Dr. Cletus M. Vonderwell, the president of the International Veterinary Acupuncture Society (IVAS) describes his use of acupuncture for treatment of various disorders in racehorses. Acupuncture is his primary diagnostic approach. Dr. Vonderwell seldom asks the owner to tell him what the problem is with the horse, and he does not often ask to see the horse moving before his examination. He simply palpates the acupuncture points and the reaction of the horse provides sufficient information for him to diagnose the problem. "Owners are always amazed that the problem can be identified without hearing the history or seeing the horse move", he said, "In practice, acupuncture recognizes syndromes; this means that if a group of body points are sore on palpation, a predictable anatomical area is involved and is the source of soreness." He described the acupuncture points which are sore when the horse has a stifle problem. He described those sore with the hock syndrome, and those with several other syndromes. One point on the rear leg, which he described in detail, is diagnostic for equine protozoal myeloencephalitis (EPM)- at least in his hands.
"It is important to remember that individual horses will often show signs of more than one problem," he said. "Acupuncture diagnosis will help determine which problems are present."
Stimulation of the sore points is the basic means of treatment with acupuncture. The traditional method of stimulation is by inserting a needle in the point but, today, lasers and electrical stimulation are sometimes used. Some veterinarians inject Vitamin B12 in the points. Dr. Vonderwell prefers to inject the points in most cases, because the effects last longer, he claimed.
Another veterinarian, Dr. Earl C. Sutherland, uses both acupuncture and chiropractic manipulation in his standard lameness examination and treatment of various lameness conditions. He said acupuncture therapy primarily works through the neurohumoral systems of the body.
"Diagnostically, acupuncture is useful to map out where in the body the problem is located," he said. "Most abnormal situations of the body, such as pain, inflammation, decrease or increase in circulation, decrease or increase in myofacial tone, etc., are already mapped out by the central nervous system. The central nervous system reflects this map onto the surface of the body by way of the acupuncture meridians and points. By palpation of the meridians and points, noticing increased or decreased reflexes and differences in tissue quality (firm, soft, yielding to pressure, tightening up under pressure, warm, cold, etc.), the acupuncturist can figuratively read the reflected map. This not only helps in locating the problem areas but also helps in differentiating between primary and secondary lameness."
He explained how joint abnormalities can cause lameness in horses. "A joint with all its associated structures is called a motor unit," he said. "These motor units can be hypomobile or hypermobile. Hypomobile or fixated motor units result in a decreased range of motion. This causes stiffness, pain, and contracture of the associated soft tissue. Short term this causes some muscle spasms because of the local damage or stress on the nervous system. Long term this causes some muscle atrophy because of constant damage to the nerves or because of disuse that is due to pain."
Dr. Sutherland uses both acupuncture and chiropractic manipulation to correct many lameness problems. He emphasizes that he uses all the traditional methods in lameness diagnosis such as imaging techniques. This helps to not only do a better job of assessing the entire horse in relation to movement, but helps him to perform or offer treatment options that in combination gives the best of all three approaches- acupuncture, manipulation, and standard veterinary techniques.
"The result," he claimed, "is a horse that can quickly achieve its optimum movement with respect to its conformation and training and, usually, extremely satisfied clients."
A scientific approach to equine acupuncture.
By Rahel M. Klapheke with Dr. Allen Schoen
The word "acupuncture" has raised, and lowered, many horse owners' eyebrows recently. Some people swear by it; others shake their heads. Regardless of the reaction, acupuncture has created great interest in the equine industry.
Acupuncture (acus -needle, punctura -puncture) is defined as a technique for treating certain painful conditions. It produces regional anesthesia by passing long, thin needles (or other forms of pressure) through the skin to specific points. It stimulates these points on the body to alter various biochemical and physiological conditions in order to achieve a desired effect. "It is not a panacea, a cure-all," states Dr. Allen Schoen of Veterinary Acupuncture and Alternative Therapies in Sherman, Conn., "but where it is indicated, it works well."
The history of equine acupuncture dates back to the years 2000-3000 BC during the Shang and Chow dynasties in China. Interestingly, one of the first veterinary textbooks, "Bai-le's Canon of Veterinary Medicine," written around 650 B.C., was based primarily on acupuncture and its derivatives. It has been practiced in the Far East for centuries but has received little attention by Western equine veterinary practitioners until the last decade in the 20th century.
"Acupuncture is actually the treatment of choice for one-quarter of the world's population," Dr. Schoen states, "which is surprising when acupuncture is theoretically considered a naturally occurring phenomenon. No one mechanism can explain all the physiological effects observed. This lack of concrete explanation causes some to disbelieve and doubt acupuncture's validity."
However, acupuncture is being utilized by an increasing number of veterinarians for various conditions. Many reputable equine associations have supported acupuncture as a sound veterinary treatment. The American Veterinary Medical Association (AVMA), for example, considers acupuncture a "valid modality" and states its "techniques should be regarded as surgical and/or medical procedures." The American Association of Equine Practitioners (AAEP) also considers acupuncture a valid modality and has formed a Task Force on Therapeutic Options to consider the value of acupuncture and other practices.
The organizations do say, however, that the potential for abuse of acupuncture and related therapies exists. They recommend that extensive research and education be upheld to ensure competent acupuncture therapists and that acupuncture only be practiced by a licensed veterinarian. If there is no one, simple explanation, then why do people use and support acupuncture? Because there is proof that it works. Traditional Chinese medical theories have documented these effects for 4000 years, based on empirical observations and descriptions.
