It is recommended that extensive continuing education programs be undertaken before a veterinarian is considered competent to practice acupuncture. One of the main applications in equine practice is related to the treatment and diagnosis of lameness.
Deciding which acupuncture point to stimulate is based on locating points on the body where stimulation will produce a beneficial change in the central nervous system, altering ongoing physiologic activity in the horse’s body. The number of treatments required depends upon the condition treated and how long the problem has existed.
Acupuncture is an excellent diagnostic aid as an adjunct to conventional lameness examination. For example, a triceps trigger point is often quite sensitive to palpation when a lower forelimb lameness is present.
The combination of reactive points often times will assist the diagnosis and aid in localizing the cause of the problem. Acupuncture diagnosis can be an excellent adjunct to the lameness examination in addition to flexion tests, diagnostic nerve blocks, radiographs (x-rays), ultrasound and fluoroscopy (x-rays in motion).
It is not uncommon to use all of these diagnostic techniques, including nuclear scenography (bone scanning), and still not arrive at a diagnosis. For instance, a primary hock problem may be treated with an injection of medication directly into the joint.
There often times is secondary compensation resulting in patterns of trigger points in the back or neck that remain unresolved. Acupuncture may also be beneficial in the treatment of non- lameness problems in the horse such as colic and diarrhea as well as reproductive, neurologic and respiratory conditions.
Acupuncture is an exciting new (yet ancient) diagnostic and therapeutic technique that has been incorporated into a number of equine practices. It offers an additional approach to diagnostic and therapeutic dilemmas that may not have adequate answers based on conventional western medicine.
Veterinarians who are trained in acupuncture will use this increasingly popular veterinary treatment for a variety of problems in different animal species, for example lameness, urinary incontinence, ’downer’ cows, colitis, sinusitis etc. However, the most common use for acupuncture in my experience in small animal practice is to treat back problems or other causes of lameness in dogs which have not responded to drugs or surgery.
The most common causes of back problems in dogs are trauma (car accidents, falling, repeated jumping and twisting during exercise), often superimposed upon an existing poor conformation. The dog will show pain, unwillingness to perform, an uneven gait or often a lameness in one leg due to the pinching of nerve origins in the spine.
I also see “over-responsible” dogs who I think suffer back problems due to being emotionally tense while active e.g. working relies and healers. For unfortunate dogs with “slipped disc” leading to a sudden onset of pain and/or partial or total paralysis of limbs, acupuncture is now considered the treatment of choice if surgery is not indicated.
There are many well-documented research papers providing proof of the high rate of effectiveness of acupuncture over anti-inflammatory or no treatment in cases showing recurrent back pain or varying degrees of paralysis. In a sample of 100 dogs seen by Dr. Janssen, a prominent Norwegian acupuncture veterinarian, the following data has been published.
(Remember that most, if not all, of these dogs would have been treated with rest or drug/surgical treatments for days or weeks and been deemed non-responsive and sent off to the acupuncture vet as a last resort.) It is interesting to see that acupuncture points and meridians can be measured electrically, and seen under a microscope, as being distinctly different from surrounding tissue.
Laminates is an incredibly painful hoof disease that is challenging to treat using traditional Western medicine. Kevin May, DVD, CVA, of El Cajon Valley Veterinary Hospital, in California, evaluated how effective acupuncture is in improving pain and lameness in chronic laminates cases and presented his results at the 2018 American Association of Equine Practitioners Convention, held Dec. 1-5 in San Francisco, California.
“Thirteen percent of barns and/or owners deal with laminates each year, with 50% of those referred to hospitals eventually euthanized,” he said. He ensured caretakers made no supplement, medication, shoeing, or management changes during the study, so he could clearly evaluate acupuncture’s effects.
He said the results of this study support the anecdotal evidence that acupuncture can significantly reduce lameness in horses with chronic laminates. May said veterinarians can use acupuncture in laminates cases not responding to current therapies (e.g., therapeutic shoeing, medication, diet restrictions) without interfering with the treatment course.
As a horse owner, you want more options for helping your equine friends, especially when conventional treatments carry risks and sometimes have limited efficacy. Acupuncture is a safe and effective adjunctive therapy for acute or chronic laminates patients.
The research that does exist on equine patients has primarily focused on gastrointestinal or reproductive problems, with a handful of papers investigating the use of acupuncture for lameness. When used as part of multimodal therapy, acupuncture is a safe and effective option for both acute and chronic cases.
Laminates poses a treatment challenge because of its multisystem involvement and the complex nature of laminated pain. But this is what makes it a particularly appropriate disease for acupuncture, which is known to influence multiple body systems and modulate complex pain pathways.
Acupuncture has regulating influences on multiple organs and tissues such as those commonly involved in laminates patients including musculoskeletal, gastrointestinal, and immune systems. In chronic laminates, altered weight-bearing can lead to myofascial pain syndromes that can be difficult to treat using conventional therapy.
