engleski

Treatment of Hansen type I disc disease with acupuncture - a case report

TREATMENT OF HANSEN TYPE I DISC DISEASE WITH ACUPUNCTURE - A CASE REPORT Introduction Hansen type I disc disease is commonly described in small, typically chondrodystrophoid breeds of dogs, with 85 % occurrence in the thoracolumbar segment between T9-L7. Discs are usually herniated or extruded dorsally. The mass of nuclear material is forcibly ejected into the vertebral canal and causes concussion and compression of the spinal cord. Clinical signs following described pathological changes are neurological dysfunction with sign of paresis or paralyses of one or both hind limbs. Depending on the severity of disease, therapy ranges from surgical treatment, conservative treatment by use of medicament's or physical therapy. Combined therapy is also a possibility. Our case report describes the non surgical physical therapy approach, with only the effect of acupuncture as a therapeutic modality. Description of the case A 4 year old female Pekingese dog was referred with sign of acute onset of thoracolumbar paraspinal pain and paraparesis that lasted for 5 days. No trauma was reported. Since the time of arrival it hasn't been medically treated. Dog was reluctant to move and showing signs of paraparesis of the pelvic limb with linging to the right side. Urinary bladder function and anal tone were not altered, although there was no defecation since the incident occurred. Further neurological examination revealed absence of the proprioceptive response on both hind limbs. Hypertonicity of muscles and exaggerated pelvic limb reflexes were also present with slightly increased signs on the right limb. There was absence of sensory function ( deep pain perception ) in both hind limbs. Survey radiography showed a narrowed intervertebral space between vertebral bodies of T11-T12, and a calcified intervertebral disc. For definitive diagnosis myelography was performed. After the lumbar injection, lateral and ventrodorsal myelogram confirmed extradural lesion and compression of spinal cord between thoracic vertebrae T11-T12. Conventional acupoints were chosen, steel needles (0.25x0, 25) , as well as laser acupuncture ( 13 mW, 633 nm). Acupoints: Ji Zhong ( laser) , Xuan Shu, Ming Men, Bai Hui, Wei Gen, Xi Xia, Hou San Li, Liu Feng Treatments were done 3 times per week, each treatment lasted for 25 minutes Owner was encouraged to do passive range of motion (PROM) and a gentle massage of the muscles of hind limbs on daily base. Posture was improved after the 1st treatment, and normal defecation was restored after 2nd. Neurological assessment followed the 4th treatment, proprioceptive response was still absent, but deep pain perception was normal in the left limb and reduced in the right. After the 6th treatment the dog was able to stand by itself and walk for a few steps. The evaluation on the 9th treatment showed proprioception was delayed, and there were no more signs of hipereflexion. Deep pain perception was normal in both hind limb, and the animal was able to walk for a short period. Conclusions Conservative management of thoracolumbar disc dissease ( TLDD) is often limited to restricted movement and carefully selected methods of physiotherapy. In order to remove pain and restore the function of hind limbs, our aim was to use acupuncture as a non-invasive method of rehabilitation. As throughout the treatment no medications were administered, the obtained results are due to biopositive effect of acupuncture treatment. Within 3 weeks of therapy we managed to achieve significant alternation of neurological symptoms, as well as restoration of motor function. Rehabilitation period of dogs suffering from TLDD can last for several weeks, even months, and in our case this period was shortened. Results in our case open a new possibility of using acupuncture as a method of rehabilitation in cases of conservative managment of TLDD in dogs. Bibliography Janssens LA. , Acupuncture for the treatment of thoracolumbar and cervical disc disease in the dog., Probl Vet Med. 1992 Mar ; 4(1):107-16 Sharp N., Wheeler S., Small Animal Spinal Disorders, Elsevier Ltd, 2005 Schoen A., Veterinary Acupuncture, Mosby 1994

dog; disc disease; acupuncture

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