Abstract
A female dwarf mongoose (Helogale parvula), 14 years of age, who was living with two males, became acutely grade 1–2/5 ataxic. Radiographs indicated an area of narrowed disks in the T–L region, consistent with her neurologic signs. She was isolated from the males and started on meloxicam (Metacam®, 0.5 mg/ml oral suspension, Boehringer Ingelheim Vetmedica, Inc., St. Joseph, MO, USA) a nonsteroidal antiinflammatory drug, and gabapentin (100 mg capsule, Camber Pharmaceuticals, Inc., Piscataway, NJ, USA), used for neuropathic pain, daily. After eight weeks, she continued to show evidence of grade 4/5 ataxia. At that time, acupuncture was added to the treatment plan. It has been demonstrated in canine patients that adding acupuncture to traditional Western medical treatment plans for intervertebral disk disease (IVDD) can help decrease recovery times and improve outcomes.1 Another study has suggested that electroacupuncture is more effective than decompressive surgery in canine patients with longstanding neurologic deficits due to thoracolumbar disk protrusion.2 Once weekly for seven consecutive weeks, the dwarf mongoose was anesthetized via isoflurane induction. She was maintained on isoflurane from 20–40 minutes. While under anesthesia, body temperature, pulse oximetry, heart and respiratory rates were monitored.
The mongoose’s acupuncture treatment was formulated from both traditional Chinese medicine (TCM) and Western medicine approaches. From a TCM standpoint, the goal is to move Qi and Blood to eliminate stagnation caused by injury, thus improving function and comfort.3 Local points above and below the area of concern were treated along the Bladder meridian (the iliocostalis muscles). In addition, peripheral points on the extremities were also treated to try to benefit appetite and stress. Electroacupuncture was used on a low-intensity, low-frequency setting during all of the sessions. Electrodes were attached to needles above and below the lesion, as well as to distal points. After each of her sessions, the patient recovered uneventfully from anesthesia and was relatively calm (less anxious) for a period of 1–2 days.
After three acupuncture treatments, the dwarf mongoose was re-introduced to her primary enclosure without the males present. She showed improvement by climbing deliberately, using her right hind leg well and the left better than she had used it previously. At this time, her private, secondary enclosure was modified to try to encourage her to climb easy obstacles and to increase her daily exercise. Unfortunately, given the social nature of the dwarf mongoose, she was not comfortable enough in the solitary, secondary enclosure to venture out much. Even with coaxing and food motivators (crickets and yogurt) the keepers were unable to get her to consistently come out of hiding.
After seven weeks of acupuncture, a physical therapy plan was instituted. Given her sedentary behavior, it was deemed necessary to help to rebuild her musculature before reintroducing her to the group and her primary habitat. A large, clear plastic exercise ball was introduced. The dwarf mongoose was surprisingly calm in the exercise ball even at the first introduction. She was started at a routine of 3–5 minutes twice daily. Between exercise sessions, she was still being isolated from the other dwarf mongooses. Because she was reluctant to move around her secondary enclosure, the exercise in the ball was the most efficient way to get her to use her front and hind legs. The ball turned out to be an excellent tool for a number of reasons. It required little handling of the patient, and she was always visible in the ball, making it easy to ascertain that she was not in a compromised position. The inside of the ball has ridges which acted as Cavaletti rails to help develop proprioception and balance. Initially, she would fatigue, and someone would have to help roll the ball for her to walk. Within a week, she was strong enough to propel the ball on her own. By the end of 4 weeks, she was walking in the ball over smooth terrain for a total of 15–20 minutes twice daily.
At this point in treatment, the dwarf mongoose was returned to her primary habitat. This decision was made for a variety of reasons, one being concern regarding the amount of time the animal had been in an isolated environment. The other two dwarf mongooses were removed from the primary habitat and the patient was given time alone to explore and climb. At this time, it was observed that her ataxia maintained at a grade 4/5. She was able to navigate the tree branches and tunnels, but still tumbled on occasion. She was given three days in the enclosure on her own. Then, due to concerns about her slow positive progress, safety and welfare in the habitat, and inability to return to a fully social status, humane euthanasia was elected.
Literature Cited
1. Hayashi AM, Matera JM, Fonseca Pinto AC. Evaluation of electroacupuncture treatment for thoracolumbar invertebral disk disease in dogs. J Am Vet Med Assoc. 2007;231(6):913–918.
2. Joaquim JG, Luna SP, Brondani JT, Torelli SR, Rahal SC, de Paula Freitas F. Comparison of decompressive surgery, electroacupuncture, and decompressive surgery followed by electroacupuncture for the treatment of dogs with intervertebral disk disease with long-standing sever neurologic deficits. J Am Vet Med Assoc. 2010;236(11):1225–1229. doi: 10.2460/javma.236.11.1225.
3. Schoen AM. Veterinary Acupuncture: Ancient Art to Modern Medicine. St. Louis, MO: Mosby; 2001.