Veterinary Medical Acupuncturists Point To Science

By Narda Robinson, DO, DVM

Every now and then, a spate of stories on veterinary acupuncture sweeps through the popular press. The Washington Post ran two such stories between May 2012¹ and February 2013.²

Columns typically begin by describing how an animal benefited by acupuncture when drugs and surgery failed. The piece then proceeds to discuss acupuncture's growth within the profession and a list of responsive conditions. ABC-TV's “Nightline” produced a similar story this year, as well.³

Publicity for acupuncture is a good thing. It causes consumers to consider trying a safe and relatively non-invasive intervention that they might otherwise have overlooked. In the past, veterinary acupuncturists who believed in invisible “Qi” or energy would confess that they could not adequately explain acupuncture's effects.

Nowadays, fortunately, more integrative practitioners are describing the neural influences of needling, perhaps because they themselves hungered for a legitimate explanation.

More Defined

In the past, when these “Qi-ists” would espouse unfounded notions about needles unblocking stuck energy, it seemed reasonable and warranted for authors to invite a skeptic or “quackbuster” to call out the pseudoscience. Because more veterinary acupuncturists have accepted contemporary biomedical explanations, the token naysayers seem out of touch and behind the times as they dutifully disavow the neurophysiology of needling.

For example, one high-profile skeptic contended, “There's actually no logical reason to believe that sticking needles into any human or animal can have the slightest influence on any disease…”⁴ This startlingly uninformed statement reveals much about the skeptic's denial or ignorance of somatic afferent stimulation physiology, i.e., one of the main mechanisms of acupuncture.

Another prolific critic of “animal acupuncture” cautioned,⁵ “[W]hen you read the next article extolling the virtues of the practice, keep in mind that you're reading a level of journalism commensurate with what's seen on the entertainment pages, information that has essentially nothing to do with good science.”⁶ Featured in the recent ABC “Nightline” segment, this individual quipped, “Another half-truth is that there is no such thing as an acupuncture point. Nobody has ever been able to demonstrate that there is such a thing” anatomically.⁷

Veterinary medical acupuncturists would vehemently disagree.

“Good science” reveals, in fact, an enormous amount about the anatomy of acupuncture points.⁸ The dots and lines on acupuncture models merely indicate, respectively, neural loci and neurovascular routes through which acupuncture engenders reproducible physiologic alterations. Translating the well-described anatomy of human points onto nonhuman structures opens doors to comparative research and One Health advances.^9,10 Obviously, acupuncture points do not contain anything strange, discrete or unknown.

The number of studies attesting to the value of acupuncture has grown to the point that a large number of systematic reviews have become available. Systematic reviews constitute some of the highest levels of evidence in medicine. The variety of conditions and patient populations studied in the list below speaks to the robust and diverse effects that result from neuromodulation stimulated by acupuncture.

Acute Ischemic Stroke
Improves neurologic score and clinical outcome over conventional approach.¹¹

Co-morbid symptoms among military fighters
Effectively treats headaches, anxiety, sleep disturbances, depression and chronic pain as components of the trauma spectrum response.¹²

Burning Mouth Syndrome
Reduces sensation of burning in the oral cavity.¹³

Addictive Behavior
Increases smoking cessation rate and reduces cigarettes smoked each day.¹⁴

Postoperative Nausea and Vomiting
Both invasive and non-invasive acupuncture point stimulation prevent post-operative nausea and vomiting with minimal side effects.¹⁵

Tension and Neurovascular Headache^16,17

Shoulder Pain after Stroke
Treats pain in the shoulder after stroke when combined with exercise.¹⁸

Back Pain¹⁹
May more effectively alleviate the symptoms of acute low back pain than non-steroidal inflammatory drugs.²⁰
Provides more relief than no treatment.²¹

Pelvic Organ Dysfunction
Improves symptoms, lessens pain and bolsters quality of life by means of percutaneous tibial nerve stimulation.²²

Pregnancy Rates in Women Following In-Vitro Fertilization
Increases clinical pregnancy rate and live birth rate.²³

Labor Pain
Both acupressure and acupuncture lessened the intensity of pain; acupuncture reduced analgesic drug intake.²⁴

Primary Dysmenorrhea
Reduces pain in the short term with non-invasive point stimulation.²⁵

Chronic Pain²⁶
Outperforms sham and no-acupuncture for the treatment of chronic pain.²⁷

Osteoarthritis of the Knee and Other Peripheral Joints²⁸
Outperforms standard care treatment, sham acupuncture and waiting for further treatment in cases of knee pain from osteoarthritis.²⁹

Cancer Care
Controls nausea and vomiting.³⁰
Relieves hiccups.³¹

Obesity
Produced similar efficacy as anti-obesity medication but with fewer adverse effects.³²

In veterinary medicine, several studies have shown benefits from acupuncture for control of postoperative analgesia in dogs^33,34 and improvement of neurologic function and analgesia following spinal cord injury from intervertebral disk disease, whether or not dogs undergo surgery.^35-39 Acupuncture also aids in reducing recurrent otitis.⁴⁰

It is not difficult to find the facts on acupuncture. Reporters, please continue to write about veterinary acupuncture and alert the public to this effective method of healing animals. Talk to a science-based veterinary medical acupuncturist who can explain the mechanisms clearly and without a drop of pseudoscience. To read about the history of acupuncture, click here.

