Acupuncture most commonly refers to a method of inserting thin, sterile, solid needles into specific sites on the body that, when activated, induce complex, autoregulatory physiologic responses within the central, peripheral, and autonomic nervous systems. Aside from needling, however, acupuncture may incorporate an array of interventions intended to either augment the needle’s effects or obviate the need for needling altogether. Such interventions include:
electrical stimulation (electroacupuncture)
moxibustion, in which a smoldering herb heats an acupuncture point or embedded needle
laser stimulation (laser acupuncture)
pressing techniques (acupressure)
injection of fluids with substances such as vitamins, saline, herbs, homeopathics, or medications into acupuncture point locations; this technique is termed aquapuncture or, when referring to medication injections, pharmacopuncture
Of these, electroacupuncture most frequently appears in scientific studies because of its robust and reliable physiologic influences.
The scientific approach to acupuncture, often referred to as medical acupuncture, evolved from Asian acupuncture decades ago. It regards acupuncture as part of conventional medicine, not something "alternative." Medical acupuncturists use current knowledge of anatomy, physiology, pathology, and neuromodulation to explain the mechanisms of action instead of relying on metaphorical concepts such as Yin, Yang, and Chi (or mystical energy). Modern medical insights have elucidated, in detail, the many ways acupuncture works. This includes neurophysiologic changes in the central, peripheral, and autonomic nervous systems, as well as connective tissue influences that serve to normalize tension and circulation within and throughout the myofascial network.
Mechanisms of Action of Acupuncture in Veterinary Patients
Acupuncture is a comparatively widely utilized complementary therapy. It is based on traditional Chinese medicine and involves insertion of thin needles into specific points on the body. Such point stimulation is believed to activate somatic afferent nerve fibers in the nearby tissue. By adopting a gentle treatment technique, an acupuncturist selectively stimulates mechanoreceptors rather than nociceptors, aimed at augmenting endogenous analgesic mechanisms. Signals traveling along these neural pathways initiate a series of reflexive and homeostatic responses within the local, regional, autonomic, and central nervous systems. Acupuncture is thus thought to result in benefits including alleviation of pain, inflammation and improved local circulation. Furthermore, neuromodulation may affect neurotransmitter concentrations and overall CNS function, potentially benefiting the patient.
Ultimately, the specific improvements that may occur in response to acupuncture depend on the skill of the medical acupuncturist;, the patient's health status and disease chronicity; and the locations and types of stimulation selected for treatment. If performed correctly, acupuncture treatment is generally regarded as safe; however, depending on the species caution should be exercised and appropriate training is always indicated.
Indications for Acupuncture in Veterinary Patients
Research into medical acupuncture presents challenges and the level of evidence in support of efficacy varies. Nonetheless, acupuncture is often part of integrative veterinary medicine. Indications for which veterinarians may prescribe for acupuncture include signs of pain, weakness, neurologic injury or disease, immune dysfunction, digestive disorders, reproductive disturbances, and more. lists conditions typically encountered in a veterinary medical acupuncture practice. The table also presents typical neuromodulatory goals and myofascial considerations that inform and direct a science-based acupuncture intervention.
Contraindications for Acupuncture in Veterinary Patients
Whereas acupuncture is generally regarded as safe, it may be contraindicated if a veterinary patient cannot remain still enough to perform needling safely. High levels of anxiety, fear, or aggression could counteract health-promoting autonomic changes generated by acupuncture. In such cases, efforts to calm the animal may be warranted, or the procedure should not be performed.
Although pregnancy is often considered a contraindication due to concern that acupuncture might affect hormone levels or uterine innervation, evidence of serious adverse effects is lacking, even in late pregnancy.
Coagulopathies or immune compromise might represent contraindications if needling leads to excessive bleeding or local infection, respectively.
In animals with cancer, caution should be exercised to avoid areas of neoplasia or tumor. Similarly, needling infected regions of the body surface should be avoided.
Adverse Effects of Acupuncture in Veterinary Patients
Acupuncture provided by appropriately trained veterinary professionals generally results in few adverse effects. The risks of iatrogenic injury to a major organ or vessel with a needle are reportedly limited provided the practitioner is cognizant of relevant anatomic landmarks. Extreme negative reactions may indicate that the needle has entered a nerve; in those cases, the needle should be immediately withdrawn. It should be noted that horses may react badly and injure practitioners and handlers during acupuncture treatment. Needle ingestion by the patient is possible, although there are no published reports of injury. Adverse reactions in people include syncope, skin infections, and hepatitis; such reactions have apparently not been reported in veterinary patients.