AVAC AGM: Fall Weekend Intensive Advanced Acupuncture Course

Join your colleagues October 22-23, 2016 in downtown Toronto for the Annual General Meeting of the Association of Veterinary Acupuncturists of Canada.

Dr. Neal Sivula, DVN, PhD, FAAVA will be lecturing on acupuncture from a neurological perspective for internal medicine, musculoskeletal and neurological disorders.

Acupuncture case presentations and Round Table discussions to share different approaches to common issues.


Fall weekend registration form October 2016

Fall weekend CE Neal Sivula brochure

Fall weekend CE call for cases

We are offering registration discounts to our colleagues who present a case for the Round Table discussion. There is still space for a few cases, but case presentations are on a first-come first served basis so don’t delay.

Intervertebral Disc Disease (IVDD)

For many people, the cutest dog breeds are the small ones; dacshunds, poodles, bichons, shi-tzus and others typically referred to as toy breeds.

Unfortunately these breeds are also over-represented in the caseload of patients with intervertebral disc disease, also referred to by its initials IVDD. It is sometimes called a “slipped disc” or “herniated disc”.  It is caused by degeneration of one or more of the shock-absorbing pillow-shaped discs located between the vertebral bones of the spine. These discs can become hardened and stiff (calcium deposits form inside them) causing bulging of the disc into the spinal canal, or they may rupture, letting the soft jelly-like material they contain out into the canal. There is really only enough room for the spinal cord in the spinal canal, so it gets compressed and sometimes irreparably damaged.


When the spinal cord or the nerves passing out of it to the body are compressed, pain and impairment of neural function are the result. Some dogs show minimal symptoms but stop doing things that hurt such as going up or down stairs, jumping on the bed or going about their usual activities. An observant guardian may sometimes notice a change in gait, a wobble or hitch in their step, especially when turning or changing directions. Others may have severe and unrelenting pain and refuse to move, eat or void their bowels or bladder. in the most severe cases there is no pain- all sensation and movement beyond the location of the spinal cord damage is lost, resulting in complete paralysis.

Damage to the spinal cord causes a loss of communication between the brain and the body. Most dogs that have grade 2-4 IVDD will remain permanently impaired, if they are able to regain their ability to walk at all. There are 27 discs (or more in some long-backed breeds such as dachsunds, basset hounds and corgis)  between the vertebral bones from the nape of the neck to the tail. Since the disease in a degeneration, multiple discs may be affected. A recent veterinary study at The Royal Veterinary College in the United Kingdom established a relationship between long backs, short legs and IVDD.vertebral anatomy

Early treatment is critical for IVDD. In cases of unrelenting pain or paralysis, an MRI of the spinal cord to determine location of damage followed immediately by surgery to remove the herniated disc material is usually recommended. Unfortunately this surgery only has a success rate of  50%.

Intensive acupuncture with electrostimulation and physical rehabilitation is essential for return to full function, or as full as posible depending on the extent of spinal cord damage. For back pain only with no loss of nerve function (such as loss of spatial sensation, called proprioceptive deficits) the treatments are started at twice a week and taper quickly to once a month for maintenance. For paralysis the treatments will be daily to every third day until sensation returns. Nursing care for these dogs is critical, as bladder and bowel function is lost as well. Poor hygeine can lead to bedsores, bladder infections and painful skin rashes.

So if you have a long-bodied, short-legged dog in your family, be aware of this devastating disease and keep an eye out for the little signs you might otherwise miss. Regular acupuncture treatments can not only help keep your dog’s back flexible and healthy but the veterinary acupuncturist will check for subtle signs at every visit to catch and treat dysfunction before pain and disability occur.

Pain is a Pain

Recently when suffering a barometric pressure-change headache I was thinking about pain in our companion animals. We can’t ask them where and how it hurts, if the pain is worse with certain activities or at certain times of day. As veterinarians we have to play detective, and try to figure things out with physical examination and lab test findings, and integrative veterinarians have extra tools such as knowledge of trigger points, Traditional Chinese Veterinary Medicine diagnostic points and meridian flow. Guardians need to be ever aware of subtle changes in behaviour that may be an indication of pain in your beloved companions. Here is a good article on picking up those subtle changes, http://bit.ly/apdFOb
All of the injuries and disorders that can cause human beings pain can cause pain in animals.
Complementary therapies for pain such as acupuncture, massage, cold-laser therapy and herbal medicine can safely combine with or even replace the use of painkillers such as opiates, non-steroidal anti-inflammatories (NSAIDS) and other pharmaceuticals.

