to have been written in the second century BCE. The book addresses the subjects of physiology, morphology, pathology, diagnosis and prevention of disease. The first written veterinary acupuncture text was likely written around 450 BCE.
Western veterinary medicine was introduced into China in the early 1900s, and since that time, both systems have coexisted. In Chinese veterinary healthcare, the current emphasis and goal is the integration of Traditional Chinese Veterinary Medicine (TCVM) with Western veterinary medicine to gain the benefits of both while minimizing the disadvantages of either.
In 1972, President Richard Nixon established diplomatic relations with the People’s Republic of China, opening the channels of communication in medicine. After American James Reston received postoperative acupuncture for pain control following a well publicized emergency appendectomy, interest in acupuncture and TCM began to grow.
The National Institute of Health sponsored a team of physicians over the next several years to research acupuncture, the mechanisms of its actions and its efficacy. In 1997, the NIH sponsored a consensus statement concluding that the efficacy of acupuncture in adult postoperative cases, chemotherapy-induced nausea and vomiting, and in postoperative dental pain showed promising results. They also stated that acupuncture may be of benefit for addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome and asthma. By the time a JAMA study was conducted in the 1990s, 42% of the American public was looking for alternatives for their personal healthcare.
The Neurophysiology of Acupuncture
Most research on acupuncture has been focused around pain control. Studies have used laboratory animals, healthy humans, and humans and animals with spontaneous disease (usually chronic pain). Functional MRI is providing further information on the links between acupuncture points and the activation of specific regions of the brain. Presently, models of the neurophysiologic mechanisms of acupuncture have been put forward; making it possible for us to integrate acupuncture into our conventional pain-relieving methods.
Acupuncture needles are placed in very specific points based on surrounding anatomy. Acupuncture points are areas of the skin (often in surface depressions located along the cleavage between muscles) rich in free nerve endings, nerve bundles, inflammatory and immune mediating cells, capillaries and tiny veins. They also tend to be areas of lower electrical resistance and higher electrical conductance compared with the surrounding skin.
Stimulation at acupuncture points activates three Central Nervous System regions (spinal cord, brainstem, and hypothalamus-pituitary). This releases neurotransmitters to block pain messages.
Other mechanisms may also be involved in the mediation of acupuncture. Acupuncture needling induces very small tissue damage, in turn, stimulates local inflammation, which includes the release of many messages within the body. Acupuncture has been documented to enhance immunity.
Traditional Model of Acupuncture
The TCM paradigm centers on the concept of Qi (or Chi). Qi was understood by ancient Chinese practitioners as an energy or life force that circulates throughout the body and controls its harmony. It travels in and through organs and over the surface of the body along Meridians or Channels. In a balanced, healthy body, Qi flows smoothly and is at adequate and appropriate levels throughout the body. In a disease state, Qi can be obstructed, reduced, or in excess. Acupuncture helps by tapping into the body’s Qi and helping to restore the body’s balance.
What Can Acupuncture Help With?
Acupuncture treatment can be used for a great many conditions. Musculoskeletal conditions are among the most commonly treated, consisting mostly of arthritis, hip dysplasia and intervertebral disc disease. Dermatologic conditions such as lick granulomas and chronic allergic dermatitis are also indications. Traumatic nerve injury and epilepsy are treated frequently as are asthma and cases of inflammatory bowel disease and chronic constipation. Post-operative pain control is another area where acupuncture can augment conventional treatment.
Veterinarians and clients are often surprised at the ease with which animals take to acupuncture. While not every patient is amenable to acupuncture treatment, the great majority are cooperative. A typical treatment begins with a conventional physical exam and TCVM exam. (The TCVM exam pays special attention to the color and nature of the patient’s tongue and palpation of the femoral pulses, as well as palpation of meridians, searching for reactive acupuncture points). A thorough history is taken. Acupuncture needles are placed; the specific points are chosen based on the exams and the history. At this point, the patient maintains the needles for anywhere from 30 seconds to 45 minutes.
Few patients show any signs of pain, discomfort or distress when the needles are placed.
Some veterinary acupuncturists will stimulate the needles by rotating them; others will simply allow them to remain still. The client stays with the patient the entire time. Often, the patient will become very relaxed and even fall asleep during the treatment. The needles are then withdrawn.
Certain patients and conditions warrant modalities other than needles alone. Electroacupuncture (attaching electrical stimulation to the needles themselves), aquapuncture (injecting solutions such as Vitamin B12 into acupuncture points), acupressure (applying manual pressure to acupuncture points) and laser (applying low level laser to acupuncture points) are all commonly used in treatments.
Side effects of acupuncture are rare. Occasionally, an animal will show deterioration in their condition temporarily before improving. Sterile, single-use needles preclude infection.
Acupuncture treatment schedules vary. It is often recommended that six to eight treatments be performed to establish whether a pet is positively responding to acupuncture. Some animals improve after just one session, others take many sessions; chronic diseases tend to respond more slowly. These treatments often start off more frequently (as often as one to two treatments weekly) then taper off once an improvement in symptoms is established. This tends to be dependent on the acupuncturist, the patient’s condition and the client’s availability. Maintenance therapy is often recommended and can vary between one and six months in duration.
While research into the mechanisms and applications of acupuncture is ongoing, there are many places in modern small animal medicine where it can be very useful. Whether it is an adjunct to the use of herbal, homeopathic supplements and non-steroidal anti-inflammatories for arthritis treatments, or an alternative treatment for patients that cannot tolerate the conventional medication given, acupuncture is a great modality for our pets. Blending the ancient art of acupuncture with our modern day practice can lead to integrative and effective medicine.
1. Schoen, A. 2001. Veterinary Acupuncture. Mosby.
2. Xie, H. and V. Preast. 2007. Xie’s Veterinary Acupuncture. Blackwell Publishing.
3. NIH Consensus Statement Online 1997 November 3-5; 15 (5): available at http://odp.od.nih.gov/consensus/statements/cdc/107/107_stmt.html
4. Marsden, S. and S. Wynn. 2003. Manual of Natural Veterinary Medicine: Science and Tradition. Mosby.
5. Macoccia, G. 1989. The Foundations of Chinese Medicine. Churchill Livingstone.
6. Eisenberg DM et al: Trends in alternative medicine use in the United States, 1990-1997, JAMA 280: 1569-1575, 1998.
Photos and video courtesy of Sleepy Dog Acupuncture