Introduction The addition of acupuncture to integrative treatment protocols for a variety of equine conditions offers an adjunctive approach
based on a historical model of experience-based clinical findings and therapies. Although many clinicians employing the modality
pursue advanced training in the traditional diagnostic and therapeutic systems of Chinese medicine, a conventional diagnosis
often lends itself to the selection of a basic group of points suitable for a particular condition. Where available, clinical
research and revision guides the recommendation of the most appropriate and beneficial acupoints. However, given the infancy
of scientific studies on equine acupuncture,1 this research-driven approach is supplemented by practitioner experience, as has been related in the following descriptions
of common clinical applications. Clinicians starting to use the technique generally find that acupuncture needles, alone or
in combination with other techniques including the injection of sterile saline or vitamin B12, elicit worthwhile clinical
results, as described later. Musculoskeletal Applications 
Table 1 Indication and location of diagnostic points in horses
|
The most common and rewarding aspect of equine acupuncture remains the diagnosis and treatment of musculoskeletal pathology,
whether acute or chronic. Foundational texts for the location of acupoints in horses date as early as 1608, in which 189 points
are described, many with emphasis on treating lameness.2 Acupuncture, through a combination of proposed mechanisms, is well suited to addressing the needs of the equine, regardless
of athletic ability3; as with all of Chinese veterinary medicine, new concepts have emerged that refine modern clinical practice. One such recent
addition is an expansion of "diagnostic points," which are palpated to determine specific anatomic structures that may contribute
to an observed lameness. From a traditional sense, these embody connections along meridians, or channels, between points.4 When looking through a more scientific lens, myofascial trigger points, as described elsewhere,5 may explain why sensitivities can be appreciated in areas referred from the primary site of lameness. In practice, practitioners
can simply palpate these points and meridians using their fingers. A 2 mm metal probe is used to check these points, or more
commonly, the end of a discarded plastic guide tube from an acupuncture needle is employed. Important diagnostic points follow
to facilitate an integrative lameness examination (Table 1).
Diagnostic points, when sensitive, may serve as treatment points. However, it is beneficial to treat the suspect area first
with local acupoints and recheck the degree of sensitivity—generally one finds that when the correct joint or muscle groups
are treated, the referred sensitivity is no longer appreciable. 
Table 2 Core or foundational points for the treatment of equine lameness
|
Core points for the treatment of any lameness cover acupoints said to display clinical effects over either skeletal, tendon,
or muscular pathologic conditions. To cover all three areas, one may select BL-23 and BL-11 for the first, GB-34 and BL-18
for the second, and BL-20 for the third area, respectively. In addition, SI-9, SI-3, and TH-1 for any lameness of the forelimb
and BL-54, BL-67, and ST-45 for the hindlimb are recommended. A trained acupuncturist makes modifications by accounting for
the "pattern" diagnosis: the collection of physical examination, historical, environmental, behavioral, and seasonal factors
that produce the observed signs.6 However, knowledge of the pattern is not necessary to elicit systemic effects mediated by opioids,7 serotonin,8 or the local effects that may be influenced by histamine9 or substance P.10 Local points in addition to the aforementioned core points are selected on the basis of either diagnostic sensitivity or
confirmatory conventional diagnostic testing and will vary based on the region involved (Table 2).
|
Featuring Information from:
