TCVMNews2012Spring

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TCVM Newsletter: Voice of Dr. Xie’s Jing Tang Herbal, Issue 17, Spring 2012

- by Dr. Aituan Ma, Professor, College of TCVM, Hebei AgriculturalUniversity of China

In Traditional Chi-nese VeterinaryMedicine (TCVM),seizures and epilepsybelong to Nei-feng(Internal Wind)syndrome.1 The ear-liest literature on In-ternal Wind can befound in Su Wen

published during the 3rd century BC.2 In-ternal Wind is often related with hyperac-tivity of Liver Yang and manifested byaltered consciousness, muscle tremors andconvulsions.1 This paper will focus on howto select Chinese herbal medicine, acu-puncture points, and techniques for treat-ment of different patterns of seizures andepilepsy in dogs. Clinical case studies willalso be presented.

Etiology: From the conventional perspec-tive, seizures are caused by an electricalstorm in the brain or a paroxysmal distur-bance of the electrical activity of thebrain.3,4 From a TCVM perspective, sei-zures are directly caused by Liver YangRising. Liver Yang Rising generates Heat,which flares up and disturbs the brain andShen (Mind), leading to Internal Wind(seizures). Liver Yang Rising can becaused by Liver Yin Deficiency, LiverBlood Deficiency, Phlegm, Blood Stagna-tion and Liver Fire. Liver Qi Stagnationcan trigger Liver Yang Rising as well. Thedetailed information of etiology of InternalWind is illustrated in Figure 1.

Pattern Differentiation and TreatmentThe Internal Wind is often divided intoExcess and Deficiency Patterns. The Ex-cess Pattern refers to Phlegm (Wind-Phlegm, Phlegm-Fire) and Stagnation(Blood); the Deficiency Pattern includesLiver Yin, Blood and Yin+Blood Deficien-cy. Excess and Deficiency Patterns maymingle together and make seizures morecomplicated.

Clinical Signs: Detailed information ondifferentiation of various patterns of sei-zures can be found in Table 1.

Acupuncture Treatment: Includes GV-20, GB-20, Nao-shu, BL-17, BL-18, SP-10 and LIV-3 for any Pattern of seizures.4-5 The following acupoints should beadded for each Pattern: Wind-Phlegm Pattern: BL-20, BL-21,ST-40 and GV-1Phlegm-Fire Pattern: GV-14, BL-20,LIV-13, LIV-2 and Wei-jian Blood Stagnation: An-shen, GV-17, LI-4, GB-41 and BL-40 Liver Yin Deficiency: BL-23, LIV-8,SP-6, SP-9 and LIV-14 Liver Blood Deficiency: CV-15, HT-7,LIV-8, SP-9 and ST-36

Liver Yin + Blood Deficiency: BL-23,SP-6, SP-9, LIV-13 and LIV-14

Dry-needling and/or aqua-acupuncture canbe performed once every month initiallyfor 3-6 sessions. After the seizures areunder control, acupuncture can be per-

(Continue to Page 3)

TCVM NEWS

Remembering the PatternPage 9

A Case for EscapeStagnation

Page 10

Kidney Qi Deficiency &Bony Bi Syndrome

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Chi Institute Australia is Taking offThe Chi Institute is proud to announce thatthe 2012 Small Animal Acupuncture coursein Australia begins in May! The course willbe 5 sessions, 2 online and 3 onsite, downunder in beautiful and spectacular Australia!For more info, visit www.tcvm.com.au.

Chi Institute of Europe 2012 VeterinaryAcupuncture Class (English) kicked off onApril 12 at San Lorenzo de El Escorial, Ma-drid. The class is truly international and par-ticipants come from 9 different countries(Austria, Belgium, Dubai, Hungary, Ireland,Italy, Norway, Spain and Sweden).Chi Scholarship 2012 WinnersThe Chi Institute received over 30 applica-tions for the 2012 Scholarship ($20,000). Thefour CVM faculty winners are: Dr. MarkAcierno (Assoc. Prof., LSU), Dr. LindseySnyder (Assist. Prof., Univ. of Wisconsin),Dr. Jacob Mecham (Assist. Prof., OregonState) and Dr. Lisa Sams (Anesthesia Resi-dent, Ohio State). The six CVM student win-ners are Kristen Brown (UC Davis), BrittanyBell (UF), Courtney Bowers (MississippiState), Taylor Moore (Texas A&M), BrookeWilson (Cornell) and Jennifer Brewer(Kansas State).PBS Spotlight on TCVM Airing in JuneThe Chi Institute has been working with aproducer from PBS to create an episode ofthe network’s show “Spotlight On” Tradi-tional Chinese Veterinary Medicine. Thisexciting episode will be aired to reach 6 to 10million viewers in June to promote publicawareness of benefits of TCVM.

