Download Dialogue for the introduction to Acupuncture PowerPoint

Dialogue for the introduction to Acupuncture PowerPoint Presentation
(Note: Open the presentation and select the “read only” option. You can then present it
normally, but can not change the wording. This presentation is approximately 45-50
minutes long, leaving about 5-10 minutes for questions. It has been designed mainly for
veterinary groups and is for all species, but you can change some of the wording to adapt
it for specific species and lay groups; DO NOT READ this script to the audience as that
is a sure way to put them to sleep. Practice the text ahead of time so you can speak it to
them and only occasionally look at the script)
Slide 1: Thank-you for your invitation to speak tonight about veterinary acupuncture.
(Introduce yourself if a moderator did not do so already). My name is Dr…. (Then tell
how you became interested in acupuncture and a little bit about your training) I am going
to share with you some of my experiences as a veterinarian using acupuncture for a
variety of disorders. I ask that you hold your questions until the end of the presentation,
as I will take questions at that time.
Slide 2: “It matters not whether medicine is modern or ancient, it only matters
that it produces a result” (Read the slide to them slowly as they are reading it on the slide.
Don’t stand there silent because the visual and auditory together makes a bigger impact
than the visual alone)
Slide 3: Traditional Chinese veterinary medicine or TCVM, as we call it, is a very
ancient form of medicine that began approximately 3,000 years ago. It has of course
changed and evolved over that time as our understanding of the body in health and
disease has increased. TCVM concepts of medicine are compatible with current
conventional western concepts. For many diseases, the two forms of medicine can be
integrated to provide a better outcome than either medicine alone. For other diseases that
currently have no conventional veterinary treatment, TCVM may be used alone to resolve
the clinical signs. There are 4 types of TCVM treatments. Acupuncture is the TCVM
treatment that I will discuss tonight, but the other treatments include: Chinese herbal
therapy, which can be used to further enhance the acupuncture treatment; Tui-na which is
a form of Chinese therapeutic massage to balance the body and relieve muscle spasms;
and Diet and Food which can profoundly affect the balance and health of the body over
time.
Slide 4: Tonight my discussion will focus on acupuncture. First I’ll present some history
so you can see how it all began. Then I will discuss the anatomic basis, locations and
types of acupoints and their Channels in animals. This will help reduce your confusion
when an acupuncturist may say to you, for instance, “I treated BL-22”. Then I will
discuss how acupuncture works and some of the scientific basis of acupuncture. I will
briefly review some of the research support demonstrating the presence and actions of
acupuncture using the newest brain imaging technologies. Then I will review by systems
the types of animal diseases that can benefit from acupuncture integrated with
conventional therapies or as a sole therapy. I will provide resources so you can find an
acupuncturist in your area so you may refer patients for treatment. If you become
interested in acupuncture, I will also provide resources where veterinarians can receive
training to become an acupuncturist.
Slide 5: The use of acupuncture to treat veterinary patients began in China for the royal
horses of the Emperor. A man named Bo Le lived around 659-621 BC and he was an
expert judge of the swiftest horses. He was renowned for his abilities to determine the
healthiest, highest quality horses. He began applying acupuncture to horses to prevent
disease and keep them performing well. He is considered one of the early fathers of
veterinary acupuncture. He also wrote one of the earliest acupuncture books called BoLe
Zhen Jing or Bole’s Canon of Veterinary Acupuncture, in which he shared his wisdom
and experiences. Dogs and cats have only been treated with acupuncture for
approximately the past 100 years in China and the past 40 years in the United States.
Many of the acupoints used today have been adapted from horses and humans over the
years.
Slide 6: So what are acupuncture points or acupoints as they are also called? In Chinese
they are called Shu Xue, which literally translates as “communicating holes”. The area of
skin over the acupoint actually has reduced electrical resistance and increased electrical
conductivity measurable with an ohmmeter. The acupoints lie beneath the skin and
subcutaneous tissue at the fascia and muscle levels. Although there is no actual physical
hole in the skin, there is a communication port between the exterior environment and the
acupoint as shown in the schematic drawing on the right. The exact anatomic basis of the
acupoint has yet to be discovered, but most acupoints are located in areas where there is a
dense concentration of nerves, blood vessels, lymph ducts, connective tissue and mast
cells. It is suspected that each of these structures plays a role in the initiation of
acupuncture’s effects.
Slide 7: Related acupoints are connected by Channels. The picture shows 10 of these
Channels drawn on the surface of the skin, but the Channels are actually located under
the skin and pass through the fascial and connective tissue layers. Research studies have
shown that stimulation of one acupoint on a specific Channel will alter the activity of the
other acupoints on the related Channel, but not acupoints on a different Channel. As can
be seen on the picture, Channels beginning on the head end on the toes of the hind feet
(point to the path of GB Channel). While other Channels begin on the toes of the front
feet and end on the head (point out the path of the LI Channel). Still others begin on the
toes of the hind feet and end on the chest or begin on the chest and end on the toes of the
front feet (point to the path of the PC Channel).
Slide 8: There are 14 Channels near the surface of the body. Twelve of them are paired
and pass on both the left and right sides of the body and two are single and pass along the
back, neck and head on the dorsal and ventral midline of the body (point to the path of
the GV). The exact anatomical and physiological basis of the Channels is currently
unknown. Since the 1970’s, research utilizing acoustic recordings, scintigraphy, electrical
recordings, thermography, various tissue specific dyes, confocal scanning and electron
microscopy, computerized tomography and magnetic resonance imaging has provided
insights into the structure and functions of the Channels. Channel research has currently
evolved into four main schools of thought (1) the nerve-conduction Channel theory of
neurophysiologists, (2) the interstitial fluid circulation Channel theory of anatomists,
physiologists and biochemists, (3) the bioelectrical field Channel theory of biophysicists
and (4) the connective tissue/fascia Channel theory of anatomic physiologists. The
Channels shown in these pictures actually only represent the external portion of a
complex matrix of interconnected Channel branches that form a communication network
throughout the interior of the body.
Slide 9: Each of the Channels has a name and a specific number of acupoints. Eleven of
the Channels are named after familiar organs such as Lung, Large Intestine, Stomach,
Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, Gallbladder and Liver and
many of their acupoints exert effects on that specific organ system and others have
special effects related to the whole body. The other three Channels are the Triple Heater,
Governing Vessel and Conception Vessel which affect many different organ systems.
Although there are 361 total acupoints on these Channels, a little less than half of them
are commonly used to treat diseases in animals. These are called transpositional
acupoints as their locations have been transposed from humans to animals.
Slide 10: Each transpositional acupoint has a Channel name and number. For instance
LU-9 is the ninth acupoint on the Lung Channel (point to it). LU-9 is also known through
experience to have specific actions that support Lung function. PC-6 shown in the picture
(point to PC-6) is another commonly used acupoint in humans and animals for nausea
and vomiting and is the sixth point on the Pericardium Channel.
Slide 11: Besides the transpositional acupoints, there are single acupoints not associated
with a specific Channel. These acupoints are called Classical acupoints as they have been
used over hundreds of years for their special actions. They are usually numbered and
given Chinese names. For example number 12 in the picture (point to it) is called NaoShu. This acupoint is known to be supportive for the brain and can be used to treat
disorders such as seizures, head injuries and behavioral problems. There are 77 classical
acupoints in dogs and cats and 210 classical acupoints in horses. The greater number of
classical acupoints in horses reflects the vast experience with acupuncture treatment in
this species.
Slide 12: There are many ways to stimulate acupoints. As the name implies, acupuncture
is the insertion of specially made fine solid needles through the skin and into acupoints. If
needle stimulation alone is used this is referred to as dry needle acupuncture. The needles
are so fine that the animal rarely objects to their insertion. Typically during a treatment
session, 12-24 needles are inserted at acupoints all over the body. Many animals actually
go to sleep during the treatment, as the needles are often left in place about 20-30
minutes. Electricity can be applied through the needles using a special machine called the
electronic acupunctoscope that delivers a specific strength and frequency of electrical
impulses to the acupoint. Different electrical impulse frequencies have been shown to
produce different effects. Heat can be applied to the needle with a special “cigar-shaped”
burning herb called a “moxa” stick and this technique is called moxibustion. Aquaacupuncture also called aqua-puncture is the injection of substances, like diluted B12,
into the acupoint. In some chronic cases gold beads or other substances, like cat gut, may
be implanted into the acupoints, for low level chronic stimulation. Gold bead implants in
acupoints of the head may interfere with future MRI and CT scans, so are avoided in
young animals. Special low level impulse lasers have now been designed to stimulate
acupoints, one by one for approximately 2-3 minutes each.
