Pain Management and Acupuncture

First Appointment for assessment +/- first treatment £50 (£60)

Each subsequent treatment £30 (£36)

The first appointment lasts around 45 minutes.  This involves assessment of the patient and discussion of pain medication, supplements, diet, environmental modification, exercise  requirements and physical therapies. For patients under the care of a Veterinary Surgeon referral and the clinical history are required. If addition or change in medication/diet/supplements is recommended, this is first discussed with the referring Veterinary Surgeon.

Clients will be advised to purchase any medication/supplements from their regular practice.

If acupuncture is appropriate, the first treatment is carried out at the first appointment and is included in the price.

The number and frequency of subsequent treatments depends on the condition(s) and the patient’s response.

An initial course of 3-4 weekly treatments is normally recommended, though, initially,  some conditions may require more frequent treatments.

What is acupuncture?

Acupuncture is the insertion of very fine (single use, disposable) needles through the skin at selected points on the body. It is a very ancient form of treatment, practised by the Chinese and eastern culture, though there is also evidence of its use in the West even earlier. Oetzi, the the ice man over 3000 years old found in the Alps in 1991, has tattoos on his body which may have been associated with acupuncture or acupressure for pain relief.

How does acupuncture work?

Acupuncture works through the nervous system, blocking pain messages to the brain, stimulating the release of natural painkillers (for example, endorphins) and stimulating healing mechanisms. In non-painful conditions, acupuncture may help reset the body’s normal functioning, through normalising effects to the hypothalamus and autonomic nervous system. Practitioners may have a Western approach, a Traditional Chinese Medicine (TCM) approach or or a combination of the two. TCM practitioners use acupuncture to improve the flow of energy or QI (Chi) around the body and to address imbalances in Yin and Yang, to restore balance between emotional, physical and spiritual factors. Selection of points follows the TCM meridians in both approaches as these have been found to coincide closely with nerve pathways which explain the effects found in scientific research. This has led to a greater acceptance of acupuncture as a mainstream treatment. In human medicine acupuncture is a treatment recognised by NICE (National Institute for Clinical Excellence) for certain conditions, such as lower back pain.

Is acupuncture safe?

It is very safe. There have not been any official reports of problems in animals, though caution is advised with certain conditions (e.g.epilepsy). There are few contraindications, e.g. extensive skin infections. It can be safely combined with conventional medicine and as such it is considered a complementary rather than an alternative therapy. Legally, it must be carried out by a veterinary surgeon.

Which conditions may be treated with acupuncture?

Pain is the most common indication for acupuncture. Pain associated with joint, muscle, tendon or ligament problems tends to respond best, as in osteoarthritis, injuries, or post- operative recovery for cruciate or disc surgery. Muscle problems, secondary to changes in posture, gait or weight-bearing, tend to respond well.
Other painful and non-painful conditions may also be helped:

  1. Functional problems such as constipation, incontinence or inflammatory bowel
    syndromes.
  2. Wound healing can be stimulated; the immune system can be modulated in allergic
    disease and some skin conditions can be improved.
  3. The wellbeing of the patient can be improved and anxiety associated with ill health can
    be relieved by stimulating the release of natural pain killers such as endorphins and mood modulating substances such as serotonin.
Is acupuncture suitable for any pet?

Dogs, cats rabbits, birds and potentially any pet can be treated with acupuncture.

Will acupuncture hurt?

Sometimes animals may react, briefly, to the sensation caused by the insertion of the needle, but then relax as the sensation is not painful. Occasionally a patient will not tolerate needling of a particularly tender point. In that case the needle will be removed and an alternative point will be needled instead. Most patients accept the needles very well and often become relaxed and sleepy during treatment.

What happens during treatment?

After a thorough assessment, needles are inserted at selected points and left in place or turned/twisted a few times. There is no ‘set dose’ of acupuncture and needles will be left in place for anything between a few minutes to 15-30 minutes depending on the condition, your pet’s response and the stage of treatment.

What happens after the treatment?

After a thorough assessment, needles are inserted at selected points and left in place or turned/twisted a few times. There is no ‘set dose’ of acupuncture and needles will be left in place for anything between a few minutes to 15-30 minutes depending on the condition, your pet’s response and the stage of treatment.

What happens after the treatment?

It is not uncommon for the patient to sleep very soundly and for a long time after a treatment. This is a good sign and shows that s/he is likely to respond to acupuncture. However don’t worry if s/he is not sleepy, this does not mean that s/he will not respond. Sometimes patients may seem a little more euphoric than usual. This is also a good sign but it is best to keep them quiet for the rest of the day, or they may overexert themselves. Otherwise patients should be treated normally. Medication, diet or exercise regime should not be changed unless they have been discussed with your vet.

What kind of response can be expected?

Patients may show one of three responses to the first treatment:

  1. Your pet may seem a little stiffer or more uncomfortable. This means that the treatment was a little too intense or long, but it also shows that s/he should respond well. After one or two days s/he should improve and be better than before. However, you need to report this so the treatment can be adjusted next time.
  2. There may be no response. This is disappointing but it does not mean that your pet will not respond. It may just mean that it will take a little longer or that the improvement was too small or short-lived to be noticeable after the first treatment. Not all animals or humans are acupuncture ‘responders’; approximately 80% are and it may take a few treatments before we get a response.
  3. There may be an improvement. This may occur anytime in the three days after treatment. Your pet may appear to ‘relapse’ before the next treatment, but that is fine. After each subsequent treatment the effects should last longer, so that eventually our pet may not need further treatment for some time or at all.
How often do we need to treat?

Initially we treat once a week for four to six weeks. It takes at least four weeks to assess if and how your pet is responding to treatment and plan accordingly. Most commonly, treatment is gradually tailed off and top up treatments are carried out if and when the need arises, to maintain the effect as long as possible.

