TCVM News, Issue 27, Summer/Fall 2015 TCVM · PDF fileTCVM News, Issue 27, Summer/Fall 2015 1...

TCVM News, Issue 27, Summer/Fall 2015

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HEADLINE NEWS

Sponsored by Dr. Xie's Jing Tang Herbal

Hyperadrenocorticism, orCushing's disease, is acondition where the adrenalglands produce excessiveglucocorticoid hormones andresults in clinical signs suchas increased thirst, increasedurination, increased hunger,pendulous abdomen,

enlarged liver, hair loss, lethargy, muscleweakness, obesity, increased panting, skinchanges, and immunosuppression. Cushing'sDisease can be subdivided into pituitarydependent (85% of all cases) and adrenaldependent (15% of all cases). Currently, twomedications that are commonly used to treatpituitary dependent Cushing's disease aremitotane and trilostane. Both of thesemedications have their respective benefits andside effects. Side effects such as weakness,vomiting, anorexia, diarrhea, and ataxia occur indogs receiving mitotane or trilostane. If nottreated, Cushing's disease is usually progressivein nature with a poor prognosis for quality.

Cushing's disease can be treated and managedeffectively by Traditional Chinese VeterinaryMedicine (TCVM). A recent unpublishedretrospective study done by Dr. Huisheng Xieand I revealed all twelve dogs in the study hadmoderate to marked improvement of clinicalsigns with no notable side effects following anaverage of 3 months of acupuncture and Chineseherbal medicine alone. Eight of twelve dogs withconfirmed diagnosis had significantimprovement in ACTH stimulation test resultsafter an average of 12 months. Of the eight dogs,four dogs had the results of basal serum cortisolconcentration returned to the normal range in 8

months. We concluded that acupuncture andChinese herbal medicine served as a safeand effective treatment for canine Cushing'sdisease.

In TCVM, Cushing's disease correlatesclosely with Xiao-Ke in most instances. Xi-ao-Ke means thirsting and wasting disorder.Other disorders that also fall into this cate-gory include diabetes and hyperthyroidism.Cushing's disease is particularly consideredas Xia-Xiao pattern, which means Xiao-Kein the Lower Burner (Xia Jiao) pattern.TCVM organs that are involved in Cush-ing's disease include Kidney, Liver, andSpleen, with the Kidney as the root (Ben) ofthe disease. Thus the treatment principle istypically focused on managing the branch(Biao) and supporting/balancing the root,Kidney. The causes of Cushing's diseaseinclude poor diet, obesity, lack of exercise,chronic drug therapy, stress and chronicdiseases that have weakened the TripleBurner (San-Jiao), resulting in Damp-Heatand Phlegm. Patients started to show signsof Excess Heat, such as thirst, increasedappetite, irritability, and restlessness. If leftuntreated, the Heat can further damage Qiand scorch Yin, leading to Deficiency of Qiand/or Yin. Signs of deficient Qi includeweakness, fatigue, muscle atrophy, weightgain/loss, vomiting, diarrhea, pale tongue,and weak pulses. Signs of Deficient Yininclude polyuria, polydipsia, dry hair coat,small amounts of dandruff, insomnia, pant-ing, red-dry tongue, and thin-fast pulses.The treatment strategy for Cushing's disease

Degree programs are now offered at theChi Institute! We are pleased to announcethat the Chi Institute was approved to own aprovisional institutional license from theFlorida Commission for Independent Educa-tion (CIE) on May 21st, 2015. We will beginoffering both a Master of Science in TCVMdegree program as well as a Certified TCVMPractitioner Diploma program. The Chi Insti-tute will become the first higher educationinstitution to offer the TCVM master degreeprogram outside of China. (See back coverfor details)

Our hardworking Chi Staff and Dr. Gregg Todd at thestate CIE commissioner meeting on May 21st, 2015

The Chi Institute installs more solarpanels in the new teaching facility.100,400 of so-lar panels havebeen installedfor this project.This is the sec-ond building tohave solar pan-els installed on the Chi campus. Chi now runscompletely on solar energy.

