‘First, modify the patient’s diet and lifestyle and only then, if these do not effect a cure, treat with medicinals and acupuncture.’ Sun Simiao’s advice, offered some 1500 years ago, is just as relevant today. Indeed, the World Health Organisation and many other international medical bodies recognise the benefits of acupuncture for humans. But what about our companion animals? Can it work for them? We asked Dr. Amy Watson, one of the UK’s leading veterinary acupuncturists, to explain how this ancient medical practice can help our dogs, cats, horses and other furred and feathered friends…
Acupuncture in the veterinary world is being utilised on a regular basis – predominantly for pain – and mainly for small animals and horses. The word ‘acupuncture’ itself derives from the Latin acuro, which means needle and punctura, which means, puncture. Acupuncture, therefore, literally translated means needle puncture. It is the practice of inserting fine, solid needles into the body to produce a healing response. Acupuncture is well-recognised as being a Chinese medicine treatment, however therapeutic techniques involving piercing the soma have developed independently in many communities around the world. For example, the Vedas, one of the most ancient scriptures of Hinduism and which are thought to be between 5000 and 7000 years old, contain the Ayurvedas (or ‘Science of Life’) which include the use of acupuncture. In Egypt, the ancient Papyrus Ebers discuss the use of acupuncture like treatments.
History
Otzi the iceman is a particularly interesting example of what may be a very early form of acupuncture. Otzi is a 5000-year-old iceman who was found in the Tyrolean Alps in 1991. He was initially thought to have 47 tattoos on his back and legs, in 15 groups, although more recent work has revised this upwards to 61 tattoos on his back and legs in 19 groups. None of these tattoos were on exposed parts of the body where they could have served an ornamental purpose. Otzi was also found to have signs of lumbar degeneration and numerous whipworms. Fascinatingly, when acupuncturists looked at the sites of the tattoos and Otzi’s clinical pathology, the tattoo groups corresponded closely to points that would be used for treatment of both spinal arthritis and gut problems. This could allow one to speculate that the use of acupuncture for treatment of both musculoskeletal and more internal problems has been present for at least 5000 years and in a much wider variety of cultures than might be otherwise suspected.
The advent of acupuncture into modern Western society seems to have occurred in the 1960’s and 1970’s. During President Nixon’s visit to China in 1972 one of the American correspondents accompanying him underwent an emergency appendix removal after which acupuncture was used and he subsequently wrote about it in the New York Times.
However, in the veterinary world, acupuncture really started to be seen as a treatment modality in the 1960’s in Vienna, France and Germany. The International Veterinary Acupuncture Society, or IVAS, was formed in the United States of America in 1974 and held their first course in 1975 with 73 attending vets. In the United Kingdom, the Association of British Veterinary Acupuncturists (the ABVA) was formed in 1987.
Acupuncture has been used for some animals for millennia, but whilst there are traditional points for both horses and chickens (these were food and war animals so keeping them healthy was important), most points are based on the human acupuncture points and have been ‘transposed over’ by laying onto the animal body the points where we would assume they would be given where we know them to be on humans. This can lead to interesting discussions on the sites of certain points. For example, the point Large Intestine 4 (LI4) is found on the webbing between a human’s thumb and first finger, so where does this point reside in a horse, who walks on digit 3, with mere remnants of digits 2 and 4?
What is an acupuncture point?
An acupuncture point, if looked at under the microscope, is seen to be a vertical column of loose connective tissue surrounded by thick, dense connective tissue. They are often associated with nervous system structures including nerve endings, nerve bundles, or nerves as they exit a foramen. An A delta fibre is generally found to be present. Most points are found at small natural depressions, between muscles, muscle and tendon or between muscle/tendon and bone. Most acupuncture points are sites of low electrical resistance and high electrical conductance. They are 5mm to 10mm in diameter on the surface. It is worth remembering that these are 3D structures, rather than just a point on the surface of the skin – consider them to be tornado shaped and delving into the structures underlying the skin. As well as being associated with nervous system components, 85% are associated with arteries and veins too. The highest concentration of small blood vessels are at the centre of the acupuncture point.
