Vet AI Scribe for Integrative Medicine

Juniper

Wednesday, October 21, 2026 at 2:00 PM

Acupuncture session 3 — chronic hip osteoarthritis

Subjective

Reason for Visit

Third acupuncture session for Juniper, a 12-year-old spayed female German shepherd mix with bilateral hip osteoarthritis, managed together with her primary care veterinarian.

Owner Report

• Getting up from her bed more easily in the mornings since session 2; still slow on the back steps.
• Walks back to 20 minutes twice daily, up from 10 minutes before the first session.
• Grapiprant continued once daily as prescribed by the primary care veterinarian; omega-3 fish oil given daily.
• Restless and panting at night on 2 nights this week; seeks cool floors.
• Appetite and stools normal.

Objective

Conventional Exam

• Weight: 31.2 kg
• Gait: Shortened stride in both hind limbs at the walk, left more than right; mild hind-end sway
• Pain: Discomfort on extension of both hips, left more than right; lumbosacral palpation non-painful today
• Muscle: Mild bilateral hind-limb muscle loss, unchanged from session 1
• Pain score: Canine Brief Pain Inventory completed by the owner: pain severity 3/10 (5/10 at session 1)

TCVM Findings

• Tongue: Pale lavender, slightly dry
• Pulse: Weak and thready on the left, slightly rapid
• Other: Seeks cool surfaces, warm ears and back at rest
• Pattern noted by the clinician: Kidney yin deficiency with qi and blood stagnation in the hips

Treatment Today

• Dry needling: GV-20, Bai Hui, BL-23 and BL-40 bilaterally, GB-29 and GB-30 bilaterally, KID-3 bilaterally
• Electroacupuncture: GB-29 to GB-30 bilaterally, 20 Hz, 15 minutes
• Photobiomodulation (laser): Both hips, 8 J/cm²
• Relaxed throughout; lay down and dozed after 5 minutes of stimulation

Assessment

• Bilateral hip osteoarthritis with improving comfort and mobility after 3 sessions: owner pain severity score down from 5/10 to 3/10, walks doubled in length.
• Night-time restlessness and seeking cool surfaces are consistent with the TCVM pattern noted above.

Plan

Integrative Treatment

• Continue acupuncture weekly for 2 more sessions, then move to every 2 weeks if improvement holds.
• Start the herbal formula prescribed today (dose and duration on the prescription label); owner to stop it and call if there is vomiting or diarrhea.
• Continue omega-3 fish oil at the current dose.

Conventional Treatment

• Continue grapiprant as directed by the primary care veterinarian; no change today.
• Copy of today's note to the primary care veterinarian.

Home Care

• Keep walks at 20 minutes twice daily on soft ground; avoid ball chasing.
• Non-slip rugs on the kitchen floor and a ramp for the back steps.
• A cooling mat for night-time.

Follow-Up

• Next session October 28; repeat Canine Brief Pain Inventory at session 5.

Client Communication:
Explained to Ms. Okeke that acupuncture is being used alongside Juniper's pain medication, not instead of it, and that any change to the medication goes through her primary care veterinarian. Went through how to give the herbal formula and which side effects to watch for. Discussed the ramp and rugs to make the back steps and the kitchen floor safer.

— Dr. Mei-Lin Arroyo, DVM, CVA