In dogs with thoracolumbar disc extrusion does the use of acupuncture improve clinical recovery?

PICO question: In dogs with thoracolumbar intervertebral disc extrusion does the use of acupuncture with medical management compared with medical management alone improve clinical recovery? Clinical bottom line: Category of research: Treatment. Number and type of study designs reviewed: Three papers were critically appraised: one randomised controlled trial, one non-randomised controlled trial, and one cohort study. Strength of evidence: Moderate. Outcomes reported: Acupuncture, and more specifically the combination of electroacupuncture and manual stimulation of acupuncture points when used as an adjunct to medical management, is more likely to result in both the recovery of ambulation and a quicker recovery of ambulation in dogs presenting with nonambulatory paraparesis or paralysis with deep pain perception due to thoracolumbar intervertebral disc extrusion, compared with medical management alone. It is less likely to make a difference in dogs that present with paralysis and no pain sensation.There is less robust evidence supporting the use of bee venom injections in acupoints, however; it too may have a beneficial effect when used as an adjunct treatment in dogs with nonambulatory paraparesis or paralysis with deep pain perception due to thoracolumbar intervertebral disc extrusion, compared with medical management alone. Conclusion: There is moderate evidence supporting the conclusion that there is a mild benefit in the use of acupuncture with medical management to improve the clinical recovery of dogs with thoracolumbar intervertebral disc extrusion.