Slide 13: Through research we are learning the many complex mechanisms of action of
acupuncture. Simply put, disease processes cause injury and disrupt normal physiological
functions of the body and innate healing and regenerative mechanisms fail. Acupuncture
restores homeostasis to the body, so that the innate healing and regeneration processes
can again function and restore health. In acute severe disorders, like infections,
acupuncture can be combined with antibiotics or other conventional drugs. The
antibiotics kill the infectious agent and the acupuncture rapidly restores homeostasis so a
faster more complete recovery may occur. For chronic conditions like deafness and nerve
injuries, where there is no specific conventional treatment, acupuncture has been shown
to increase the rate and degree of recovery in research involving laboratory animals and
humans.
Slide 14: Restoring normal homeostasis sounds simple, but actually involves very
complex mechanisms that include local effects on neurovascular, neuromuscular,
connective tissue and cellular structures as well as systemic effects through the brain and
other organs. The result is an alteration of hormones and chemicals through-out the body.
Current technology like functional magnetic resonance imaging (fMRI) and positron
emission tomography (PET) scans can record changes in the brain before, during and
following acupuncture and show the areas of the brain affected. Specific acupoints affect
specific brain regions, confirming that acupoint stimulation does alter the brain and
different acupoints affect different regions, thus producing different effects. The PET
scan in the picture (point to the picture) shows the red to yellow areas of the human brain
stimulated during an acupuncture treatment. This has been shown to be different than the
PET scan before acupuncture.
Slide 15: The increasing experiential evidence of the effectiveness of acupuncture is
growing. The interest in scientific scrutiny of these findings and the funding of research
projects has increased, especially in the past 15 years. With current technology like the
PET and functional MRI scans, the differences in brain function before and after
acupuncture can now be visualized. These and other advanced technologies have been
applied in many human and laboratory animal studies of acupuncture mechanisms. The
top image is a functional MRI of a normal healthy human brain. The middle image is of
the brain of a person with pain from carpal tunnel syndrome, CTS, before acupuncture.
Note the increased areas of yellow and red compared to the normal image. The bottom
image is of the brain after receiving acupuncture. Note the reduction of the yellow and
red areas that accompany the reduced irritation and inflammation of the nerves and relief
of pain. Circulating levels of beta-endorphins and other internally produced analgesic
chemicals have been shown to increase following acupuncture in humans and animals.
Slide 16: The increase in research interest can be seen by reviewing the PubMed data
base of the US Library of Medicine at: www.ncbi.nlm.nih.gov/pubmed. As of late 2010
there were 15,917 references for acupuncture alone and approximately 50-70 references
are added monthly. Of these only 282 relate to acupuncture in dogs, cats and horses so
research in veterinary medicine is lagging behind that of humans and laboratory animals.
There are now many studies that support the efficacy of acupuncture for a variety of
disorders in humans and we can expect an even greater scientific understanding of the
mechanisms of action and support for the use of acupuncture in veterinary practice in the
future.
Slide 17: So why would acupuncture be used in veterinary practices. Besides improving
recovery time and rates for a variety of diseases, the addition of acupuncture may result
in the need for smaller doses of a conventional medication, like non-steroidal antiinflammatory drugs, steroids and anti-convulsant drugs, which are known to have adverse
long term side effects. In some instances the drugs may be discontinued once acupuncture
treatment is instituted, so the duration of drug treatment is less and side effects may be
avoided altogether. Further, in disorders like intervertebral disk disease and “wobbler”
syndrome, risky and expensive surgery may be avoided, when acupuncture is part of the
treatment regime.
Slide 18: What can you expect from acupuncture? In some cases the effects of
acupuncture can be seen shortly after treatment, but for others it may take a few days.
The effects are cumulative and multiple treatments are usually needed to achieve the
optimum result. Although 3-7 treatments are typical in dogs and cats some horses only
need 1-3 treatments. Chronic disorders may need more treatments than acute disorders.
Acute disorders may initially be treated every 1-3 days if possible, while chronic
disorders are initially treated every 1-2 weeks. For chronic progressive degenerative
diseases maintenance acupuncture is often needed every 1-3 months after the initial
treatment series. There is a variation in both the response of individual animals and the
response of different disease processes to acupuncture. The 10 year old greyhound in the
picture is receiving monthly electro-acupuncture in the thoracolumbar region for chronic
Type II intervertebral disk disease. The acupuncture controls the pelvic limb weakness
and pain. Conventional drugs and surgery have been avoided in this dog and she enjoys a
high quality of life.
Slide 19: Acupuncture can be useful to treat a variety of diseases in many body systems
including musculoskeletal, dermatologic, neurological, ophthalmological, behavioral,
cardiac, pulmonary, gastrointestinal, renal, reproductive, endocrine, immunological and
neoplastic disorders.
