Chapter 22 The Role of Acupuncture and Manipulative Therapy in Canine Rehabilitation 553Cautions and contraindications
There are numerous acupuncture points located
around the eyes, which should be used with cau-
tion so as not to puncture the globe. Points
located along the lateral thorax and abdomen
should be inserted at an oblique angle to avoid
entering the pleural or abdominal cavities. It
is imperative to note that electroacupuncture
is contraindicated in patients with a history of
seizures, epilepsy, cardiac arrhythmias, and those
that have a pacemaker; and it should be used
with caution in patients with neoplasia and con-
gestive heart failure (Altman, 1994). Acupuncture
should never be performed directly into or
around a tumor, into open wounds or scar tissue,
or directly into skin that has severe dermatitis.
There are certain acupuncture points that cause
uterine contraction and induce parturition, there-
fore these points are contraindicated in preg-
nancy that is not at term. Points contraindicated
in pregnancy include LI-4, SP-6, BL-23, BL-24,
BL-25, BL-26, BL-27, BL-28, BL-40, BL-52, BL-60,
BL-67, ST-36, CV-2, CV-3, CV-4, CV-5, CV-6, and
Yan-chi (Xie & Preast, 2007).
Training and certification
In most states, only licensed veterinarians can per-
form acupuncture. Before engaging in the practice
of acupuncture, successful completion of a certi-
fied veterinary acupuncture training program is
required. Institutions that offer veterinary acu-
puncture training programs in the United States
include the Chi Institute of Chinese Medicine, the
International Veterinary Acupuncture Society, and
Medical Acupuncture for Veterinarians. In addi-
tion, there is a unique opportunity to receive a
Master’s Degree in Traditional Chinese Veterinary
Medicine (TCVM) through China’s Southwest
University. This is a chance for veterinarians certi-
fied in basic acupuncture to pursue a greater
understanding of veterinary acupuncture and
Chinese herbal medicine.
What is manipulative therapy/
chiropractic?
Spinal manipulation or chiropractic focuses on
the relationship between structure (primarily
the spine) and function (as coordinated by the
nervous system) and how that relationship
affects the preservation and restoration of health
(see the Association of Chiropractic Colleges
website). The basis of chiropractic is to improve
the mobility of hypomobile joints (all joints,
not just vertebral), which, in turn, improves
appropriate afferent and efferent neurological
function. Appropriate neurological function is
necessary for maintaining all bodily functions,
including proper muscle action.
The word chiropractic was coined in
American English from chiro (hand) and prak-
tikos (practical), which loosely means done by
hand (Etymology Dictionary). Chiropractic is
the study of the relationship between structure
(primarily of the spine) and function (primarily
of the nervous system), and how that relation-
ship affects the restoration and preservation of
overall health and mobility (Gatterman, 2005).
Modern-day chiropractic, credited to Dr.
Daniel David Palmer, who performed the first
adjustment in September 1895, started by
adjusting a patient’s vertebral mobility. A tra-
ditional adjustment is a precise, high-velocity,
low-amplitude (HVLA) thrust, similar to a
Maitland Grade V thrust manipulation (see
Chapter 6). The difference between joint mobi-
lization and joint manipulation (adjustment)
is that during mobilization a joint is manually
brought from its normal range of motion into
its passive range of motion, but during a
manipulation the joint that has been brought
into its end passive range of motion is then
brought into its paraphysiological space/range
of motion without exceeding the boundaries of
its anatomic integrity (Vernon & Mrozek, 2005).
To perform manipulative therapy/animal
chiropractic appropriately, one needs to have
keenly honed palpation skills, appropriate
training in adjustment techniques, and the abil-
ity to integrate biomechanics, anatomy, neurol-
ogy, and physiology to determine the patient’s
differential diagnoses and the potential results
of an adjustment.
An anatomic abnormality requiring adjust-
ment has traditionally been referred to as a sub-
luxation (Gatterman, 2005). This term meets
with significant controversy as subluxations
have not been scientifically proven to exist and
there is no agreement as to a specific definition
of the term. Some medical sources require