Get a signed copy of Dr.Xie's newest book! The 3rdvolume of Practical Guide toTCVM is available now andthe first 100 copies sold willbe signed by Dr. Xie. Referto pg. 6 for more details.You can order now online at

https://bookstore.tcvm.com.

TCVMCamp with Dr. Xie in the Inner Mongolia grasslands at the 2016 Pre-confernce

tour and then join us for the TCVM Annual Conference in Beijing, China.


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is based on TCVM pattern diagnosis.

I. GENERAL TREATMENT STRATEGYa) Five common patterns: Qi Deficiency with Phlegm, Liver Qi

Stagnation, Yin Deficiency, Qi-Yin Deficiency, Yang Deficiency• Yin Deficiency and Qi-Yin Deficiency account forabout 70-85% of all patients with Cushing’s disease

b) Common clinical signs of Cushing’s disease and its indicationon TCVM patterns

* Def = Deficiencyc) General acupoints:

• Nourish Kidney: BL-23, KID-3, KID-7• Support Spleen: BL-20, ST-36, SP-6• Soothe Liver: BL-18, LIV-13, LIV-3

d) Modalities:• Dry needling for 20-30 minutes• Electroacupuncture, 20 Hz for 10 min, 80-120 Hzfor 10 min• Aquapuncture with diluted vitamin B12 at BL-18,BL-20, BL-23, ST-36, LIV-13, KID-3, or acupointsbased on pattern

e) Acupuncture plan:• Once every 2-4 weeks for 3-6 sessions• Afterwards, 3-6 months intervals for maintenance

f) Common Chinese herbal formulas:• Yin Deficiency: Mai Men Dong San (OphiopogonFormula)• Qi-Yin Deficiency: Xia Xiao Fang (Rehmannia 11)• 0.5 g per 10 lb (0.5 g per 4.5 kg), q8-12h for 3-6months or longer

II. PATTERN DIFFERENTIATION & TREATMENT

Qi Deficiency with Phlegma) Signs: early stage or all stages, overweight or obese, more

PP, less PU/PD, diarrhea or constipation, lethargy, fatigue,

excessive panting. Pale wet with thick coating tongue.Deep weak pulses.

b) Treatment principles: strengthen Qi and transform Phlegm.c) Acupoints: general acupoints above; add LI-10, ST-40,

BL-22 to strengthen Qi and clear Phlegm.d) Herbal formula: Fat Phlegm Formula; add Four Gentlemen

for severe Qi Deficiency.Liver Qi Stagnation

a) Signs: early stage or all stages, more PD, less PU/PP,irritability, depressed, nausea/vomiting, flatulence, inter-mittent diarrhea/constipation, red eyes. Red to purple withthin white coating tongue. Wiry and fast pulses.

b) Treatment principles: regulate Liver Qi and clear Stagna-tion.

c) Acupoints: general acupoints above; add LIV-3, GB-34,GB-41 to soothe Liver; add LI-4, GV-14, Er-jian, Wei-jianto clear Heat.

d) Herbal formula: Chai Hu Shu Gan or Liver Happy; addXiao Yao San for diarrhea or Xiao Chai Hu Tang fornausea/vomiting.

Yin Deficiencya) Signs: more PU and PD, less PP, general dryness, thin dry

hair coat, alopecia, small dandruff, insomnia, excessivepanting, warm body, cool seeking, restlessness, signsworse at night. Red dry with little to no coating tongue.Deep, weak and fast pulses, weaker on the left.

b) Treatment principles: nourish Yin, generate fluids, andclear Heat

c) Acupoints: general acupoints above; add KID-6, SP-9 tonourish Yin; add LI-4, GV-14, Er-jian to clear Heat.

d) Herbal formula: Mai Men Dong Tang (Ophiopogon For-mula) or Zhi Bai Di Huang (with severe deficient Heat);add Yi Guan Jian for elevated liver enzymes.