Visiting Professor Met Toruk - Page 2

Voice of Dr. Xie’s Jing Tang Herbala FDA cGMP Compliance Company

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S m a l l A n i m a l P a t i e n t s

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Figure 1. TCVM Etiology of Internal Wind (Seizures)

Toruk, a two year old male Leucistic BengalTiger enjoys his happy life with the caretakerMs Deborah Warrick at the St. Augustine WildReserve, Florida. Aituan Ma is a professor atthe College of Traditional Chinese VeterinaryMedicine, Agricultural University of Hebei,China. Dr. Ma graduated from the College ofTCVM, University of Hebei, China in 1987and from there she became a teaching assistantat her hometown University. She received herMaster of TCVM in 2005 and got her PhDfrom the College of Veterinary Medicine,China Agricultural University in 2008. Nowshe is a visiting professor at Chi Institute.Meeting Toruk in Spring 2012 inspired Dr. Mato write this article. In the Chinese culture atiger stands for power and wind. Excessivewind in the spring leads to seizure.

(Photo by Deborah Warrick, Carnivore Biologist)

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formed once every 6-12 months for maintenance. Please notethat electro-acupuncture is contraindicated in any seizurecase.4-5

Herbal Treatment: Detailed information on how to selectherbs can be found in Table 1. If seizures are mild (one episodeevery 10 days or longer), the TCVM treatments - includingacupuncture and herbal medicine - can be the sole treatmentprotocol. If seizures are more severe, it may be necessary to useboth conventional western medicine (CWM) and TCVM treat-ments. If animal is 8 years old or under and is seizure-free forthree months or longer, the dosage of western drugs can bereduced by 25% monthly over the next three-month period; ifthe animal continues to remain seizure-free, the western drugsmay be discontinued. If there are two drugs, it is very importantto wean off one drug each period, typically over three to sixmonths. It is too risky to discontinue drugs too rapidly in dogsknown to have episodes of status epilepticus or cluster sei-zures, as seizures may worsen and cause adverse consequencesfor the dog and caretaker.4

Other considerations1) Avoid the Yang meats (including beef and lamb) andseafood.8 Yang meats intend to generate Heat, which enhancesLiver Yang Rising and potentially leads to Internal Wind(seizures). Seafood tends to generate Phlegm which may alsocause Internal Wind.2) Avoid chemicals and drugs which could make them moresusceptible to seizures. These drugs include Heartgard® orHeartgard Plus®, Program® and Advantage®, which maylower the seizure threshold.

Cases studiesCase 1: 10 year old, 68 pound, spayed female RhodesianRidgeback

Current Complaint: Grand mal seizures that started one yearago. The frequency of seizures had gradually increased fromevery three months to every two weeks; the most recent inci-dent to the time of presentation included clusters of threeseizures over 36 hours. The time of occurrence was variable inthe beginning, but at the time of presentation consistentlystarted at 4 am. No western medication had been used forseizures.

History: The only abnormality on screening lab work wassevere hypoglycemia (21mg/dL) preceding and shortly afterthe first seizure episodes. Insulin to glucose ratios were normal.She also had a persistently high normal T4 level initially. Allthese abnormalities had been rechecked subsequently and arewell within normal range at the time of presentation. She wasvery healthy and normal on western physical examination(except for seizures).

TCVM Physical Examination: She was a typical FireConstitution (outgoing, active, happy, playful, no phobiasand not dominant). The dog had Back-Shu sensitivity fromBL-17 to BL-19. She was also sensitive at LIV-14. Therewas dark fur coloration around the eyes with evidence ofrecent graying of the haircoat in that area (the owner be-lieved this coincided with the initial occurrence of the sei-zures). She had a dry haircoat with dandruff. Her tongue

was pale and dry, and pulse was weak in general, beingweaker on the left side.

TCVM Diagnosis: Liver Blood Deficiency. Seizures alongwith sensitivity at BL-17, BL-18, BL-19 and LIV-14 indi-cated Liver. Blood Deficiency was diagnosed on the basisof dry skin, dandruff, pale and dry tongue, and weaker pulseon the left side. Change of the color of the haircoat aroundthe eyes may have also indicated Liver Blood Deficiency, asthe eye is the window of the Liver.

Acupuncture Treatment: GV-20, GB-20, Da-feng-men,BL-15, BL-17, BL-18, BL-19, SP-10, SP-9 and LIV-3. Dryneedling was conducted about 20 minutes each session, onesession every month for three sessions.

Herbal Treatment:1) Di Tan Tang: 5 capsules (0.5 gram per capsule),

given orally twice daily for three months2) Bu Xue Xi Feng: 5 capsules (0.5 gram per capsule),

given orally twice daily for three monthsOutcome: The dog responded well to the TCVM treatment.Her seizures had completely resolved after three acupunc-ture sessions (each session one month apart) and threemonths of herbal medication. She then received acupunc-ture once every 3-12 months and Tian Ma Plus II (3 gramstwice daily) for her rest of seizure-free life until she passedaway at the age of 13.

