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Acupuncture Treatment for Treating Forelimb Extensors Muscle Atrophy

Acupuncture Treatment for Treating Forelimb Extensors Muscle Atrophy

by José R. Castro, DVM, DABVP-Equine, DACVS-LA

Author: Chi Institute/Friday, August 28, 2015/Categories: Student Case Reports, TCVM Articles, 2015 Summer/Fall Issue

HISTORY and PHYSICAL EXAM A 5-month-old, American Quarter Horse colt, was presented for gait evaluation of his right forelimb. Two months prior to presentation, he was kicked by another foal and suffered a traumatic injury to the cranial aspect of his right distal humerus and proximal radius. The injury healed by second intention, but the owner noticed intermittent buckling of the right carpus while the horse was standing or in motion.

There was severe muscle atrophy of the Extensor Carpi Radialis and Common Digital Extensor Muscles of the right forelimb. The circumference of the radius, measured distally to the lateral metaphysis, was 27cm on the right forelimb and 40cm on the left forelimb. At a walk, a severe, intermittent buckling of the carpus (knee) was noticed. Buckling was also elicited by a light touch applied at the caudal radius. The same response was not elicited from the left radius. Radiographic evaluation concluded presence of fibrotic tissue at the previous site of trauma with no evidence of associated bone or joint abnormality. An electromyogram demonstrated decreased insertional activity and number of motor unit action potentials of the right antebrachial extensor muscles (when compared with shoulder muscles and antebrachial flexor muscles). These findings were consistent with fibrosis of the right antebrachial extensor muscles. Ultrasonographic evaluation displayed a mixture of hyper- and hypo- echoic areas, as well as, a significant decrease in cross sectional area of the right antebrachial extensor muscles when compared with the opposite limb.


The diagnosis was neurogenic muscle atrophy of the Extensor Carpi Radialis and Common Digital Extensor muscles of the right antebrachium as a result of neuropathy of the cranial cutaneous antebrachial and superficial branch of the radial nerves.

 

OCTOBER 10, 2014

Body Condition

6/9

Constitution

Metal

Back Temperature

cold/normal

Ear Temperature

cold/normal

Tongue Color

normal pink

Tongue Moisture/Coating

moist/clear normal

Left Pulse

strong

Right Pulse

weak

Body Scan

(R) TH-15 +

 

 

 

TCVM Diagnosis and Strategy: Spleen Qi Deficiency and Qi Stagnation localized to the right forelimb extensor muscles. (R) TH-15 indicates shoulder or front limb pain. Weak pulse on right indicates Qi Deficiency. The strategy was to activate blood and ease tendons and muscles; tonify the Qi, and invigorate the meridians.

Dry Needle:   Right:   SI-10, SI-11, GB-21, LI-4, LI-10, LI-11, LI-15, TH-5, TH-9, TH-10, BL-13

Aqua-acupuncture: 3 cc of undiluted Vitamin B12 on Right SI-9, SI-10, TH-14, and LU-1.

OCTOBER 23, 2014

The colt appeared stronger at the carpus when pressure was applied to the caudal-distal radius. Gait deficit was improved by 50%.

Dry Needle: Bai-hui, GB-21, Qi-hai-shu, BL-20, BL-21

Electro-acupuncture Intermittent wave: f1=0; f2>0 for 30 minutes. SI-10 to GB-21, SI-11 to   LI-10, TH-15 to BL-13, TH-9 to TH-15, LI-4 to LI-11, SI-9 to LU-1, SP-20 to SP-20.

The acupoints for Electro-acupuncture were chosen following the recommendations for the treatment of Paralysis of the Radial Nerve in Xie’s Veterinary Acupuncture. Xie, H; Preast, V. Blackwell Publishing 2007.Ch. 8-6. Pg.254 and the frequency, duration and intensity were chosen following recommendations for muscle atrophy of the Electro-Acupuncture Stimulator JM-2A. Wuxi Jiajian Medical Instrument, Inc., Wuxi, China.

NOVEMBER 06, 2014

The colt’s gait continues to improve. A significant increase in strength of the extensor muscles was noticed.

Dry Needle and Electro-acupuncture: Same acupoints as previous visit.

Pneumo-acupuncture: 100 of air were injected subcutaneously over each affected muscles.










NOVEMBER 20, 2014

The strength of the extensor muscles continues to increase.

Dry Needle, Electro-acupuncture and Pneumo-acupuncture: Same as previous visit.

Herbal medicine: Qi Performance 15 gr PO BID. 

DECEMBER 4TH, 2014

The owner reported that no buckling of the carpus has been noticed. The strength of the extensor muscles was about 80% compared to the normal limb. The circumference of the radius was 34cm (7cm increase since the beginning) on the right side and 40cm on the left.

Dry Needle, Electro-acupuncture and Pneumo-acupuncture and Herbal Medicine: Same as previous visit.

The colt was discharged with the instructions to continue with Herbal medicine for 6 more weeks and unrestricted exercise activities.

          

Resolving Muscle Atrophy 11/20/14            Pneumo-Acupuncture 12/04/14

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