Many clients seek us out when their pets have chronic diseases that western medicine has failed to cure. As veterinarians trained in Chinese Veterinary Medicine, we are often times “the doctor of the last resort”. While TCVM is very effective in controlling chronic diseases and restoring health, the best use of TCVM, and perhaps of all health care approaches is to detect and reverse the imbalances before a disease occurs. By monitoring the subtle changes (including tongue color, shape, coating and pulse quality) with regular checks and balancing an individual’s constitution according to the relationships of the Five Elements, TCVM can achieve the goal of preventing diseases and maintaining optimal health.
This is the case of a patient who was brought to me for an acute problem eight years ago. A client presented her 6-year-old, intact male Nova Scotia Duck Tolling Retriever for an episode of acute back pain. The owner noticed that the dog was unable to jump onto the bed and would occasionally cry out, although she was unable to determine what movement or body postures elicited the vocalizations. The dog was competing in conformation shows, agility trials and field trials. The owner hoped to get him healthy and back to competition as soon as possible, as well as to prevent re-injury in the future.
On presentation the patient’s tongue was lavender and his pulses were rapid, strong and wiry. Pain was elicited on palpation of the lumbosacral junction and extension of the left pelvic limb. The presence of pain indicates a disharmony at the anatomical location of the pain. In this case the demonstration of acute pain with relatively mild pressure at the lumbosacral area and the lower back indicated a problem related with the Kidney element. Because the pain was both acute and fixed (repeated only at one location), it indicated a Stagnation of Blood, while the pain increasing with pressure indicated a Stagnation of Qi. There were no conscious proprioceptive deficits and no apparent lameness.
A TCVM diagnosis of lumbosacral Qi and Blood Stagnation with insult to the Kidney Meridian was made along with a western medical diagnosis of probable left lateralizing lumbosacral intervertebral disc involvement. A treatment plan was developed to induce Qi and Blood flow through the lumbosacral area in order to reduce pain and prevent recurrence. Dry needles were used at LIV-3, LI-4, Shen-shu, Shen-peng, Shen-jiao, BL-23, BL-40 and GV-4, which are points that strengthen the Kidney element. Electro-acupuncture was used at the Shen-shu points, to amplify the stimulation at the acupuncture points and increase the dispersion and movement of the stagnant Qi.
Body Sore was prescribed at a dose of 1g per 10lb of body weight BID. Body Sore is a patented Jing-Tang herbal formula that moves Qi and Blood to resolve Stagnation and pain specifically associated with musculoskeletal and soft tissue injuries. Due to the intensity of this patient’s discomfort, a non-steroidal anti-inflammatory drug, Deramaxx and a muscle relaxant, Methocarbamol were dispensed to be used when necessary. Short term uses of a NSAID can help to resolve acute Qi Stagnation, although long-term reliance on NSAIDs for inflammation control will decrease Blood flow and result in additional Qi Stagnation. The combination of short-term western medications to relieve symptoms and the longer-term use of Chinese herbal formulas to address the underlying cause of these symptoms is an improvement on either treatment used in isolation from each other.
On the second exam five days later, the patient showed no overt signs of pain and his tongue was pink. His pulses remained wiry. He exhibited mild discomfort on direct palpation at the lumbosacral junction and had decreased extension of the left pelvic limb. Acupuncture was repeated. Electro-acupuncture was used with wires crossing the lumbosacral joint and connecting the needles of Four Classical acupoints. Right Shen-peng was linked to Left Shen-jiao and Left Shen-peng was linked to Right Shen-jiao. Immediately following this treatment, the dog was relaxed and able to extend both hind limbs normally. Body Sore and exercise restrictions were continued.
Two weeks after the initial presentation, the dog presented decreased extension of the left pelvic limb and mild lumbosacral discomfort again. Double PII was added at a low dose of 1g per 35lb of body weight BID. Double PII is a patented Jing-Tang herbal formula containing potent herbs to move Qi, relieve Stagnation, and tonify Kidney Yang. It is much stronger than Body Sore and is used primarily in cases of acute Wei syndrome with paresis or paralysis secondary to intervertebral disc disease. Because this case had subtle signs of disc involvement detected by increased pain at the lumbosacral joint with extension of the left hind leg, a low dose was initiated. Acupuncture was repeated using electro-acupuncture at local points and Body Sore was continued. One week later, the dog exhibited no pain on palpation of the lumbosacral joint and good extension of both pelvic limbs.
One month later, the dog was successfully returned to competition, after what can often be a career-ending injury. The owner was so impressed that she scheduled regular appointments for well-care to maintain her dog’s health.
Over the past 7 years, I have continued to see this dog at least 6 times a year. At each visit he receives complete western and TCVM exams, and all joints are palpated and their range of motions are evaluated. He has not had any more episodes of lumbosacral pain so far. Other minor problems have been found over time and treated with TCVM. Sometimes these were issues of which the owner was completely unaware. TCVM’s emphasis on life balance, health and harmony makes it an ideal technique for detecting small changes in physiology that may negatively impact health. The TCVM Bian Zheng or diagnosis of a pattern of Qi imbalance can often detect problems before they would become apparent on blood work or radiographs.