Case 2: 5 year old, 60 pound, castrated male Mixed BreedMajor complaints: Uncontrolled seizures

Current medications: Phenobarbital and Potassium Bro-mide (KBr)

History: Clusters of seizures started 10 days after receivinga vaccination seven months previously. Clusters of seizureshad resolved using phenobarbital and KBr, but the dog stillhad seizures every 15 to 30 days. One week before presen-tation, the dog had five seizures within one hour - startingearly in the morning - with severe disorientation. The sei-zures were strong and each seizure lasted about five to sixminutes. The dog received the increased doses of phenobar-bital and KBr, but he still had a cluster of seizures daily forthe next week. He had occasional diarrhea and was slightlyoverweight.

TCVM Examination: He was a very sweet, laid-back andfood-motivated dog. His ears and body were hot. Heshowed cool-seeking behavior. He panted excessively andit became worse at night. His skin and paws were dry. Histongue was red with white foam and a greasy, white, thickcoating. His pulse was thin and fast, weaker on the left side.

TCVM Diagnosis: Internal Wind due to Liver Yin Defi-ciency

Acupuncture Treatment: GB-20, BL-10, BL-12, GV-14,LIV-3, BL-18, BL-19, BL-20, BL-21, BL-23, SP-6, KID-3

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Table 1. Herbal selection for most common Patterns of seizures (epilepsy)

Pattern Type Clinical Signs Herbal Formulas 6-7

Obstruction byWind-Phlegm

Sudden onset of seizure without any pre-ictalsigns/warning Loss of consciousness or convulsions Foaming at the mouth or screaming Possible incontinence of urine and stool Sporadic, temporary disorientation without seizure Tongue: Pale or purple with white greasy coating Pulse: Wiry and slippery

Ding Xian Wan (H2410)

Internal Profusion ofPhlegm-Fire

Wood type of personality (agitated, irritable) Sudden onset of seizure without any pre-ictalsigns/warning Loss of consciousness or convulsions Foaming at the mouth or screaming Sporadic constipation or cough with yellow mucus Tongue: Red or purple with greasy coatingPulse: Slippery

Di Tan Tang (H2412)+

Long Dan Xie Gan (E3907)

Stagnation of Blood

History of trauma to the head Sudden onset of seizure without warning Loss of consciousness or convulsions Foaming at the mouth or screaming Possible incontinence of urine and stool Sporadic, temporary disorder of consciousness Temporary disorientation without seizure Tongue: Pale or purple with white greasy coatingPulse: Wiry and slippery

Stasis in Mansion of Mind(B2023)

+Di Tan Tang

(H2412)

Liver BloodDeficiency

Chronic seizures Anemia, emaciation Dry or burned hair Weakness in all four limbs Cool ears and nose Tongue: PalePulse: Weak and thin

Bu Xue Xi Feng (A3320)

Liver/KidneyYin Deficiency

Dry nose and mouth Chronic seizures Seizure occurs at night or late afternoon Tongue: RedPulse: Weak and thin

Yang Yin Xi Feng (A3325)

Yin Deficiency and Blood Deficiency

Seizure, epilepsy, convulsions Dry and flaky skin Tongue: Red or pale and dryPulse: Deep, thin and weak

Tian Ma Plus II (A3330)

Modification: Add Tian Ma Bai Zhu (F2430) for Damp or Spleen Qi DeficiencyGeneral Dosage: Dogs and cats: 0.5 gram per 10 pounds body weight twice daily

Horses: 15-30 grams twice daily

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and ST-40. Dry needling acupuncture was conducted 20minutes each session, with one session every two weeks.Herbal Treatment:

1) Di Tan Tang: 7 capsules (0.5 gram per capsule),given orally twice daily for three months

2) Tian Ma Gou Teng: 7 capsules (0.5 gram per cap-sule), given orally twice daily for three months

Outcome: The dog responded well to the TCVM treatment.He only had one to two seizure episodes per week for the firstmonth, and only one seizure episode in the second monthfollowing treatment. He then required only one session ofacupuncture every 3-12 months and Tian Ma Plus II (3.5grams twice daily) for maintenance. He has not had anyseizures over the past six years (until the time this paper waswritten).

Conclusion: The combination of the TCVM and CWM is avery effective therapeutic approach to control seizures andepilepsy. CWM is effective to control severe seizures ini-tially and to identify the cause of the disease. TCVM can beeffectively used for the treatment of milder seizure cases andhelp control those cases that fail to respond to CWM.

References

1. Xie H, Priest V. Traditional Chinese Veterinary Medi-cine. Reddick, FL: Jing Tang Publishing, 2007: 409-415.

2. Unschuld PU. Huang Di Nei Jing Su Wen. London,University of California Press, 2002: 183-194.

3. Chrisman C, Mariani C, Platt S, Clemmons R. Neurologyfor the Small Animal Practitioner. Jackson Wy: Teton-NewMedia, 2003:85-114.