Qi and Yin Deficiencya) Signs: mid to late stages, more PD and PU, less PP, pendu-

lous abdomen, hepatomegaly, thin fragile skin, calcinosiscutis, general weakness, muscle atrophy, trembling, maydevelop other complications. Pale to red tongue. Deep,weak, thin or thready pulses.

b) Treatment principles: tonify Qi and nourish Yinc) Acupoints: general acupoints above; add BL-24, BL-26,

Shen-shu, Bai-hui, CV-4, CV-6, LI-10 to tonify Qi; addKID-6, SP-9, SP-10 to nourish Yin.

d) Herbal formula: Xia Xiao Fang (Rehmannia 11).Yang Deficiency:

a) Signs: terminal pattern, PD and PU with large amount ofurine, decreased appetite, pendulous abdomen with emaci-ated body, poor hair coat, incontinence, lethargy, exerciseintolerance, cool body, warm seeking, other concurrentdiseases (diabetes, renal failure, heart failure). Pale wet andswollen tongue. Deep, weak and slow pulses.

b) Treatment principles: warm Yang, tonify Qi, and nourishYin-Blood

c) Acupoints: general acupoints above; add GV-3, GV-4,Bai-hui, Shen-shu/peng/jiao, BL-24, CV-4, CV-6 to tonifyQi and warm Yang. Moxibustion at Bai-hui, GV-3/4, CV-4/6, BL-23/26.

d) Herbal formula: Rehmannia 14 or Jin Gui Shen Qi WanFang (Rehmannia 11).

Signs TCVM PatternsPolydipsia Kidney Qi and/or Yin DefPolyuria (PU) Kidney Qi, Yin and/or Yang DefPolyphagia (PP) Stomach HeatWeight gain Phlegm, Spleen Qi DefMuscle wasting Spleen Qi or global Qi DefWeight loss Spleen QiReduced activity Spleen Qi or global Qi DefExcessive panting Heat, Yin defHair loss Heat, Qi/Yin/ Blood DefThin, dry, fragile skin Lung Yin defRecurrent skin infection Damp-Heat, Wei Qi or Lung Qi DefTissue calcification Heat, Yin Def, Blood stasisPot bellied Spleen Qi Def, PhlegmHyperpigmentation Heat Kidney Yin Def, Blood stasisHypertension Kidney Yin def with Yang floatingUrinary Tract Infection Lower-Jiao Damp-Heat, Wei Qi or

Kidney Qi Def. KidneyIncreased liver enzymes Lower Yin DefHyperlipidemia PhlegmVomiting Stomach Yin Def, Spleen Qi Def,

PhlegmDiarrhea Damp-Heat, Spleen Qi Def

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III. CASE EXAMPLESnowflake, a 10 year old, spayed female Maltese was presented forTCVM evaluation for PDH Cushing’s disease that was diagnosed 6months earlier with an ACTH stimulation test. She had a history ofincreased drinking, increased urinating and insomnia. Routine bloodwork revealed a persistently increased liver enzyme (ALP) andmildly elevated cholesterol. A grade 3/6 left systolic heart murmurwas auscultated at that time with no associated clinical signs. Theprimary care veterinarian was treating her with trilostane. Snow-flake had since been drinking and urinating less than previouslyobserved. However, she was still restless at all times and had troubleresting at night, which had greatly affected the sleep quality of thedog and the caretakers. Her appetite seemed to have decreased. Thecaretaker was seeking TCVM to help improve her sleep quality andother signs, as well as to be able to wean her off the trilostane.