Many horse owners appreciate the naturalness and safety of acupuncture. Side effects are rare. No drugs or chemical substances ever enter the body. In the Western world, it is used primarily when surgery is not feasible, or when medications are not working or could not be used due to possible adverse effects.
"Because acupuncture balances the body's own system of healing, complications rarely, if ever, develop," states Dr. Schoen.
"It bridges the gap between medicine and surgery," he says. "It is a means by which the body can heal itself."
For those who must see proof before they believe, acupuncture has been used to treat hundreds of ailments. In small animals, acupuncture is most commonly used for such disorders as hip dysplasia, arthritis, lick granulomas, certain types of paralysis and feline asthma. In horses, back problems, navicular disease, founder (laminitis), "bleeders" (heaves) and many types of lameness have been treated using acupuncture.
There is a scientific explanation. Essentially, a domino effect occurs. Applied pressure on a specific point on the skin stimulates various sensory receptors (pain, temperature, pressure and touch). These receptors then stimulate sensory afferent nerves, or nerves that transmit impulses from the outer body to the central nervous system (CNS). These nerves send a signal to the CNS and then to the hypothalamic-pituitary system (located at the base of the brain). The hypothalamus-pituitary glands are responsible for releasing neurotransmitters and "natural pain-killing" hormones.
These substances cause subsequent effects throughout the body. They increase circulation, relieve muscle spasms, stimulate nerves and the body defense system and cause other numerous beneficial results.
Therapeutic effects are produced only when specific, pre-determined points on the body are stimulated. These points designate areas of increased electrical sensitivity. Selection is based on locating points on the body where stimulation will produce a beneficial change in the CNS by adjusting ongoing physiological activity.
Specifically, acupuncture points, or acupoints, correspond to four known neural structures, explained as the following:
Type I makes up 67 percent of all acupoints. They are considered motor points, which are located near the point where the nerve enters the muscle.
Type II are located on the superficial nerves along the top of the back (dorsal line) and midline of the belly.
Type III are located at highly dense points of outer nerves, or network of nerves, such as the lower limb.
Type IV are located within a tendon where a spindle-shaped sensory end organ provides information about muscle tension to the brain.
How are these points stimulated? Many people think of tiny needles sticking out of the skin when they picture acupuncture.
It is traditionally performed with sterilized, thin stainless-steel needles, and, contrary to many beliefs, the medical process involves minimal sensitivity.
"There is occasionally a brief moment of sensitivity as the needle penetrates the skin in certain areas," Dr. Schoen explains. "However, once the needles are in place, most animals relax, often falling asleep during treatment."
Treatments usually last from five to 30 minutes. Patients are often treated one to two times a week.
There are actually many modes, other than the traditional dry needle method, to stimulate acupoints. Alternate stimulants of acupuncture include electroacupuncture, aquapuncture, moxibustion (use of heat and combustion), laser stimulation, gold implants and acupressure. People sometimes confuse acupuncture with other forms of alternative therapy. Chiropractic methods, for example, are often mistaken for acupuncture. This type of therapy is based upon the relationship between the animal body, spinal column and the nervous system. It does not involve stimulation through acupoints.
The lameness dilemma
The equine practice has recently related acupuncture to one of its most perplexing and troublesome disorders: lameness. Both the equine public and medical community seem to be hungry for a "magical solution" or "cure-all," especially when dealing with unsoundness. Yet, they seem sceptical of anything new or unfamiliar.
"Acupuncture is an excellent diagnostic aid as an adjunct to our conventional lameness examination," states Dr. Schoen. "It may not tell you exactly where the lameness is or what the cause is, but it does indicate that something is reactive in that region."
During an equine lameness exam, a certified practitioner will palpate particular acupoints. Reaction to this palpation corresponds with specific conditions.
For example, suppose a veterinarian feels sensitivity along the bladder meridian lateral to the dorsal midline along the back (a point on the back right above the flank). This may indicate that there is a hindlimb lameness related to the stifle or hock, a primary back problem related to the saddle fit or seat position of a rider, or a conformational problem.
The veterinarian will also look for trigger points, which are knots or tight bands in the muscle. For instance, when a lower forelimb lameness is present, a triceps trigger point will become quite sensitive to palpation.
"Since each diagnostic acupuncture point may have four or five meanings," Dr. Schoen states, "it is always recommended that a certified veterinarian perform acupuncture to determine proper diagnosis."
Acupuncture can be a very valuable tool, therefore, in an equine lameness exam that includes flexion tests, diagnostic nerve blocks, radiographs, ultrasounds and fluoroscopy. But it can also be used in various muscle conditions.
For example, suppose a horse was injected with an intra-articular substance and, though the horse is not lame, he seems to be "off." Acupuncture may be used to treat secondary problems of the hock such as neck and back disorders.
"Acupuncture enables the veterinarian to treat the primary cause as well as secondary consequences," Dr. Schoen adds. "Both the horse and the owner are happy."
Tips for successful therapy
Dr. Schoen suggests the following tips for successful acupuncture therapy:
Be sure the therapist is certified.
Before treating your horse, check with your regular veterinarian first. Discuss all options.
Never replace good management with acupuncture. Integrate proper saddle fit, riding and shoeing for your horse at all times.