4. Chrisman C. Seizure disorders. In Xie H, C Chrisman andL Trevisanello (Ed). Traditional Chinese Veterinary Med-icine for Neurological Diseases. Reddick, FL:Jing TangPublishing 2011:71-94

5. Xie H, Priest V. Xie’s Veterinary Acupuncture. Ames,Iowa: Blackwell Publishing 2007:129-234,263-265

6. Xie H, Preast V. Xie’s Chinese Veterinary Herbology.Ames.IA: Wiley-Blackwell, 2010:261-272, 486-510,449-460

7. Xie H, Preast V. Chinese Veterinary Herbal Handbook 2nd

Ed. Reddick, FL: Chi Institute of Chinese Medicine,2008:10,110,111,113,274-277

8. Leggett D. Helping Ourselves: A Guide to TraditionalChinese Food Energetics. Totnes, England: MeridianPress 2005:21-36.

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-by Laurie Tyrrell-Schroeder, DVM, CVA

A nine year old female spayed Labra-dor Retriever came to me due to anacute LF lameness two weeks prior,after chasing a squirrel in the yard. Thelameness worsened with exercise. Shealso had a history of chronic bilateralhind limb stiffness and intermittentlameness, worse after resting. She hasa chronic intermittently draining

wound between the fourth and fifth digits of the right hind limb,which was previously diagnosed as chronic folliculitis.Diet:Grain Free Salmon and Sweet Potato dry kibble, 3 cupsdaily. She also received a joint supplement (Dasuquin) daily.

Western Physical Examination:WNL, BCS: 7/9. The patient was moderately lame on the leftforelimb at the walk and trot. She was stiff behind, and exhib-ited mild right hind limb lameness. Bilateral muscle atrophywas evident in both hindquarters. She exhibited a mild reactionto extension of the left shoulder and was moderately painful onextension of both hips, right >left.

Radiographs of the left shoulder revealed mild bony change inthe region of the biceps tendon insertion and the caudal aspectof the glenohumeral joint. Radiographs of the hips revealedsevere DJD in both hips, right worse than left. Lumbosacralspondylosis was also evident.

TCVM Examination and Diagnosis:The patient is an earth personality. She prefers soft surfaces, butdoes not really have a preference to warm or cold regions. Shenwas good. Tongue was pale purple and wet. Pulses were deepand weak bilaterally, slightly weaker on the left. Coat wasdandruffy, with large flakes. Her back was cool over the lum-bosacral region. My diagnosis was Bony Bi Syndrome(Underlying Kidney Qi Deficiency) with local stagnation at leftshoulder, hips and lumbosacral region.

1st Treatment, Oct 13, 2010:Dry Needle:GV 20, GB 21 left side, BL 11 bilateral, TH 14, LI15 left side, BL 54 bilateral, GB 29, GB 30 bilateral, LIV 3right; Aqua (AA): 2cc B12 at BL 23 bilateral. Herbal: Body sore5 grams BID. Loranthus Powder for Kidney Qi/Yang deficien-cy: 5 grams BID.

2nd Treatment, Oct 22, 2010:The patient’s forelimb lameness was markedly improved afterthe first treatment. Her hind limb stiffness was progressively

worse, likely due to the restricted exercise prescribed for heracute forelimb injury. Her tongue was less purple, and wet.Pulse was deep, weaker on the right.

Dry Needle:GV 20, BL 11 bilateral, TH 14 left, SI 9 left, GB 34left; EA: BL 54 bilateral, BL 23 bilateral, BL 26 bilateral; AA:BL 40 bilateral (2cc Vitamin B12 each site). Herbals werecontinued.

3rd Treatment, Nov 5, 2010:The patient’s forelimb lameness was resolved. Her hind limbstiffness was improved. She was less stiff after rising. Tonguewas pale and wet. Pulses were weaker on right.

Dry Needle: GV 20, GB 34 left, BL 54 bilateral, BL 20, 29right, BL 60 right, LIV 3 right; EA:BL 28 bilateral.

4th Treatment, Nov 19, 2010:The patient was doing well. She had not shown any forelimblameness. She was noted to be stiff after sleeping, but able to goup and down stairs more comfortably. On this day, the chronicwound that is between her fourth and fifth digit of her right hindwas open and draining serosanguinous fluid. Owner reportedthat it had been draining for two days. It was mildly irritatedfrom licking and the fifth digit was swollen. Tongue was palepink and wet. Pulses were symmetrical.

Dry needle: GV 20, BL 29, 30, 54 bilateral, LIV 3.Circle the Dragon: four needles were placed in a diamondpattern around the opening of the wound on her right hind foot,approximately 1cm from the wound edges. EA: BL 11 bilateral,BL 23 bilateral, BL 25 bilateral.

Topical Treatment: Golden Yellow Salve was sent home to beused topically on the draining wound twice a day. DiscontinuedBody Sore, continued Loranthus Power 5G BID.