In the TCVM exam, Snowflake had normal Shen, thin hair coat withgreasy skin, warm ears, feet and body. Her tongue was red and drywith cracks and her pulse was thin and fast (weaker on the left side).She was restless and panting during the exam. The TCVM diagno-ses were Qi and Yin deficiency with false Heat. Snowflake wastreated with acupuncture once every 2 weeks, was given a coolingdiet and daily Chinese herbal medicine with Zhi Bai Di Huang andFour Gentlemen for 2 months initially. 2 weeks later, Snowflakeshowed significant improvement. She had normal appetite and

seemed to be calmer, panting less, and slept better at night. Herbalmedicine was switched to Ophiopogon Formula and acupuncturesessions were then tapered to once a month. 4 months after theinitiation of TCVM, Snowflake had normal appetite, water intakeand urination. Her skin coat was normal and she continued to sleepwell at night. Trilostane was successfully weaned off over a 2-month period without any signs of relapse of the disease. Snowflakecontinued receiving acupuncture every 3 months for maintenance,as well as daily herbal therapy based on pattern diagnosis.

IV. SUMMARYTCVM is a viable treatment option that is safe and effective forCushing’s disease in dogs. It can be used in conjunction withconventional therapy to manage advanced or later stages of thedisease and minimize the occurrence of side effects. It can also beused alone in patients that cannot tolerate medications, are unre-sponsive to medications, are in early stage, or have atypicalCushing’s disease. TCVM can help improve the quality of life ofpatients and exceed their life expectancy. TCVM patterns of YinDeficiency and Qi-Yin Deficiency account for about 70-85% of allCushing’s disease cases. Treatment is typically focused on lifelongmanagement of the disease. The most common Chinese herbalformulas for Cushing’s disease are Mai Men Dong Tang and XiaXiao Fang (Rehmannia 11).

New


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Dear friends and colleagues,

We are very pleased to invite TCVM practitioners and clinicalresearchers to submit abstracts of a presentation for the 18th

Annual TCVM Conference held in Beijing, China from August 28to 30, 2016. The main theme of this conference will be TCVMSpirit-Mind-body, behavioral issues, infection/inflammatorydiseases, TCM Schools. This International TCVM Conference willbe co-sponsored by the World Association of TCVM, ChinaTCVM Society, Beijing Small Animal Veterinary Association &Chi Institute.

Presentation CategoriesYou may span multiple topics – please indicate all applicablecategories when submitting your abstract.

Clinical Research including any study on efficacy orsafety/side effect of any TCVM therapeutic, clinicalrandomized controlled studies or a retrospective study of aseries of cases of a disease or syndrome. This is a 30-60 minutepresentation.

Clinical Application including any new acupuncturetechniques/methods, herbal formulas, and Tui-na/food therapyin dogs, cats and horses. This is a 30-60 minute presentation.

How to including DISEASES OF MASTICATION pearls andclinical tips of how to diagnose and/or treat a disease or medicalcondition/syndrome of dogs, cats and horses. This is a 30-minute presentation.

A Case Study including any unique or special case study ofdogs, cats, horses, or other species. This is a 10-minutepresentation.

Presentation AwardsEach selected presentation will be awarded $600 for 1-hour, $300for 30-minute, and $150 for 10-minute presentations. The awardswill be subtracted from the conference/pre-conference tourregistration. The detailed information on this conference and tourcan be found at www.tcvm.com. A certificate will be awarded tothe first place recipient in each category.

Abstract FormatThe abstract must be submitted in a Microsoft Word document,single-spaced, and no more than two pages. Abstracts may be sent

by e-mail as an attached document identified as "Abstract TCVMConference" in the e-mail subject line. The Abstract must includethe following items:

Title of Topic

Name of Author(s)

Mailing Address

Telephone Number

Email Address

Abstract

Reference

Your curriculum vitae (Resume)

E-mail your Word Document as an attachment to: [email protected] must be received electronically no later than 11:59 PM(CDT) on December 1st, 2015. You will receive notification bye-mail that your abstract has been received. Please advise if theacknowledgement is not received within 5 days of submission.Notification of acceptance or rejection of abstracts will be e-mailedby January 1st, 2016.

