Straight to the Point

Data from the 1998 AAEP Equine Practitioners Therapeutic Options Task Force showed that remarkably 37 percent of its members used acupuncture in their practice. The millennia-old practice can be used for a variety of conditions in stallions and mares, especially for reproductive stimulation.

Acupuncture treatments have worked in stallions that have a low libido and/or poor sperm quality.

Rhonda Rathgeber, DVM, Hagyard-Davidson-McGee, readily uses acupuncture in her equine practice and details the theory and practice in her book, "Understanding Equine Acupuncture". Acupuncture can be used as a diagnostic tool or therapy, predominantly for horses that fail to respond to treatment by conventional Western medicine.

Shen Xie, DVM, PhD and MS, University of Florida College of Veterinary Medicine, compares the uses of acupuncture to treat reproductive problems to a traffic cop. In a bustling city, people might be inclined to drive their cars aggressively in different directions, going everywhere, he explains. It would be better to have a policeman there to guide the traffic flow.

Acupuncture is like the policeman to help guide the disorder of traffic flow or the disorder of hormone levels. If hormone levels, either luteinizing hormone (LH), follicle-stimulating hormone (FSH) or progesterone are fluctuating wildly or too high, then acupuncture, in general, is beneficial to regulate and provide homeostasis to the hormone levels. But if there is a crisis, then Xie says the use of Chinese herbal medicine is necessary.

Physiological mechanisms for acupuncture's effects on the reproductive system include an endorphin-mediated mechanism affecting the hypothalamic-pituitary-gonadal endocrine axis and a direct effect on gonadal paracrine and autocrine control of steroidogenesis.

As in a severe auto accident, one needs a fireman or a doctor to rescue the people. If there is a tumor or cyst on the ovary, then herbal medicine is better suited for the severe condition. Originally, the practice of Chinese herbal medicine, recorded in ancient Chinese literature, dates back to 3,000-year-old recipes, while others only have been formulated recently, Xie says.

Comparative treatments

Acupuncture is physiologically specific compared to other forms of Chinese medicine. While the effectiveness of the Chinese herbal remedies to treat equine reproductive disorders may be controversial, there have been numerous successful outcomes over many centuries. However, the difficulty of assigning significant scientific efficacy to the formula or a particular ingredient of an herbal formula obviously is confusing.

Most of the herbal recipes are of multiple ingredients—usually eight to 10. Within the literature, there are few if any controlled studies of the individual ingredients to discern their particular role to the effects or successful treatments noted. It would be of interest to conduct studies on the constituent ingredients at varying dosage levels to measure their result with some physiological response. It would also be of interest to measure some parameter in the blood or tissues once they have been consumed. Their bioavailability is of interest, as well as their metabolism. It is not to be skeptical of their benefit, only to measure their actual metabolic and physiological role and possibly learn to be able to prescribe them at particular dosages, explore the most effective compounds and get the maximal benefit from each of them.

Equine ICU opens at LSU

The physiological mechanism for acupuncture's effectiveness to treat reproductive disorders, on the other hand, is more definitive. The two proposed physiological mechanisms for its effects on the reproductive system include an endorphin-mediated mechanism affecting the hypothalamic-pituitary-gonadal endocrine axis and a direct effect on gonadal paracrine and autocrine control of steroidogenesis.

General attributes

Acupuncture is thought to trigger the release or inhibition of the various hormones, including LH, FSH, estradiol and progesterone. Electroacupuncture (EA) decreased plasma LH levels in sows (Lin et al. 1992). Acupuncture can affect these hormones via endorphin release. It is known that endorphins, as well as opiods, inhibit LH release.

Studies have shown that acupuncture increases endorphin levels in the brain, spinal chord and blood, Rathgeber says. There is evidence that the hypothalamic beta-endorphin system has a central role in mediating the pain-relieving effect of acupuncture (Wang et al. 1990), as well as the changes seen in autonomic functions after acupuncture. Acupuncture has been shown to alter plasma beta-endorphin levels and might have an effect on gonadotropin-releasing hormone (GnRH) and pituitary gonadotrophin secretion (Stener-Victorin 2000, 2002). Acupuncture also can affect the gonadal paracrine and autocrine control of steroidogenesis by stimulating the release of epinephrine, catecholestrogens and growth factors (Chang et al. 1983; Battista et al. 1987), or it might affect the stimulation of sympathetic and parasympathetic nerve fibers.

