By Marlene Cimons, The Washington Post
February 20, 2013
The trouble began in early January 2012, when Hershey, my then nearly 11-year-old chocolate Lab, developed the first in a series of urinary tract infections. Eventually, the problem worsened to include full-blown incontinence, with Hershey waking up in a puddle two or three mornings a week.
If dogs can be embarrassed, my dog must have been mortified. I was certainly getting weary of laundering her doggy bed, but I assumed this was a consequence of having an older dog. My veterinarian put her on a widely used drug to stop the incontinence and possibly help prevent further infections.
But the drug can cause an increased heart rate and other side effects, and within hours of her first dose, Hershey became restless, began panting excessively and lost her appetite. After two days, my vet said to stop the drug. Other options, hormone therapy among them, seemed no safer.
I wanted an effective, nontoxic approach and wondered whether complementary medicine — specifically, acupuncture — could help my dog.
I'd used acupuncture myself, and I believe the ancient Chinese practice of inserting fine needles into certain points in the body — to relieve pain, speed healing, ease arthritis and conquer addictions, among other things — works. Acupuncture eliminated my lower back pain and helped me recover from shoulder surgery. Could it work for Hershey too?
My vet urged me to give it a try, so in October I brought Hershey to see Jordan Kocen, a veterinarian in the integrative medicine department at VCA SouthPaws Veterinary Specialists & Emergency Center in Fairfax, Va. I'd taken Hershey there previously for another problem and was impressed with the veterinarians' expertise and warmth.
After observing Hershey, Kocen suspected she was suffering from a neurological weakness in her hindquarters, often caused by impaired nerve impulses to the muscles and worsened by tightness in her lower back muscles. Both had affected her mobility and the strength of her urinary sphincter.
"Part of the neurological check involves turning each paw over and seeing how long it takes for her to place it back properly. She was a little slow, a sign she had some neurological weakness," Kocen said. "She also did a little hopping maneuver to get up off the floor, which usually indicates some lower back tension."
He inserted a series of acupuncture needles along her back, specifically targeted to her weaknesses, and said it was fine if she moved around. Dogs can't always remain still for 20 minutes — the usual time for an acupuncture session — and apparently it doesn't matter.
"Acupuncture stimulates nerve endings, which send a message to the spinal cord," Kocen explains. "The cord then sends out a message. If the area being needled is tight, then the message will be to the local muscle to relax. If the area is weak, the message will be to strengthen. Since nerves go everywhere, all conditions potentially could respond to acupuncture."
We scheduled a series of treatments a week or two apart. Kocen told me to keep a diary and record how things were going. The effects could take time, he said, advising me to be patient.
I decided to write "D" for dry and "W" for wet on the calendar each morning.
That first treatment was on Friday, Oct. 19. Saturday morning, Oct. 20, she woke up dry. I wrote a "D" on the calendar. Sunday morning, Oct. 21, she woke up wet. I wrote a "W." On Monday, Oct. 22, she woke up dry and stayed that way for the next 10 mornings. Then on Thursday, Nov. 1, and Friday, Nov. 2, she woke up wet.
And that was it.
She's had a few small leaks in the evening, but she's been sleeping through the night accident-free ever since.
Applications in animals
The Chinese believe that the needles release painful blockages of energy — known as qi or chi — along pathways called meridians. Although we know of acupuncture as a human treatment, the ancient Chinese did use it for animals, though not dogs.
"The acupoints were developed for horses, pigs and cattle," says Susan Wynn, an Atlanta veterinarian who is president of the American Academy of Veterinary Acupuncture. "Modern maps of dog and cat acupoints and meridians are derived only recently from those developed in people over the last few thousand years."
In animals, acupuncture seems to be most effective for mobility problems such as arthritis and for spinal issues such as disk disease. It's also helpful for neurological disorders, in behavior problems such as anxiety disorders and in healing chronic wounds, according to Wynn, citing numerous peer-reviewed studies.
Veterinary acupuncture "is used less often for problems that are inflammatory and hormonal in nature, yet it can be helpful in diseases like allergic dermatitis, allergic respiratory disease and inflammatory bowel disease," Wynn says. "It can return an abnormally still gastrointestinal tract to normal function and is very effective in the treatment of nausea and appetite loss."
Acupuncture in animals has also been found to help control epileptic seizures, treat ear infections by enhancing the effects of antibiotics and preventing recurrences, and ease hip dysplasia pain, said Cheryl L. Chrisman, editor of the American Journal of Traditional Chinese Veterinary Medicine. She said it can also treat pain in general, control vomiting and reduce intraocular pressure, making it "a potential treatment for glaucoma."
Numerous studies have shown the benefits of veterinary acupuncture, said Larry A. Bernstein, a North Miami Beach, Fla., veterinarian and founder of the American Holistic Veterinary Medical Foundation.
"There are copious amounts that show the efficacy and mechanisms in both veterinary and human acupuncture," he said. "It is probably the most researched of all the complementary modalities."
Because Hershey is a dog, I am quite sure she's not experiencing a placebo effect.
It's been four months and her incontinence seems to be history. She hasn't had a urinary tract infection since August. She is livelier, more energetic. She runs around the yard like a puppy. We still go for treatments once every two weeks but, because she is doing well, she soon won't have to go as often.
My pet insurance, which costs about $500 a year to cover Hershey, pays 80 percent of my costs after a $200 deductible, which I find ironic since my own health insurance won't cover acupuncture for me. The initial consultation/treatment was $225, subsequent sessions $110 each. Thus, my out-of-pocket cost is $22 for each regular session.
Hershey's 12th birthday is later this month. It will be a very happy — and dry — one.
Marlene Cimons is a former Washington health policy reporter for the Los Angeles Times.
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