IN-DEPTH: COMPLEMENTARY MEDICINE


three showed improvement of 1 lameness grade on one or both limbs, one horse did not change, and one horse’s lameness worsened through the course of the study. There was no statistically significant differ- ence in grade of lameness between treatment and control animals at both initial and final assessment. Therefore, the researchers of this study concluded that acupuncture did not reliably modulate palmar heel pain in horses.26 A 2006 systematic review indicated that there was no compelling evidence to recommend or reject acupuncture for any condition in domestic animals including horses and dogs even though some encouraging data do exist that warrant further investigation in independent rigorous trials.27 Different outcomes of acupuncture on lameness


may be associated with the fact that lameness itself can be subjective to study. However, objective gait analyses using inertial sensors were adopted in a recent blinded and crossover study in horses. Ob- jective gait analyses were performed before and af- ter each treatment and at 1, 3, and 7 days after the last treatment (time points 1–9, respectively).28 Horses were assessed at the trot in a straight line on a hard surface and on the lunge on the left and right reins on a soft surface (conditions 1–3, respectively). Acupuncture treatment was found to decrease hip hike difference under all conditions including condi- tion 1: control, 6.3 6.4 mm versus treatment, 0.26.4mm(P.007); condition 2: control, 9.7 7.8 mm versus treatment, 2.8  7.8 mm (P  .032); condition 3: control, 7.3  6.3 mm versus treat- ment, 2.7  6.4 mm (P  .003). This study indi- cated that acupuncture treatment changed the horses’ gaits (appreciable by objective analyses), with treated horses moving in a more symmetrical manner, which suggests a lesser degree of discomfort.


5. Electro-Acupuncture Analgesia for Surgical Procedures


Electro-acupuncture analgesia (EAA) was used for surgical procedures without anesthesia drugs for the first time in 1958.29,30 EAA was conducted with the frequency of 20 Hz initially for 10 minutes and then gradually increased the frequency to 55 Hz for another 10 to 20 minutes. The frequency of 55 Hz was sustained for the entire surgical procedure. Under the EAA, multiple surgical protocols includ- ing suturing skin lacerations, subcutaneous mass excision, hernia repair, and castration have been performed successfully without drug-induced gen- eral anesthesia in 18 healthy experimental animals (10 stallions and 8 mares, from 8 to 15 years old, weighing from 350 to 450 kg) and 7 equine clinical cases (2 foals, 1 gelding, 2 stallions, and 2 don- keys).31 Surgeries on the head and neck, the chest wall, the thigh, and the abdomen, as well as castra- tion were performed on experimental animals. Each animal, whether clinical or experimental, had an independent acupoints plan, depending on the site of surgery with EA stimulation throughout the duration of the surgery.31


In another report, 23 surgeries in 23 cattle de-


scribed the effectiveness of EA-induced surgical anesthesia/analgesia relative to regional needle placement.32 The locations of regional EA were di- vided into 4 groups: a dorsal acupoint group (Tian Ping [GV-5] and Bai Hui (n  7); a lumbar acupoint group: Yao Pang 1 [BL-21]; Yao Pang 2 [BL-23]; Yao Pang 3 [BL-24]; and Yao Pang 4 [BL-25], (n5); a combined dorsal-lumbar acupoint group (n  8); and a control group using the last intercostal space to the femoral area as shame points (n  3). Sur- geries performed on cattle in the dorsal acupoint group and assessed for degree of analgesia were 2 laparotomies, 3 umbilical hernia repairs and 2 cas- trations. Similarly, surgeries performed on cattle in the lumbar group were 5 omentopexy surgeries for correction of left-sided displacement of the abo- masum, whereas surgeries performed on the dorsal- lumbar acupoint group consisted of 4 omentopexies for correction of left-sided displacement of the abo- masum, 1 omentopexy for correction of right-sided displacement of the abomasum, 2 rumenotomies and 1 cesarean section. The acupoints were stimulated with currents of 2 to 6 V (30 Hz) in dorsal acupoint group, 0.5 to 2.0 V (30 Hz) in lumbar acupoint group, and 0.3 to 2.5 V (30 Hz) in dorsal-lumbar acupoint group. The results of their analyses showed that the recumbency and induction time in the dorsal acupoint group were about 10 seconds to 1 minute, respectively, and the induction time of analgesia was about 1 to 6 minutes, in all animals except 1, who failed to respond to the EA. While the induc- tion time of analgesia in lumbar and dorsal-lumbar acupoint groups was about 10 minutes. The au- thors concluded that with their protocols in respon- sive animals that their described dorsal acupoints might be useful in providing analgesia for surgeries requiring the patient to be in a recumbent position. Whereas the use of their described lumbar and dor- sal-lumbar acupoints might be useful for standing surgeries in cattle.32 A clinical trial was conducted to compare the ef-


fects of EA and butorphanol on hemodynamic and respiratory variables and rectal analgesia in mares (N  8) using controlled rectal distention as a nox- ious stimulus.33 Each horse received saline (0.9% NaCl) solution (0.01 mL/kg, IV; control treatment), butorphanol tartrate (0.1 mg/kg, IV), or 2 hours of EA at acupoints BL-21, 25, and 27 on both sides of the vertebral column, Bai hui, and ST-36 (right side only). The order of treatments in each mare was randomized. At least 7 days elapsed between treat- ments. A balloon was inserted in the rectum of each mare, and controlled distention of the balloon (pressures of 220 mm Hg) was used to measure nociceptive rectal pain threshold. Both butorpha- nol and EA provided statistically equal analgesia to induced rectal stimuli (mean  SD, 214  24 vs 174  35 mm Hg of balloon pressure, respectively). The conclusions and clinical relevance were that EA and butorphanol (0.1 mg/kg, IV) may provide useful


AAEP PROCEEDINGS  Vol. 64  2018 323


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