At the 5th treatment, the patient was doing very well. The ownerreported that the wound on the foot was closed 48 hours aftertreatment. A combination of dry needles, electroacupunctureand aquapuncture was performed. Loranthus Powder 5g SIDwas continued, Body Sore given as needed. Moxa were used athome over local back and lumbosacral points once a week.

This was a very successful case of a common condition facedby owners of older dogs. While the dog had a chronic historyof mild to moderate hind limb lameness, the acute presentationof a LF lameness initiated the visit to a referral veterinarian forfurther investigation. After the severity of the degenerativejoint disease in both hips was realized, treatment was institutedto not only resolve primary complaint of the LF injury, but toalso begin to more proactively manage hip pain. The previouschronically draining wound has not since reopened. Her LFlameness responded beautifully to TCVM, and she continues tobe managed well with periodic TCVM treatments.

4 days post treatment

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Ruth West, UFCVM Class 2011Two weeks after finishing Session 4 of the2010 Spring Mixed Practice Acupuncturecourse, I was on my way to Coos Bay,Oregon for the last of my vet school sum-mer externships. I would be working at asmall animal practice on the southern coastof the state for two weeks, and taking a fewdays to visit my best friend.

My friend, Genie, who I hadn’t seen innine years, lives on a small ranch in Ash-land, Oregon with her two daughters, threedogs, a cat and five horses. I had asked herin advance if I might be able to practicesome acupuncture on her horses, and sheagreed. So, I packed some needles in myluggage (which, of course, was searchedand granted with ok by airport security)and headed across the country.

After a few days of catching up, we wentout to look at the horses. Being a dog/catperson, I had never treated a horse bymyself, and was undeniably nervous.“Lil”, a 17 year old quarter horse mare wasmy first victim..er..I mean, patient. Lilbelongs to Rihana, Genie’s 17 year olddaughter, who rides her in gymkhana and4H events.

Lil’s tongue was pale and swollen andpulses deep and weak. She had ++ sensitiv-ity at BL-23,24,26, and 54 and +++ sensi-tivity at Ba-jiao and Lu-gu on both sides ofher body. I figured she had Kidney QiDeficiency, with local hip stagnation, so Igot out my lab notes and picked somepoints that would do some good and beeasy for a rookie to find. I ended up dryneedling local hip points, Bai-hui and the“Shen brothers”, Bl-23,24,54 and ST-36.After treatment, Lil was much less sensi-tive to scanning and seemed quite relaxed.A few days later, Rihana and Lil ran theirfastest times ever at a local gymkhanaevent. Was it a coincidence?

I left the next day for the coast, and had agreat time at my externship. I performedmy first “solo” spay and many cat neuters.I even was able to needle one of the veteri-narians’ personal pet, a precious pug withsome hind-end weakness and ataxia.

Upon returning to Ashland, Rihana beggedme to treat Lil again. The County fair wasa few days away and, as a senior, it was herlast year to perform in 4H events. Now thepressure was on!

I examined Lil, and found that her tonguewas no longer swollen, and was a nice lightpink color. Her pulses felt equal on bothsides. I scanned her and she had no sensi-tive areas on her left side, and only slightsensitivity in the right hip area. I wentahead and dry needled the same points as

last treatment, amazed that she had im-proved so much with just one treatmenttwo weeks earlier.

With much sadness, I said good-bye andboarded a plane to return to Florida. A fewdays later, Genie sent me a text. “Rihanaand Lil are competing today. Lil is movingvery well.” I was so happy. Two dayslater, Genie sent me this picture via Face-book:

They had won Champion and GrandChampion in Gymkhana! This experiencereally gave me confidence to go ahead andtry equine acupuncture, even though Idon’t consider myself a “horse person”. Ialready have multiple requests fromGenie’s friends to return to Oregon to workon their horses!

Having first practiced conventional veteri-nary medicine for 20 yrs, I have never beenhappier in practice than over the past 10 yrsdoing holistic veterinary medicine. I amselling this wonderful practice because Ihave decided to retire and would like tofind a doctor who would appreciate owninga practice like this. Sunny Arizona, moder-ate elevation & climate, wonderful commu-nity, open space. Acupuncture, Chineseherbs, manipulations. Relaxed 60-90 min-ute appointments. Referrals back and forthwith conventional vets. Peaceful office,many windows, established trees. Thrivinggrowth and terrific net profit. Practice andReal Estate included. Training considered.Please contact us at:[email protected]

FOR SALE: Exclusive HolisticPractice, Beautiful North Central

ArizonaLisa Trevisanello graduated from the Col-lege of Veterinary Medicine at the Uni-versity of Padua, Italy in 2003. Shebecame certified in veterinary acupunc-ture at Chi in 2004. She incorporated acu-puncture into her practice of smallanimal medicine. Currently, she is work-ing on her Master Degree of TCVM fromthe Southwest University, China. She co-authored chapters of Xie’s VeterinaryAcupuncture, Equine Acupoints CD andXie’s Chinese Veterinary Herbology. Dr.Lisa is currently the Chi Institute Adminis-trative Director and offers free herbaland acupuncture consultations for veter-inarians. Lisa is a resident of Gainesville,FL where she spends her free time play-ing with her 3-year old daughter Isabella.

