Presentatin: Integrative veterinary therapy fr small animals 16.04.2014 Auckland Beagle Club Overview f Acupet Services Acupuncture Laser Therapy Pain Management Physical Rehabilitatin Tday s presentatin What is pain? Hw d I knw my dg is in pain? Ostearthritis and multimdal management Lts f ptins t manage arthritis. Pain- what is it? An unpleasant sensry and emtinal experience assciated with actual r ptential tissue damage. Pain is prcessed in the brain Pain is als extensively prcessed in the spinal crd. Pain Adaptive: Usually acute. Serves a purpse. Prtects the bdy frm injury Prmtes healing by inhibiting mvement Shrt duratin, easily treated. Maladaptive: serves n purpse t the bdy. Surces: stearthritis, cancer pain, neurpathic pain. Difficult t treat
Pain becmes a disease state f its wn Maladaptive pain leads t wind up Anatmical and physilgical changes t the spinal crd. This cnditin is called Wind Up. Pain is perceived as wrse than it shuld be Areas away frm the site f pain becme painful Tuch and pressure are cnsidered painful Pain becmes super difficult t cntrl Treat pain as early as pssible t prevent wind up. What else is happening in the bdy with uncntrlled pain? Increased cardivascular demands Reduced immunity Reduced gut mtility Increased metablism: breakdwn f muscle, fat and glucse stres Anxiety, depressin, pssible aggressin Reduced fd intake Pr sleep habits Respiratin: cmprmised. Hw d I knw my dg is in pain? Changes in: Temperament Behaviur Psture Vcalisatin Mbility Dislike palpatin f particular parts f the bdy Temperament Mre subdued, depressed Less interactive? Mre anxius? Attentin seeking? Withdrawal frm usual activities Pssible aggressin Drpy eyes, wrried facial expressin (arched eyebrws, darting eyes), ears back Behaviur Reduced appetite r picky with fd. Reduced water intake Less active in general and reduced energy levels Less interactive with peple/ ccurrences ging n arund them Reluctant t respnd when beckned Reduced play behaviur Unsettled r restless- may mve arund a lt trying t get cmfrtable.
Pacing behaviur- cmmn with abdminal pain Licking, biting certain areas f the bdy. Flinches when tuched Trembling, shaking. Limbs, bdy. Des nt shake any mre when wet. Panting Lapses in huse training Pstural changes Change in psture- Hunched in abdminal/spinal pain; head held dwn with neck pain. Weak tail wag, lw tail carriage- maybe n lnger wags his r her tail Reduced stretching. The usual psitin they sit and/r lie in has changed. Difficulty getting up frm a seated psitin Vcalisatin Becming mre vcal- whimpers, crying, graning, barking, grwling Whimpers, cries, pulls away when an area f their bdy is tuched. Many dgs will nt vcalise when in pain. Mbility Reduced weight bearing n a limb(s), lameness Obviusly hlding a limb up Change in gait pattern e.g. stiffness, scuffing feet. Unable t d activities they culd nrmally d e.g. jump in the car, climb stairs A strange gait e.g. Bunny hpping with hip dysplasia Ostearthritis The prgressive and permanent deteriratin f the articular cartilage in jints due t primary r secndary causes Primary causes: n knwn cause Secndary causes: Abnrmal frces n a nrmal jint Nrmal frces n an abnrmal jint What happens? Articular cartilage breaks dwn Bne underlying articular Underges degeneratin Decreased lubricatin f jint by mdified synvial fluid
Jint fluid is a sup f inflammatry prducts that sensitise pain receptrs Ostephytes develp t try and stabilise the jint Thickening f the jint capsule, ligaments etc Management f arthritis Multimdal Target management frm varius angles Attentin t management everyday, nging. Management f arthritis Weight cntrl Nutraceuticals High EPA diet Glucsamine/chndritin Pain management Acupuncture r laser therapy Pharmaceutical agents e.g. NSAIDS Physical rehabilitatin Envirnmental mdificatin Weight cntrl Best way t reduce the pain f arthritis!!!! Can reduce need fr pain meds by 25 t 30% Special weight lss diets if required Hills w/d r r/d Hills metablic diet Nutraceuticals EPAs (mega 3 fatty acid) Eicsapentanic acid Decreases inflammatin & jint pain Suppresses cartilage breakdwn Fish il Diets: Hills J/D Glucsamine/chndritin Chndrprtectants Building blcks fr articular cartilage Slw degenerative jint changes Decrease inflammatin and pain Increases jint fluid prductin Csequin and Synquin have prven results.
