Case Reports - Dogs
Limb paralysis - owner's description
"The first picture is of Troy completely paralyzed in his back legs - this occurred first week of March and we came for the first acupuncture treatment on 12.3.2013.
No control of bladder and no feeling up to middle of his back. He was dragging his legs when trying to move, but we prevented him from dragging his legs behind him.
We visited again on 14.3.2013 - started to see small signs of feeling further down spine toward tail. During this time he was kept in a confined space and we assisted in emptying his bladder as shown by you. We also dipped him in warm baths and kept his sleep space clean and urine free as he had no control.
Third visit - 19.3.2013, then had a break of 2-3 weeks. During this time there seemed to be small reflex moves in his hind legs but we could not verify whether voluntary or involuntary. He did start wagging his tail, but still no feeling in his hind paws although he was whining to go out when he needed to relieve himself, showing signs that he was more aware of bladder control.
By week end 13.4.2013 - he was attempting to stand a lot, urinate on his own and was ambitiously lifting himself out of his enclosure. Picture 2 shows him on his toes as he was trying to stand and walk. We assisted by holding his tail to get him to walk on his feet. Still no feeling. By 16.4.2013, he was walking on his feet, very wobbly, but attempting to lift his leg. Then all he wanted to do was to run.
Another acupuncture treatment on the 19.4.2013 - he still had no feeling in his legs or tail but had regained most movement although not perfectly. You said we did not have to come back unless necessary. Since then, he has further improved. He is still not 100% and often runs with his legs to one side. We are happy that acupuncture helped to get Troy back on track, being a much loved pet and family member."
Comments: Troy is a 7-year cross-bred dog and was diagnosed with a severe degree of thoracolumbar disc disease ("slipped disc"). Various options were discussed with the owner at the initial consultation including spinal surgery, medical treatment, as well as acupuncture. The owner eventually opted for acupuncture. At each session, 12 to 16 fine metallic acupuncture needles were inserted into selected acu-points situated on the hind limbs and low back.
Acupuncture points & meridians in the shoulder area of the dog.
A 10 year old female Dachshund Jena was presented with a complaint of stiffness in her front legs over the last few weeks. The condition improved when she moved around. The neck was often held down and the owner noted occasional jerks in the neck when Jena was lying down.
When brought into my Veterinary Consulting Rooms, Jena showed tenderness on palpation of the shoulder muscles, as well as in her lower neck, upper and low back. Selected acupuncture points in these areas were needled; nerve sites in the upper back were additionally injected with diluted local anaesthetic.
On the next visit three days later, the owner reported a significant improvement: Jena was more mobile and able to jump up – something that she had not done for a long time. Wobbly and stiff gate in front limbs was noted again 9 months later. Again, two treatments were necessary to improve the lameness and increase the general level of discomfort.
Nine year old Labrador male Sandy was fit and he routinely ran with his owner several kilometers. Lately, he started to be stiff and even lame in his front limbs. He was brought for an examination to a veterinary clinic. Radiographic examination of his limb joints did not reveal any signs of osteoarthritis or any other bony abnormalities. There was no visible improvement while he was on a short course of anti-inflammatory drugs.
While my clinical examination further confirmed that his joints moved well and were pain-free in a wide range of movements, I noted tenderness in his triceps muscles behind the shoulder joint. These tender points, as well as a few other acupuncture points were needled on two occasions four days apart. Three weeks later, the owner reported that Sandy was running again with no signs of the lameness.
These two cases illustrate that pain and lameness in front limbs, namely in the shoulder area, can be successfully treated using acupuncture. Acupuncture is used to treat soft tissue pain – that is the pain originating in muscles, ligaments and nerves. The response to the treatment varies: “simple” muscle strain due to over-use usually responds well.
On the other hand, the treatment of pain and lameness associated with advanced or multiple arthritis, or following a major injury, can be more challenging: especially so in elderly dogs. More treatments and occasional follow ups may be necessary in these cases.
Sometimes, it is necessary to combine acupuncture with medical treatment to bring about any long-term pain relief.
