Archive for the 'clinicalresources' Category

Apr 10 2006

Veterinary Acupuncture

Dr Barbara Fougere
BSc BVMS (Hons) BHSc (Comp Med) MODT MHSc (Herb Med) CVA (IVAS), CVCP, CVBM.

Introduction
Veterinary Acupuncture
Diagnosis
Does it work?
Precautions for Vet Acupuncture
Conditions that respond to acupuncture
Vet Acupuncture treatments
What can you expect
How successful is vet acupuncture?
For further information

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Introduction

As a young girl , acupuncture was the only treatment that helped prevent my Migraines. It was no surprise then, that when I was at vet school I took the opportunity to start my life long interest in veterinary acupuncture by taking on an elective in my final year. After graduating in 1986 I explored a number of complementary therapies and became a certified veterinary acupuncturist through the International Veterinary Acupuncture Association (IVAS) in 1997. Acupuncture for animals is a growing field and there are some 240 qualified veterinary acupuncturists in Australia now.

Veterinary Acupuncture

Along with herbal medicine it’s probably one of the oldest forms of veterinary medicine in the world. Although pets have only recently been treated with acupuncture, in China, horses, cows and pigs have been treated for well over 3000 years. Like acupuncture in people Veterinary Acupuncture has come a long way since the early 1970s.

One of the most common concerns that people have about acupuncture on their pets is the ‘ouch’ factor. Cats and dogs can be a little apprehensive at first but they very quickly relax, becoming calm and even falling asleep. Most animals come back the next time, quite content to stand, lie down or be held by their owner and be treated.

Diagnosis

Similarly to human acupuncture veterinary acupuncturists will check the pet’s smell, listen to any noise they make, examine the tongue colour and coating, and check the pulse and specific acupuncture points. A TCM diagnosis helps with point selection but more often that not an intuitive approach, sensing the points and checking pulse changes determines the treatment.

Like disease in human TCM, in animals there are external and internal causes, including emotional causes. Its no surprise to find out that dogs get “hot spots” in summer and Bi syndrome in winter, they suffer Blood deficiency (often when on poor diets) and cats suffer Spleen Qi deficiency and Kidney Yin deficiency very frequently. The challenge with animals is in interpreting their signs and behaviour to make a TCM diagnosis, when you can’t ask them how they feel. Good palpation and observational skills as well as communicating with the owner, helps a great deal. Sometimes routine blood tests will pick up and confirm liver changes or kidney changes that just make sense!

Does it work?

Acupuncture works in much the same way it does in people. Acupuncture has also been shown to stimulate the release of numerous neurochemicals including endorphins and other pain relieving, anti-inflammatory hormones into the bloodstream. From an energy perspective it is likely (though not proven) that acupuncture also works by changing the electrical resistance of the acupuncture points, facilitating the flow of electromagnetic energy through the body. TCM views disease as a stagnation or blockage of the vital life force or Qi, and that acupuncture serves to regulate the flow of Qi and remove blockages from the body.

Precautions for Vet Acupuncture

Acupuncture is a very safe form of therapy if practised correctly and preferably by a trained veterinary acupuncturist. The International Veterinary Acupuncture Society (IVAS) certifies qualified veterinarians.

• Because acupuncture relieves pain and can alter the symptoms, a diagnosis should be made beforehand by a veterinarian otherwise acupuncture may simply mask a more serious problem.

• Ideally your acupuncturist is also a veterinarian. Treating animals is very different from treating people. And you wouldn’t expect your veterinary acupuncturist to treat human disease and problems.

• Acupuncture diminishes pain, and your animal will feel better; it is important to follow advice concerning rest and activity, as pain is ‘nature’s’ way of slowing an animal down so that they may rest and heal.

• Your pet should be treated on an empty stomach or light meal only.

• Acupuncture should be avoided if pregnant.

• Do not plan to bath or swim your dog, immediately before or after acupuncture treatment.

• It is best not to treat an animal that is extremely anxious, aggressive or frightened.

• Your veterinary acupuncturist will need to know whether your pet has been given any injections or is being treated with atropine, narcotics or corticosteroids such as prednisolone, as these can affect the acupuncture treatment.

• Your veterinary acupuncturist may not treat your dog if there is a skin infection or local skin tumours where the needles may carry the infection or growth deeper.

• If needle acupuncture cannot be performed, laser acupuncture is another alternative.