Holistic VS Homeopathic- what’s the difference?

Differences between Holistic, Integrative, Naturopathic, Alternative and Homeopathic therapies and practices:

 Do you use holistic, homeopathic and naturopathic interchangeably? Have you ever discussed holistic health and discovered that the other person was defining holistic totally differently? This is not surprising, since no accepted standards exist for holistic, holistic health, or holistic medicine.

Many people, myself included, define holistic as a whole made up of interdependent parts; an inclusive view of the animal in its environment, encompassing its relationships with other pets and the guardian (family).  When applied to illness, it is called holistic medicine and includes a number of factors, such as dealing with the root cause of an illness; increasing client involvement; and considering both conventional (allopathic) and complementary (alternative) therapies.

Some people use Holistic as a synonym for alternative therapies. By this definition, “going holistic” means turning away from all conventional medical options and using alternative treatment exclusively. This meaning mainly relates to illness situations, and sometimes is used for controversial therapies.

Integrative Medicine is the combiantion of conventional and alternative therapies, using multiple modalities to gain the “best of both worlds”.

Naturopathic Medicine is focused on prevention and the use of natural treatment options to promote healing.

Alternative Medicine is defined as modalities of therapy that have not been taught or embraced by colleges of veterinary medicine, used in place of conventional therapies. This definition is very fluid, as different universities in different locations in the world all have variations in what is taught. Over time this also changes. For example, 30 years ago, essential fatty acid supplements were alternative, now they are mainstream. Alternative therapies can include a wide range of modalities such as:  acupuncture, chinese and western herbs, orthomolecular medicine, nutritional supplements, low-level laser therapy, Tellington Touch, acupressure, Reiki, Craniosacral therapy, chiropractic, flower essences, ozone therapy, homeopathy, massage and many other modalities.

Complementary Medicine is defined as modalities that are not taught or embraced by colleges of veterinary medicine, used in addition to conventional therapies (see Integrative Medicine)

Homeopathy from the Greek words homoios (similar) and pathos (suffering) is an entire system of medicine, notable for its practice of prescribing water-based solutions that contain extremely diluted ingredients. The theory of homeopathy was developed by the Saxon physician Samuel Hahnemann (1755–1843) and first published in 1796. Homeopathy calls for treating “like with like” (law of similars). The practitioner considers the totality of symptoms of a given case. He or she then chooses a homeopathic remedy that has been reported in a homeopathic proving to produce a similar set of symptoms in healthy subjects. This remedy is usually given in extremely low concentrations.

Arthritis therapy: Integrative approach

Many patients I see suffer from joint pain, loss of mobility, stiffness, and decreased quality of life due to degenerative joint diseases such as arthritis.

A multimodal approach is required for this very challenging condition. Usually an increase in mobility, a decrease in pain and a much better quality of life results. Key modalities are diet, acupuncture, cold-laser therapy, herbal supplements, nutraceuticals (nutritional supplements such as omega-3 EFA, green-lipped mussel extract, glucosamine,  chondroitin, MSM, antioxidants), injectable joint-support products such as Cartrophen and Adequan, Prolotherapy, non-steroidal anti-inflammatory drugs such as Metacam, and Deramaxx, and non-sedating narcotics such as Tramadol.  Sometimes steroidal anti-inflammatory drugs are used, but they are usually reserved for cases where the benefits outweigh the greater risks of that class of drug. Physical therapy such as underwater treadmill exercises and swimming in a controlled environment is helpful for improving mobility and building muscle strength lost due to inactivity. For the very difficult cases, nerve-pain drugs such as Amantadine and Gabapentin are added. Surgery is needed when there is significant joint instability leading to partial or full luxation (dislocation), bone chips in the joint space or for hip replacement. A new cutting edge modality now available is Vet-Stem Regenerative Stem-cell Therapy for dogs!