Reproductive treatments in stallions

In addition to the literature supporting studies of acupuncture and equine reproductive disorders, there is considerable information regarding its use in dairy cows, bulls and sows.

Stallions have been treated successfully with acupuncture.

"I've done quite a few yearling stallions with unilateral undescended testicles," says Martha Rodgers, VMD, certified acupuncturist in Lexington, Ky. "I haven't done very many where they've had both retained. I've done a couple that have had both testicles high in the ring so that you could palpate the testicle in the ring. I've not done any where I could not feel the testicle at all bilaterally. We've had some resolution with the testicle high in the ring, about 60 to 70 percent that will descend, depending on how high they are and how palpable, usually within three to four treatments with some GnRH in the testicular and reproductive points to try to help stimulate function and increase weight to the testicle to help bring it down. We also use some points for muscular relaxation in case it is a muscular tension issue. We also use it in those horses that are unilaterally high. Though if I can not palpate the testicle at all, I feel it is less than a 15-percent chance, a pretty slim chance that you'll get them to descend if you can't palpate them."

Rodgers also has used acupuncture in three to four stallions that had breeding problems due to lameness or soreness issues. It's a valuable use, where stallions might be sore in the back or in the hind legs, and they are having difficulty or are resistant to breed due to those hind-end musculoskeletal issues. With acupuncture, they have been able to perform well. They've also used it in about three to four stallions that have had good libido but have had suboptimal sperm quality.

"Of those that I've used it on, it has helped almost all of them," she says.

With stallions that were breeding two to three times a day, treatment efficacy would fall off after about 48 hours, and then they received a repeated treatment and were fertile again after breeding the next mare after the second treatment. It appeared to be a more transient effect for sperm quality, but it did seem to have some correlation with improvement of motility or quantity once they had the acupuncture. With those stallions, they also were using some GnRH in the testicular and reproductive acupoints.

Chris Cahill, DVM in Lexington, Ky., uses acupuncture to treat reproductive problems of both mares and stallions. For stallions, he uses the same reproductive points.

"You are basically working on the kidney, the bladder and the tri-heater meridian points, which are associated with the hormonal system," he says.

Cahill treats many yearlings in the spring of the year, but, as Rodgers noted, if they are truly abdominal cryptorchids, then he can't do them any good.

"If I can feel the tip of the epididymis coming through the external ring, I have really good luck bringing them down," Cahill notes.

But the impotent stallion is a good candidate for likely improvement.

"A lot of them are breeding quite frequently. Just like in human men, a big cause of impotence is lower-back pain," Cahill says. "You breed these horses three times a day, seven days a week for a couple of months, many of these horses with arthritic hocks, hips and sore lower backs, they'll just quit breeding."

The response with acupuncture is "absolutely irrefutable," Cahill says. "When I first started doing acupuncture, I wanted in some ways to disprove it or had to prove it to myself."

Cahill has taken impotent stallions that have quit breeding and successfully treated them with acupuncture. Prior to Cahill's use of acupuncture in most cases, "they tried everything on them."

Because they were sore, the attending veterinarian would give them non-steroidal anti-inflammatory drugs (NSAIDs). Exercise routines varied, but they'd still be too sore to breed. Prior to treatment, their serum testosterone would be similar to a yearling, about 800 to 900 nanograms (ng). Once treated with acupuncture—three times during a seven-day period—there is a significant increase in the testosterone level from the suppressed level of 900 ng/ml up to 2,800 ng/ml. Not only does the testosterone level increase, but they typically returned to breeding the next day, Cahill says.

"It's absolutely irrefutable. I've gotten to where I don't draw blood samples any longer (to check testosterone levels)," he says. "Before I wanted to prove to myself that I was really doing something. But the results have been very dramatic, especially in the non-breeding stallion."

Dr. Kane earned his doctorate in equine nutrition and physiology from the University of Kentucky in 1978. He works within the animal-feed industry with a specialty in horses.