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Most importantly, in this report involving neuronal degeneration, in contrast to the central nervous system, the peripheral nervous system retains the ability to regenerate axons to supply target tissues (Deumens et al. 2010). Close approximation of the damaged portions is required, however, to achieve timely and appropriate target tissue reinnervation (Ray and Mackinnon 2010). Surgical techniques facilitate approximation and limited guidance of regenerating axons towards their target. Electrical stimulation has been demonstrated to promote neuronal regeneration and expression of growth-promoting genes (Geremia et al. 2007; Alrashdan et al. 2010). While regeneration of axons is randomly directed, electrical stimulation has variably demonstrated the ability to improve the functionality of reinnervated tissue by neurologically connecting it in a manner more closely approximated to that prior to denervation (Elzinga et al. 2015). Both duration and frequency of stimulation are important, as prolonged stimulation, or that of an unfavourable frequency, has been shown to curtail or misdirect regenerating axons compromising the functionality of the reinnervated tissue when compared to more suitable electrical profiles (Chan et al. 2016). Therefore, a physiological basis for the application of electroacupuncture exists in situations of traumatic denervation. In summary, the use of TCVM to promote a return of
function such as in this case is a valid technique, and above all, seems not to have the potential to add further harm to the affected neurological structures. It is a useful adjunct to those limited techniques currently available, which are, essentially, merely supportive. In addition to the usefulness of TCVM for pain management, regeneration of axons can be promoted by electroacupuncture as demonstrable effect has been proven experimentally. Cauda equina syndrome leading to perineal analgesia, loss of rectal tone and urinary incontinence as in this case report can in some cases lead to complications precipitating euthanasia of the horse, and in others, chronic dysfunction impacting welfare and utility. Rectal paralysis such as in this case report is easily preventable: veterinarians should not practice the technique, and should strongly counsel lay people who they have the opportunity, and responsibility, to advise not to attempt it.
Author’s declaration of interests No conflicts of interest have been declared.
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