• Veterinary acupuncture treatment may also involve aquapuncture (injecting substances into acupuncture points), moxibustion, gold beading

Conditions that respond to acupuncture

Muscle and Joint Problems
Acupuncture is perhaps best known for its use in pain relief. It can be used as primary treatment, or in conjunction with conventional treatment. It is a real alternative where the risk for surgery or anaesthetic is high. Acupuncture relieves pain, reduces muscle spasms, improves circulation, reduces swelling and improves healing.

• hip dysplasia

• Osteochondritis dissecans (OCD)

• arthritis in the stifle, hock, carpus (wrist), shoulders, hips and elbows

• lameness due to pain or injury

• chronic lameness due to trigger points, which are small muscle spasms, and can resemble the symptoms of arthritis

• muscle and ligament injuries

Nervous System and Spinal Problems
Dogs with disease that affects their spinal cord such as disc protrusions causing paralysis, partial paralysis or severe pain may benefit from acupuncture. Cats often suffer back pain in silence, you might not even know they have a problem, but a crouched walk or dislike of being touched are just two signs that back pain could be present.

• degenerative myelopathy

• spondylitis

• Cauda equina syndrome

• spinal instabilities

• Wobblers syndrome

• nerve injuries

• epilepsy

• vestibular syndrome

• deafness (particularly in old animals)

Skin Disorders

Skin disorders that are poorly responsive to conventional treatment such as some allergies, chronic itching, lick granulomas, and skin disease due to disorders of the immune system or endocrine system may benefit from acupuncture. Acupuncture can also be used in conjunction with other therapies for skin disorders.

Digestive Tract Disorders
Besides pain relief, acupuncture normalises the movement in the gut and the secretions of digestive juices as well as improving blood flow.

• Sudden diarrhoea and vomiting

• Chronic diarrhoea

• chronic vomiting

• constipation

• poor appetite

• megaoesphagus

Heart Disorders
Acupuncture has one of its greatest benefits in the treatment of shock, unconsciousness, or cardiac arrest. In an emergency you can stimulate a special point midway along the groove between the nose and the upper lip. This is Governing Vessel 26, a very powerful point that can be used to revive puppies, kittens, or dogs and cats of any age. The point can be stimulated with the nail, a pen tip or sharp needle, depending on what you have in the emergency situation, until you can reach a vet.

Heart failure can be improved with acupuncture along with conventional drugs such as diuretics and beta-blocker medications. The condition needs to be monitored very carefully when acupuncture is used, as the dosages of normal drugs usually need to be reduced as the condition responds. Heart rhythm problems may also benefit from acupuncture as acupuncture can have a direct effect on regulating the heartbeat.

Behavioural Problems
One of the less known areas where acupuncture can help is in the treatment of behavioural disorders. Like humans, behavioural problems are associated with excessive emotion and what are called ‘Shen disturbances’. By treating specific points and harmonising the body, acupuncture can assist with:

• fear

• aggression

• grief

• shyness

• show ring nervousness

• phobias

• anxiety

• depression

Immune Disorders
Acupuncture has proven anti-inflammatory and immune stimulating effects. Certain points will also reduce allergy and stimulate different parts of the immune system. This is one of the reasons why pets, particularly older ones, benefit from regular ‘tune-ups’ of acupuncture to help keep them healthy. Any animal with an infection will benefit from acupuncture, by reducing the time it takes to recover. Any animal that is prone to infections can also receive preventive treatments to reduce the severity and number of times they get sick.

Cancer
Acupuncture is a good adjunctive treatment for animals undergoing chemotherapy or other treatments for cancer. It helps reduce nausea, improves the sense of well-being, and regulates the immune system (especially when it is impaired with certain drugs used in cancer treatment). It may also be used to treat small growths, or where surgery and chemotherapy are not viable options due to age, poor prognosis, expense or other reasons.

Reproduction
Acupuncture can be used in females to help lack of cycling, irregular heat cycles, cystic ovaries and false pregnancies. It can also be used during labour and to help stimulate lactation. In males acupuncture can help increase sperm counts, and reduce any inflammation of the testicles or prostate gland.

