| New Insights: Acupuncture and Chiropractic
William E. Jones, DVM
The veterinary profession is made up of individuals with a wide variety
of opinions, experience, skills, and prejudices. Some are content to live
in a University ivory tower all their lives, others take their university
education to the countryside and let it flower into a rich understanding
of the animals they treat. Some never get their noses out of the books
they studied in school, while others develop a specialized set of skills
and quietly settle down in their corner of the world and perform minor
miracles on a daily basis.
These realities are reaffirmed each December at the convention of the
American Association of Equine Practitioners (AAEP). This is an organization
of all types of veterinarians. While they are the cream of those who practice
equine medicine and surgery, they vary greatly in abilities, experience,
and knowledge. The program is usually a reflection of the current state
of veterinary practice, but varies in its scope depending on the program
director, who is the incoming president. This past year, Dr. Gary Norwood,
a racetrack practitioner from Louisiana was in charge, and he brought a
wide variety of very practical information to the meeting.
One session, billed as "Therapeutic Options," focused on the techniques
of chiropractic and acupuncture for diagnosis and treatment of a variety
of problems in the racehorse. Not so many years ago all leaders in the
AAEP considered acupuncture and especially chiropractic to be of no value
in equine practice. What's more, they considered anyone who practiced these
techniques on horses to be a charlatan. Over time, the value of acupuncture
for horses has been proven, but the value of chiropractic for horses has
been slow to surface.
Over the years it has become evident that these techniques are not learned
in a short period of time, and that understanding and expertise in them
is built on a strong base of knowledge of equine anatomy, physiology and
pathology. Acupuncture and chiropractic techniques for horses are similar,
but not the same as those for humans. While formal training in human acupuncture
and human chiropractic is helpful to those who attempt it on horses, the
differences in anatomy make special equine training a necessity for success.
Chiropractic
Speaking at the AAEP meeting, Dr. Kevin K. Haussler said that because
veterinarians have not been formally educated in chiropractic principles
or techniques in their traditional education, many practitioners do not
understand the basic premise behind chiropractic or its indications or
contraindications. Dr. Haussler holds both a chiropractic degree (DC) and
a veterinary degree (DVM). He explained that owners of horses who believe
in chiropractic value for themselves, want to believe that it also holds
value for their horses. If these owners do not get equine chiropractic
help from their veterinarian, they often turn to someone who is not professionally
trained in the techniques on horses. The result is not the best thing for
the horse.
Dr. Haussler's appeal to the equine practitioners was to become familiar
with the value of chiropractic for horses. He explained and demonstrated
with videos how joints of the horse can be manipulated. It is not done
with giant mallets or mechanical hammers. Firm pressure with the heal of
the hand in the appropriate area of the horse is usually all that is required
for proper adjustment of a joint.
He described the concept of a spectrum of wellness, with ideal wellness
on one end and death on the other. Often there develops a "dis-ease" condition
which is difficult to define because it is not yet a disease state. The
horse is not acting right, but it is hard to say why. In many cases this
is because joint dysfunction has affected the normal neurological balance.
It is just as important for the veterinarian to know when chiropractic
manipulation is not needed as it is to know when it is and how to do it.
In general more value is obtained when there has been an acute injury than
when a condition is chronic. Dr. Haussler emphasized that chiropractic
is not a cure-all for all neck or back problems and is not appropriate
for the treatment of fractures, infections, neoplasia, metabolic disorders,
or non mechanically related joint disorders. The most important contribution
the veterinarian makes is accurate diagnosis of the underlying problem,
and application of the proper treatment modality, which often is not chiropractic
manipulation.
Acupuncture
The president of the International Veterinary Acupuncture Society (IVAS)
described his use of acupuncture for treatment of various disorders of
racehorses. Dr. Cletus M. Vonderwell lives in Delphos, Ohio, which is not
close to any racetrack, but there is a steady trail of racehorses being
hauled to his clinic for evaluation and treatment. Acupuncture is his primary
diagnostic approach.
Dr. Vonderwell said that he seldom asks the owner to tell him what the
problem is with the horse, and he does not usually ask to see the horse
move before his examination. He palpates the acupuncture points and the
soreness of some of them provide enough information for him to tell the
owner what the problem is with the horse.
"The newcomers are always amazed that I can tell them what the problem
is without hearing the history or seeing the horse move out. 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 by various means is the basic means of
treatment with acupuncture. The traditional method of stimulation is by
inserting a needle in the point. 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.
"My personal choice is to inject the points because many times I see
the patient only one time before he races again, and I feel I get better
longer-lasting results," he said.
Many of the veterinarians were astonished to hear Dr. Vonderwell declare
such unwavering belief in his ability to diagnose EPM by detecting soreness
in the gall bladder 32 point (GB32). He said that 92 out of 93 horses he
diagnosed as positive, had later been confirmed positive by traditional
laboratory testing.
It was hard for many to imagine the effectiveness of acupuncture diagnosis
for this disease. After all EPM is a disease in which a parasite, Sarcocystis
neurona, invades and damages the spinal cord. The traditional diagnosis
is the detection of antibodies from the parasite in a cerebrospinal fluid
(CSF) sample. As the disease develops, the horse becomes ataxic. The affected
nerves cause a syndrome which continues to get worse unless the horse is
treated with medication designed to kill the invading parasites.
A nationally known expert in EPM diagnosis, Dr. Clara K. Fenger, reported
at the meeting her study which compared acupuncture diagnosis to the CSF
test (Western blot test). She concluded that acupuncture diagnosis was
not accurate, but in the face of Dr. Vonderwell's claimed results, many
veterinarians realized that perhaps experience in acupuncture was a key
factor in obtaining good results.
Another veterinarian, Dr. Earl C. Sutherland, described how he 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 acurpuncturist 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 went on to describe how he uses both acupuncture and
chiropractic manipulation to correct many lameness problems. He emphasized
that he uses all the traditional methods in lameness diagnosis such as
imaging techniques. This helps him 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 him 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."
Dr. Kevin K. Haussler, Veterinary
Orthopedic Research Laboratory, Dept. of Anatomy,
Physiology and Cell Biology, School
of Veterinary Medicine, University of California, Davis, California.
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Dr. Earl C. Sutherland, PO Box 12009,
Lexington, KY
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Dr. Cletus M. Vonderwell, 840 Ohio
Street, Delphos, OH
Dr. Clara K. Fenger, 3288 Valhalla
Dr., Lexington, KY
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