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PICO Question In dogs with thoracolumbar intervertebral disc extrusion does the use of acupuncture with medical management compared with medical management alone improve clinical recovery? Clinical bottom line Category of research Treatment. Number and type of study designs reviewed Three papers were critically appraised: one randomised controlled trial, one non-randomised controlled trial, and one cohort study. Strength of evidence Moderate. Outcomes reported Acupuncture, and more specifically the combination of electroacupuncture and manual stimulation of acupuncture points when used as an adjunct to medical management, is more likely to result in both the recovery of ambulation and a quicker recovery of ambulation in dogs presenting with nonambulatory paraparesis or paralysis with deep pain perception due to thoracolumbar intervertebral disc extrusion, compared with medical management alone. It is less likely to make a difference in dogs that present with paralysis and no pain sensation. There is less robust evidence supporting the use of bee venom injections in acupoints, however; it too may have a beneficial effect when used as an adjunct treatment in dogs with nonambulatory paraparesis or paralysis with deep pain perception due to thoracolumbar intervertebral disc extrusion, compared with medical management alone. Conclusion There is moderate evidence supporting the conclusion that there is a mild benefit in the use of acupuncture with medical management to improve the clinical recovery of dogs with thoracolumbar intervertebral disc extrusion. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. |
