Acupuncture
A growing number of studies show the efficacy of acupuncture in treating pain conditions [ 22 ] . The mechanism of action is due to the release of endogenous opioids , endorphins , enkephalins and corticosteroids , via peripheral , spinal and supraspinal mechanisms [ 9 ] . The analgesic effects of acupuncture can be reversed with naloxone .
In ferrets , acupuncture techniques have been used successfully to provide an antiemetic effect in cases of nausea induced by morphine and chemotherapy [ 23 , 24 ] , in cases of hindlimb lameness / weakness , chronic diarrhoea and urinary incontinence [ 25 ] , and in medically managed intravertebral disc disease [ 15 ] .
‘ Electroacupuncture ’ is electrical stimulation of acupuncture points ( Figure 11 ). Veterinary acupuncturist Mitsie Vargas [ 26 ] reports the successful use of electroacupuncture in intervertebral disc disease in ferrets , alongside traditional Chinese veterinary medicine .
The pre- and post-treatment videos recorded by Vargas can be viewed on YouTube at : https :// www . youtube . com / watch ? v = dG1njEBfoDU and https :// www . youtube . com / watch ? v = ugdtHo3SG7c & feature = youtu . be .
In ‘ aquapuncture ’ treatment , a small amount of sterile fluid ( saline , or an injectable diluted vitamin , such as vitamin B12 ) is injected into the patient to create pressure on the acupuncture site instead of using an acupuncture needle . Aquapuncture is used in species such as ferrets that may not tolerate acupuncture needles for any length of time .
Photobiomodulation
A large body of evidence is available on the use of photobiomodulation ( also known as low-level laser therapy ) in small exotic mammals , with most research conducted on laboratory rats and rabbits .
Photobiomodulation interacts with chromophores in the cells , and up- or down-regulates biochemical processes . The mechanism of action is not entirely understood , but one known process is that wavelengths of light between 500 nm and 1,100 nm break bonds between nitric oxide and cytochrome C oxidases , resulting in the release of nitric oxide for vasodilatory effects , reactive oxygen species for cytoprotective signalling , and the production of adenosine triphosphate ( ATP ) for energy , pain reduction and healing [ 27 ] .
Generally , laser therapy increases microcirculation in tissues , increases leucocyte infiltration and macrophage activity , increases neovascularisation and potentially provides pain relief .
Photobiomodulation has been shown to be effective in exotic pet species for wound healing , pododermatitis , arthritis , fracture repair and bone regeneration , oedema , hair loss , muscular sprains and strains , scurvy , spondylosis , and any condition that requires antiinflammatory treatment , analgesia or an increased rate of healing [ 27 , 28 ] .
There are few contraindications , but it is not recommended to use laser therapy on haemorrhagic tissue , an open fontanelle , over endocrine glands or in patients on light-sensitive medication .
As yet , there is insufficient evidence on whether it is safe to use on neoplasia ( although some studies show an inhibitory effect on cancerous tissue [ 27 ] ). Similarly , evidence is lacking on its effect on foetuses in pregnant patients . The dose should be reduced over metal implants . The patient ' s eyes should be protected . Overabsorption can occur with pigmented skin . Care should be taken to prevent overheating of the targeted area [ 27 ] .
Figure 11 . Electroacupuncture being used as part of medical management for several lumbar disc compressions . Photo permission from Mitsie Vargas .
Small exotic mammals require lower doses than larger mammals . There is no consensus yet on the ideal parameters for the use of photobiomodulation across certain conditions and species , but Mayer and Ness [ 28 ] have provided a general dosage table for small exotic mammals .
36 Veterinary Nursing Journal