The cornerstone of diet therapy is to maintain or acheive a lean body condition. Often these pets have not been able to exercise for a very long time, and subsequently gained weight. This added weight is a serious complication for painful joints, as every extra gram the animal has to carry stresses the affected joint more. Sometimes weight loss is all that is needed for the return to full mobility, but in the majority of cases additional modalities need to be used. To determine how much weight needs to be lost and a safe rate for the slimming program, consult your veterinarian. There are prescription weight loss diets available, as well as a medication (Slentrol-for dogs only) to help acheive ideal body weight.

Acupuncture is an often-overlooked modality, but it really shines for treating chronic pain. In the hands of a practitioner trained in Traditional Chinese Veterinary Medicine, the whole body is treated, not just the affected joints, so many other issues can be addressed at the same time. The cost of acupuncture treatments is usually comparable to or even less than conventional drug treatment. Side effects are rare and usually very minor such as mild bruising at the acupuncture site.

Cold-laser therapy can be used for laser acupuncture, to stimulate acupoints without needles, or as regional therapy directly over the affected joint. The laser treatment reduces pain, increases blood flow and stimulates healing. It is usually given very frequently at first, such as 3-4 times per week, then tapered down to weekly or even monthly.

Herbal supplements are available at many pet and health-food stores, as well as online. The english name of the herb on the label is not sufficient, as many very different herbs have similar common names. The part of the plant used needs to be identified, as some plants have toxic roots but safe leaves, and vice versa. The product should be tested for contaminants, such as bacteria, mold, heavy metals and other toxins. Finally, the extraction process and amount of herb present in the product should be listed. Sadly most of the products available directly to the consumer are lacking in many if not all of the above. Another issue is the use of herbs that may be safe for people, but are toxic to pets; cats are  especially sensitive to many things that are safely used for dogs and people.  Remeber that herbs, like drugs, can have severe and even life-threatening side effects. Do not be lulled by the fact that they are “natural” products; they contain a wide range of chemical compounds that can work synergistically to help OR harm. Please consult a veterinarian trained in herbal medicine before using an herbal remedy for your pet. Listings of qualified veterinarians can be found at www.vbma.org www.tcvm.com and www.ahvma.org

What is Laser Acupuncture?

Laser Acupuncture uses an infrared “cold” laser beam to stimulate the acupuncture points instead of inserting needles into them. A feeling of warmth or tingling may temporarily occur. Laser Acupuncture is particularly indicated in sensitive, bony areas of the body such as the feet, or in areas that are dangerous to insert needles into, such as the umbilicus (bellybutton).

What about herbs, supplements and massage?

Sometimes the use of botanicals (herbal medicines) supports the acupuncture treatment. The veterinarian trained in TCVM may supplement, or even replace acupuncture treatments with botanical therapy. Herbs are often used in situations that have not responded to conventional veterinary medical interventions. Supplements provide higher levels of nutrients that are found naturally in food, but which the individual may require in larger amounts than would usually be eaten.

Tui-na is an ancient Chinese method of manipulation/bodywork that encompasses techniques similar to chiropractic, physical therapy and massage. Simple techniques are often taught to the pet’s guardian to perform at home to support the acupuncture treatments. Tui-na sends energy past blocked points, relieves muscle tension, energizes and comforts the pet.

Who will be treating my pet?

In most countries, states and provinces, veterinary acupuncture is considered a surgical procedure that only licensed veterinarians may legally administer to animals. A veterinarian trained in TCVM is in the best position to diagnose an animal’s health problem and then to determine whether an it is likely to benefit from an acupuncture treatment, or whether its problem requires herbal, conventional pharmocological, surgical, or no intervention. Dr. Sherebrin, DVM, CVA administers all acupuncture treatments personally. She remains present the entire duration of the first session to ensure that both the guardian and the pet are completely comfortable, and is available to answer questions at all times.

How often are treatments given?

A simple acute problem, such as a muscle sprain, may require only one treatment, whereas more severe or chronic ailments may need a dozen treatments. When multiple treatments are necessary, they usually begin intensively. Patients often start with 1-3 treatments per week for 4-6 weeks. A positive response is usually seen after the first to third treatment. Once a maximum positive response is achieved treatments are usually tapered off. Animals undergoing athletic training can benefit from acupuncture treatments as often as twice a week. The frequency depends on the intensity of the training and the condition of the athlete.

How long do treatments last?

The length and frequency of acupuncture treatments depends on the condition of the patient and the method of stimulation that is chosen. Stimulation of an individual acupuncture point may take as little as 10 seconds or as much as 30 minutes.