Clinical conditions seen in laminates patients -- such as gastrointestinal distress, reproductive system damage, infection, or hormonal imbalance -- can respond to specific acupuncture treatments. This can be particularly useful in patients with organ damage that make them more susceptible to adverse effects from pharmaceutical therapies.
This will include classic acupoints around the hoof in addition to other anatomic points on the limb that may not necessarily appear in textbooks. Acupuncture works on multiple physiologic pathways and processes at different levels of the nervous system.
For example, local effects at and around the tissue-needle interface work in part by stimulating various sensory receptors in skin, fascia, and muscle. At the spinal cord level, pain signaling, visceral autonomic tone and motor output are modulated.
Endocrine and immune regulation is associated with activation of different regions of the brain that can be influenced by specific acupuncture needle placement in the periphery. With tightening sport horse competition drug regulations, increased scrutiny surrounding horse racing, and the public’s desire to turn toward natural alternatives to medications, many veterinarians are seeing a rising demand for equine acupuncture.
In fact, a 2017 survey of 423 horse owners in the U.K. found that 81% were willing to try a complementary or alternative form of veterinary medicine. In this article we’ll explore the scientific basis of equine acupuncture, so you can come to your own informed decision about pursuing it to treat your horse’s ailments.
Integrative medicine combines all forms of holistic care, wellness, and medical practice in a coordinated fashion. Acupuncture is simply the stimulation of a specific point using a sharp object, such as a needle, to create therapeutic effects.
Equine veterinary acupuncture traces back to ancient China’s Tang Dynasty in 618-907.² Although its origins have not been described, many feel it might have been observational, from recording unintentional treatments from being struck with sharp objects, thus serving as the longest clinical trial in medical history. Researchers have conducted only two systematic reviews of companion animal acupuncture literature in the English language, and both concluded that most scientific evidence of veterinary acupuncture’s efficacy was nonexperimental and of low quality (not randomized and controlled trials) and, therefore, inconclusive.
Acupuncture points correspond to areas of decreased electrical resistance and increased conductivity, as well as increased density of free nerve endings, small blood and lymphatic vessels, and mast cells (immune cells found in connective tissues). From a physiology standpoint, acupuncture elicits a response at different levels of the nervous system.³ First, it causes local effects, such as increasing blood flow to a certain point and relaxing the surrounding muscle and tissue.
This means stimulating an acupuncture point can cause nerve impulses to travel up the pathway and into the spinal cord. As early as 1997, the National Institutes of Health concluded that acupuncture was effective in treating human nausea and dental pain and was useful for myriad medical issues ranging from osteoarthritis to low back pain to asthma.4 Since then, researchers have performed many case studies and experimental studies on the efficacy of acupuncture in horses, dogs, and cats.
For example, in a single clinical study involving horses with laminates and particular disease, researchers found no significant difference in lameness between those treated with acupuncture and those not. For treatment of gastrointestinal (GI) disorders, acupuncture’s efficacy comes from its ability to alter blood flow to organs, decrease pain by releasing opioids into the bloodstream, and normalize GI motility.6 Acupuncture should not, however, replace colic surgery.
For respiratory conditions such as equine asthma, study results show that acupuncture can help dilate the airways, making it easier for affected horses to breathe. That said, clinical trials have not shown statistically significant differences between lung parameters of equine asthma patients treated with or without acupuncture.
An integrative approach including TCM and Western medicine can, therefore, effectively normalize equine patients with reproductive diseases. Physicians use acupuncture to treat various ophthalmic conditions in humans, including dry eye and glaucoma.
Although stimulating local acupuncture points around the eye seems to be anecdotally effective, and efficacy has been proven in dogs and rabbits, there have been no controlled studies performed specifically in horses to support this. Nicole Estes, DVD, associate practitioner at Geneses Valley Equine Clinic, in Pottsville, New York, and owner of Woods Dry Veterinary Services, has used acupuncture “to help control pain and other clinical signs associated with glaucoma and equine recurrent uveitis (aka moon blindness).
I am always quick to remind owners that we are treating a disease process with a balanced approach, utilizing Western medications along with Eastern medicine,” she says. Neurologic conditions in horses resulting from peripheral nerve injuries seem to respond well to acupuncture.
Researchers have shown that four horses suffering from acidosis (an inability to sweat) that received aqua puncture in conjunction with other TCM treatments experienced positive results.² Based on his or her clinical experience, your veterinarian will need to perform at least three treatments to see improvement in lameness conditions.
Limited evidence exists as to its efficacy for treating equine asthma, and no equine-specific studies have been conducted on its effects on eye conditions. A survey examining attitudes towards equine complementary therapies for the treatment of musculoskeletal injuries.