Important DatesAbstract submission deadline: December 1, 2015Selection notifications sent: January 1, 2016Whole paper submission deadline: March 1, 2016Conference Registration deadline: May 1, 2016Powerpoint presentation submission deadline June 1, 2016

For More InformationFor additional information please contact [email protected] or call1-800-891-1986 extension 113

Dr. Huisheng Xie DVM, MS, PhDPresident of the Chi Institute

Pre-conference Tour A: Aug 19-23, 2016 Inner Mongolia Pre-conference Tour B: Aug 23-27, 2016 Beijing, China

Conference: August 27-31, 2016 Beijing, China


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Having switched from a general practitio-ner to a TCVM practitioner, I often getthe question, “How did you get into acu-puncture or Chinese medicine?” Whilemy story is pretty typical, I believe themost interesting thing about it is that Iknow it is not just my own story, but it isshared with hundreds of other veterinari-ans who found belief and faith in TCVMthe way I do.

After graduation, I started out as a general practitioner at a privateanimal hospital. At the time, I really enjoyed being a general practi-tioner helping the sick and injured animals. However, I quicklyrealized that treating the disease rather than the individual patient iswhere “modern” medicine falls short, especially for treating chronicconditions. I was then introduced to animal acupuncture by mycolleague, Dr. Tsai Li-Juan and was astounded and inspired by itswonderful outcomes for a variety of illnesses. Immediately I knewI found my calling.

As I researched more about the theories behind Chinese medicine, Ibecame fascinated with this mysterious, yet time-proven, system ofmedicine. I was intrigued by its concepts of the body being areflection of the universe, and as the only way to ultimate healingwas treating it as a whole. I started seeing an acupuncturist for mychronic neck and back pain. I was amazed at how well I recoveredafter each session and everything he could tell me about my body,simply by looking at my tongue, reading my pulses, and askingabout my life style. I knew then that this was what I was meant todo. I began studying the theory of TCVM and shadowing acupunc-ture and Chinese herbal medicine with Dr. Tsai.

In 2009, I went to Lanzhou, China for a month to further my TCVMknowledge at the Institute of TCVM, Chinese Academy of Agricul-tural Sciences. I attended advanced studies with lectures on thetheory of TCVM and clinical practice of acupuncture, moxibustionand herbal medicine. I spent time at a TCM Hospital observing howacupuncture, moxibustion and Tui-na are used in different settingsin China. After returning from China, I immediately applied theknowledge to my practice and saw good results.A year later, I was accepted for an internship specialized in acupunc-ture at the University of Florida Veterinary Medical Center. I wasvery fortunate to have been able to learn closely from the master ofTCVM, Dr. Xie. His influence was the most powerful personaltraining I had yet experienced in my life. In addition to being ableto learn TCVM from him, my greatest gain is that I learned andpracticed all of the arts of living that he modeled. He is no doubt myhero, my inspiration and my role model. He has my greatestgratitude for the healing skills that I have!

After the internship program, I followed my interest in acupunctureand continued post-graduate study at the UF CVM, where I receivedmy Master’s Degree of Veterinary Science in Acupuncture. In 2012,

I accepted a position at Louisiana State University VeterinaryTeaching Hospital to build the Integrative Medicine program thatoffers acupuncture, herbal medicine, nutraceuticals, and nutrition.I then added canine physical rehabilitation as a combination for avery effective treatment of musculoskeletal injuries and neurologi-cal problems. Today, our caseload continues to grow, and we re-ceive referrals for almost all of the other services. In addition, wereceived positive student response when we became an electiverotation for senior students. We now have students from othercolleges asking to do rotations and veterinarians wanting to shadowat our Integrative Medicine service. My goals are to educate veteri-narians, students and the public about the benefits and usefulness ofTCVM, as well as adding research to better understand acupunctureand herbal medicine.