Slide 20: The most researched application of acupuncture is for the control of pain from
musculoskeletal disease. In a 2003 analysis of controlled human clinical trials, the World
Health Organization (WHO) concluded that there was enough scientific support to
recommend acupuncture for cervical, lumbar and post operative pain. Since that time
further studies in human and veterinary medicine have confirmed the efficacy of
acupuncture for lameness and neck and back pain from arthritis, tendon and ligament
disorders, intervertebral disk disease and muscle injuries as well as to control pain postoperatively. The mechanisms of acupuncture pain control have been extensively studied
and are quite complex. Part of the effect is due to the increase in beta-endorphin
circulation following acupuncture. Acupuncture will reduce painful muscle spasms and
inflammation and promote tissue healing. The dog in this picture had had 2 surgical
procedures on her neck to control pain from intervertebral disk disease without relief and
although prednisone helped the pain, the dog urinated all over the house and drank lots of
water. Monthly acupuncture controlled the pain so she could enjoy her life more and
prednisone was no longer needed, so her caretakers could enjoy living with her more.
Slide 21: Acupuncture can assist recovery from many skin disorders by reducing pruritis
and inflammation and allowing the skin to heal. Dogs with seasonal allergies, like the
West Highland White terrier in this picture, can benefit from acupuncture just prior to the
beginning of the season and periodically throughout the season. Steroids and antihistamines dosages may be reduced or the drugs discontinued when acupuncture is
integrated into atopy treatment.
Slide 22: Acupuncture is used to control seizures and promote recovery from ataxia,
paresis or paralysis of the limbs associated with spinal cord disorders. As well facial
nerve paralysis, vestibular disorders, deafness, laryngeal paresis or paralysis and
peripheral nerve injuries benefit from acupuncture. Experimental studies have confirmed
the ability of acupuncture to promote nerve regeneration. The dog in this picture has
idiopathic epilepsy. The seizures were not controlled with high levels of phenobarbital
and potassium bromide. In fact, she was sleepy and uncoordinated most of the time. With
the addition of acupuncture every 4-6 weeks, the frequency and duration of the seizures
were reduced dramatically, as were her anticonvulsant doses and she returned to her
normal high energy fun-loving self.
Slide 23: Acupuncture has been used for a number eye conditions in animals including
glaucoma and conjunctivitis. Experimentally acupuncture has been shown to reduce
intraocular pressure in glaucoma animal models. The picture is of glaucoma in a dog and
acupuncture for glaucoma treatment in dogs is currently being evaluated. Acupuncture
also reduces inflammation and promotes healing of tissues in many different ocular
diseases.
Slide 24: Behavior disorders in dogs, cats and horses are common. Separation anxiety
and thunderstorm phobia cause great suffering for many dogs. As we know they may
hide under the bed and shake like the dog in the picture or cause severe destruction to the
house and hurt themselves. Acupuncture integrated with conventional drug therapy can
often result in relief for even the most severely affected animals. In milder behavior
disorders, acupuncture alone may be enough to reduce or control the clinical signs, as it
reduces anxiety and anger and promotes relaxation.
Slide 25: Acupuncture may be integrated into the conventional therapeutic regime for
congestive heart failure, cardiomyopathy and arrythmias. Acupuncture can help increase
heart muscle strength and stamina, reduce fluid accumulation and arrhythmias and
increase the quality of life and in some cases the length of life as well.
Slide 26: Asthma or COPD is a common problem especially for horses and cats.
Acupuncture can reduce airway inflammation, ease breathing and control the panic and
anxiety that accompanies the inability to breathe. Early acupuncture treatment often
reduces the clinical signs of allergic rhinitis. Human clinical trials are currently underway
to confirm the clinical impressions of acupuncture efficacy. Early acupuncture treatment
of upper respiratory infections as seen in the cat in this picture may shorten the course of
the disease by boosting the immune system. Acupuncture may be combined with
antibiotics for bacterial pneumonia and may shorten the course of the disease.
Slide 27: Acupuncture may be helpful to treat a variety of gastrointestinal disorders that
produce colic, anorexia, vomiting, diarrhea or constipation. Inflammatory bowel
syndrome can often be regulated with periodic acupuncture. Megacolon, as shown in this
radiograph of a cat after barium infusion, can be difficult to treat by conventional
methods, but affected cats and dogs may respond to the addition of acupuncture to the
treatment regime. Acupuncture has been experimentally and clinically shown to
normalize gut motility to restore smooth muscle function and stop vomiting, diarrhea and
constipation. Acupuncture can also reduce gastrointestinal pain and stimulate appetite.
