Clinical experiences with Acupuncture: failures and successes

5. Premature withdrawal of therapy

The number of AP sessions needed to elicit the optimal therapeutic response depends on the condition being treated and the ability of the adaptive mechanisms to respond. In acute simple cases, such as myofascial syndromes, 1 to 3 sessions may suffice. In chronic cases, 3 to 10 sessions may be needed. In severe chronic human cases, such as limb paralysis in poliomyelitis, post-CVA etc, therapy may continue for 10-60+ sessions.

A good response to AP may be gradual (i.e. continuous improvement after each session) or sudden (i.e. no change for the first few sessions, then a marked response after (say) the 5th session. Occasionally, little change may be seen until after AP has been discontinued.

Following the first 1-3 AP sessions, there may be one of three responses: no change,improvement in signs, or exaggeration of signs. Exaggeration is usually due to over-stimulation of points. In my opinion, exaggeration is a better response than no change. It suggests that therapy is activating some response and that alteration of the points or a lesser degree of AP stimulus is indicated.

Because the cost of AP therapy must be weighed against the financial value of animal patients, AP may not be attempted in cases with a difficult prognosis. Premature withdrawal of therapy occurs more commonly in Vet AP than in human AP, if acceptable clinical responses are not seen after 2 to 5 sessions in cases which could possibly respond to further sessions.

NON COMPLIANCE OF OWNER/HANDLER

Failure to use supportive methods: In large stables, owners and trainers frequently have little to do with individual horses. They delegate day-to-day responsibility for the care and management of patients to a groom/ handler who may be over-worked, under-paid, incompetent, apathetic, or (rarely) malevolent. It often happens that handlers are changed frequently, i.e. different handlers may be responsible for the patient from day to day or week to week. Instructions given to one handler may not be passed on (or carried out) by other handlers. As in orthodox vet practice, even when only one handler is involved, instructions to administer specific supportive treatment (medical, homoeopathic or physical), or to exercise the patient in a specific way, may not be carried out.

Failure to give physiotherapy between AP sessions: If other physiotherapy (for instance TENS) is not available, I usually ask that TPs in muscle be fisted (thumped gently but firmly with the closed fist) for 4-6 minutes each day between AP sessions. In my experience, when this is done, fewer AP sessions are needed and clinical recovery is faster. I attribute most of my failures in simple TP cases to non-compliance with that request or to the owner/trainer refusing to have further sessions of AP if 2 or 3 sessions had not been able to restore locomotor function on its own.

Failure to accept advice re use of "Allweather" tracks: A famous trainer was advised by three different vets not to use the "Allweather" track for speed-work for a potentially great colt. (Each time the colt was galloped on the "Allweather", he came in lame). AP at TPs and regional points successfully treated a long-standing back muscular lameness in 2 sessions, after which the colt won an Irish Classic race. One week after the win, the trainer insisted in using the "Allweather" and the horse came in acutely lame again, this time with TPs in the scapular muscles. (The colt was to run in an English Classic within 14 days). Four days after the injury, one session of AP at the TPs and regional points restored locomotor function in 36 hours. The manager was instructed to examine the colt daily for TP tenderness at the clipped points and to inform me within 3-4 days if tenderness persisted there. The training speed was so good that the trainer instructed that AP was not necessary, even though the TPs were still tender and his manager had told him of my advice. On the day before the second race, the TPs were still present. The colt ran a poor last in that race.

Failure to rest horses with strained tendons: In treating horses with tendinitis/bowed/strained flexor tendons, rest is very important when the tendon is "hot" or painful. In all my cases in which laser treatment for simple tendinitis failed, the owner/trainer refused to rest the patients and to re-introduce them gradually to full work, as I had instructed.