Page 2120 - Cote clinical veterinary advisor dogs and cats 4th

Acupuncture 1057

(TCM), the eight principles, medical-empirical, • Anesthesia is not indicated; sedation is rarely • After the appearance of a useful response
and bioelectric acupuncture. All systems use needed. to treatment in the patient, supportive or
VetBooks.ir same acupuncture points. Differences in Anticipated Time in some cases, especially for chronic pain
maintenance treatments may be needed
the same needles and insert them into the
• Varies from 15 to 60 minutes for each
clinical outcome among these methodologies
conditions in older animals.
are difficult to measure and appear to be
treatment session
system, or dermatologic conditions and cases
slight. • Particular problems may be resolved after • For a number of visceral organ, immune
• The standards for education and certification a single treatment, but most will need 3-8 of back pain, maintenance treatments may
in animal acupuncture are well established. treatments. not be required.
Referral for this treatment should be to a • Maintenance treatments for chronic condi-
veterinarian with appropriate credentials from tions (e.g., hip dysplasia, epilepsy) may be Postprocedure
the International Veterinary Acupuncture performed at intervals of 1-6 months. • Other than occasional somnolence, there
Society or the Chi Institute. are few postprocedure considerations after
Preparation: Important routine acupuncture.
Indications Checkpoints • In cases where acupuncture is intended to
• Chronic orthopedic pain, especially • Acupuncture may be performed on the eventually replace medication, the clinician Procedures and Techniques
○ Hip dysplasia (p. 469) sedated or anesthetized patient, but this should anticipate this by gradual dose reduc-
○ Cranial cruciate ligament injury (p. 218) is seldom necessary and may cause more tion of systemic analgesic or antiinflamma-
○ Elbow dysplasia (p. 288) problems than it prevents. tory drugs.
○ Other degenerative joint disease • Physical restraint for needle placement is
• Postoperative (acute) pain seldom required and can make future treat- Alternatives and Their
• Back pain (including nonsurgical interver- ments more difficult. Relative Merits
tebral disc disease [IVDD]) (p. 555) • Quiet surroundings and the presence of the • The relative merit of pharmaceutical alterna-
• Lumbosacral syndrome (p. 592) owner can provide reassurance, especially for tives varies widely with the disease being
• Canine epilepsy (p. 301) cats. treated.
• Asthma syndromes • There is no requirement for preparation of • For treatment of pain, nonsteroidal antiin-
• Demodectic mange (p. 244) the skin at the site of needle insertion, even flammatory drugs (NSAIDs) can be effective
• Acral (lick) granuloma (p. 16) in immunosuppressed patients. but carry the risk of adverse drug reactions
• Malaise of chemotherapy in a significant percentage of patients.
• Inflammatory bowel disease (p. 543) Possible Complications and • Treatment of chronic orthopedic pain
NOTE: In the abstract, acupuncture is capable Common Errors to Avoid is best accomplished with multimodal
of influencing virtually any disease process or • Clinically relevant complications of acupunc- therapies, and the combination of a low-
organ system. Although we may accept the ture in animals are rare, and patients do not dose NSAID and acupuncture is often very
theoretical basis for this point of view, there require hospitalization. effective and reduces the likelihood of renal
are numerous medical and practical reasons to • It is common for patients to experience or gastrointestinal injury from the use of
avoid considering acupuncture as an isolated somnolence for 12-24 hours after treatment. NSAIDs alone.
treatment modality. Acupuncture may be • A stuck or “frozen” needle (resists removal) • For conditions likely to persist for the rest
helpful as a treatment for hypothyroidism, often occurs: this is easily resolved by further of the patient’s life (e.g., osteoarthritis), it
for example, but thyroid supplementa- manipulation of the needle for a few minutes. may be appropriate to place a permanent
tion is known to be successful, low cost, • Immediately after the first treatment, patients implant in the acupuncture points that have
and safe. may show a transient increase in disease signs been successful in treatment of the problem.
of the condition being treated. For example, small rods or spheres of sterile
Contraindications • Concurrent use of pharmaceuticals is not a metallic 0.999 gold are often used in this
• Pregnancy and tumors are often cited as contraindication for acupuncture. way for long-term treatment of degenerative
relative contraindications. Use of acupuncture • Local infection or seizures occur in < 0.1% joint disease.
therapy in patients with these conditions of patients. • When acupuncture fails to provide adequate
should be reserved for clinicians with clinical results or cannot be continued for
advanced knowledge of safe protocols. Procedure other reasons, it may be necessary to consider
• There are specific cautions for the use • Acupuncture is normally performed on an pharmaceutical or surgical options.
of electroacupuncture, which should be outpatient basis.
understood by practitioners who use this • Although some practitioners find simple SUGGESTED READING
modality. (minimal) methods of restraint to be needed Han JS: Acupuncture and endorphins. Neurosci Lett
for some cases, most patients will be treated 36:258-261, 2004.
Equipment, Anesthesia without forceful or unpleasant restraint.
• Needles: 28-38 gauge, sterile, disposable, • Most patients do not feel most needles; when AUTHOR: Arthur I. Ortenburger, DVM, MS
EDITORS: Leah A. Cohn, DVM, PhD, DACVIM;
solid, acupuncture needles they do, the clinician may elect to remove Mark S. Thompson, DVM, DABVP
• Microamperage electrostimulator the needle.
• Moxa (herbal product) • Needles remain in place for an average of
• Milliwatt diode laser equipment is useful for 10-20 minutes before removal.
younger animals, birds, ferrets, and pocket • Treatments are repeated at intervals of 24
pets. hours to several weeks.

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