Respiratory Disorders

• Chronic sinusitis

• Coughing

• Bronchitis

• feline asthma

• pneumonia

Urinary Tract Problems

• Incontinence of bitches

• Incontinence of older animals

• Cystitis

• Feline lower urinary tract disease

• bladder

• kidney disease

Eyes and Ears
Acupuncture can be used for a number of eye conditions including dry eye and chronic conjunctivitis. It can also be useful to alleviate age-related deafness.

Fleas
People often ask me if acupuncture is good for fleas, I have always had great difficulty putting my needles in fleas, so I don’t really know.

Vet Acupuncture treatments

If the problem is an acute, treatments may be required every couple of days until the desired result is seen. For more chronic conditions there are usually a couple of treatments 1 to 2 times a week, or weekly for a few weeks, followed by regular ‘top ups’ which might be monthly or six monthly or as needed.

What can you expect?

If the problem is a recent one, a single acupuncture treatment should stimulate a quick response, although follow up treatments may be necessary to restore health fully. If the problem has been a long-standing one, sometimes there is no apparent change initially. A second treatment may show an improvement for three or four days, then the effect seems to wane, but follow up treatments seem to extend the effect more and more each time until the condition resolves. Occasionally the symptoms may actually appear to be worse for 12 to 24 hours, or alternatively your animal may simply sleep restfully for 12 to 24 hours. There is often a change in your pet’s temperament; they can seem brighter and more relaxed. It is also important not to give up too early with treatments. Remember acupuncture is stimulating the body’s own internal healing mechanisms, sometimes it takes a while for it to wake up and start working!

How successful is vet acupuncture?

In the hands of a qualified and experienced acupuncturist, treatment will usually bring about a marked improvement if not recovery for many complaints. By discussing the likely outcomes with your veterinarian you should plan a course of treatments, and a point at which you may choose not to continue, or the type of result that you want. For example this may be simply pain relief in an older animal, or full recovery in a younger one. Importantly acupuncture is a safe alternative or adjunctive therapy to drugs and surgery. However, it does not cure everything. More and more veterinarians are becoming qualified to use this time-tested therapy, and more and more animals will benefit from pain free lives.

For further information

Natural Vet Care

• Fougere B Healthy Dogs A Handbook of Natural Therapies (Hyland House) $29.00 plus postage available 02 9712 5844 or book stores
• Fougere B Pet Lovers Guide to Natural Healing for Cats and Dogs (Elsevier) $35.00 including postage 1800 263 951
• All Natural Vet Care www.naturalvet.com.au

2 responses so far

Oct 20 2005

Acupuncture Meridians

What are acupuncture meridians? Have a look at these comparative diagrams put together by Rogers and Rogers (UTS, 2002) which show the main channel pathways.
Click here to view TCM charts

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Oct 13 2005

Treating Scars

By Carole Rogers

* Did you see the discussion in the Acupuncture Network Australasia forum about treating scars? If you want to learn more click here:

http://forums.acupuncture.net.au/viewtopic.php?t=49

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Oct 06 2005

TREATING SCARS – A PRACTICAL GUIDE

Background

Classical Chinese medicine is based on a belief in relatively superficial pathways of energy that, for the most part, travel vertically up and down the body. These energy pathways or channels are interconnected and penetrate deep into the body to associated organs and centres of internal energy. Health is believed to stem not only from the balance of energy but also from a free flow of energy. This free flow of energy is said to maintain the vigour of the organs and the coordinated operation of all parts, internal and external, physical and psychological, in every individual.

It is therefore understandable that acceptance of the Chinese classical view of the physiology of energy, or qi, within the body, leads the practitioner of acupuncture to be concerned with any condition that blocks or impedes this free flow of qi. Scars due to accidental trauma or to medical surgery are frequently the cause of blockage in acupuncture channels and as such deserve close attention by the practitioner.

Scar Therapy

The treatment of scars does not appear to be part of the traditional body of information related to acupuncture. This is perhaps due to the relative unpopularity of surgery in ancient China but even so, naturally occurring scars due to war or accidents must have been familiar to Chinese practitioners. If survivable, such scars do not usually penetrate far into the body and, unlike surgical intervention, they do not involve internal organs - nevertheless, they may still block major channels. It may be that scar treatments are described in Chinese texts but that no one has yet considered them important enough to translate. Perhaps the main reason for the exclusion of this information is that it appears to be so obvious and simple that it hardly seems worth mentioning. The classical writers however, included many minute details of treatment and the apparent absence of particulars on scar therapy is one of the mysteries of TCM and modern writings on acupuncture. I have asked practitioners in China if they treat scars and the question is usually met with bewilderment so it is safe to say that it is not part of standard TCM education.

