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Remembering the Pattern

Remembering the Pattern

by Kay Wahl, DVM,CVA

Author: Chi Institute/Sunday, April 1, 2012/Categories: Student Case Reports, TCVM Newsletter, 2012 Spring Issue

An accurate TCVM (Traditional Chinese Veterinary Medicine) diagnosis is the foundation of effective therapy, be it with acupuncture and/or herbs, as it allows the TCVM practitioner to design a treatment protocol, based on the Eight Principles, the Zang/Fu organs and their interactions, and the Five Element Theory. One benefit of TCVM is: the advantage one can have on predicting or managing future problems a patient might have based on the constitution of said animal; this report is to showcase this practitioner’s failure to address this issue.

Moose, a 12 year old Selle Francais gelding belonging to my daughter, is a competitive jumper. He travels between his home in North Carolina and Gainesville, FL. He is shown frequently and ridden almost daily.

February 2011: Upon returning to a new barn in Gainesville after being at the family farm in North Carolina for 3 months, Moose is becoming reluctant to work, difficult to handle on the ground, and starting to pace the fence line. He is getting more aggressive towards his pasture mates, as well. A routine western medical physical examination was unremarkable. I was asked to come to Florida and reexamine Moose. Moose is a Wood personality. Pulses were fairly even, but forceful. His tongue was red. Wood personalities are prone to Shen disturbances and the liver and gallbladder are the Zang/Fu organs associated 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 Qi stagnation causes imbalance in the Shen. This is exhibited as restlessness, anxiousness, and irritability. Diagnosis was Liver Qi stagnation with Shen disturbance.

Moose was very resistant to needling. As I also lived 400 miles away, it was decided to use herbals to treat the Shen disturbance. Based on clinical signs, Shen Calmer was prescribed, at the rate of 15gms. BID. Shen Calmer nourishes Heart Yin and Blood and soothes Liver Qi. Shen Calmer was used at 15 grams BID for 2 months, and Moose was able to compete very successfully in Ocala for the show season. After 2 months, the Shen Calmer was reduced to 15gms once a day for another month, then discontinued. Competitions continued to go well and Moose moved back to North Carolina for the summer. The only issue, and here is the caveat, was that his hooves were cracking and dry, and the farrier had to put clips on to prevent Moose from pulling his shoes. The reason I have mentioned this is because the Liver controls the health of hooves and I did not pay attention to this change in Moose’s physical constitution. Looking back, even though the Liver Qi stagnation was considered resolved, Liver Blood and Yin were obviously compromised and ignoring this fact led to the next clinical complaint.

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

Tongue purple, pulses bounding, with the left side slightly weaker. Patient was agitated. A scan examination was positive over AP points Bl 18/19, a diagnostic point for tendon/ligament issues, and LI 17, a point for carpus pain. A diagnosis of Liver Yin and Blood deficiency was made with local stagnation.

TCVM Treatment: Sept, 12, 2011: Ting points were easily accessed: TH 1, PC9, SI 9, on the front feet; LIV 1, GB 44 on the rear. Distal points: GB 34 and LIV 3: Pattern points: BL 18, 19. At this point, Moose wouldn’t allow any more points to be needled-I had hoped to needle SP 10 and BL17 to help with blood stagnation and ST 36 and LI 10 to move Qi. The owner was instructed to wrap the affected area with relief salve 12 hours on and 12 hours off for one week. Body Sore and Tendon Ligament herbals were prescribed-both at 15 gms twice a day.

Body Sore was chosen due to its ability to move Qi and eliminate stagnation, and Tendon/Ligament formula is designed to treat Liver Yin and blood deficiency, as well as tendon injuries and weakness of tendons and hooves. TCVM assessment and treatment:Oct. 22, 2011: (More frequent treatment was unable to be performed due to the distance required for myself to travel). Moose was found to be sound at a walk and only mildly lame at a trot. Swelling and pain over the check ligament were minimal. Pulses were fairly equal; tongue pale purple. Both herbals were still being given. Moose was more difficult to needle today-Ting points were done-TH1, SI9, LIV 1 and GB44. Bl 17, 18, and 19 were needled as was Bai hui. No more needles were tolerated. Electro acupuncture was not attempted.

Dec. 10th, 2011: A local Florida veterinarian ultrasounded the affected 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 and pulses fairly equal, with some deficits over the liver pulse on the left side. The affected tendon palpates normal and Moose’s hooves are healthy and strong. It was advised Body Sore be continued for one more month and Tendon Ligament for 3 more months.

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

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