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An accurate TCVM (Traditional Chi-nese Veterinary Medicine) diagnosis isthe foundation of effective therapy, beit with acupuncture and/or herbs, as itallows the TCVM practitioner to de-sign a treatment protocol, based on theEight Principles, the Zang/Fu organsand their interactions, and the Five Ele-ment Theory. One benefit of TCVM is

the advantage one can have on predicting or managing futureproblems a patient might have based on the constitution of saidanimal; this report is to showcase this practitioner’s failure toaddress this issue.

Moose, a 12 year old Selle Francais gelding belonging to mydaughter, is a competitive jumper. He travels between hishome in North Carolina and Gainesville, FL. He is shownfrequently and ridden almost daily.

February 2011: Upon returning to a new barn in Gainesvilleafter being at the family farm in North Carolina for 3 months,Moose is becoming reluctant to work, difficult to handle on theground, and starting to pace the fence line. He is getting moreaggressive towards his pasture mates, as well. A routine west-ern medical physical examination was unremarkable. I wasasked to come to Florida and reexamine Moose. Moose is aWood personality. Pulses were fairly even, but forceful. Histongue was red. Wood personalities are prone to Shen distur-bances and the liver and gallbladder are the Zang/Fu organsassociated with the wood element. When emotional stress,such as changes in training schedules, travel, and environment,overwhelms the liver, Liver Qi stagnation can result. Liver Qistagnation causes imbalance in the Shen. This is exhibited asrestlessness, anxiousness, and irritability. Diagnosis was LiverQi stagnation with Shen disturbance.

Moose was very resistant to needling. As I also lived 400 milesaway, it was decided to use herbals to treat the Shen distur-bance. Based on clinical signs, Shen Calmer was prescribed, atthe rate of 15gms. BID. Shen Calmer nourishes Heart Yin andBlood and soothes Liver Qi. Shen Calmer was used at 15 gramsBID for 2 months, and Moose was able to compete verysuccessfully in Ocala for the show season. After 2 months, theShen Calmer was reduced to 15gms once a day for anothermonth, then discontinued. Competitions continued to go welland Moose moved back to North Carolina for the summer. Theonly issue, and here is the caveat, was that his hooves werecracking and dry, and the farrier had to put clips on to preventMoose from pulling his shoes. The reason I have mentionedthis is because the Liver controls the health of hooves and I didnot pay attention to this change in Moose’s physical constitu-tion. Looking back, even though the Liver Qi stagnation wasconsidered resolved, Liver Blood and Yin were obviouslycompromised and ignoring this fact led to the next clinicalcomplaint.

Sept. 11, 2011: Moose came in from the pasture lame, withswelling and pain distal to the carpus on the right front. Hedisplayed a mild lameness at a walk, with increased lamenessat a trot. An ultrasound exam showed a 15mm tear in theinferior check ligament.

Tongue purple, pulses bounding, with the left side slightlyweaker. Patient was agitated. A scan examination was positiveover AP points Bl 18/19, a diag-nostic point for tendon/ligamentissues, and LI 17, a point for car-pus pain. A diagnosis of Liver Yinand Blood deficiency was madewith local stagnation.

TCVM Treatment:Sept, 12, 2011: Ting points wereeasily accessed: TH 1, PC9, SI 9,on the front feet; LIV 1, GB 44on the rear. Distal points: GB 34and LIV 3: Pattern points: BL18, 19. At this point, Moosewouldn’t allow any more pointsto be needled-I had hoped to needle SP 10 and BL17 to helpwith blood stagnation and ST 36 and LI 10 to move Qi. Theowner was instructed to wrap the affected area with reliefsalve 12 hours on and 12 hours off for one week. Body Soreand Tendon Ligament herbals were prescribed-both at 15 gmstwice a day.

Body Sore was chosen due to its ability to move Qi andeliminate stagnation, and Tendon/Ligament formula is de-signed to treat Liver Yin and blood deficiency, as well astendon injuries and weakness of tendons and hooves. TCVMassessment and treatment:Oct. 22, 2011: (More frequent treat-ment was unable to be performed due to the distance requiredfor myself to travel). Moose was found to be sound at a walkand only mildly lame at a trot. Swelling and pain over thecheck ligament were minimal. Pulses were fairly equal; tonguepale purple. Both herbals were still being given. Moose wasmore difficult to needle today-Ting points were done-TH1,SI9, LIV 1 and GB44. Bl 17, 18, and 19 were needled as wasBai hui. No more needles were tolerated. Electro acupuncturewas not attempted.

Dec. 10th, 2011: A local Florida veterinarian ultrasounded theaffected area and found the initial injury to be only 5mm long,with healthy longitudinal fibers filling in the original defect.Jan. 15, 2012: Moose is 100 % sound. Tongue is pink andpulses fairly equal, with some deficits over the liver pulse onthe left side. The affected tendon palpates normal and Moose’shooves are healthy and strong. It was advised Body Sore becontinued for one more month and Tendon Ligament for 3more months.

