As a horse owner, you want more options for helping your equine friends, especially when conventional treatments carry risks and sometimes have limited efficacy. The safety profile and lack of contraindications make acupuncture worth trying in almost any patient. Acupuncture is a safe and effective adjunctive therapy for acute or chronic laminitis patients.
Acupuncture is the ancient traditional medical practice of inserting thin flexible stainless steel needles into specific anatomic locations for the treatment of pain or disease. This centuries-old therapy is part of modern medical practice for both human and veterinary patients. Sometimes acupuncture alone can be effective, but more commonly it is used in conjunction with standard medical and surgical protocols.
For equine laminitis, I have found that an initial response is generally seen within 2 or 3 treatments. As with any therapy for laminitis, response is monitored and positive outcomes are marked by specific changes that typically include:
- increased appetite
- improved attitude
- normal vital signs
- better posture
- freer movement
- normalized digital pulses
- reduced weight shifting
- increased willingness to stand comfortably for the farrier
Limited research has been published on equine acupuncture. The research that does exist on equine patients has primarily focused on gastrointestinal or reproductive problems, with a handful of papers investigating the use of acupuncture for lameness.
Despite the lack of formal study on acupuncture for laminitis, many clinicians are using it with reports of success. Acupuncture can be used as part of multimodal therapy for equine laminitis. Acupuncture can enhance the beneficial effects and sometimes reduce adverse effects of conventional therapy. When used as part of multimodal therapy, acupuncture is a safe and effective option for both acute and chronic cases.
Laminitis poses a treatment challenge because of its multisystem involvement and the complex nature of laminitic pain. But this is what makes it a particularly appropriate disease for acupuncture, which is known to influence multiple body systems and modulate complex pain pathways.
ACUPUNCTURE EFFECTS
Acupuncture can reduce pain and modulate inflammation. Acupuncture has regulating influences on multiple organs and tissues such as those commonly involved in laminitis patients including musculoskeletal, gastrointestinal, and immune systems. The effect of needles varies with point location. A few of the most well documented effects include generalized homeostatic influences, such as normalizing GI motility, as well as regional influences on specific tissues such as blood flow changes and release of muscle spasms in myofascial trigger points.
CLINICAL APPLICATIONS IN LAMINITIS
Acupuncture appears to help laminitis patients by reducing different types of pain. In chronic laminitis, altered weight bearing can lead to myofascial pain syndromes that can be difficult to treat using conventional therapy. Specific point selection can be used to relieve pain in the feet and also relieve muscle spasms in the body. Electro-acupuncture can be used to enhance the effect in certain cases.
Acupuncture can also assist in treating comorbid conditions. Clinical conditions seen in laminitis patients -- such as gastrointestinal distress, reproductive system damage, infection, or hormonal imbalance -- can respond to specific acupuncture treatments. Acupuncture can break pain cycles, allowing lower doses of drugs to be used. This can be particularly useful in patients with organ damage that make them more susceptible to adverse effects from pharmaceutical therapies.
ACUTE VERSUS CHRONIC LAMINITIS
In both acute and chronic cases, the clinical goal is to reduce or halt laminar degeneration and treat associated clinical conditions. Therefore, points will be selected that modulate hoof pain and function as well as underlying conditions. This will include classic acupoints around the hoof in addition to other anatomic points on the limb that may not necessarily appear in textbooks. In chronic cases, there has often been significant damage to the musculoskeletal system as a whole. Foot pain is a component, but in chronic cases neuropathic pain may be involved beyond the foot. In complicated disease states, theoretically needles could be placed in many locations. Your veterinary acupuncturist will consider patient-specific criteria for point selection and “dosing” of acupuncture.
Acupuncture works on multiple physiologic pathways and processes at different levels of the nervous system. For example, local effects at and around the tissue-needle interface work in part by stimulating various sensory receptors in skin, fascia, and muscle. Messages then travel from the needle to the spinal cord. At the spinal cord level, pain signaling, visceral autonomic tone and motor output are modulated. Studies have also shown that many acupuncture effects involve the brain. Endocrine and immune regulation is associated with activation of different regions of the brain that can be influenced by specific acupuncture needle placement in the periphery.
Emotional components of pain states are not easy to study in animals. If acupuncture can help horses feel better emotionally, that is just one more reason to give it a try.
Dr. Lisa Lancaster leads the team at Lancaster Veterinary Services, a mobile veterinary practice offering acupuncture and chiropractic services in the Denver, Colorado area. lancasterequine.com