He had one episode of mild neck pain which was discovered when examining the range of motions of the spinal segments. It was noted that he was unable to rotate the lower vertebrae of his neck laterally to the right and had decreased extension of his left front limb. This was successfully treated with two acupuncture treatments and one month of the Cervical Formula. Cervical Formula is a patented Jing-Tang Herbal formula that moves Blood and relieves Stagnation. Two herbals that it contains, Ge Gen and Qiang Hou, are specific for the neck, acting as transporting herbs to increase the dispersion of Qi to the cervical area of the spine.
This patient also had occasional episodes of Liver Qi Stagnation involving the GI system that presented as bile vomiting and lip smacking which occurred primarily early in the morning or late at night. Each Zang-fu organ has a specific direction of Qi flow. The Liver Qi is both ascending and expanding throughout the channels. The smooth flow of Qi is necessary for the proper function of the Stomach and the Spleen. According to the Five Element Theory, the Wood element is the Grandparent of the Earth element. In the Ke cycle (the Restraining or Controlling cycle), this relationship allows the Wood element to restrain the Qi of the Earth element. When the controlling energy of the Wood element is constrained, the Liver Qi cannot disperse and thus becomes stagnant, overpowering the ascending flow of the Spleen Qi and the descending power of the Stomach Qi, resulting in bile vomiting or bile regurgitation. The herbal formula, Xiao Yao Wan soothes Liver Qi stagnation and, at the same time, strengthens the Spleen. It was prescribed, along with diet changes, to restore the balance between the Liver Qi and the Spleen Qi.
Although the owner is unable to change completely to a home-made diet, she feeds the dog quality kibbles and home-made food mixed half-half. The home-cooked portion is adjusted from time to time according to his conditions. Cooling or neutral proteins such as beef, turkey and fish, along with dark leafy greens which help support the liver and blood organs (Heart and Liver), are the main ingredients. After treatment with Xiao Yao Wan and these dietary changes, the bile vomiting resolved.
The owner added another dog (this dog’s son) to the household. Shortly thereafter, the owner noticed that 1-2 times each month, the dog would smack and lick his lips excessively at night. This is symptomatic of Liver Qi Stagnation which resulted in an upset of the flow of bile. Lip smacking or esophageal reflux can be a symptom of hypochondriac pain or tension in the area of the upper abdomen and chest. The herbal formula, Shu Gan Wan (Mayway brand Soothe Liver Teapills) is based on the basic Liver Qi moving formula, Chai Hu Shu Gan with additional herbs to move Qi and invigorate Blood. Although the dogs appeared to live in harmony, the presence of an additional dog in the household, particularly another intact male, would occasionally frustrate the older male, resulting in Liver Qi Stagnation. Shu Gan Wan was prescribed at the dose of 1 teapill per 10lb of body weight BID for 3-5 days when lip smacking starts. Thereby, the owner is able to control these subtle symptoms without them advancing to grass eating, bile vomiting, or prolonged chest or hypochondriac tension. Treatment with Shu Gan Wan has only been necessary for 2-3 short periods of time each year.
At 12 years of age, the dog developed prostatitis and was treated with Baytril® antibiotic. His owner wanted to have his sperm collected and stored. So he was treated with Prostate Invigorator, a Jing-Tang formula that clears Heat and Stagnation from the Lower Burner and helps to move Blood and stop pain. Although his prostatitis resolved, the owner decided against collecting him and had him neutered. At this time, she owned a 2-year-old male Nova Scotia Duck Tolling Retriever sired by this dog.
Now at 13 and a half years of age, this dog has lenticular sclerosis OU, fine flake dandruff, dry foot pads, a pale pink tongue and thin pulses. He is currently being treated for a global Blood Deficiency with the Eight Treasures herbal formula. Eight Treasures is a combination of the four herbs that make up Si Jun Zi Tang (the basic formula for Qi Deficiency) and the four herbs that make up Si Wu Tang (the basic formula for Blood Deficiency). It is a formula that I find very useful in helping many of my geriatric canine patients with signs of Blood and Qi Deficiency.
The life cycle is illustrated with the relationship of the Five Elements in TCVM . Birth and growth is represented by the Wood element where the tree sprouts from a seedling and grows strong. The Fire stage of life is where the leaves start to blossom and sexual maturity is reached. The Earth stage is represented by family life, and the tree creates seeds to generate new life. The Metal stage is one of quiet maturity where the leaves turn brown and begin to fall and the tree stands out in the forest by its’ strength and size. The Water element represents the period of life where the tree’s work is done, potential has been met and quiescence begins. The Water element contains the Kidney which is the root of the Yuan Qi or Source Qi. Protecting the root’s Source Qi is the way to live a long and dignified life.
This dog completed his Breed Championship, Master Hunter title, Master Agility title and Obedience titles. He was retired from formal competition at 13 years of age due to hearing loss, a symptom of Kidney Qi Deficiency. His routine treatments now emphasize the preservation and tonification of the Kidney element. He continues to take part in agility and hunting events, “just for fun” as in the owner’s word, and helps with training the son he sired at age 10, and remains the beloved friend and companion of his owner, who is delighted that he continues to live a full and happy life, thanks to the benefits of TCVM.