(Adapted from the original paper in Bull. Anim. Hlth. Prod. Afr. (1995) 43:157-158)
Needle acupuncture was applied at the umbilical scar of a Highland Zebu steer with diarrhoea due to paratuberculosis. The acupuncture resulted in a sixteen-days cessation of diarrhoea and alleviation of clinical signs. It was suggested that acupuncture therapy could be a potential component of the treatment of Johne's disease and other diarrhoeal diseases.
Acupuncture, an ancient Chinese art of healing, is used to treat a wide variety of diseases. In different parts of the world, intensified research is going on to understand its mechanism of action. However, studies conducted so far indicate that acupuncture stimulates the body's cellular and humoral defence systems(1). In Ethiopia, the only documented information on the veterinary practice of acupuncture is by members of Chinese Veterinary Team who reported on a successful treatment of equine colic(2) and on electric needle anaesthesia(3)
Paratuberculosis (Johne's disease) is a chronic debilitating disease of ruminants caused by Mycobacterium paratuberculosis; its definitive diagnosis requires faecal culturing(4). Microscopic examination of suspected faecal smear or rectal pinch biopsy after Ziehl-Neelson staining can be used also(5,6). Prospects for treatment of the disease are poor and the usual fate of the patients is destruction(6). This trial attempted to examine the effect of needle acupuncture on the clinical manifestations of Johne's disease.
Materials and Methods
Case History and Clinical Examination
A 19-year old Highland Zebu steer was presented in March 1994 to the clinic of the Faculty of Veterinary Medicine, Addis Ababa University, with history of diarrhoea that lasted two years. It was emaciated and dehydrated. Rectal temperature was within the normal range. Faecal examination for parasites was negative, due to deworming by the owner. It was nevertheless wormed with Albendazole (TAD PHARMAZEUTISCHES WERK GMBH, Germany). However, the animal was brought back to the clinic for incessant watery diarrhoea and further loss of condition and was this time severely dehydrated. Then Johne's disease was suspected and faecal sample as well as rectal scrapings was taken. Ziehl-Neelson staining revealed clumps of acid-fast bacteria of mycobacterial morphology in both samples. The rectal mucosa was hyperaemic and wrinkled.
Treatment with streptomycin, the only available drug of choice, at a dose rate of 50 mg/kg daily would cost 6 Birr (=1 USD) per day. Such a bill would be more than the animal's value and was not affordable to the owner. Even if such a regimen had been instituted, the result would have been only a transient improvement in the clinical signs(6). Therefore, instead of leaving the animal to die in due course, it was decided to intervene by stimulating an acupoint at the umbilical scar indicated for diarrhoeal cases(7). Three to five 20-22 G, 0.5-1 inch hypodermic needles were used, with proper aseptic procedure, to puncture the umbilical scar. The needles were twirled and pecked in situ for 3 -5 minutes and the urachus was also stimulated. Treatment was repeated daily for four days and then recess of 3 days for another two days. Follow up was made every two days.
The diarrhoea ceased after the third session, when faeces changed to a soft consistency; treatment was discontinued after six sessions. The degree of dehydration decreased subsequently and gross thickening of the rectal mucosal reduced also. However, acid-fast bacilli were still detected during the remission of the diarrhoea. However, diarrhoea recurred 16 days after its cessation. Then we used other acupoints, viz. GV01 (human Changqiang; animal Jiaochao), BL20 (Pishu) ST36 (Zusanli) and ear tip venipuncture(8). These points were stimulated by needling to similar depths as used by Hwang & Jenkins (1988). As the animal was not brought back as regularly as required, unfortunately it was not possible to continue the therapy and follow up.
The animal's condition, the method used (electrical, traditional, laser, magnetic, irritant chemicals etc) and the practitioner's experience can influence the effectiveness of acupuncture. Besides lack of proper facilities to apply the different therapeutic methods, the steer was old. Its age may have had a negative impact on the immune response, affecting the duration of recovery from diarrhoea.
The history of the animal indicated that such an interruption of diarrhoea, like that observed after acupuncture, was not seen earlier. Moreover, the cessation of diarrhoea and improvements in clinical signs were noticed in a relatively short time (3 days) after the start of treatment. These facts suggest that the change noticed was due to acupuncture therapy.
We believe that acupuncture could be a potential therapy, either alone or with antibacterial therapy, in alleviating the clinical manifestations of paratuberculosis. Further studies, under controlled conditions and by applying different methods of acupuncture, either alone or in combination with specific therapies for various diarrhoeal cases, are recommended.
Editor's Note: Most developed nations classify Johne's disease (bovine paratuberculosis) as a notifiable disease; legislation requires owners or professionals who suspect its presence to notify the appropriate veterinary authority. Suspect cases are tested and positive cases are killed as soon as possible. Therefore, treatment of Johne's disease is forbidden or inappropriate in states that operate a national policy to eradicate it. The value of this article is that it suggests that acupuncture may alleviate diarrhoea in chronic bacterial disease. The authors do not advocate its use to treat Johne's disease in countries where it is illegal to do so.
The authors acknowledge the technical assistance provided by W/ro Amelework Eyado and W/ro Senait Atlaw.