A combination of conventional therapies and alternative treatments such as PEMF, acupuncture and ozone therapy provides an integrative approach to managing partial paralysis and paresis in canines.
Mobility is one of two predominant methods clients use to assess the health of their dogs, with the other being appetite. Some owners are very attentive to changes in their dogs’ gait, while others only notice significant deterioration, such as an inability to rise or walk. Frequently, gait changes are associated with pain, leading clients and practitioners alike to assess quality of life concerns.
However, from a neurologic standpoint, pain is only a single indicator of neurologic or musculoskeletal dysfunction. Paresis or weakness in muscular response, and paralysis or absence of muscular response, can involve either painful or non-painful conditions. Because pain assessment can be challenging in patients who cannot voice their discomfort, both clients and practitioners fall back on function as an assessment of quality of life and therapy success. In this article, we focus on taking an integrative approach to partial paralysis/paresis in canine patients.
Causes of paresis and paralysis in dogs
Paresis and paralysis are complex conditions and can be the sequelae of multiple and varied causes. Among well-known underlying conditions are spinal, peripheral nerve or orthopedic trauma, and degenerative conditions such as degenerative myelopathy or axonal degeneration, intervertebral disc disease (which in and of itself is a broad category with multifaceted pathophysiologies), autoimmune conditions and toxin exposure. Although there are many ways dysfunction can occur, these conditions are similar in that they include a lessening or loss of neurologic stimulation, and/or a reduction or loss of the ability of the myofibril to respond to the stimulation.
Integrative treatment options
- Neuroprotective treatments include the use of pharmaceutical and non-pharmaceutical anti-inflammatories. NSAIDs, steroidal anti-inflammatories and pulsed electromagnetic field (PEMF) therapy are all labeled as reducing inflammation. Pharmaceutical anti-inflammatories block the formation of prostaglandins to reduce the inflammatory response that causes pain and can lead to tissue damage and dysfunction. Newer NSAIDs aim to limit the bulk of their effect to the suppression of Cox2 while sparing the physiologically beneficial Cox1. The degree to which this effect is achieved is dose dependent and based on the sensitivity and physiology of the individual patient.
- Glucocorticoids are steroidal anti-inflammatories that suppress all the inflammatory pathways. This results in more complete inhibition, not just of pain, but also immune system response to tissue damage. Due to their broad immune and tissue suppressive effects, glucocorticoids have been avoided when a dog simply seems “painful”.
However, some studies have shown that in the early treatment phase of certain neurologic conditions such as trauma or IVDD, glucocorticoids, particularly methyl sodium succinate, can offer a neuroprotective component combined with pain management. Nevertheless, consensus on using steroids in the management of IVDD is very controversial. In the case of compressive effects from neoplastic lesions, corticosteroids may afford temporary relief from pain through tumor suppressive effects and reduced pressure to the nerve.
- PEMF therapy can help reduce inflammation by increasing the nitric oxide (NO) response to tissue damage. NO increases blood flow via the binding of calcium to calmodulin receptors. PEMF can also reduce interleukin, interferon gamma and tumor necrosis factor, which can exert a neuroprotective effect and promote musculoskeletal healing. This combination of effects not only helps modulate pain, but also reduces the cascade of damaging events that can exacerbate a loss of function.
- Acupuncture is a widely known adjunctive therapy that is gaining popularity even among allopathic practitioners. The stimulation from acupuncture needles modulates many autogenous biochemical molecules to affect physiologic pathways. These include the aforementioned Cox2, interleukin and TNF. Acupuncture promotes normalization of the parasympathetic and sympathetic nervous systems through modulation of neurochemicals.
Electrical acupuncture causes elevations in Gaba, dopamine and serotonin, which both elevate mood and reduce neuropathic sensations. Acupuncture increases endocannabinoids, and endogenous opioids help modulate pain. These neurologic changes can impact mobility by reducing pain and improving the willingness of a patient to try to get up and move, even when challenged by weakened muscles, nerve input or pain.
- Ozone and prolozone are lesser-known techniques for reducing inflammation, addressing localized tissue pain and stimulating tissue healing. Ozone and prolozone refer to the use of the ozone molecule to stimulate a cascade of pathways that result in enhanced antioxidant levels. Ozone is an oxygen molecule that contains three atoms sharing covalent bonds, rather than the usual two atoms. The presence of the third oxygen atom creates stress on the electron position, such that the entire molecule is reactive and looking for another electron to balance the positions.
Infusion of ozone causes the formation of a very small number of free radical and lipid peroxidases. Although the small number of reactive oxygen species molecules is quickly neutralized, this minor stimulation promotes an increase in production of antioxidant molecules, including glutathione and superoxide dismutase. This means that when ozone is used as a treatment local to the area of pain, it can enhance the body’s natural healing processes and potentially lead to improved outcomes for canines suffering from partial paralysis.
Conclusion
Integrative approaches to managing partial paralysis in canines highlight the importance of combining conventional therapies with innovative treatments. These methods not only reduce inflammation and pain but also promote tissue healing. By utilizing a comprehensive strategy that includes PEMF, acupuncture, and advanced therapies, veterinarians can offer an integrative treatment plan that addresses both symptoms and underlying causes. As research continues to support these integrative practices, pet owners can look forward to improved recovery options for their canine companions, ultimately enhancing their quality of life and mobility.
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