And skip the skeptic next time.

He's no longer needed. 

Dr. Robinson, DVM, DO, Dipl. ABMA, FAAMA, oversees complementary veterinary education at Colorado State University.

FOOTNOTES
1. Wax E. Pet acupuncture more popular as practice becomes more mainstream. Washington Post. Style. May 22, 2012. Accessed at /redirect.aspx?location=http%3a%2f%2farticles.washingtonpost.com%2f2012-05-22%2flifestyle%2f35457817_1_veterinary-acupuncture-pet-acupuncture-practice-acupuncture on 02-19-13.

2. Cimons M. Many veterinarians offer acupuncture, which the Chinese have long used for animals. Washington Post. Health & Science. February 11, 2013. Accessed at /redirect.aspx?location=http%3a%2f%2fwww.washingtonpost.com%2fnational%2fhealth-science%2fmany-veterinarians-offer-acupuncture-which-the-chinese-have-long-used-for-animals%2f2013%2f02%2f08%2ffc8ac79e-64ce-11e2-b84d-21c7b65985ee_story.html on 02-19-13.

3. Chang J and Arsenault C.. Pet acupuncture: treating animals with human therapies. ABC Nightline. February 7, 2013.  Dr. David Ramey talking to the reporter. Accessed at /redirect.aspx?location=http%3a%2f%2fabcnews.go.com%2fHealth%2fpet-acupuncture-treating-animals-best-human-medicine%2fstory%3fid%3d18434112 on 02-18-13.

4. Wax E. Pet acupuncture more popular as practice becomes more mainstream. Washington Post. Style. May 22, 2012. Accessed at /redirect.aspx?location=http%3a%2f%2farticles.washingtonpost.com%2f2012-05-22%2flifestyle%2f35457817_1_veterinary-acupuncture-pet-acupuncture-practice-acupuncture on 02-19-13.

5. Ramey DW. Do acupuncture points and meridians actually exist? Compend Contin Educ Pract Vet. 2000;22(12):1132-1136. Accessed at /redirect.aspx?location=http%3a%2f%2fsram.org%2fmedia%2fdocuments%2fuploads%2farticle_pdfs%2f5-3-03-Ramey.pdf on 02-18-13.

6. Ramey D. Animal acupuncture. Science-Based Medicine. Accessed at /redirect.aspx?location=http%3a%2f%2fwww.sciencebasedmedicine.org%2findex.php%2fanimal-acupuncture%2f on 02-18-13.

7. Chang J and Arsenault C.. Pet acupuncture: treating animals with human therapies. ABC Nightline. February 7, 2013.  Dr. David Ramey talking to the reporter. Accessed at /redirect.aspx?location=http%3a%2f%2fabcnews.go.com%2fHealth%2fpet-acupuncture-treating-animals-best-human-medicine%2fstory%3fid%3d18434112 on 02-18-13.

8. Dung HC. Anatomical features contributing to the formation of acupuncture points. American Journal of Acupuncture. 1984;12(2):139-143.

9. Lancaster LS and Bowker RM. Acupuncture points of the horse's distal thoracic limb: a neuroanatomic approach to the transposition of traditional points. Animals. 2012;2:455-471.

10. Robinson NG. One Medicine, One Acupuncture. Animals. 2012;2:395-414.

11. Wang Y, Shen J, Wang WM, et al. Scalp acupuncture for acute ischemic stroke: a meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2012; 2012:480950. doi: 10.1155/2012/480950.

12. Lee C, Crawford C, Wallerstedt D, et al. The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews. Systematic Reviews. 2012;1:46. doi: 10.1186/2046-4053-1-46.

13. Yan Z, Ding N, and Hua H. A systematic review of acupuncture or acupoint injection for management of burning mouth syndrome. Quintessence Int. 2012;43(8):695-701.

14. Cheng HM, Chung YC, Chen HH, et al. Systematic review and meta-analysis of the effects of acupoint stimulation on smoking cessation. Am J Chin Med. 2012;40(3):429-442.