This disease is diagnosed more often in older dogs and larger breeds. The onset of the condition is usually progressive. In the early stage, typical clinical signs would include difficulty rising, the dog does not jump or has difficulty going up the stairs. These clinical signs are related to pain originating in the lumbo-sacral (low back) area. The cause of the pain should be investigated and, depending on the findings, acupuncture can be considered. Acupuncture treatment is usually effective in this early stage of the disease.
In the advanced stage of the disease, the dog will usually display progressive hind limb weakness, stiffness or even incoordination. Urinary and faecal incontinence may progressively develop. It is important to carry out a proper clinical examination including radiography and eventually even more advanced diagnostic techniques such as MRI in order to establish the cause of the disease. Depending on the findings, surgery may be an option.
Acupuncture is considered in dogs where surgery is not indicated and where other causes such as infection, trauma or nerve degeneration have been eliminated. Acupuncture is useful in managing low back pain. Dry needling or injections into acupuncture points are further beneficial through the stimulation of specific peripheral nerves which can bring about functional recovery of the hind limb function.
The improvement of urination and defecation is less predictable. Depending on the degree of the lumbo-sacral disease, some dogs will improve well while there may be a poor response in other cases. The latter would be particularly true in very old and debilitated dogs, as well as in advanced cases with major hind limb weakness and ongoing faecal or urinary incontinence.
Great Dane - hip & low back problem
Brutus had been diagnosed with hip dysplasia early in his age. He has always been rather wobbly and unsteady on his hind quarters; his low back being roached and stiff. The owner started to come for acupuncture treatments five years ago when Brutus was only one-year-old.
On clinical examination, he was usually tender in his low back and sacro-iliac ligaments, as well as around the hips. Over the years, the condition has been managed with injections of local anaesthetics or saline/vitamin B injected into selected acupoints in the affected areas.
The owner usually noted an improvement of mobility as early as the next day after the treatment. To this day, the chronic condition has been successfully managed with occasional treatments given every few months. The dog has remained active and reasonably mobile.
He enjoys regular exercise - a few times a week, he goes with his owner for up to 40 minutes walks into the park where he plays with other dogs. Larger breeds of dogs especially can be affected by skeletal developmental conditions such as hip dysplasia or abnormalities of the spine. Ongoing pain and poor quality of life may be a consequence, especially as the dog gets older. While there are certainly surgical options available to correct or modify these abnormalities, some dogs can be successfully managed with periodic acupuncture treatments and related techniques such as in this case. In some more severe or advanced cases, it might be necessary to combine acupuncture with pain medication and life-style modification.
Muscle pain, spasm and stiffness
Adam, an 11-year-old Whippet, suffering from muscle pain, spasm and stiffness, was clearly in discomfort: for months, and he was reluctant to move his neck freely and his limbs were stiff. The owner suspected that the condition was due to chronic arthritis. An examination with his regular veterinarian did not reveal any particular problem.
When presented for an acupuncture treatment, the dog was found in good general health, except for extensive muscle pain, spasm and stiffness. Several muscles, particularly behind the shoulders, in the low back and around his knees, were sore and in spasm. The mobility of the spine, as well as around the shoulders and hips was severely restricted.
Eight fine metallic acupuncture needles were inserted into selected acupuncture points and gently manipulated throughout an acupuncture treatment lasting 15 minutes. When brought for a second treatment, the owner confirmed that Adam had become essentially more mobile and was apparently pain-free again. Another eight points were treated again in this session before terminating the treatment.
On an enquiry two months later, Adam was reported to be still sound, mobile and pain-free.
Many dogs suffer from painful conditions affecting neck, back or limbs. The pain and the associated stiffness are manifested in various ways: your dog might be just "different", "unhappy", showing difficulties on standing up, or reluctant to move freely, withdraws from contact with people and other dogs, etc. Depending on the location and nature of the disorder, it may be also yelping when lifted up by the owner, or display signs of lameness.
