Aquapuncture For Hemorrhage Prevention

Hello Summarians!

A vitamin B12 injection at a specific acupuncture point on a dog cuts surgical blood loss by more than half. The data holds up.

Also this week: new evidence confirms that altrenogest is absorbed through equine and human skin and into the bloodstream, which means anyone handling it without gloves is taking a real risk. And a survey of five thousand pet owners makes one thing clear: when something goes wrong, they want to know immediately.

Three studies. One surprise, one warning, one reminder.

If it is valuable to you please consider sending it on to a friend 😄 

Regumate Safety

This study examined whether altrenogest, a synthetic hormone widely used in equine reproductive management, can be absorbed through the skin after topical exposure. Researchers conducted a randomized crossover trial involving eight healthy mares, applying oral altrenogest to clipped skin on either the neck or the back for five consecutive days. Blood samples collected throughout the study demonstrated that altrenogest entered the bloodstream following application at both sites, confirming that the drug can penetrate equine skin. Peak plasma concentrations were significantly higher when the drug was applied to the thinner skin of the neck compared to the thicker skin of the back, indicating that skin thickness strongly influences absorption. Detectable concentrations persisted for at least 48 hours after the final treatment, suggesting prolonged systemic exposure.  

The findings are important because altrenogest exposure in humans has long been associated with adverse effects such as menstrual irregularities, fatigue, headaches, skin irritation, and decreased libido, yet prior evidence for dermal absorption had been largely theoretical. Since human skin is generally thinner than equine skin, the study suggests that people handling the drug may face substantial risk from accidental skin contact. Researchers emphasized that the oil-based, highly lipophilic nature of altrenogest likely enhances its ability to penetrate the skin barrier and remain within tissues for extended periods.  

The study also highlighted occupational safety concerns within the veterinary and equine industries. Inconsistent use of personal protective equipment was identified as a major contributor to exposure risk. The authors recommended that all individuals handling altrenogest, regardless of sex or pregnancy status, wear non-porous gloves and protective clothing and immediately wash exposed skin with soap and water if contamination occurs. The researchers concluded that injectable alternatives may reduce occupational exposure and should be investigated further as safer long-term treatment options. 

Loy, J., K.Sornalingam, A.Cawley, C.Scrivener, J.Keledjian, and G. K.Noble. 2026. “Pharmacokinetics of Topical Administration of Altrenogest in Mares and Implications for Human Health.” Journal of Veterinary Pharmacology and Therapeutics49, no. 3: 274–281. https://doi.org/10.1111/jvp.70040. 

Bottom line — Be aware when applying.

Aquapuncture For Hemorhage Prevention

This randomized controlled clinical trial evaluated whether aquapuncture using vitamin B12 at the acupuncture point GV-5 could reduce intraoperative bleeding during ovariohysterectomy (spay surgery) in female dogs. Fifty-one healthy female dogs undergoing routine ovariohysterectomy were randomly assigned to one of three groups: a treatment group receiving vitamin B12 injections at GV-5, a sham-control group receiving vitamin B12 at GV-14 (an acupuncture point not associated with hemostasis), and a no-treatment control group. The injections were administered 15 to 30 minutes before surgery, and surgeons as well as data collectors were blinded to treatment assignments. Blood loss was measured by weighing surgical gauze immediately after surgery and normalizing blood loss to body weight.  

The results demonstrated a significant reduction in blood loss among dogs treated at GV-5. Healthy dogs in the treatment group lost an average of 0.13 mL/kg of blood compared with 0.28 mL/kg in the sham-control group and 0.34 mL/kg in the untreated group. Similar findings were observed in dogs with minor laboratory abnormalities, suggesting that the effect was consistent across different patient populations. Statistical analysis confirmed that the GV-5 treatment group experienced significantly less bleeding than either control group, while the two control groups did not differ from each other.  

The authors concluded that aquapuncture with vitamin B12 at GV-5 may provide meaningful hemostatic benefits during canine spay procedures. Reduced bleeding could improve surgical visualization, shorten operative times, decrease tissue swelling and inflammation, lessen postoperative pain, and potentially allow for smaller surgical incisions. No adverse effects associated with the treatment were reported. However, the study had limitations, including a relatively small sample size and the fact that the surgeon administering acupuncture was aware of treatment assignments. The authors recommend further research involving animals in estrus, male dogs, and additional surgical procedures to better understand the mechanism, duration, and broader clinical applications of GV-5 aquapuncture. Overall, the findings suggest that presurgical aquapuncture at GV-5 may be a safe and effective adjunctive technique for reducing surgical blood loss in dogs. 

Perry, T., & Shiau, D. (2026). Evaluation of aquapuncture in the reduction of intraoperative hemorrhage in canine ovariohysterectomy. American Journal of Veterinary Research https://doi.org/10.2460/ajvr.26.03.0111 

Bottom line — Suggests safe and effective.

Disclosing Medical Errors

This study examined how pet owners view medical errors in veterinary medicine and how they want those errors communicated. Researchers surveyed 5,026 pet owners from seven veterinary teaching hospitals across the United States between 2021 and 2022. The goal was to understand owners’ expectations regarding medical error disclosure, trust in veterinarians, and perceptions of patient safety.  

The findings revealed that transparency is highly valued. Nearly three-quarters of respondents wanted to be informed about every medical error involving their pet, regardless of whether harm occurred, and 72% wanted disclosure immediately after the error was discovered. Even more participants (88%) wanted notification if an error had the potential to cause harm. Only a very small minority preferred not to be informed or wanted disclosure left to the veterinarian’s discretion.  

Trust was strongly influenced by communication quality. When veterinarians handled error disclosure poorly, 87% of respondents reported a moderate or complete loss of trust. In contrast, effective communication improved trust for approximately 58% of participants. Open-ended responses showed that clear explanations, honesty, and sincere apologies often helped preserve relationships, whereas defensiveness, poor communication, or failure to acknowledge mistakes frequently damaged trust.  

Participants most commonly identified medication mistakes, treatment errors, communication failures, and diagnostic errors as significant medical errors. Qualitative responses highlighted misdiagnosis, failure to diagnose, incorrect treatments, medication dosing errors, and poor communication as recurring concerns. Many owners associated these errors with negative outcomes, including emotional distress, loss of trust, additional expenses, and, in some cases, the death of a pet.  

The study also found that individuals with higher levels of education were more likely to believe medical errors are inevitable, yet they expected error rates to remain very low. Overall, the research demonstrates that pet owners strongly favor prompt, complete, and honest disclosure of medical errors. The authors conclude that veterinarians should prioritize transparent communication, timely disclosure, and compassionate responses when errors occur, as these actions play a critical role in maintaining client trust and strengthening veterinary patient safety culture.

Hofmeister, E. H., White, A. G., Landers, C. G., Kramper, S., Gordon-Ross, P., McCool, K., Welborn, N., Griffenhagen, G., & Shaver, S. (2026). Pet owners expect veterinarians to disclose medical errors. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.25.12.0872

Bottom line — Transparent and timely disclosure is best.

Just putting things in perspective …