From the practitioner’s viewpoint, scar therapy is a very simple procedure. Usually a 1-inch needle is used and insertion is very superficial. Needles are placed at each extremity of the scar, in the junction of scar tissue and normal skin. No needle manipulating is used, but the needles are left in situ for 20 to 25 minutes.

One treatment is often sufficient to clear the blockage of energy within the scar, but in cases of severe scarring or if keloids or internal adhesions have formed, the treatment may have to be repeated several times. In any case, as energy blockages usually build up slowly over a number of years, patients should be advised to have the treatment repeated at yearly to 3-yearly intervals, depending on the severity of the scarring.

Scars should be treated as soon as post-operative healing has taken place as a preventative therapy. The very dramatic results that may occur with this form of acupuncture usually only occur in the treatment of old scar tissue where there has been a build-up of blocked energy over some time.

TCM Perspective of Scar Therapy

The effects of scar treatment can be immediately observed in the alteration of the qi in the 12 pulses. Even those who are not skilled in pulse diagnosis will be able to feel these obvious changes within a few minutes of needle insertion and before any additional treatment point are used. Pulses that have been full, tight, and bounding may suddenly empty, while a weak, thready pulse may strengthen and firm. This change may take place at only one or two pulse positions or the alteration in quality may affect all pulse positions.

Why treat scars?

There are three major reasons for treating scars.

1 Unless scars are treated it may be impossible to read the pulse picture accurately.

2 The patient’s presenting signs and symptoms may not coincide with the condition of the pulse causing diagnostic confusion.

3 The patient’s condition may not respond to treatment, causing concern to the practitioner and unnecessary suffering to the patient.

The effects of scar treatment can be immediately observed in the alteration of the qi in the 12 pulses. Even those who are not skilled in pulse diagnosis will be able to feel these obvious changes within a few minutes of needle insertion and before any additional treatment points are used. Pulses that have been full, tight, and bounding may suddenly empty, while a weak, thready pulse may strengthen and firm. This change may take place at only one or two pulse positions or the alteration in quality may affect all pulse positions.

The third consideration listed above: slow response or no improvement in health can best be explained by a simple example. The use of ST 36 and the lower he points ST 37 and St 39 to improve qi production may be quite ineffective if there is a horizontal scar across the lower abdomen that blocks the Stomach channel.

Observation of the scar itself shows that marked changes take place in the tissue during treatment. Jagged, lumpy, knotted, red or tight scars often soften and change colour to nearer normal, while lumps, knots and stretched areas relax and in some cases, disappear. Any local sensitivity will usually diminish as will pain and pulling from internal adhesions.

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scar treatment.JPG

Preliminary Study

To isolate the efficacy of scar treatment from the rest of acupuncture therapy is a difficult task. To do so in a controlled clinical trial requires the researcher to withhold any additional acupuncture treatment – something that may not be in the best interests of the patient. Below is a table of a preliminary investigation I undertook in the 70s. In no way can the results be seen as anything but anecdotal; however they do indicate a potential research area that may be undertaken at some future time.

There were 25 female subjects aged between 22 and 74 years. Presenting problems were various but the common presenting factor was a lower abdominal operative scar (midline, transverse or diagonal). The interval between scarring and treatment was between 3 and 30 years. In no case were the presenting symptoms evident before scarring. Individualised acupuncture treatment with scar therapy was carried out at weekly intervals. Results of the study are listed as:

Satisfactory - presenting symptom no longer evident at the conclusion of treatment and the patient remained symptom free for a period of at least 6 months.

Improved - presenting problem responded well to treatment but the patient still suffered some tendency toward the condition.

No change – (case 19) the 70 year-old patient had been deaf for 15 years and this condition did not improve, however secondary problems of arthritis and recurrent bronchitis responded well.

Case Studies

Case 1 Insomnia

Number of treatments=4

Total number of scars=4

Scar position= transverse

Result= satisfactory

Case 2 Tension headache

Number of treatments=6

Total number of scars=6

Scar position= vertical

Result= satisfactory

Case 3 Backache

Number of treatments=4

Total number of scars=4

Scar position= trans./vert. & diag.

