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Tierarztpraxis E.Schulze |
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Zusatzbezeichnung AKUPUNKTUR |
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GOLD ACUPUNCTURE FOR ELBOW DYSPLASIA
Erhard Schulze, prakt. Tierarzt Kamen, Germany
INTRODUCTION
The elbow dysplasia (ED) is a common problem in small animal practice. It is a term used to describe several different diseases that all result in elbow arthrosis (fragmented coronoid process (FCP), ununited anconeal process (UAP), osteochondritis dissecans (OCD) of the distal humerus), as seen in Figure 1:
Figure 1: Localizations of ED
The resulting changes to normal anatomy cause arthrosis, pain and reduction in range of motion in the joint. In addition to that, ED may be caused by a short-ulna- or a short-radius-syndrom. All these changes of normal anatomy will produce arthrosis, only the localization will differ. This arthrosis will force pain and a reduction in movement. The corresponding x-ray is shown in Figure 2:
Figure 2: Elbow arthrosis The conventional medicine has several treatment options, beginning with NSAIDs, like Carprofen® or Meloxicam® up to joint surgery. These treatments can reduce the pain but cannot prevent the arthrosis. So, about two years after surgery, the problems are back. After I treated hip dysplasia and hip arthrosis by Gold Acupuncture with tremendous success, I tried it for the elbow as well. And the success was quite astonishing.
THEORETICAL BACKGROUND
Doing Gold Acupuncture we have to keep in mind, that this is a special kind of permanent acupuncture and the point selection may differ from dry needle acupuncture. The most important differences to dry needle acupuncture are shown in Table 1:
Tab. 1
To be successful we have first to answer the following questions: ¨ Is it really a Bi-syndrome? ¨ Which meridians cross the joint? ¨ Which points can we find there? ¨ What are the effects of those points? ¨ Which points can be used avoiding possible side-effects?
At the elbow joint we find the Yin-meridians Lung (LU-5, Chi Ze), Pericardium (PC-3, Quze) and Heart (HT-3, Shaohai) and the Yang-meridians Large Intestine (LI-10, Shousanli, LI-11, Quchi, LI-12, Zhouliao), Small Intestine (SI-8, xiaohai), and San jiao (SJ 10, tianjing) (San Jiao is the Triple Heater channel). . These points have the following main effects: LU-5: this is the water-point of the meridian, cools heat, tonifies Yin and has only poor local effect. PC-3 is the water-point as well and cools acute heat, blood heat, heat fire etc. HT-3 is the next water-point, which mainly cools heart-fire and treats heart yin deficiency.
As you see, all these points can be used to cool heat, but if we consider that we have a bi-syndrom there is no heat to cool and I never have used one of these points.
LI-10 is related to ST-36 and is indicated in three main syndromes: disturbances in the meridian, Qi-stagnation in stomach and intestine and for swellings. In dry needle acupuncture it is a very successful point because it chases wind away. In Gold Acupuncture I don’t use this point because of its very strong effects far away from the elbow.The next point, LI-11, is – beside LI-4 – one of the greatest and most important points in acupuncture. It chases wind, mainly wind-heat, and is a very good point treating acute fever. It regulates the complete meridian and calms the liver-yang. Because of these effects on the entire body, I don’t use it in permanent Gold Acupuncture . LI-12 makes the meridian and the small net-vessels (luo vessels) permeable. This allows its supporting effect on the elbow. Finally we found one point, which can be used in permanent acupuncture without any risk of side effects.
The next meridian, the San Jiao, has with SJ-10 connection to the elbow. It is the earth-point of the meridian and has, because of this, energetic effects. But first of all it removes congestions in the meridian, mainly at the elbow region. Because its main effect lies in the meridian and energetic effects are only to receive if it is combined with other points, I will use this point, too.
The last meridian in this region is the Small Intestine. The point SI-8 is the earth-point of the meridian, but its main effect is a local one. We can use this point in Gold Acupuncture.
In summary, we have 8 points in the elbow region, but only 3 points can be used in Gold Acupuncture without the risk of side effects to the entire body. However, we have no original point on the Yin side where you can often see arthrosis caused by FCP. The solution of this problem is very easy: I place the gold a few millimeters away from the point but on the meridian. Doing it this way we have no risk of side effects but we reach the joint via the small Luo-vessels.
PROCEDURE
When the dog first presents to the clinic a conventional western examination is first done with an orthopedic and neurological focus. The next step is a short examination in TCM (Shu- and Mu – points etc.) to be sure that there is primarily a Bi-syndrom. When the indication for the Gold Acupuncture is clear, the dog is sedated with medetomidin (0,01mg/kg) and butorphanol (0,01 mg/kg). The sleeping dog will be prepared as if we do surgery (shaving, washing, decontamination etc). I use 24 carat pure gold (no magnetics), 14G needles and a trocar to place the gold (see Fig. 3)
Figure 3: That’s what we need With the dog lying with the affected leg on top (see Fig. 4) I begin with SJ-10; the next point is LI-12 and then the third one is placed near LU-5.
Figure 4: Beginning with Treatment
This order has no medical reason only a practical one: near LU-5, HT-3 and PC-3 lies the vena circumflexa cubiti which you may puncture. You would then be busy with stopping bleeding and not with doing acupuncture. If both elbows must be treated, an assistant holds the upper limb back and I treat the other, again from caudal to cranial ( see Fig 5).
Figure 5: The medial side After that the dog is turned around (over the ventral side and not over the dorsal one because of stomach-torsion!!!) the same procedure begins once again. Once finished the dog recieves an injection with atipamizol (0,15 mg/kg) intramuscularly to reverse the anesthetic and twenty minutes later it is awake.
Following this point-selection and procedure I have 1250 dogs with elbow dysplasia up until submission for this presentation; end of March 2007.
RESULTS
The age of these dogs ranges from 6 months up to 14 years and the weights range from 1,5 kg (Chihuahua) up to 87 kg ( Irish Wolfhound). From these 1250 dogs, only 39 did not respond to the treatment and 26 dogs respond only slightly. The rest responded very well and had no need of anti- pain drugs anymore, (NSAIDs, etc), and were able and willing to move. This means there is a success-rate of 95% at the elbow (similar to results I have had with the hips).
Not one dog got worse after treatment; none showed any side-effects up to 8 years after treatment. I think, this shows the great power and safety of Gold Acupuncture if it’s done correctly.
EPILOGUE
Some dogs need to have conventional surgery, mainly when the fragmented coronoid process or the processus anconeus can be moved a little bit: then they are foreign bodies and must be taken away. I think there are about 25% of the dogs which received surgery before and after that were developing arthrosis. In our clinic we combine this conventional surgery with Gold Acupuncture and we have not provoked any arthrosis in 5 years! We discovered that it does not matter if the dog has surgery before Gold Acupuncture or not.
By answering the general questions stated at the beginning, I have found protocols for each joint; even arthrosis in the toes can be treated successfully.
Veröffentlicht in: IVAS (Hrsg); Proceedings of the Thirty-Third Annual International Congress on Veterinary Acupuncture, Niedernhausen, Germany, August 22-25, 2007, S. 153 - 158
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