The individual acupuncture points are also related via channels, or meridians. These come from traditional Chinese medicine, or TCM, and form the Jing Luo. This is a carefully elucidated system based on observations and in TCM the channels provide a network for communication and circulation. In western medicine, the channels have been shown to follow fascial planes in many cases, and research does support the possible connection between channels and connective tissue (incidentally, fascia is an amazing substance; if you aren’t familiar with it then imagine it to be nature’s equivalent of clingfilm wrapping around every structure in your body and then linking them all together, a true web throughout the body). Some fascinating research by Helene Langevin using electron microscopy shows the winding of subcutaneous collagen and elastic fibres around an acupuncture needle – rather like cotton candy used to wrap around the stick at a fair (I may be showing my age with this analogy!). This then leads to pulling and reorganisation of the subcutaneous tissue i.e., a mechanical signal that subsequently leads to mechanotransduction and a cellular response. It is possible that the 12 main channels used in acupuncture may constitute the key places where the fascial planes throughout the body intersect. In traditional Chinese medicine, each acupuncture point has specific actions when stimulated. This technique has been used in veterinary practice in China for thousands of years to treat many ailments. The Chinese also use acupuncture as preventative medicine.
Acupuncture is used all around the world, either alone or in conjunction with western medicine, to treat a wide variety of conditions in every species of animal. Clinical research has been conducted showing positive results in the treatment of both animals and humans, and the use of acupuncture is increasing. Acupuncture will not cure every condition, but it can work very well when it is indicated.
What conditions can be treated with acupuncture?
The following are some of the general conditions which may be treated with acupuncture:
- Musculoskeletal problems, such as arthritis, intervertebral disk disease, traumatic nerve injury, pre and post operative orthopaedic conditions, elbow and hip dysplasia, OCD lesions, panosteitis, back pain and general sprains and strains.
- Respiratory problems, such as asthma, bronchitis, COPD.
- Skin problems such as lick granulomas and allergies.
- Gastrointestinal problems such as diarrhoea, IBD, chronic pancreatitis, colitis.
- Urinary conditions such as chronic cystitis and incontinence.
- Selected reproductive problems, such as failure to conceive and irregular oestrus cycles.
Please do not think that if a condition is not listed here that it cannot be helped by acupuncture, contact your vet or veterinary acupuncturist to ask.
In addition, regular acupuncture treatment can settle minor sports injuries as they occur and help to keep muscles and tendons resistant to injury. Human athletes often use acupuncture as a routine part of their training. If your animals are involved in any athletic sport, such as agility, flyball, racing, dressage, jumping, gundog work, or showing, regular acupuncture can help them keep in top physical condition. The German Olympic Equestrian team travel with a veterinary acupuncturist as an additional aid to ensure the horses are able to perform to the best of their ability.
How does acupuncture work?
Although acupuncture has its roots in ancient times before modern scientific methods were available many studies have been done to indicate how acupuncture works and what physiologic mechanisms are involved in its actions. Using Magnetic Resonance Imaging (MRI), to examine 15 different points, the basic tenets of acupuncture have been determined. Those are that acupuncture is based upon the point selected, the method of stimulation, and the duration of stimulation. Stimulation of these points result in specific changes in the central nervous system. It was shown that acupuncture points that have pain relieving properties associated with them tend to activate specific pain- association brainstem regions. The National Institute of Health (NIH) said that there was compelling evidence that acupuncture was useful in the management of osteoarthritis and musculoskeletal pain. The Work Health Organisation (WHO) recognises the use of acupuncture in humans in the treatment of a wide range of medical problems, including digestive disorders, respiratory disorders, musculoskeletal and neurological disorders and urinary problems.
In western medical terms, acupuncture can assist the body to heal itself by causing certain physiological changes. Acupuncture works on the neuroendocrine system (nerves and hormones – examples of the latter include endorphins which are one of the body’s natural pain control chemicals, and cortisol which is a natural steroid), it has an impact on blood circulation by the release of various substances including Calcitonin Gene Related Peptide (CGRP) and Nitrous Oxide which cause blood vessels to dilate both locally and more remotely, and it relieves muscle spasm. Acupuncture has effects both locally around the needle placement, and remotely in the spinal segment being stimulated and within the brain itself. Although many of acupuncture’s physiological effects have been studied, many more are still unknown. Further research must be conducted to discover all of acupuncture’s effects and its proper uses in veterinary medicine.
Is acupuncture painful?