Result= satisfactory

Case 4 Overweight

Number of treatments=3

Total number of scars=6

Scar position= transverse

Result= improved

Case 5 Backache

Number of treatments=3

Total number of scars=5

Scar position= transverse

Result= satisfactory

Case 6* Menopausal problems

Number of treatments=2

Total number of scars=6

Scar position= vertical

Result= satisfactory

Case 7 Menopausal problems

Number of treatments=3

Total number of scars=4

Scar position= transverse

Result= satisfactory

Case 8* Excessive fatigue

Number of treatments=3

Total number of scars=6

Scar position= transverse/vertical

Result= satisfactory

Case 9 Deafness

Number of treatments=3

Total number of scars=12

Scar position= vertical

Result= improved

Case 10* Overweight

Number of treatments=2

Total number of scars=8

Scar position= transverse/vertical

Result= improved

Case 11 Weakness of legs

Number of treatments=1

Total number of scars=3

Scar position= transverse

Result= satisfactory

Case 12* Excessive fatigue

Number of treatments=2

Total number of scars=5

Scar position= vertical

Result= satisfactory

Case 13 Menopausal problems

Number of treatments=3

Total number of scars=6

Scar position= transverse

Result= improved

Case 14 Incontinence

Number of treatments=3

Total number of scars=8

Scar position= transverse

Result= improved

Case 15* Nervous tensions

Number of treatments=3

Total number of scars=8

Scar position= vertical

Result= satisfactory

Case 16 Chronic gastritis

Number of treatments=1

Total number of scars=3

Scar position= vertical

Result= satisfactory

Case 17 Nervous tension

Number of treatments=2

Total number of scars=4

Scar position= transverse

Result= satisfactory

Case 18 Arthritic knee

Number of treatments=3

Total number of scars=3

Scar position= transverse

Result= improved

Case 19 Deafness

Number of treatments=3

Total number of scars=6

Scar position= transverse/vertical

Result= no change

Case 20 Incontinence

Number of treatments=4

Total number of scars=5

Scar position= transverse/vertical

Result= improved

Case 21 Varicose veins

Number of treatments=3

Total number of scars=5

Scar position= transverse/vertical

Result= improved

Case 22 Menstrual problems

Number of treatments=1

Total number of scars=3

Scar position= vertical

Result= satisfactory

Case 23 Internal adhesions

Number of treatments=4

Total number of scars=5

Scar position= transverse/diagonal

Result= satisfactory

Case 24 Backache

Number of treatments=1

Total number of scars=3

Scar position= transverse

Result= satisfactory

Case 25 Gastritis

Number of treatments=2

Total number of scars=3

Scar position= vertical

Result= satisfactory

* Indicates patients who had previously been treated with acupuncture for the presenting problem without success.

Since this study was carried out, laser technology has become available. Low powered lasers can be very effective for treating recent scars, inflamed or weeping areas, ulceration, and burns. The area is simply irradiated with the laser light for 5 to 10 minutes depending on severity and extent. This treatment will usually help healing as well as easing irritation and/or discomfort.

About the author

Dr Carole Rogers trained at Acupuncture Colleges (Australia) in Sydney in 1973 completing both the Acupuncture Diploma and the International College of Oriental Medicine degree. She joined the College as a teacher in 1976 and subsequently became Director of Studies. In 1984 she was appointed Vice Principal, and Principal in 1987 on the retirement of Russel Jewell, the College’s founder and Principal.

Carole was central to the accreditation of the ACA Diploma of Acupuncture in 1986 by the NSW Higher Education Board - the first program in complementary medicine to receive Governemnt recognition - and in 1990 the Diploma was enlarged and accreditedas a Bachelor of Acupuncture - only the second degree program in NSW to be accredited in a private college. In 1994 ACA transferred their degree into the University of Technology, Sydney. Carole was appointed Associated Professor and Head of the UTS College of Acupuncture (now TCM).

During her years at the College and at UTS, Carole continued with her own studies gaining her Doctorate of Health Science Education and a Grad Cert in Learning and Technology in Higher Education. She has presented papers in the USA, Sri Lanka, the Philippines and China as well as being appointed as a consultant to WHO and to a number of governemnt departments both here and overseas. Throughout her career in Chinese Medicine Carole has always been a committed practitioner and has acquired wide ranging clinical experience. She retired in 2001 but still plays an active role in research, education and consultation - she is an Adjunct Professor at UTS.

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