Clinical History: Lilah is an 11 year old female spayed large mixed breed dog with a chronic history of front limb lameness. Lilah has had multiple x-rays performed on her feet, joints, and shoulders, but no apparent cause for her limping was found. About 6 months ago, neck pain was discovered on a physical exam. Lilah went to an orthopedist who confirmed that her neck pain is likely the reason for her forelimb lameness. The suspicion is that she has one or multiple intervertebral discs pressing on her spinal cord in her neck and causing nerve pain that extends into her front leg. The next steps recommended were an MRI and potentially decompressive surgery on her neck. Lilah’s owner is hesitant to move forward with an invasive surgical procedure, and has elected to try acupuncture as an alternative therapy.
Before this issue, Lilah loved to run and play with her housemate, Eddie. She is an easy going dog but can get anxious when she is in situations she is not familiar with. She has no apparent temperature preference and has a normal appetite. She is current on her vaccinations and takes heartworm and flea / tick prevention regularly. Lilah takes pain medication (Gabapentin) and an anti-inflammatory (Novox) as needed to control her discomfort.
Western Diagnosis: Intervertebral disc disease leading to front limb lameness
TCVM Diagnosis: Kidney Qi Deficiency leading to Bony Bi Syndrome; Blood Stagnation of neck / front left leg
Treatment Principles: Tonify Kidney Qi and clear Stagnation
- Dry Needles:
- LIV-3 – clear stagnation
- Jing-jia-ji – local point for neck pain
- LU-7 – Master Point for the head and neck
- Electroacupuncture (20 Hz for 10 min, 80 Hz / 120 Hz for 10 min):
- GV-20 connected to GV-14 – local points directly along the spinal cord to move stagnation
- BL-11 connected to SI-9 – the Influential Point for bone and the Master Point for the front limbs, respectively
- GB-20 connected to GB-21 (crossing) – local points connecting the neck to the front limbs to clear stagnation
- ST-36 – Qi tonic
- LI-10 – Front 3 mile point (gives enough energy to walk 3 miles)
- BL-23 – Back Shu Association Point for Kidney
Outcome: At first, Lilah did not enjoy her treatments. She yelped when needles were placed and became very anxious. Lilah’s owner did not notice any significant change for the first several weeks of treatment (treating once weekly), and continued to give her pain medications almost daily. As time went on, Lilah tolerated her acupuncture sessions much better. She even would start to doze off during her electroacupuncture treatments. After about 6 weeks of consistent therapy, Lilah’s owner has started to notice fewer sore days, and has backed off her pain medication to as needed, sometimes going 10 days between doses. This weekend, Lilah was able to enjoy the nice weather and play with her brother, something she has not been able to do for months!
Discussion: Just as in Chaos’ case, Lilah’s condition stems from a problem with her Kidney system, which rules the bones in Chinese Medicine Theory. However, Lilah did not demonstrate any hot or cold signs. This, along with the chronic nature of her condition, led to a diagnosis of Kidney Qi Deficiency. Neck pain and spinal cord compression represent a Blood Stagnation. One job of Qi (energy) is to move the Blood. Because Lilah has a Qi deficiency, her Blood stagnates and creates local pain. Lilah’s case is an excellent example of how conditions, especially chronic ones, can take time to treat. For the first 6 weeks of treatment, there was no noticeable change in her condition. Because Lilah’s owner was consistent and continued her sessions, she has started to show improvement. The longer a disease condition has been present, the longer it may take to respond to therapy.
Emily Falk, DVM