Coral Springs Animal Hospital's Pawfessional PAWfessional Rehab Issue 2017 | Page 36

Acupuncture stimulates the release of endogenous substances such as beta-endorphins, dynorphins, enkephalins and serotonin (Skarda 2002, Wu 1995, Han 1984, Scherder 1993, Costa 1982). Acupuncture is routinely used either as a single modality or more commonly as part of a multi-modal approach to pain management. Painful feline conditions that respond favorably to acupuncture include degenerative joint disease/osteoarthritis, degenerative lumbosacral stenosis, cystitis, stomatitis, aortic thromboembolism and neuropraxia. Typical treatments are composed of about 5-20 needles that are left in place for 15-30 minutes, and are frequently connected to an electrical acupuncture unit for increased stimulation. The mechanisms by which low-level laser therapy (LLLT) decreases pain includes release of endogenous opioids, changes in conduction latencies of nerves, increase of cellular metabolism, increase in circulation, promotion of neovascularization, decrease in fibrosis formation, and reduction of inflammation (Hagiwara 2007, Schlerder da Rosa 2012). LLLT also improves wound healing via increasing cellular proliferation, re- epithelialization and collagen deposition (Yu 1997, Favaro-Pipi 2011). Feline conditions that respond well to LLLT include osteoarthritis, degenerative lumbosacral stenosis, fractures, chronic wounds and stomatitis. Most cats tolerate the treatment well as it is not in itself painful and requires a relatively short time to deliver the treatment. Extracorporeal shockwave therapy (ESWT) is a high-energy, focused pressure wave that delivers energy to a specific focal point in the body. The pressure from this energy causes cells to release proteins, cytokines and growth factors. ESWT can decrease pain through the release of serotonin in the dorsal horn and descending inhibition of pain signals (Niebaum 2013). In cats, ESWT is most commonly used to treat osteoarthritis, tendinopathies, non- healing fractures, and chronic non- healing wounds. Typically 1-3 treatments every 2-3 weeks are performed under sedation.