By Zita Orisa Okarina DVM
Small Animal Practitioner
At small practice drh.Zita, Depok, Indonesia
Abstract
Pou, 6 months old, local female dog, active, experienced head bobbing or head tremor in vertical (“yes” gesture) repetitively and generally weak. Pou was diagnosed to Distemper. Treated with acupuncture once a week with dry needle and laser acupuncture. At first treatment Pou didn’t give much reaction, on the sixth session the shaking started to slow down and Pou can run faster. After six months of treatment, Pou’s head reaching an almost normal stage.
Key Words
Acupuncture, head tremor
Abbreviation
TCVM Traditional Chinese Veterinary Medicine
BL Bladder
LU Lung
KID Kidney
ST Stomach
GV Governor Vessel
Introduction
Head tremors are a series of repetitive, horizontally (“no” gesture) or vertically-directed (“yes”), involuntary muscle contractions involving the head and neck. The most likely cause is dyskinesia (a movement disorder) that originates in the basal ganglia – the area of the brain involved in patterned motor activity, which we believe causing by Distemper virus. Dogs and cats with this episode may remain fully conscious and aware1.
According to TCVM overview for head tremors because Kidney Jing Deficiency with Wind-Cold invasion causing Qi / Blood stagnation and local Qi deficiency. In TCVM, Kidney Jing is the solid form of the source Qi (Primary Qi or Yuan Qi). Source Qi is the initial energy that stimulates the body’s growth and development, like the sprouting of a seedling, thus a Kidney Jing Deficiency leads to slow growth and improper development. Clinical signs include lameness, head bobbing and wiry pulse. TCVM strategies are dispel Internal Wind, support the liver and nourish Kidney Jing2.
History
Pou is a rescued female dog, she was 4 months old and her body weight was 5 kg when she was brought home. In July 2016 owner took Pou to Veterinarian to get her vaccinated and a week after, she started to having head bobbing. Pou was came to my practice to seek second opinion. The owner was agree for acupuncture treatment. Pou was cooperative during her treatment. The acupuncture goes once a week. On the sixth acupuncture the bobbing head started to slowing down. On the sixth month of therapy Pou was barely to head shake and the acupuncture treatment still continuing once a week for maintenance until now.
Figure 1 : Pou early treatment, head was heading down due to non-stop tremor
Medical Examination
On her medical examination, Pou has a normal temperature, pulse and respiratory within normal range but a slow walker. Her mucous membran was pink pale, the tongue color was pale. Pou’s head couldn’t stay still and keep having tremors in vertical direction (“yes” gesture). Western diagnostic was idiopathic head tremors, prognosis was dubious – infausta. Treatment to Pou was antibiotic drugs and vitamin from the first Veterinarian.
TCVM Examination
Primary complain for Pou was head tremor. Pou constitution was earth, she was nice and friendly to everyone, enjoys sleeping and relaxing under the sun, dry nose, dry skin, body temperature at head, ear, abdomen, paw were warm, normal defecation and urination. Pou daily feed is dry kibble.
TCVM Diagnosis
TCVM diagnosis is a Internal Wind from Kidney Jing Deficiency. Eight principles method is Yang deficiency, Interior pattern, Cold, Zang-Fu organ is Kidney. Meridian channels include kidney, bladder, gall bladder, stomach, liver and governing vessels. Prefer warm place means Yang Deficiency. The pale tongue and wiry pulses reflect the Kidney Jing Deficiency.
TCVM Treatments Principles
Treatment is include dispel Internal Wind, support the Liver, and nourish Kidney Jing. Pou received acupuncture once a week with Dry Needle for 15 minutes at GV-20, GV-17, GV-1, Nao-shu, Da-feng-men, Long-hui, An-shen, Tai-yang, GB-20, BL-18, LU-7, KID-1, KID-3, KID-7.
Figure 2 : Pou is having Acupuncture Treatment
Table 1
Acupuncture point used for permission5
| Acupuncture Point | Clinical Indication |
| GV-20 / Bai-Hui | Calming point, Shen disturbance |
Table 2
Acupuncture point for balance Kidney Jing deficiency5
| Acupuncture Point | Clinical Indication |
| KID-3 | Yuan (Source) point for Kindey |
| KID-7 | Mother point for Deficiency |
| ST-36 | General tonic |
Table 3
Acupuncture point for support the Liver3
| Acupuncture Point | Clinical Indication | |
| GV-17 | Epilepsy, cervical stiffness | |
| GV-1 | Remove qi/blood stagnation | |
| GB-20 | Internal Wind, Epilepsy | |
|
|
||
| Nao-shu | Seizures and Shen disturbances | |
| Da-feng-men | Calm mind, Internal Wind, Seizures, Tremors, Headche, Vertigo | |
| Long-hui | Seizures | |
| An-shen | Calm Shen, Internal Wind, Facial Paraalysis | |
| Tai-yang | Headache, Facial Paralysis | |
Table 4
Acupuncture point at back area5
| Acupuncture Point | Clinical Indication |
| BL-23 | Back-shu (Association) point for Kidney |
| BL-18 | Back-shu (Association) point for Liver |
Table 5
Distal acupuncture point 5
| Acupuncture Point | Clinical Indication |
| LU-7 | Master point for head and neck |
| KID-1 | Jing-well point (Wood) |
Clinical Outcome
August 2016, Pou had experiencing head tremor non-stop and generally less active a week after she had a vaccination shot. She had an antibiotic and vitamin treatment from the first Veterinary and nothing has changed, the owner came to my practice and seek for second opinion, and I suggested her to have an acupuncture treatment. I only did dry needle on her acupuncture treatment.
Figure 3 ; Pou’s head stay still
Pou did acupuncture treatment once a week, the owner very supportive for the treatment, during the sixth visit of acupuncture, her head started to slowing down and run faster. On the sixth month, the head tremor reach almost a perfect stage of normal, the tremor reduced a lot compared the first treatment.
The owner satisfied, because Pou has returned to almost normal stage. And now Pou still doing the treatment once a week to maintain the condition until now.
Discussion of TCVM Treatments
Acupuncture would reduce the problem for head tremors. Treatment is carried out at least six times to get good results and need some time to return to almost normal condition. Acupuncture effects are release B-endorphin, reduces muscle spasm, reduce inflammation and promote tissue healing. The method of dry needle works effectively to support the healing4.
Conclusion
As for Pou’s case, the head tremor showed very good progression and almost full recovery with acupuncture to improve pets quality of life.
References
- Landstra L, McDonnell Jay. Veterinary Neurology of The Chesapeake. www.drjaymcdonnell.
- Xie H, Wedemeyer L, Chrisman CL, Trevisanello L. Practical Guide to Traditional Chinese Veterinary Medicine. Reddick, FL : Chi Institute of Chinese Medicine Publishing. 2014
- Xie H, Preast V. Traditional Chinese Veterinary Medicine Fundamental Principles 2nd Edition. Reddick, FL: Chi Institute of Chinese Medicine Publishing. 2013
- Xie H, Preast V. Xie’s Veterinary Acupuncture. Ames, Iowa: Blackwell Publishing. 2007: 3-347
- Xie H, Priest V. Traditional Chinese Veterinary Medicine. Reddick, FL: Jin Tang Publishing 2002 : 1-581.