I feel more close attention to this horse’s predisposition toligament/tendon injury at the time of Shen disturbance MAYhave prevented the possible career-ending check ligament tear.This is a lesson learned.

-by Kay Wahl, DVM, CVA

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Daisy, a six year old rough-coatedcollie dog was brought to me with ahistory of chronic diarrhea, a moistcough, hind end weakness, and vom-iting of phlegm almost every nightfor nearly two years. The vomitcontained thick, clear, stringy liquid.Her care giver reported that all theseproblems started shortly after vacci-nations were given. She had devel-oped too numerous to count hard

skin nodules as well that resolved after a number of months.Biopsy of the nodules was attempted but the previous veter-inarian found them to be rock hard.

The care giver then took Daisy to a second animal hospital.A complete blood count and serum chemistry panel showednormal values. The thyroid (T4) value was borderline low at1.0 ug/dL and a cTSH value was high at 0.82 ng/ml. Thyroidsupplement was dispensed by the second veterinary hospitalhowever she vomited each time the medication was given sothe caregiver discontinued it.

The diet was a fish and sweet potato kibble supplementedwith brown rice and organic salmon. The care giver empha-sized that this was the only diet that did not give Daisydiarrhea.

On TCVM examination the tongue color was very palepurple with a thick coat of phlegm. Femoral pulses werefloating, forceful, choppy, fast, and wiry. The skin haddandruff and the nose was cold and moist. Daisy drank a lotof water and often vomited foamy liquid immediately afterdrinking. Her appetite was poor and she struggled to standfrom a sitting position. Dark spots were present on the skinof the abdomen. She reacted to pressure at BL-18, BL-19,BL-20 and BL-21. Daisy had an easy going, mellow, Earthconstitution.

The TCVM diagnosis was Five Stagnations: Food, Phlegm,Heat, Qi and Blood Stagnation. The complex pulse patterntold the story—floating and fast pulses indicated an ExcessHeat; wiry and choppy pulses indicated Stagnation of Qi,Blood and Phlegm. The Phlegm on the tongue was remark-able; and the color was also consistent with Stagnation.Vomiting after drinking suggested Food Stagnation. Al-though Daisy appeared weak her pulses were forceful indi-cating an Excess pattern. In addition, the dry coat and thirstwere a result of a Liver Yin and Blood deficiency. Treatmentof a deficiency pattern first would exacerbate the Excesscondition.

The Excess pattern had to be treated first. Acupoints cho-sen were: An-shen to calm the mind; LI-11 and GV-14 todispel Damp Heat; BL-18, BL-19, and GB-34 to moveBlood and Qi; BL-20 and BL-21 to benefit the digestion;ST-40 to transform Phlegm; and SP-6 to move and nourishBlood, move Liver Qi, resolve Damp, Cool Blood, andtonify Yin.

In the first week after acupuncture Daisy had only oneepisode of vomiting. The acupuncture was repeated and theChinese herbal formula Escape Stagnation was dispensedat a dose of 0.5 grams for every 10 pounds of body weightevery 12 hours.

Escape Stagnation contains five herbs to treat each of thefive stagnations: Cyperus Xiang Fu Zi moves Liver Qi;Atractylodes Cang Zhu transforms Phlegm; LigusticumChuan Xiong moves Blood; Massa Fermentata Shen Quresolves Food Stagnation; and Gardenia Zhi Zi clears Heat.

Nine days later the care giver reported that the dog had nodigestive problems at all and no cough. She was runningaround and playing more and her appetite had improved.She readily ate the herbal powder. No phlegm was visibleon the tongue. Ten days later, the dark spots had disap-peared from the abdominal skin and the tongue color wasbrighter (changed from Rose’ to Red Clover on the Sher-win-Williams paint chip chart).

Acupuncture was repeated ev-ery two weeks for two moretreatments and then monthlywhile the herbal formula wascontinued. After three monthsfrom the onset of acupuncturethe tongue color continued tobrighten (Cyclamen on theSherwin-Williams paint chipchart). Hind end weakness wasstill an intermittent problemand the caregiver was encour-aged to have the thyroid valuesretested.

Four months after the initial visit the T4 value was withinnormal limits at 1.7 ug/dL with normal values rangingfrom 1.6-5.0 ug/dL and borderline low values ranging from0.8-1.5 ug/dL.

This case emphasizes the importance of a TCVM diagnosiswhen standard medical diagnostics fail. The thyroid wasnever the problem but was the result of a sick dog and aeuthyroid condition. The herbal formula was graduallydecreased and the dog continued to have normal digestion.

