Acupuncture

Acupuncture was first described in Ancient Chinese practices thousands and thousands of years ago, in which practitioners used stone needles to let out small volumes of blood. Needless to say the practice has progressed tremendously since its primitive beginnings, being widely used today in human medicine and quickly gaining traction in the veterinary field. Still acupuncture has been debated in both the human and veterinary medical fields whether it is truly an effective treatment option, or just homeopathic mumbo jumbo. The SkeptVet, a veterinary blog questioning various practices, brings into question the legitimacy of science-based evidence supporting acupuncture. Given the nature of the treatment, designing well controlled studies is tricky; how do we know if an individual is actually experiencing benefits from the treatment, or if it’s just a placebo? With normal drug trials, one can easily give one group a sugar pill and the other group the experimental pill, but acupuncture is administered through sticking dozens of needles all over the body (hard to control for the Placebo Effect when you can’t exactly “pretend” to poke a needle through someone’s skin). Many other vets question the evidence, but enough successful clinical trials have been done in human and animal patients to prove its validity in alleviating the side-effects of many conventional Western practices, as well as enhancing these treatments, providing pain relief for an array of conditions, enhancement of immunity, and treating neurologic disorders all without any side-effects.*

Last week I discussed the benefits of laser therapy in providing pain relief, but cold lasers are not an option with cancer patients (if you recall, laser therapy stimulates cell growth, something we desperately want to avoid with cancerous tumors!). Acupuncture is often used in adjunct to pharmacological treatment of cancer since this alternative treatment can alleviate the distressing symptoms while providing much needed pain relief that is typically not fully mitigated by pharmacological means.

We all know that acupuncture involves a bunch of tiny needles poking you all over your body, but what’s going on at the physiological level? First, acupuncture practitioners strategically select points based on certain features, according to veterinary oncologist and acupuncturist Dr. Elizabeth Hershey; these points tend to be richly innervated and associated with muscular dysfunction or pain. Some treatments involve only targeting those points associated with muscle problems, other treatments are aimed towards hitting specific nerves. There is a diverse array of potential acupuncture points that the practitioner can select to create an individualized treatment.

Insertion of the needle itself begins a cascade of neurologic effects and interactions between different structures lying just under the skin. According to Dr. Fry et al., who recently published a review detailing veterinary acupuncture in its use for analgesic treatment, “these structures include blood vessels; specialized afferent nerve endings that respond to pain, touch, pressure, and chemical changes; immunomodulatory cells like mast cells; glands; and soft tissue structures like muscle spindles; collagen; and other connective tissues.” The grouping of these structures has been called a neural acupuncture unit (NAU), so named thanks to the synergistic effects of needle insertion with all these various structures and its impact on the surrounding tissue. Once the needle is inserted, interactions with the nervous system and more distant tissues can commence. This ultimately results in stimulation of serotonin and endogenous opiate release, such as endorphins, the body’s natural pain reliever. Sometimes neurohormones are also released, giving the patient a euphoric sensation for the duration of treatment.

Electroacupuncture is a common adjunct in the veterinary field. This involves applying a gentle electrical current to the needles to gain more vigorous and prolonged stimulation; high or low frequencies can be used to alter the neuromodulatory effects.

Remember the bouncy little poodle Maggie from last week? Maggie received both laser therapy and acupuncture to treat her chronic pain from a debilitating neurological disorder, Intervertebral disk disease (IVDD). Before starting alternative treatments, Maggie was cage rested and on NSAIDs (non-steroidal anti-inflammatory pain medication) for two weeks, the whole time barely able to walk without falling over. Maggie’s mom finally opted for an integrative approach since solely using conventional methods was clearly not working for her. After her second week of cold laser treatment and second acupuncture session, Maggie was able to walk again! Since IVDD is a lifelong genetic problem with no cure, Maggie needs to be careful when jumping or playing with other dogs since roughhousing can lead to flare-ups. When she does have flare-ups, Maggie will get a session of laser therapy and acupuncture to manage her pain and get her back to good as new.

Maggie receiving electroacupuncture at home!

Sticking needles in your skin may sound suspect, but acupuncture has been recognized (for the most part) as a reputable treatment. Though I only have hands-on experience in conventional Western veterinary medicine, when all else fails the doctors I work with won’t hesitate to refer their patients to an integrative veterinarian for a different approach. In fact, just a few weeks ago I encountered a frustrated client who has a large shepherd with terrible orthopedic issues. Bella never wanted to get up or be active anymore because moving just hurt too much. Normally this problem would be taken care of through surgery, but given this dog’s size and age, it’s a slim chance that a $3,000 procedure would resolve her problem. This dog was also unfortunate enough to have a ridiculously sensitive stomach; at this point the client wanted to maintain her quality of life through pain relief, but even the best pain medication for a dog with a sensitive stomach given at half the dose with a full meal resulted in immediate vomiting and diarrhea. When we realized that there were no other pharmacological pain relief options, the doctor finally recommended acupuncture and referred her to an integrative veterinarian. This concerned client was calling us every day for a week to find something that would work for Bella, and after suggesting acupuncture (which the client was very open to trying), we have not heard from her since.

Stories like this is what sparked my interest in integrative medicine. Conventional medicine works the vast majority of the time, but sometimes you’ll meet that overly sensitive shepherd or immunocompromised kitty and find that taking an integrative approach may be the only thing that can drastically improve their quality of life. Though I have been focusing on dogs for the duration of this post, I want to point out that acupuncture is something most species can benefit from, including birds and horses.

 

*I have not read through direct scientific studies on acupuncture as I lack the insight to know what qualifies as a well-controlled study. For the rest of the information presented, I rely on scientific literature reviews published in peer-reviewed journals, articles written by veterinarians (both acupuncture practitioners and not), and my own experience.