Tips and Tricks for Veterinary Cupping

Veterinary cupping is gaining in popularity, with various cupping units becoming available for effective treatment of canine and equine patients. Following conversations in our various online communities, we share some tips and tricks for successful veterinary cupping.

Veterinary cupping, or Myofascial Decompression Therapy (MDT), is a technique using cups to decompress the underlying soft tissue for a therapeutic response. To create an effective application in animals, a seal needs to be created and suction needs to be continuously maintained over the affected area.

We share some tips and tricks from those in the industry who have been using this modality with their patients.

What is cupping and how does it work?

Veterinary cupping uses cups made of silicone, glass or hard plastic which are placed on the skin to create a suction effect. The suction results in negative pressure or decompression of the soft tissues within the cup, and compression or shear of the tissue around the rim of the cup. This leads to an influx of blood flow, stimulation of lymphatic drainage, breakdown of adhesions and increased interstitial space between tissues, allowing improved mobility of the tissue layers.

The cup can be moved and manipulated while suction is maintained to achieve a deeper or more specific therapeutic effect that acts through the fascial layers. 

The tools available

Multiple cupping units are available, with two seemingly the most widely used in the veterinary profession: electrical cupping and silicon cupping.

Electrical cupping systems have a variety of cup shapes and sizes which connect to a machine that creates suction in the cup. The degree of suction can be controlled by the therapist who maintains the seal through a small hole in the cup, allowing fast and immediate release of pressure if needed.

This system creates an effective vacuum and requires minimal skin preparation. Only one cup may be used at a time, but the cup can be effectively manipulated and moved to achieve therapeutic results. The cup is held over each location for a very short time, usually only a few seconds.

Silicon cupping systems such as RockPods achieve suction in a similar fashion to a plunger. A seal needs to be created to be able to achieve and maintain the suction – a challenge in an equine or small animal patient with a coat that will naturally prevent a seal from being formed.

Multiple cups can be applied to an area and left in place for three to five minutes at a time. One can manipulate the cups to a limited degree while the seal is maintained. Multiple sizes of silicone cups are available, allowing easy use in dogs, cats and horses.

While there are a variety of silicone cups available on the market, we recommend these simple clear silicone cups available from Amazon.
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Breaking the seal

The greatest challenge with this modality on equine or canine patients is achieving a sufficient seal to create suction. With the electrical system, this aspect is less of a challenge, since suction is constantly created and therefore easily maintained. With silicone cups such as RockPods, we need to be more intentional about creating a seal.

When choosing this modality for a patient, you want to choose a patient that has a short coat, easily holds still for a period of time, and has an area of fascial adhesion, tightness or pain over a well-muscled region of the body. If there are too many bony prominences, creating a seal will be difficult, and a different modality may yield more effective results.

Here are some ways that you might create a seal, as shared by our community:

1. Spritz the area with water. (Michael Yeo, Cupping with the New RockPods podcast.)
2. Use copious amounts of ultrasound gel where the Pod will be applied. (General recommendation from multiple sources.)
3. Stretch out any loose tissue before applying the Pod. (Amie Hesbach, Cupping with the New RockPods podcast.)
4. Wet the coat and sprinkle flour on it. (Becky Hill, Equine Cupping Therapy, Facebook.)

The use of ultrasound gel is the most widely recommended strategy for both small animals and equines. Water alone has a shorter time span of efficacy, and tends to be slightly less effective. Flour can be quite a messy affair, and requires the patient to be cleaned before the end of the treatment session, adding time to your treatment.

The right patient

As always, we need to select from the tools available in our toolbox to address the needs of the patient in front of us in the most effective and efficient way. Having multiple tools available to us allows us to treat each patient as the individual that they are, with different needs, goals and challenges.

With regard to the use of cupping or decompression therapy versus massage or compression techniques, Diana Landskron recommends that cupping is preferable in an area where the superficial fascial tissue is hardened, especially in the thoracolumbar region. In cases of a chronic injury such as a tendon lesion or old hematoma, cupping remains her go-to modality, while in acute injuries, cupping is to be avoided.

Amie Hesbach and Michael Yeo recommend selecting a patient that is calm and relaxed, has a short coat, and has an area of tension that needs to be addressed where there is enough muscle mass for the Pod to attach. Bony prominences or areas with too much mobility will be difficult to treat with this modality.

Conditions that benefit from cupping

Some of the conditions or areas that are often addressed with this modality include:

• scar tissue
• myofascial tension or adhesion
• the lumbosacral region, proximal hindlimb and proximal forelimb in canines
• old hematomas
• the dorsal superficial fascial line in equines.
   

Is this a safe modality? What about bruising?

During patient selection, be aware of any precautions or contraindications to the use of cupping, and use the cups for only a short duration. The longer they are applied, the higher the risk of bruising or complications.

Contraindications to consider include the presence of blood flow or clotting, and whether or not the patient is on medication that may lead to integumentary or skin issues. Open wounds and acute conditions are also contraindications.

Throughout treatment, patient feedback and assessment are critical. Post-treatment feedback from the owner within 48 hours can also help guide treatment parameters. The goal of treatment in animals is not to cause bruising – we want an increase in blood circulation, but no bruising.

Get the right training

The training you receive will depend on the modality you choose, as use of the electrical cupping systems will differ in a few key ways to use of silicone cups. The company that manufactures RockPods provides training on their use in people, which gives a good foundational understanding of the modality. However, it does not help us with the specific challenges of the veterinary patient.

Sozo Equine recently launched a course in which they teach the use of RockPods on the equine patient. This course has been highly recommended by those who have attended, and the information will more easily be translated to the canine patient who will have similar challenges to the equine.

Onlinepethealth has a continuing education lecture in the Equine Members Portal, presented by Diana Landskron, on the use of electrical cupping in equine patients. 

Conclusion

As a relatively new modality on the market, we need to make sure we take the appropriate care when testing and experimenting with cupping. Maintain a cautious and conservative approach, and if possible, share your observations and findings with the community, so that we learn from one another and more deeply understand the modality. Good record keeping is essential to further analyse our findings and establish the true value of this modality in our field.

Resources

Sozo Equine
Equine Cupping Therapy, Facebook Group
RockTape FMT courses
Cupping with the New RockPods Podcast 
Equine Cupping, Diana Landskron