-by Karlene Stange DVM

11


This 496 page hard cover book is edited by Drs. Xie, Chrisman and Trevisanello,along with 13 senior TCVM practitioners who are contributors to this book. It isthe first book of its kind that focuses on the application of TCVM for thediagnosis and treatment of neurological diseases including cerebral, cranialnerve, spinal cord, neuromuscular disorders and peripheral nerve disorders insmall animals and horses. The integrated neurological evaluation, research onneurological disorders, Wei and Tan-huan syndromes are also included. It is amust have for TCVM Practitioners.

This 268 page hard cover book is edited by Drs. Xie and Trevisanello, among 8senior TCVM exotic animal practitioners who are contributors to this book. Itis the first book illustrating how to use TCVM for the diagnosis and treatmentof Exotic Animals including Small Mammal Pets, Avian, Reptiles and Amphibi-ans, Zoo Animals, and Marine Mammals, Ornamental Fishes, Pinnipeds. Thebook is also presented with 27 color pictures to demonstrate the locations ofacupuncture points and techniques.

To order above books: Online at www.tcvmherbal.com (save 5%), call 800-891-1986 or email [email protected].

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(268 pages, $75.00)

216 most commonly used herbal formulas for your daily TCVM practice. Four new herbal formulas: Hu Qian Wan, Di Huang Yin Zi, Xiao Chai Hu Tang,Damp Heat in Mind, and Bone Healing Salve

Updated herbal ingredients for many formulas to comply with the latestrequirements and regulations by the Convention on International Trade inEndangered Species of Wild Fauna and Flora (CITES)

The Toxicity of Chinese Herbal Medicine The Validation of Chinese Veterinary Herbal Medicine Research study of the Nutrition Analysis of fourteen herbal products A new useful cross-reference table of herbal names that include Pin-Yin,botanical and common names together with the Chinese character(385 pages, $35.00)

Course Highlights

For questions or details, please call 800-891-1986 or visit www.tcvm.com

- 16 lectures by Dr. Huisheng Xie

- 4 lectures by Dr. MichaelBartholomew

- by Dr. Roger Clemmons

- By Dr. Bartholomew (Canine)- By Dr. Xie (Equine)

Serving Veterinarians Exclusively Since 1999800-891-1986 www.tcvmherbal.com [email protected]

Learn 20 Individual herbs withreal sample and 30 top usedveterinary herbal formulas

Industry leading instructors.5 hrs lab demo for real casestudy. 27 CE hrs by most states

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Learn TCVM Clinical Approach:Herbal Medicine, Diagnosticsand Acupuncture for GI patients

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$900 GIFT by registering for this class:complimentary registration for the Evi-dence Based Veterinary Acupuncture on-line course, approved for 27 CE hrs by

Baltimore Veterinary Acupuncture and Herbal Medicine Introduction Seminar(AUG 25 - 26, 2012 at Baltimore Airport Marriott, 14 CE HRS BY MANY STATES)

Small Animal Session SyllabusSATURDAY, Aug 25, 2012 9:00 - 9:50: How to Understand TCM and

Five Elements10:00-11:00: Indications and Contraindica-

tions of Veterinary Acupuncture11:30-12:30: How to Use Acupuncture for

Treatment of Arthritis in Dogs13:30-14:20: How to Understand Chinese

Herbal Medicine14:30-15:30: How to Use Chinese Herbal

Medicine to Treat IBD16:00-17:30: How to Use Chinese Herbal

Medicine to Treat Cancer

Equine Session SyllabusSUNDAY, Aug 26, 2012 8:00 - 8:50: Intro to Equine Acupuncture 9:00- 10:00: Acupuncture for Diagnosis and

Treatment of Equine Lameness10:30-12:00: Acupuncture for Diagnosis and

Treatment of Equine Lameness13:00-13:50: Introduction to Herbal Medicine

in Horses14:00-14:50: Use Chinese Herbal Medicine to

Treat Cushing’s Disease, Derma-titis and Uveitis

15:00-16:00: How to Use Chinese HerbalMedicine to Treat COPD,Heaves and Cancer in Horses

Dr. Wallis is a 1988 graduate of TuftsUniversity School of Veterinary Medi-cine. After graduation, she worked atthe Brookfield Zoo and the CincinnatiZoo before entering private practice.She took the CSU Acupuncture Coursein 1997/98 and TA'd the course for 3years after that. She is IVAS certifiedand has been an examiner for the IVAScertification exam. She is certified inVeterinary Spinal Manipulative Therapythrough the Healing Oasis. She hasstudied veterinary acupuncture, Chineseherbal medicine and food therapy at theChi Institute since 2002. She currentlyhas a mixed animal clinic in Coloradowhere her practice is exclusively acu-puncture, chiropractic and Chineseherbal medicine.

By Cindy Wallis, DVM, CVA

Location & Accommodations:BWI Airport Marriott1743 West Nursery RoadLinthicum, Maryland 21090 USAPhone: 410-859-8300Student Room Rate: $99/night (by 8/5)

Tuition:$100 for each session; $175 for both;Please visit www.tcvm.com orcall 800-891-1986.

TCVMNews2012Spring

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