What is Electro-Acupuncture (EA) and when is it used?

In EA a small electrical current is passed through the needles, to provide a stronger stimulus. Its main effect is to prolong the effect of treatment. It is generally well tolerated by pets, though it may not be suitable for patients certain conditions (e.g. epilepsy, some heart disease).

CHRONIC PAIN MANAGEMENT

Controlling pain and discomfort in our pets is essential to their well being and quality of life. While acute pain, due to trauma, illness or surgery is easier to recognise and, consequently, to seek treatment for, chronic pain is trickier to detect and to treat appropriately.

How do we know our pets are in pain?

Humans can tell their doctor not only where it hurts but how the pain makes them feel and how much it affects them. Animals can ‘tell’ us where it hurts by reacting when we examine them, but cannot tell us directly how they feel. Subtle changes in behaviour are usually the first sign that something is not quite right. As the pain worsens then changes in behaviour and habits will become more obvious. Pets are highly unlikely to cry with pain unless it is excruciating, as they retain their wild instinct not to draw attention to themselves when unwell. Prey animals such as rabbits and birds are even more reluctant to show that they are unwell, so changes in behaviour/habits are really subtle until the pain or disease is quite advanced.

What is chronic pain?

Unlike acute pain, which is useful and protective, preventing us from causing further damage, this form of pain is maladaptive, in other words, ‘useless’ pain. The patient may feel pain long after the original injury has healed or the illness has gone or is considered to be under control. The pain may wax and wane (‘having good or bad days’) but it never really goes away. Chronic pain will progress unless managed appropriately and timely. It can affect our pets’ quality of life to varying degrees. In some cases it can foreshorten life.

What are the consequences of chronic pain?

It can affect appetite, willingness to exercise, sleeping patterns and it can cause anxiety and behavioural changes, including unexpected aggression. Quality of life may or may not be affected, depending on whether the pain is causing suffering.

What is suffering?

If the pain is sufficient to stop our pets doing the things they like/need to do then there is suffering. Take the following example:
Frankie and Alfie are two eight year old Labradors. Both are stiff when they first get up in the morning or if they have an extra long or energetic walk; they limp occasionally and are both a bit chubby. However, while Frankie still gets excited to go out, will play with other dogs and rushes to the door to greet his owner, Alfie lags behind on walks, is less keen to interact with other dogs and occasionally cannot be bothered to get out of his bed. They both experience pain but Alfie is suffering and needs urgent assessment and treatment to restore or at least improve his quality of life. Though Frankie is coping well with his pain at the moment, he would also benefit from prompt assessment and treatment/lifestyle adjustments to delay the progression of his condition as long as possible.

What is suffering?

If the pain is sufficient to stop our pets doing the things they like/need to do then there is suffering. Take the following example:
Frankie and Alfie are two eight year old Labradors. Both are stiff when they first get up in the morning or if they have an extra long or energetic walk; they limp occasionally and are both a bit chubby. However, while Frankie still gets excited to go out, will play with other dogs and rushes to the door to greet his owner, Alfie lags behind on walks, is less keen to interact with other dogs and occasionally cannot be bothered to get out of his bed. They both experience pain but Alfie is suffering and needs urgent assessment and treatment to restore or at least improve his quality of life. Though Frankie is coping well with his pain at the moment, he would also benefit from prompt assessment and treatment/lifestyle adjustments to delay the progression of his condition as long as possible.

What is our role as carers?

We are all reluctant, understandably, to acknowledge that our pet may be in pain. We may dismiss changes in behaviour or habits as due to ageing. Age in itself is not a disease. We do not expect significant changes to occur solely due to ageing.
For example, a dog is still very keen to go for walks or run after the ball. But sometimes he limps afterwards or takes longer to recover than he used to. A cat may still be jumping the fence, but occasionally misses her footing. These are early signs that chronic pain may be present. By being vigilant and treating the pain in its early stages we can make a huge difference to the pet’s immediate and long-term wellbeing.

What is our role as carers?

We are all reluctant, understandably, to acknowledge that our pet may be in pain. We may dismiss changes in behaviour or habits as due to ageing. Age in itself is not a disease. We do not expect significant changes to occur solely due to ageing.
For example, a dog is still very keen to go for walks or run after the ball. But sometimes he limps afterwards or takes longer to recover than he used to. A cat may still be jumping the fence, but occasionally misses her footing. These are early signs that chronic pain may be present. By being vigilant and treating the pain in its early stages we can make a huge difference to the pet’s immediate and long-term wellbeing.

What is our role as carers?

Top of the list are conditions of joints, muscles, tendons and ligaments, especially osteoarthritis and its consequences, for example muscle spasms due to changes in gait. Osteoarthritis may be age related (commonly in cats) or due to poor joint health (e.g. hip dysplasia), injury or surgery (commonly in dogs). Chronic skin disease, dental disease, ear problems or gastrointestinal conditions can also cause chronic pain.

What can we do for pets with chronic pain?

Most carers are familiar with non-steroidal anti-inflammatories (NSAIDs, e.g. Metacam) for conditions such as arthritis, as they tend to be the first line of treatment. They are not without potential side effects and many carers are worried about using them, especially long term. While they are generally safe to use in the majority of patients, there are other options. Apart from other medications which can be used instead or in addition to NSAIDs, complementary therapies such as physiotherapy, acupuncture, hydrotherapy etc can make a substantial contribution to the management of pain. Just as important, if not more important in some cases, are diet, weight management, environmental modifications, changes in management and exercise routines. A tailor-made plan, taking into account all these factors and integrating all appropriate treatment options, can resolve or improve chronic pain or at least delay its progression.