After moving to Baton Rouge, I started seeing an acupuncturist intown for my neck stiffness and pain. Dr. Xia Shou-hua is not onlythe master of TCM but also is specialized in navel acupuncture.With just a few needles in my navel area, he fixed my neck rightaway. He also addressed my hip pain that had been bothering me formonths with just needles around the navel. It was almost a year agoand my hip is still pain free. I was fortunate to learn this specialtechnique from Dr. Xia. It is based on I-Ching and Ba-Gua theory,needling points around umbilicus and awaking pre-natal energy forhealing and can be applied to all kinds of chronic, complicateddiseases. I started using it along with traditional techniques on mypatients and I could really tell the difference after treatments. I willcontinue to learn and I hope to bring this unique technique intoTCVM. I think it integrates traditional acupuncture to accelerate thebody achieving balance, just like scalp acupuncture.

The reason I got into TCVM and stayed in it is simple: it is atime-tested profound philosophy that reveals itself to the extent thatI am willing to stay present and delve deeper into this healing pathto not only help heal my animal patients, but myself, my family andfriends.

Chi FacultySpotlight


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HISTORY“Kobe” was an M/N 80 lbs Yellow Labrador witha Fire personality. His DOB was 12/30/97. Hehad been on maintenance TCVM treatmentssince he was 12 years-old for lumbosacral arthri-tis, spondylosis, and cervical IVDD (diagnosedwith MRI). TCVM diagnosis was Kidney Qi andYin Deficiency, Liver Yin Deficiency, Jing Defi-ciency as well as Bi and Wei Syndrome. Treat-

ment included acupuncture and Tui-na. This treatment was on goingevery 2-4 weeks. Herbal formulas included Body Sore 8 TeapillsBID and Hindquarter Weakness 8 Teapills BID. Tramadol 50mg1/2-1 pill BID was used for pain as needed, and Adequan 1.5cc Q 2weeks for joint support. He was also given Thyroid Support(Standard Process) for low thyroid1 tsp BID, Normalizer 3 1 BID(digestive enzyme/probiotic supplement for Immune support)

2.5 years later (~14.5 years ) a routine laboratory panel indicated aborderline non- regenerative anemia. [HGB 11.6 (LOW)] and lowT4. Suspect low T4 is due to euthyroid sick syndrome. All otherChemistry & Electrolyte values were WNL. His general orthopediccondition had continued to slowly progress. There was increasedgeneralized muscle weakness, atrophy and moderate ataxia. Other-wise he was still full of life.The updated TCVM diagnosis was LiverBlood Deficiency and mild Kidney Yin Deficiency , Jing Deficiency,Chronic Wei and Bi Syndrome. TCVM treatment included continuedacupuncture, Tui-Na and herbs plus food therapy to address theanemia.

FOOD THERAPYHonest Kitchen beef and grains, beets (Blood tonic), beef liver(Blood tonic), ground beef (Blood tonic), avocados (Yin/Bloodtonic), tuna (Blood tonic), spinach (Yin/ Blood tonic) and hardboiled eggs (Yin/Blood tonic). Some combinations of these wereadded to the diet on a rotating basis at client’s discretion. (Client didnot feel she had time to make marrow soup, though it was highlyrecommended) Additionally Vitamin B12 1.5 cc Q 2 weeks andFerrafood (Standard Process) for low hemoglobin 2 BID were start-ed.

PROGRESS REPORT10/20/12(15yr): TCVM EXAM: Tongue: pale lavender. Pulses:deep, weak, slow, thin. Feet were neutral. Back: cool, ear tipsneutral, nose cool & wet. Anemia was worsening. RBC 4.4 (LOW),

HGB 10.8 (LOW), HCT 30 (LOW). Started on Marrow Soup 1/2 -1 cup daily and Gui Pi Tea Pills started 25% of dose x 2 days (2 pillsBID), then 50% x 2 days(4 pills BID), 75% x 2 days (6 pills BID),then 100% 8 pills BID.