There are many reasons for these changes and abnormalities including arthritis, spondylitis, a muscle or ligament strain, irritated nerve, etc. The dog is usually brought for an acupuncture treatment following a general or specialised veterinary examination including radiology (X-rays), blood tests and other examinations. While pain-killing drugs are available, their long-term use is not necessarily the best option, as they may not always bring about a full recovery, or their use is associated with particular side-effects. Acupuncture is an alternative in these circumstances. It is particularly efficacious in curing so-called soft tissue injuries. Nevertheless, it can be surprisingly efficacious even in dogs suffering from chronic arthritis. In certain severe/advanced cases it may be necessary to combine acupuncture and pain-killing medication.
Sore back in a Dachshund
Schultz is an eleven-year-old long-hair Dachshund. In September 2010, he was brought for an acupuncture consultation with a complaint of constipation for six weeks. Additionally, he was notably tense in his back, as well as along in the chest and abdominal muscles. As a consequence, he could hardly move and was very unhappy about being touched.
Radiographic examination indicated that several of his intervertebral discs in the mid-back region have collapsed/slipped. The initial neurological examination confirmed the suspicion of damage to the spinal cord in the region. An acupuncture treatment was given.
The dog's poor condition slightly deteriorated before the second acupuncture treatment three days later. Acupuncture was repeated and the dog was given anti-inflammatory tablets for the next three days. On the third treatment, there was hardly any pain present and the dog's movement improved remarkably. The deranged hind limb reflexes started to improve after the third treatment. In total, four acupuncture treatments were given. In the owner's words, Schultz was then sound and pain-free.
I then saw the dog only six months later: this time with a mild wobbliness of his hind limbs, suggesting a partial relapse of the thoracolumbar disc disease. As reported three weeks after one acupuncture treatment, the dog regained full mobility.
Canine thoracolumbar disc disease affects so-called chrondrodystrophoid breeds of dogs - Dachshunds in particular. Depending on the degree of the intervertebral disc prolapse, the affected dogs can show "only" back pain in milder cases, while severe spinal damage will produce paresis and ataxia (wobbliness of the hind limbs) to total hind limb paralysis in severe cases. The dog drags its limbs behind him in this situation. The onset of the condition can vary from hours to days.
Surgical and non-surgical approaches to these cases have been recommended. Provided it's carried out within hours (maximum a few days) after an acute onset of the hind limb paralysis, the surgical management is highly successful. According to veterinary literature, anti-inflammatory drugs are not particularly effective, even if given over a longer period of time.
Acupuncture is a viable option, especially in the following situations:
- mild spinal damage - back pain only
- the onset of hind limb paralysis is protracted
- the suitable "window" period for surgery had lapsed
- the anaesthesia and surgery might be too risky in ageing or diseased patients
- the back surgery was performed, yet the dog remains paraplegic or paretic (wobbly) during the following few weeks
Acute soft tissue strain
Bell is an active 4-year-old female French Bulldog. She was brought by her owner for acupuncture treatment of pain and stiffness affecting her low back and hind limb muscles. According to the owner, the muscle spasm started suddenly, presumably following the dog's vigorous exercise. Pain-killers and muscle relaxants eased but did not fully resolve the distressing condition.
The initial clinical examination revealed painful muscle spasm extending from the low back down to hips and abdominal muscles. A marked improvement was noted by the owner when Bell was brought for a second acupuncture treatment 3 days later. She was then pain-free for the next 6 months when she developed the low back spasm again. One treatment was sufficient to release the spasm this time.
A few weeks later, Bell strained her right hind hamstring muscles. The lameness improved following two acupuncture treatments combined with injections of local anaesthetic around the tender muscle and ligament. Bell is still occasionally lifting the affected limb off the ground, although she is fully mobile and active otherwise.
Acute soft tissue strain may involve muscles, ligaments or even peripheral nerves. The conditions are characterised by a sudden onset of pain, spasm and even lameness depending on the site and extent of the injury. These injuries are relatively common in working breeds of dogs but they can happen to any dog. Depending on the diagnosis, pain-killers, physiotherapy or acupuncture can be used to address the underlying pain, spasm and inflammation.