As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.Â
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif. Although veterinarians are able to treat animals with acupuncture in almost every state, licensed acupuncturists are very limited in their access to treating animals. Where they are permitted to treat animals, supervision is usually required. Nevertheless, in some states, a licensed acupuncturist may treat animals with a referral and no supervision. Oregon is one of those states and the following case study is about a horse that was referred to me by an Oregon veterinarian.
In this case, one of the owner's horses kicked her other horse. The resulting injury over the horse's left hip did not resolve in a reasonable amount of time. Instead, even with veterinary care, the horse's hip and leg remained inflamed, the hematoma did not resolve, and the horse remained lame. The injury took place on June 23, 2014. After nearly four months, the swelling reduced and the wound closed. The hematoma only partially resolved. In mid-October of 2014, the owner tried to ride the horse for the first time since the original injury. The horse immediately went lame. When I saw the horse for the first time, two weeks following this re-injury, there was an open wound and excess swelling in the hip and into the leg. Treatment was done with acupuncture. By the following day the wound began to close and the swelling was primarily resolved. Within two weeks the horse was no longer lame.
The usefulness of acupuncture in treating traumatic injuries in the equine is clearly illustrated by this particular case. These types of injuries are not uncommon in horses. Given the serious nature of this injury, and the lack of results from any western veterinary treatment for this particular injury, this horse's quick recovery due to acupuncture is dramatic. This case demonstrates that in addition to any other western veterinary treatments, the use of acupuncture can become an important primary method of treatment in similar cases.
Case Report
This case study involves the treatment of a fourteen year old Pinto mare, Peppy, who was kicked in June of 2014 by another horse. The owner uses Peppy for barrel racing and rodeo flag drill team events. By the morning after the injury, the horse was observably lame and the owner was not able to ride the horse. The traumatized area was near the horses left hip. There was an open wound of torn tissue that was several inches in length. The left hind leg was severely swollen down to the hock. At the site of the injury, the swelling was so dramatic that there was a significant loss of visible muscle conformation. The wound itself was open and draining.
The veterinarian saw Peppy two days after the injury. Due to the nature and location of the laceration, it was not possible for the veterinarian to surgically repair the injury. He debrided the wound and shaved the area around the wound. He then administered antibiotics by injection.
By early October, the wound had generally healed and was closed. The horse was not completely sound but the area around the wound had visually improved dramatically. It had been nearly four months since the initial injury and the owner decided to try riding Peppy. She rode Peppy and within a very short time the wound area reopened with a 3-inch gash that was bleeding and draining. The area around the wound became swollen. The leg was again swollen down to the hock. The veterinarian determined that there would be significant permanent scar tissue as a result of the injury and the unresolved hematoma, and that the horse would probably never be sound again.
Peppy was referred to me for acupuncture and I saw the horse two weeks after this most recent episode. The morning after Peppy was reinjured in October, the owner took the following photo. This was the condition of the horse when I initially saw her.
It is clear from the photo that there is distinct swelling in the leg and also some subcutaneous edema that has spread to the ventral abdomen. This was essentially the condition of the horse when I examined her 12 days later. The wound was open and draining fluid and blood. Below the wound was a fairly large hematoma, approximately 10 cm wide by 16 cm long. It was also evident that this injury contained a deep laceration of the tissue. The area below the wound was very sensitive to palpation.
The veterinarian had clipped the area around the wound at the time of the initial injury when debridement of the wound was done. He again administered antibiotics after this second episode. The treatment method I used was a "surrounding" technique. One of the points I used for surrounding the wound was GB-30. I also added GB-31 to the treatment. The type of needle used was Asia Med J type. They were blue handled 0.20 x 30 mm (36 gauge). Seven needles were use to surround the wound and a needle in GB-31. Only the left side of the horse was treated. Needles were left for eight minutes and then removed.
I made arrangements with the owner to treat the horse again in five to seven days. I called her the following week to arrange a time and she explained the results of the first treatment. She said that the "swelling in the leg was 95% resolved by the morning after the acupuncture treatment. The wound itself was nearly closed. She also mentioned that the muscle conformation of the leg was now returning and more nearly normal.
I did see the horse again seven days after the initial treatment. The horse was no longer lame and there was no evidence of swelling. I palpated the skin and muscles around the wound, which had closed completely, and there was no palpation tenderness and no hardness of the area. The subcutaneous swelling near the ventral abdomen was gone. I have seen Peppy several times since the initial treatment and she has remained sound and not needed additional treatment for this injury.
Discussion
On December 18, 2014, the referring veterinarian reexamined the horse and ultrasounded the area. He determined that there was no scar tissue in the wound area. He concluded that the horse was sound and should remain sound due to the complete recovery from the injury.
In the final photo, taken five weeks after the acupuncture treatment, the area of the wound still shows the clipped area that was from when the veterinarian did the debridement of the wound. You can observe that there is no open wound. Except for the clipped area, it would be very difficult to even tell where the trauma site was. The swelling in the area is completely resolved, as well as the swelling that was into the leg. Muscle conformation returned to normal.
In the weeks following Peppy's recovery, the owner began to ride her again. The horse remained sound as the owner gradually worked with Peppy to strengthen her for competition. Two months after the acupuncture treatment, Peppy is being worked at close to 90% of her prior exercise routine and remains completely sound.
Conclusion
Traumatic injuries to the skin or tissue in the equine, such as this case, are not uncommon in horses. Wounds often occur from foreign objects such as fences, farm implements, as well as being kicked by another horse. Since this is only one case, it is not possible to predict the usefulness of acupuncture in treating lacerations in all situations. evertheless, given the dramatic changes as illustrated by these results in treating Peppy, it is clear that acupuncture can be extremely useful in treating traumatic injuries such as this. Further research should be done to determine how acupuncture could be used as an additional early treatment modality in such cases.
Resources:
- The History of Animal Acupuncture, Acupuncture Today, Vol. 15, Issue 9, September 2014.
- www.bchmt.org/esbch/BasicWoundManagementOfHorses.pdf