Slide 28: Chronic renal failure is common in geriatric animals. Most affected animals are
very depressed, anorexic and have a poor quality of life. Acupuncture reduces some of
the gastrointestinal side effects of the chronic renal failure and increases the animal’s
appetite. Although clinical laboratory renal parameters may remain abnormal, affected
animals have more energy, act as though they feel better and have an improved quality of
life. There are several experimental and clinical studies showing the efficacy of
acupuncture for urinary incontinence associated with age, stress or chronic spinal cord
injuries. Acupuncture may also be a useful adjunct therapy in cystitis and urolithiasis.
Slide 29: Reproductive disorders are common especially in equine practice. Anestrus,
infertility and poor libido in animals are common problems treated with acupuncture.
Experimental studies have shown that acupuncture has substantial effects on reproductive
function. Acupuncture modulates endogenous regulatory systems, including the
sympathetic nervous system, the endocrine system and the neuroendocrine system.
Acupuncture corrects hormone imbalances and uterine motility, reduces stress and
anxiety and controls pain from musculoskeletal disorders that may be interfering with
sexual performance.
Slide 30: Acupuncture can profoundly affect the endocrine system to restore balance in
many different endocrine disorders. Electro-acupuncture has been shown experimentally
to improve the response to insulin and glucose tolerance in diabetic animals. Clinically
acupuncture integrated into the insulin treatment can also improve control of diabetes
mellitus. The generalized pain and irritability of diabetic cats may be reduced with
acupuncture and restore them to their former happy selves. Polyuria and polydipsea are
commonly seen in Cushing’s disease, as illustrated by the dog in the picture.
Acupuncture may reduce these clinical signs as well as muscle weakness and atrophy in
Cushing’s disease. Acupuncture integrated with thyroid replacement therapy may result
in the need for lower medication doses and better regulation.
Slide 31: Experimental studies have shown that acupuncture has immunomodulatory
effects. Increases in T-lymphocyte subsets and natural killer cells have been shown after
acupuncture treatment in cancer patients. Increasing clinical evidence indicates that
electro-acupuncture is especially effective for various immunological diseases, including
allergic disorders, infections, autoimmune diseases and immunodeficiency-syndromes.
Acupuncture can reduce over-activity in autoimmune diseases and stimulate immune
function in immunodeficiency diseases. Acupuncture may be used to prevent infectious
diseases in animals that seem to become sick easily.
Slide 32: Acupuncture can be an adjunctive treatment for all types of cancer, even mast
cell tumors in dogs as depicted in this picture. Acupuncture is never performed in the area
of a tumor, because it increases the local blood supply, which could enhance tumor
growth. Instead acupuncture of distant acupoints on a Channel near the cancer are treated
as well as others that balance the immune system, reduce nausea and weakness associated
with chemotherapy and regenerate tissues damaged by the cancer. Acupuncture may also
be useful to control pain associated with the cancer and cancer surgery.
Slide 33: To find a veterinary acupuncturist in your area there are two websites that list
them by zip code and state. The lists are found on the Chi Institute website at:
www.tcvm.com and the International Veterinary Acupuncture Society website at:
www.ivas.org. You may want to write these down for future reference (Give them a
moment to write them down if needed)
Slide 34: If you are interested in receiving training in veterinary acupuncture to add to
your treatment options, there are currently three schools. Training programs for
veterinarians only are provided by the Chi Institute of Chinese Medicine, the
International Veterinary Acupuncture Society and the Colorado Veterinary Medical
Association. Visit their websites listed on the screen for current information on times and
cost.
Slide 35: In conclusion acupuncture is a safe and effective treatment for many different
diseases in many species. There are virtually no side effects except for occasional
bleeding at the acupuncture site, when the needle is removed. Acupuncture can
complement conventional medical and surgical therapies. Acupuncture can be useful to
promote recovery in some conditions such as acquired deafness, nerve injuries and other
disorders that have no conventional treatments. For geriatric animals, acupuncture is an
effective treatment to reduce arthritic pain, stimulate the appetite and increase their
cognitive function and overall energy level. Acupuncture is an effective treatment to
improve the quality of life of the animals we serve.
Slide 36: If you have any questions I would be happy to entertain them at this time.
(answer questions). Again, thank-you for your invitation to speak tonight about
acupuncture. If you have further questions or would be interested in referring patients to
me I can be reached at: (provide your name again and contact information)