Chapter 22 The Role of Acupuncture and Manipulative Therapy in Canine Rehabilitation 547endings, arterioles, lymphatic vessels, and an
aggregation of mast cells (Pan et al., 1986). Due
to their anatomic location, there are many local
effects that occur with acupuncture point stim-
ulation. These local effects include an increase
in local blood flow and circulation; release of
Hageman’s factor XII which activates the clot-
ting cascade, complement cascade, and release
of plasminogens and kinins; mast cell degranu-
lation which releases histamine, heparin, and
proteases; release of bradykinin which leads
to vasodilation; and production of local pros-
taglandins which leads to smooth muscle
relaxation (Kendall, 1989a; Omura, 1975). The
vasoactive effects that occur with acupuncture
stimulation follow a specific sequence. There is
an initial short vasoconstriction phase (lasting
15–30 seconds), followed by a quasi-control
state (lasting 10 seconds to 2 minutes), and a
final vasodilation phase (lasting 2 minutes to
2 weeks) (Omura, 1975). This results in an
enhanced local tissue immune status, improved
local tissue perfusion, and muscle and tissue
relaxation. Pain relief occurs as a result of
improved perfusion and muscle spasm relief
caused by local effects of acupuncture stimula-
tion and somatovisceral reflexes (Steiss, 2001).
Methods of acupuncture
point stimulation
There are nine ways to stimulate acupuncture
points: dry needle, electroacupuncture, aqua-
puncture, acupressure, laser acupuncture, moxi-
bustion, hemoacupuncture, pneumoacupuncture,
and gold implantation (Xie & Preast, 2007). Dry
needle is defined as the insertion of acupunc-
ture needles into acupuncture points. These
needles vary in length (0.25, 0.5, 1, 1.5, and 2
inches) and gauge (28, 30, 32, 34, and 36 gauge),
and they are typically left in place for approxi-
mately 20 minutes. Dry needle is the most com-
monly used acupuncture technique in dogs.
Electroacupuncture is the attachment of elec-
trical leads to dry needles and connection to an
electroacupuncture unit (Figure 22.1). The unit
can be set to a variety of frequencies and each
frequency stimulates a different pathway in the
nervous system. Low-frequency (1–20 Hertz)
electroacupuncture predominantly stimulates
A-delta fibers and releases beta-endorphins,
enkephalins, and orphanins. High-frequency
(80–100 Hertz) electroacupuncture predomi-
nantly stimulates C fibers which releases
dynorphins, and serotonergic fibers which
releases serotonin and norepinephrine (Melzack
& Wall, 1965; Kendall, 1989b; Fry et al., 2014).
Lower frequencies provide longer lasting and
more cumulative analgesia (Han, 2003). Canine
patients are frequently treated with a combi-
nation of dry needle and electroacupuncture
(Figure 22.2).
Aquapuncture is the injection of a sterile
liquid directly into acupuncture points. The
pressure of the liquid induces stimulation of
acupuncture points until it is absorbed. The
most commonly used injectable liquids include
saline, vitamin B12, and lidocaine.
Acupressure is the application of manual
pressure on acupuncture points for a period of
1–5 minutes per point. This is a safe and easy
technique to demonstrate and instruct clients to
perform at home.Figure 22.1 Thirteen-year-old domestic shorthaired cat
receiving electroacupuncture for the treatment of
osteoarthritis. As demonstrated here, animals frequently
find this treatment very relaxing.