15. Holmer Pettersson P and Wengstrom Y. Acupuncture prior to surgery to minimize postoperative nausea and vomiting: a systematic review. J Clin Nurs. 2012;21(13-14):1799-1805.

16. Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for tension-type headache. Cochrane Database Syst Rev 2009:CD007587.

17. Zhao L, Guo Y, Wang W, et al. Systematic review on randomized controlled clinical trials of acupuncture therapy for neurovascular headache. Chin J Integr Med. 2011;17(8):580-586.

18. Lee JA, Park SW, Hwang PW, et al. Acupuncture for shoulder pain after stroke: a systematic review. J Altern Complement Med. 2012;18(9):818-823.

19. Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, et al. A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evid Based Complement Alternat Med 2012;2012:953139.

20. Lee JH, Choi TY, Lee MS, et al. Acupuncture for acute low back pain: a systematic review. Clin J Pain. 2013;29(2):172-185.

21. Hutchinson AJ, Ball S, Andrews JC, et al. The effectiveness of acupuncture in treating chronic non-specific low back pain: a systematic review of the literature. J Orthop Surg Res. 2012;7:36.

22. Biemans JMAE and van Balken MR. Efficacy and effectiveness of percutaneous tibial nerve stimulation in the treatment of pelvic organ disorders: a systematic review. Neuromodulation. 2013;16:25-34.

23. Zheng CH, Huang GY, Zhang MM, et al. Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis. Fertil Steril. 2012;97(3):599-611.

24. Smith CA, Collins CT, CRowther CA, et al. Acupuncture or acupressure for pain management in labour. Cochrane Database Syst Rev. 2011; (7):CD009232. doi: 10.1002/14651858.CD009232.

25. Chung YC, Chen HH, and Yeh ML. Acupoint stimulation intervention for people with primary dysmenorrhea: systematic review and meta-analysis of randomized trials. Complement Ther Med. 2012;20(5):353-363.

26. Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for tension-type headache. Cochrane Database Syst Rev 2009:CD007587.

27. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444-1453.

28. Manheimer E, Cheng K, Linde K, Lao L, Yoo J, Wieland S, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev 2010:CD001977.

29. Cao L, Zhang XL, Gao YS, et al. Needle acupuncture for osteoarthritis of the knee. A systematic review and updated meta-analysis. Saudi Med J. 2012;33(5):526-532.

30. Kay Garcia M, McQuade J, Haddad R, et al. Systematic review of acupuncture in cancer care: a synthesis of the evidence. Jan 22, 2013. [Epub ahead of print.]

31. Choi T-Y, Lee MS, and Ernst E. Acupuncture for cancer patients suffering from hiccups: a systematic review and meta-analysis. Complementary Therapies in Medicine. 2012;20:447-455.

32. Sui Y, Zhao HL, Wong VC, et al. A systematic review on use of Chinese medicine and acupuncture for treatment of obesity. Obes Rev. 2012;13(5):409-430.

33. Gakiya HH, Silva DA, Gomes J, et al. Electroacupuncture versus morphine for the postoperative control of pain in dogs. Acta Cir Bras. 2011;26(5):346-351.

34. Cassu RN, Silva DA, Genari Filho T, et al. Electroanalgesia for the postoperative control pain in dogs. Acta Cir Bras. 2012;27(1):43-48.

35. Han HG, Yoon HY, Kim JY, et al. Clinical effect of additional electroacupuncture on thoracolumbar intervertebral disc herniation in 80 paraplegic dogs. Am J Chin Med. 2010;38(6):1015-1025.

36. Joaquim JG, Luna SP, Brondani JT, et al. Comparison of decompressive surgery, electroacupuncture, and decompressive surgery followed by electroacupuncture for the treatment of dogs with intervertebral disk disease with long-standing severe neurologic deficits. J Am Vet Med Assoc. 2010; 236(11):1225-1229.

37. Laim A, Jaggy A, Forterre F, et al. Effects of adjunct electroacupuncture on severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disk disease. J Am Vet Med Assoc. 2009;234(9):1141-1146.

38. Han H-J, Yoon H-Y, Kim J-Y, et al. Clinical effect of additional electroacupuncture on thoracolumbar intervertebral disc herniation in 80 paraplegic dogs. Am J Chin Med. 2010;38(6):1015-1025.

39. Hayashi AM, Matera JM, and Pinto ACBdCF. Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs. J Am Vet Med Assoc. 2007;231:913-918.

40. Sanchez-Araujo M and Puchi A. Acupuncture prevents relapses of recurrent otitis in dogs: a 1-year follow-up of a randomised controlled trial. Acupunct Med. 2011;29(1):21-26.