Abstract: Ear acupuncture uses certain points on the external auricle to diagnose and treat selected clinical conditions in man and animals. The points are usually detected as pressure-sensitive and electrically-active points. A number of diagnostic points for the body organs, parts and functions have been described in the dog. Results of a clinical study on the use of ear acupuncture in dogs suffering from thoracolumbar disc disease are described.
Ear acupuncture is a therapy in which particular points on the external auricle are stimulated for the purpose of treating disease. Ear acupuncture is based on the theory that individual parts of the whole body are represented on the external auricle. In China, even in ancient times, acupuncture was carried out at points on the auricle in man. In Arabian medicine, certain parts of the auricle of man were cauterized to treat illnesses such as sciatica. Ear acupuncture was developed to a remarkable diagnostic and therapeutical system by the French physician, Dr P M F Nogier, who discovered the method during the 1950s (Nogier, 1983). Soon thereafter, Chinese workers described a slightly different system of ear acupuncture relating certain auricular points to the meridian system (Ken and Yongqian, 1981).
Two different concepts of ear acupuncture can be distinguished. Auriculotherapyhas been defined as a method in which auricular points are detected as pressure-sensitive and/or electrically-active (low resistance) points. Auricular medicine takes advantage of the so-called "auriculo cardiac reflex" (called also "vascular autonomic signal") for detection of active points (Nogier, 1983).
Traditional Chinese texts mention a few auricular acupuncture points in domestic animals such as the horse and pig. Following the discoveries of Nogier, several authors in the 1970s and early 1980s, suggested the location of auricular points in the dog. Nevertheless, a considerable variation in location of the points can be noted among the authors.
The objective of this lecture is to review up-to-date knowledge of ear acupuncture in the dog.
In the below-discussed studies of this author, auricular points were detected as
1. Pressure sensitive points--similar to that in man, detection of a so-called active auricular point, is accompanied by a sudden jerk of the head and neck and often vocalization when the area is exposed to light pressure of the order of 80-120 g/mm2.
2. Electrical skin points--the active auricular points display reduced electrical skin resistance/impedance (i.e., increased electrical conductivity) as compared to the adjacent "inactive" skin.
In healthy subjects, no pressure sensitive points and only few sporadic electrically active points are found.
Our earlier studies (Still, 1985) in healthy dogs with mild pain (due to the compression of a paw with an elastic bandage) revealed that the pressure-sensitive and electrically active auricular points were induced in specific locations in most of the dogs. The above-described phenomenon was apparently mediated via the nervous system.
Clinical studies of this author (Still 1987 a, b), carried out in 449 dogs affected with well-defined clinical diseases, suggested location of the following auricular points corresponding to certain body parts and organs: large and small intestines, stomach (and its auxiliary point), liver/pancreas, heart/lung, sexual organs/urinary bladder, conjunctiva, vertebral column and spinal cord, and fore and hind limbs including their major joints. Location of a functional point for skin pruritus was also described. The clinical studies further revealed that particular ear points appear most frequently when the corresponding organ is affected by acute and/or painful pathological process. Significantly less reliable was auriculodiagnosis in situations when dogs were affected by chronic and degenerative disorders which were often painless. The same was true about a limited number of dogs with non-aggressive neoplasia. Active points cannot be reliably diagnosed in animals with severe depression of the central nervous system, such as in the case of coma.
Results of a study conducted in healthy dogs with experimentally-induced acute diarrhoea suggested that there is a relatively good relationship between the onset and duration of the pathological process (enteritis) on one side and the appearance and disappearance of the specific auricular points on the other side (Still, 1995).
The main objective of ear acupuncture is obviously to treat disease. There is still controversy as far as the main therapeutical effect of the method in man is concerned. Textbooks of ear acupuncture in man suggest that the method can be clinically effective in the treatment of a large number of clinical conditions including pain and neurological, dermatological, hormonal and other diseases and dysfunctions (Ken and Yongqiang, 1981). As far as pain-relief is concerned, certain controlled studies in man found that pain-relief experienced following ear acupuncture was mostly due to its placebo effect. Nevertheless, several other controlled clinical studies indicated that mechanisms other than placebo play a significant role in the observed pain-relief. As the placebo effect does not operate in animals, it is essential that controlled experimental and clinical studies of ear acupuncture are carried out in animals.
Apart from a few case reports, probably only one clinical study has been published on therapeutical effects of ear acupuncture in animals (Still, 1990). The data will be reviewed shortly and discussed in the following text.
Ear acupuncture was used by the author in 30 dogs suffering from thoracolumbar disc disease (TLDD) grade I to IV, with a duration 1-47 (mean 8) days prior to the beginning of ear acupuncture. Two dogs (7%) received one or two doses of short-acting corticosteroids prior to the beginning of the treatment. Six dogs (20%) received non-steroidal anti-inflammatory drugs 2-4 days prior to the beginning of ear acupuncture without any beneficial effects. No analgesic and/or anti-inflammatory drugs were used during the acupuncture treatment. Depending on the auriculodiagnostic finding, two to five acupuncture stainless steel 32-G needles were inserted into the "hind limb", "vertebral column", "spinal cord" and "hypothalamus" areas of one or both external auricles. The needles remained in place for 20 minutes without any additional manipulation. Acupuncture treatments and recording of clinical status were carried out on a daily basis (pain present) or every other day (pain absent). One to three treatments were used in each dog. Auriculotherapy was terminated if no essential improvement occurred after three sessions, or if the dog's condition deteriorated. Post-treatment clinical progress was recorded using a questionnaire sent to the owners.
Overall, 73% of dogs recovered or improved. Nine out of 11 (82%) dogs classified initially as grade I (backpain) and 10 out of 13 (77%) dogs of grade II (hind limb paresis +- backpain) were cured or essentially improved within 1.7 and 3.2 days respectively. Three of the six (50%) dogs suffering from TLDD grade III and IV (hind limb paralysis ± backpain) improved substantially during the few days of treatment. Another three dogs treated 1-3 times over a period of two to six days did not improve and were euthanized. Post-mortem examination revealed local myelitis or myelomalacia resulting from the thoracolumbar protrusion in all of them. Analgesic effects were the most remarkable, followed by improvement of the hind limb motility in paretic dogs. No statistically significant difference was noted between the success rate of the treatment in dogs with previous short-term medical treatment versus non-pretreated dogs (p>0.05). Bilateral auriculotherapy was not significantly more successful than unilateral needling (p>0.05). Post-treatment relapses of the TLDD occurred in four of the 13 dogs (31%) within 10 days to two months after the end of the treatment.
The obtained data suggest that auriculotherapy can be clinically effective to treat dogs affected by TLDD. The success rate recorded in dogs classified as grades I and II (this study) is comparable to that seen in dogs treated by somatic acupuncture (studies of Janssens, 1983 and Still, 1988). The mean recovery times seem to be shorter in dogs treated by ear acupuncture. As only 20% of the dogs of this study were suffering from grades III and IV TLDD, no conclusions can be drawn as regards the therapeutical effects of auriculotherapy in these cases.
It can be concluded that ear acupuncture is an alternative or complementary diagnostic and therapeutic method in the dog and possibly also in other animal species. The method operates via partially understood physiological mechanisms. The underlying mechanism(s) of action and clinical efficacy of ear acupuncture in animals should be further studied.
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