Acupuncture therapy Pain relieving and anti-inflammatry effects Bsts well being and energy levels Fact: The bdy is a magnificent self repairing rganism which can be stimulated t heal itself and return t a nrmal physilgical balance. This balance is called hmestasis By inserting fine gauge needles int specific pints, n the bdy, a cascade f physilgical effects ccur and allw the bdy t return t hmestasis. Effects f Acupuncture Pain relief Endrphin release Sedatin Dpamine, Sertnin release Endrphins Great fr behaviural prblems Hmestasis Respiratin, heart rate, bld pressure, temperature, metablic rate, sweating and electrlyte balance affected. Enhanced immunity Repair f damaged areas f spinal crd and nerves Western explanatin Essentially it wrks by stimulatin f the CNS Acupuncture pints ccur at discrete lcatins and stimulatin f the pint activates the apprpriate nerve pathways Eastern Explanatin Thery f Qi, acupuncture pints and meridian pathways Qi is the vital frce that mves in channels Pain is said t be Stagnant Qi and Bld. Musculskeletal cnditins acupuncture can treat Arthritis Hip dysplasia Spndylsis defrmans Muscular strains / sprains / tears Muscle spasms Myfascial Trigger Pints.
Any muscular pain Neurlgical cnditins acupuncture can treat Intervertebral disc disease (IVDD) Traumatic nerve injuries Certain types f paralysis (e.g facial and radial nerve paralysis) Seizures Wbbler s syndrme Degenerative myelpathy (DM) Fibrcartilaginus embli (FCE) Sciatica Cauda equina syndrme Tail pull injuries What else? SKIN: Lick granulmas and skin allergies. GASTROINTESTINAL: Chrnic/acute diarrhea Cnstipatin vmiting IBD in cats and dgs BEHAVIOURAL: Separatin anxiety, phbias, insmnia URINARY: Acute and chrnic renal failure Feline Lwer Urinary tract Disease (FLUTD) urinary incntinence Laser Therapy Laser treatment is the use f light f a specific wavelength therapy t achieve the fllwing: Relieves pain Reduces inflammatin Increases micrcirculatin (bld flw) t tissues resulting in acceleratin in tissue repair and wund healing. Physical Rehabilitatin Mdalities and exercises that: Increase speed f recvery frm injury, surgery. Imprve quality f mvement and imprve perfrmance Imprve bimechanics and flexibility Increase strength f muscles, tendns and ligaments Increase endurance Reduce pain Imprve balance and prpriceptin Aid weight lss Increase quality f life and a sense f wellbeing
Preventin f future injury thrugh tissue strengthening. Pharmaceuticals NSAIDS are an imprtant part f pain management frm the get g f arthritis Cntrls the inflammatry part f arthritis which cntributes t pain Gd fr mild t mderate pain Pain management is multimdal. Other adjunctive pain drugs added as disease prgresses. Envirnmental mdificatin Cmfrtable bedding Ramps int cars and huse Raised fd bwls Nn slip flring Dr Buzby s Te grips (fr nn slip n wden flrs. ) Warm wheaties Avid stairs Warm areas t sleep Cntrlled exercise: Be mindful f activities that wrsen stiffness and pain Dn t frget abut assistive devices Cnclusin Pain management is vital. Untreated it nly gets wrse Identifying pain: lk ut fr changes in psture, vcalisatin, mbility, behaviur. Pain treatment ptins: acupuncture, laser treatment, nutraceuticals, physical rehab Dn t frget envirnmental mdificatin Pharmaceuticals will be needed fr mre mderate t severe pain in cnjunctin with the abve.