In most cases, the insertion of acupuncture needles is virtually painless and once the needles are in place, there should be no discomfort. On occasion, there may be a needle that, as it is placed, does cause some transient discomfort; in these cases the discomfort is momentary only and then stops, if it persists for a few more seconds the needle is usually removed. Most animals become very relaxed and may even become sleepy. Nevertheless, acupuncture treatment may cause some sensation, presumed to be those such as tingles, cramps, or numbness which can occur in humans and which may be uncomfortable to some animals. Very occasionally an animal can be really sensitive to needling, in which case your vet may stop and review whether the animal has a level of chronic discomfort that is causing the central nervous system to be overly sensitive – something known as ‘windup’, or hyperalgesia, and if a short course of analgesia medication may be needed to facilitate needling once this windup has been settled.
How can my pet benefit from acupuncture?
Statistics suggest that 80% of dogs respond well to acupuncture although I find I have a much higher success rate. Rarely do I have cases that do not respond at all to acupuncture. The success of the treatment will vary according to the skill of the veterinarian, the condition being treated and the number and frequency of acupuncture treatments. The length and frequency of the treatments depends on the condition of the patient and the method of stimulation (for example dry needling or electroacupuncture) that is used by the veterinary acupuncturist. A simple acute problem, such as a sprain, may require only one treatment, whereas more severe or chronic ailments may need several treatments. In most cases we are treating chronic conditions, and thus it is not uncommon to require several treatments every 7-10 days initially, before moving to less frequent treatments.
How safe is acupuncture for animals?
Acupuncture is one of the safest forms of medical treatment for animals when it is administered by a properly trained vet. In the United Kingdom acupuncture is considered an act of veterinary surgery and so can only be performed by a vet. There are far more regulations over who can perform acupuncture on an animal than who can perform acupuncture on a small child. Acupuncture should never be administered without a proper veterinary medical diagnosis and an ongoing assessment of the patient’s condition by a vet. This is critical because acupuncture is capable of masking pain or other clinical signs and may delay proper veterinary medical diagnosis once treatment has begun. In addition, vets have good anatomical and physiological knowledge which facilitate the avoidance of some more serious complications that have been seen in the human field of acupuncture, where regulation of acupuncturists is less stringent. Elimination of pain may lead to increased activity on the part of the animal, thus delaying healing or causing the original condition to worsen.
Side effects of acupuncture are rare, but they can occur. Most commonly, an animal’s condition may seem worse for up to 48 hours after a treatment. Other animals become lethargic or sleepy for 24 hours. These effects are an indication that some physiological changes are developing, and they are most often followed by an improvement in the animal’s condition. Sometimes they are referred to as a ‘healing crisis’ and can occur because too many needles have been placed, or for too long. If this response to treatment occurs it is worth ensuring your veterinary acupuncturist is informed so that they are able to modulate subsequent treatments accordingly. Be reassured however that the patient is definitely a responder to acupuncture!
In general, acupuncture can be effectively combined with most conventional and integrative therapies. Certified Veterinary Acupuncturists have the comprehensive training, knowledge and skill to understand the interactions between different forms of treatment and to interpret the patient’s response to therapy.
How should I choose an acupuncturist for my animals?
There are two important criteria you should look for in a veterinary acupuncturist:
- Your veterinary acupuncturist must be a qualified and registered veterinary surgeon.
- Your veterinary acupuncturist should have formal training in the practice of veterinary acupuncture.
As stated previously, in the United Kingdom veterinary acupuncture is considered a surgical procedure that only veterinary surgeons may legally administer to animals. A vet is in the best position to properly diagnose an animal’s health problem and then to determine whether the animal is likely to benefit from an acupuncture treatment, or whether its problem requires chemical, surgical, or no intervention.
Because of the differences in anatomy, and the potential for harm if the treatments are done incorrectly, only a properly trained vet should perform acupuncture on animals. Proper training should include an extensive educational program. The more your veterinarian knows about traditional Chinese philosophies and western scientific basis for acupuncture the more you can be assured that your animals will be treated properly.
If you are interested in using acupuncture in your pet, please get in touch with your vet – you’d be surprised how many practices in the UK have a vet who can perform acupuncture. Alternatively, look on the ABVA website for local veterinary acupuncturists. Used as part of an integrative treatment plan, acupuncture can be hugely beneficial to so many of our animals for a wide variety of conditions.
About the author
Amy Watson MA VetMB MRCVS CCRT CVA(IVAS) is an integrative vet with a special interest in traditional acupuncture, Chinese herbal medicine and food therapy. She is based in Cranborne, on the border of Dorset, Wiltshire and Hampshire at her clinic PinPoint Veterinary Care. For more information please visit: www.pinpointvetcare.com.”
