Guest article
by Leilani Alvarez, DVM, DACVSMR, CVA, CCRT
Director of Integrative and Rehabilitative Medicine
Animal Medical Center of New York
What is acupuncture?
Acupuncture has been practiced for thousands of years and has very few if any side effects. This ancient form of Chinese medicine has been employed in conventional medical practices in the United States since the 1950s. There is a growing body of evidence supporting its use and efficacy. It’s a safe, effective method for pain relief when used in conjunction with other types of pain management.
Acupuncture involves inserting single-use sterile thin filamentous needles into designated points around the body. There are hundreds of acupoints described in the dog and each has a known physiologic effect.
How does it work?
Acupuncture helps to stimulate the body’s own healing mechanisms. Repeated treatments are known to have a cumulative effect on chronic pain management. This is because of acupuncture’s effect on the central nervous system, leading to the release of enkephalins and endorphins, the body’s natural pain killers.
Acupuncture also has modulating effects on certain areas of the brain (the hippocampus and hypothalamus, in particular) that help to change pain perception and transmission (Alvarez, HVPM 2015).
What does an acupuncture session look like?
Acupuncture treatment sessions can vary according to practitioner preferences and patient needs but generally last around 30 minutes. Acupuncturists will insert anywhere from 1 to 30 or more needles per session. The needles are as thin as a hair and range in length from ½ to 1 ½ in length.
Most dogs tolerate the treatment extremely well and often fall asleep during treatment. For dogs that are very sensitive to needles, alternative forms of acupuncture can be employed using laser stimulation or injecting small amounts of sterile fluid into points (aquapuncture), which is faster than the traditional “dry-needle” acupuncture.
It is important to note that acupuncture in human medicine is performed by certified acupuncturists who are not typically medical doctors. In contrast, acupuncture in veterinary medicine can only be practiced by licensed veterinarians.
TIP: You should strongly consider veterinarians who have completed advanced training in acupuncture and are certified veterinary acupuncturists.
Is acupuncture supported by research?
There is growing scientific literature to support the use of acupuncture in companion animals. Often, however, studies involving acupuncture are poorly designed, have too few subjects, use subjective parameters, or lack appropriate blinding.
There is also the challenge of an appropriate control group, as “sham” acupuncture has multiple physiologic effects and does not accurately represent a control group. But there are recent studies which support the use of acupuncture to reduce pain associated with musculoskeletal and neurological diseases in dogs (Silva, CVJ 2017; Lane, CVJ 2016).
There is also a moderate level of evidence for the treatment of intervertebral disk disease in dogs via electroacupuncture (Hayashi, JAVMA 2007; Laim, JAVMA 2009; Joaquim, JAVMA 2010; Han, Am J Chin Med 2010).
Research findings are mixed
In addition, a prospective, randomized clinical trial on dogs with hip dysplasia, found that dogs receiving weekly acupuncture for 5 weeks had reduced pain and lameness (Teixeira, JAVMA 2016). Another study that evaluated electroacupuncture in dogs with elbow arthritis; however, did not demonstrate changes in ground reaction forces or pain severity between acupuncture and sham treatment groups (Kapatkin, JAVMA 2006).
Similarly, a study in dogs with hip dysplasia showed improvement in pain and locomotion but no statistical difference between dogs receiving sham treatment versus gold wire implants at hip acupuncture points (Hielm-Bjorkman, Vet Rec 2001).
It is possible the lack of efficacy in these studies may be due to the fact that sham acupuncture causes physiologic changes and may not represent a true control group. Overall, there remains a need for larger prospective studies evaluating the effects of acupuncture for the treatment of osteoarthritis in dogs.
In Summary
Overall, acupuncture is safe and enough evidence exists to support its use as part of a multi-modal pain management program. This recommendation is also supported by the current pain management guidelines of the American Animal Hospital Association, which states that “acupuncture should be strongly considered as part of multimodal pain management plan” (Epstein. JAAHA 2015).
REFERENCES
Alvarez L. Chapter 18: Acupuncture. In Gaynor J and Muir M: Handbook of Veterinary Pain Management, ed 3, St. Louis, 2015, Mosby.
Epstein M, Rodan I, Griffenhagen G, et al. 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Am Anim Hosp Assoc 51(2):67-84, 2015.
Han HJ, Yoon HY, Kim JY, et al. Clinical effect of additional electroacupuncture on thoracolumbar intervertebral disc herniation in 80 paraplegic dogs. Am J Chin Med 38(6):1015-1025, 2010.
Hayashi AM, Matera JM, Fonseca PA. Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs. J Am Vet Med Assoc 231(6):913-918, 2007.
Hielm-Bjorkman A, Raekallio M, Kuusela E, et al. Double-blind evaluation of implants of gold wire at acupuncture points in the dog as a treatment for osteoarthritis induced by hip dysplasia. Vet Rec 149(15):452-456, 2001.
Joaquim JG, Luna SP, Brondani JT, et al. Comparison of decompressive surgery, electroacupuncture, and decompressive surgery followed by electroacupuncture for the treatment of dogs with intervertebral disk disease with long-standing severe neurologic deficits. J Am Vet Med Assoc 236(11):1225-1229, 2010.
Kapatkin AS, Tomasic M, Beech J, et al. Effects of electrostimulated acupuncture on ground reaction forces and pain scores in dogs with chronic elbow joint arthritis. J Am Vet Med Assoc 228(9):1350-1354, 2006.
Laim A, Jaggy A, Forterre F, et al. Effects of adjunct electroacupuncture on severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disk disease. J Am Vet Med Assoc 234(9):1141-6, 2009.
Lane DM, Hill SA. Effectiveness of combined acupuncture and manual therapy relative to no treatment for canine musculoskeletal pain. Can Vet J 57(4):407-414, 2016.
Silva NE, Luna SP, Joaquim JG ,et al. Effect of acupuncture on pain and quality of life in canine neurological and musculoskeletal diseases. Can Vet J 58(9):941-951, 2017.
Teixeira LR, Luna SP, Matsubara LM, et al. Owner assessment of chronic pain intensity and results of gait analysis of dogs with hip dysplasia treated with acupuncture. J Am Vet Med Assoc 249(9):1031-1039, 2016.