Using acupuncture in a case of calsinosis circumscripta in a teckel puppy

By Kristien Debyser DVM

Abstract

Acupuncture therapy was used to treat pain and lameness, due to calcinosis circumscripta in both shoulder joints and a rib, in a teckel puppy. Because it was very hard to find abnormalities with TCM. The teckel was treated 5 times weekly, several times every 3 weeks because owner was very concerned. Dry needle acupuncture, direct and indirect moxa was used. After 4 treatments the dog was free of medication and playing with the other dogs. A CT-scan 1 year later showed less bone formation around the shoulders. Now, 4 years later, the dog is doing fine with only acupuncture and no pain medication.

History

Oscar, a 6-month-old male teckel was presented for an acupuncture consultation. When he was a few weeks, the breeder noticed an abnormal gait. When the owner got Oscar at 9 weeks, he was walking abnormal with a round back, tail down. At the age of 4 months, the teckel was presented in urgency in the Faculty of Veterinary Medicine of Ghent because of being drowsy, stumble, squeal, being in a lot of pain.

Radiographs and CT -scan showed a large amount of granular heterogeneous bony structure at the medial aspect of both shoulders (with associated shoulder joint distention) and costochondral junction of the right second rib.

Advice was to give 10 drops of Metacam 1,5mg/ml and when necessary extra tramadol 4 drops/ day. With less Metacam, Oscar is not functioning well. There was no other medical problem noted in the history.

Clinical signs/ Diagnosis – Conventional (Western)

At the time of clinical examination, the pup was not playing with the other dogs and he walked very difficult. When he was in pain, Oscar was stumbling a lot and the owner describes him as a ‘depressive dog’. The owner had noticed a lesion with a crust on his right medial foot’ since they adopted him. The vet took already a biopt: chronic inflammation, but it wouldn’t heal. The blood results were normal. On clinical examination, Oscar lied down quickly, stepped sagging on hindlimbs, stumbled, tail low to the ground, was very painful bending and stretching both shoulders.

Based on the history, clinical signs, radio graphics and CT- scan, the teckel was diagnosed with idiopathic Calcinosis Circumscripta.

Clinical signs/ Diagnosis – TCM (Eastern)

Oscar has a kink in his tail and a lesion with a crust on the Lv meridian between Lv 3 and lv 4 of his right foot. During TCM exam, the back shu points of liver, gallbladder, kidney, and Large intestine were sensitive. Mu point of liver was also sensitive. I decided to do abdominal palpation to determine the condition of the Zang-Fu organs. According to his age, the kink in the tail, extra bone formation, we can assume the teckel has a Kidney Jing Deficiency. Pulse and tongue diagnosis were not done.

Western treatment

Because of the localisation of the calcification is operation contra -indicated. Faculty of Vet medicine Urgent suggested control of motion and weight and pain medication. Another clinic wanted to put Oscar to sleep because no cure was possible.

Treatment with TCM medicine

Treatment principle:

Relieve pain

Improve mobility

Moving stagnant Qi

My treatment strategy was to tonify kidney and to build up energy with homemade food. I gave advice to give Oscar 2 hours of rest in the morning and also 2 hours in the afternoon.

During acupuncture treatments dry needling Seirin 0,16 x 15 mm were used for 20 minutes at a depth of 5mm. When using moxa, Acupro Needles 0,25×25 mm were used.

1st Acupuncture session 24/1/2017

Oscar was very relaxed during the treatment, knowing this is a 6-month-old pup. Advice was given to change the kibble to homemade food and give him his pain medication as before.

Direct moxa was used on Kd 3 and sp 6 .

 2nd Acupuncture session 31/1/2017

Oscar starts playing. The owner is happy because Oscar moves more smoothly. The lesion on the right foot is for the first time smaller. Pain medication is still at the same doses.

3rd Acupuncture 07/02/2017

Now he is a happy pup along the owner. Now he is sometimes a rascal. The lesion on the medial site of the right foot is almost disappeared. The Metacam will be given every other day.

On cv 3 and 4, direct moxa was used, on bl 23 indirect moxa.

Control 28/02/2017

Oscar is now already 2 days without pain medication, and he is doing well. The lesion on the foot is disappeared. Until today, Oscar comes on regular basis. He never needed any pain medication anymore and is enjoying life.

Oscar is still on homemade food and he still takes a nap in the morning and afternoon.

Discussion:

A 6-month-old Teckel was presented walking abnormal with a round back, tail down, being in a lot of pain when trying to reduce pain medication. A diagnosis of Calcinosis Circumscripta was made of both shoulders (with associated shoulder joint distention) and costochondral junction of the right second rib based on blood chemistry, radiography and CT-scan. The only advice Faculty of Vet Med could give was restriction of motion, weight control and pain medication. On clinical examination, Oscar lied down quickly, stepped sagging on hindlimbs, stumbled, tail low to the ground, was very painful bending and stretching both shoulders. A TCM diagnosis of Kidney Jing deficiency was made based on the young age when problems started, the kink in the tail, extra bone formation. Diagnosis of Kd Qi deficiency was based on the weakness of the hind limbs, bone deformation and lack of energy.

Because I did not feel comfortable with this case, I wanted to have as much information as possible. Sometimes the results can be totally different than the symptoms or complaints.

The TCM treatments goal was to build Qi and Jing, help his Spleen and Kidney. During the 1st session, there was a deficiency in a lot of yin organs, diagnosted to relieve pain in certain meridians (Heart, Small Intestine). Both axis (yin, abdomen and yang, the meridians) should be in balance. Oscar was very relaxed during the treatment.  This dog was lacking Pre-natal Essence, so it was important to produce good Post-natal Essence through digestion. To help his spleen, homemade food was suggested instead of the kibble.

During the following treatments, Oscar got more energy, less pain, could move more smoothly. The life of Oscar got more quality because of acupuncture treatments. The CT-scan after 1 year showed a decreased amount of mineralization at the level of the shoulders.

I never had a case like this. Maybe we could have managed this with less treatments. Also, considered, the concern of the owner and being a Teckel, I still see Oscar every 3 months and his is doing very well. The owner had never dare to hope, that Oscar, would be still alive, because the Faculty Vet Med told them Oscar would survive maximum 1 year. In this case, I was happy to know the Japanese abdominal acupuncture too.

References:

  1. IVAS – course (BEVAS  2014-2015), DVM Dolores Puertas, DVM Albert Snijders & Emiel Van Den Bosch
  • Veterinary acupuncture for small animals (Christina Matern)
  • -Practical Guide to traditional Chinese Veterinary Medicine (Huisheng Xie)

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