The Use of Acupuncture and Conventional Drugs in the Treatment of Epilepsy in a Dog
Enikő Tokács-Máthé DVM, TCVA
Sentinel Veterinary Clinic, Budapest

Abstract: Stewie, a 5-year-old 12 kg neutered male French bulldog, was presented with severe, intractable, idiopathic epilepsy. The patient was nonresponsive to high levels of different types of anticonvulsant drugs and was presented to the author’s clinic in March 2019 for acupuncture treatment. In the year prior to acupuncture treatment, the owners took Stewie to a veterinary epilepsy specialist and tried various kinds of anticonvulsants, such as phenobarbital, potassium bromide, levetiracetam and carbamazepine. Before acupuncture treatment, Stewie had had seizures every 1-11 days. Clinical signs of seizures decreased right after the first acupuncture treatment (no seizures for 29 days). This case report documents the successful treatment of epilepsy with acupuncture in combination with anticonvulsant drugs (levetiracetam and carbamazepine).

Background
Epilepsy is a group of heterogeneous conditions that share a common feature: chronic, recurring seizures. The terms epilepsy and seizures are not synonymous. A seizure is the clinical manifestation of abnormal electrical activity in the brain. It is a specific event in time. Epilepsy refers to multiple seizures occurring over a long period of time.¹ Epilepsy is the most common chronic (long-term) neurological disorder in dogs, affecting an estimated 0.6-0.7% of all dogs (around 1 in 130 dogs).¹

Idiopathic epilepsy, the most common cause of seizures in the dog, is an inherited disorder but its exact cause is unknown. Other causes include liver disease, kidney failure, brain tumors, brain trauma, or toxins.¹

Seizures often occur at times of changing brain activity, such as during excitement or feeding, or as the dog is falling asleep or waking up. Affected dogs can appear completely normal between seizures.¹

Clinical Findings
The patient usually had seizures at night or late afternoon. He had warm ears, back and feet, dry skin and hair with small dandruff flakes. His tongue was red, and his pulse was deep-weak, worse on left and thready, wiry if having cluster seizures. Stewie preferred cool places and had a panting breathing pattern.

The traditional Chinese veterinary medicine (TCVM) examination revealed a patient with a Wood Constitution. Seizures (Internal Wind) and wiry pulse indicated a Wood/Liver disorder.

Treatment
Treatment principles were the following: dispel Internal Wind, support the Liver, tonify Liver Yin, tonify Kidney Yin.²

Dry-needle (DN) acupuncture was used for seizures and to support the Liver in the following points: GV-1, GV-17, GB-20, BL-17, BL-18, HT-7, LU-7, Nao-Shu, LIV-3, KID-6, SP-9. Aqua-acupuncture (Aqua-Ap) was used in the following acupoints: GB-20, BL-17, BL-18, BL-23, Nao-Shu.²

The DN treatment duration is usually 10-30 minutes. Aqua-AP with 0.25-0.5 ml Vitamin B12 may be administered to head and other acupoints.

The number of seizures since the beginning of treatments have significantly reduced. After 4 weeks of treatment, the seizures had decreased for 29 days. From this point, he received 1 treatment every 3-4 weeks and reached 52 seizure-free days.

Discussion
It is risky to discontinue drugs too rapidly in any dog but especially those known to have episodes of status epilepticus or cluster seizure, because the seizure frequency and severity may worsen and require emergency intervention and may cause brain damage. That is why drug administration should be continued. These results were obtained by combining anticonvulsant drugs (levetiracetam and carbamazepine) with acupuncture.

Food therapy is recommended to clear false Heat and tonify Kidney Yin. In Stewie’s case, cool and cold foods were recommended and hot foods should be avoided. Fortunately, Stewie doesn’t have any known food allergies.  He was recommended the following foods to cool and tonify Yin: turkey, pork, duck, crab, eggs, rice, wheat germ, peas, kidney beans, sweet potatoes, tomato, spinach, kiwi, lemons, bananas, watermelon.³ Hot foods to avoid: lamb, chicken, cherries, basil, sweet rice, chilies, cinnamon, ginger, rosemary.³

Conclusion
This case represents a severe case of epilepsy, treated successfully with a combination of dry needle acupuncture and aqua-acupuncture. The use of this alternative treatment has greatly improved Stewie’s quality of life in the past six months and also satisfied his owners.

Acknowledgements:
This case was submitted to the Chi Institute of Europe, Madrid, Spain as a part of the requirements to become a Certified Veterinary Acupuncturist. Due to limited space in the newsletter, this case report was shortened. For additional details on the case, please contact Dr. Enikő Tokács-Máthé at This email address is being protected from spambots. You need JavaScript enabled to view it..

References:

1. Thomas W. Veterinary Clinics: Small Animal Practice. 2010: 40 (1): 161-179.
2. Xie H, Preast V. Traditional Chinese Veterinary Medicine Fundamental Principles 2^nd Chi Institute Press 2013.
3. Xie H, Wedemeyer L, Chrisman C et al. Practical Guide to Traditional Chinese Veterinary Medicine Small Animal Practice. Chi Institute Press. 2014: 2: 81-89.