3/1/2013: CBC indicated anemia was resolved, RBC =5.5, HGB=13.6, HCT=39. TCVM exam still indicated Blood Deficiencysymptoms (pale tongue & cool body). All treatments remained thesame.

8/12/2013: Kobe had been unable to walk for 4 months, although hewas able to swim daily. He had an acute episode of shoulder pain.Blood work was unremarkable except the CBC values had droppedslightly indicating a borderline anemia. A diagnosis of acute localQi/Blood Stagnation in the shoulders was made. Treatment includedTui-na, laser, & electroacupuncture in the shoulder area. The clientwas instructed to do Tui-na daily and she leased a cold laser to alsouse over the shoulders daily. The tramadol was increased PRN for 2days. The stagnation cleared in 48 hours. These daily laser/Tui-natreatments by client continued.

12/27/13: Kobe was again very painful over his shoulders, wouldnot eat or sit up at all and was drinking very little. His gums werepale and dry, his nose was cool and dry, his pulses were thin weakand slow, his body was cool to the touch including ears, feet, backand abdomen. TCVM DX = severe blood deficiency with Worsen-ing global Qi/Jing Deficiency & local Qi/Blood Stagnation in shoul-ders). A CBC showed a moderate macrocytic anemia. (RBC =3.4,HGB =8.5, PCV=28, MCV =80). In spite of acupuncture, Tui-na,and SQ fluids Kobe worsened over the next 2 days, never lifting hishead without assistance.

12/30/13: He was given the opportunity to get in the pool. He wouldnot move his legs and showed none of his usual excitement orinterest. Due to his age, level of discomfort, lack of Shen, diminishedJing and appetite he was euthanized on his 16th birthday. This caseis a wonderful example of using TCVM for Palliative Care. Kobehad a good quality of life even after he could no longer walk. It wasrewarding to use food as therapy especially when the patient enjoysthe treatment so much. It was also validating to demonstrate herbsand food improved and sustained objective laboratory values (RBC,HGB, PCV) in this geriatric patient without any negative side effects.

Integrative Mixed Practice Seeking Part-time orPer Diem Doctor Location: Pagosa Springs, CO

Donald P. Thompson, DVM, owner of Elk Park Animal Hospital inSouthwestern Colorado, is seeking to hire a veterinarian to work part-timeor per diem. The practice utilizes acupuncture and Chinese herbalmedicine extensively in its integrative setting. Dogs and cats make upapproximately 65% of the patient load, horses approximately 20%, withthe remainder being beef cattle, camelids , small ruminants and exotics.

Pagosa Springs, famous for its namesake hot springs, is in the heart of skicountry, with nearby Wolf Creek boasting the most snow in Colorado, pluscopious hiking, fishing, hunting and other outdoor activities. Denver, SantaFe and Albuquerque are all within easy driving distance of Pagosa Springsfor opportunities in Western cities. Our regional airport is in Durango, anhour's drive to the West.

“Consider a move to the Southwest!"

Please contact Dr. Thompson via email: [email protected]


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HISTORYA 7 year old spayed female DSH had pre-

sented to another clinic for a rabies vaccine inFebruary 2014. Shortly thereafter she devel-oped a bilateral otitis with a purulent discharge.She was treated with antibiotics for 2 weeks.The ear discharge stopped, but she developed asevere head tilt and ataxia. She fell down whenshe jumped. She was then treated with silica,

which was no help. Blood work and radiographs were non remark-able. Since March there was no improvement with the head tilt andataxia. On July 26, 2014 she came to my clinic.

WESTERN EXAM July 26, 2014:She had a prominent head tilt with a 60 degree rotation with theright side down. She was ataxic at the walk. Her mucous mem-branes were pink and the heart and lungs auscultated normally.The optic exam was normal and the ear drums were within normallimits. Abdominal palpation was non remarkable. There were noproprioceptive deficits. The retina and optic disc appeared to benormal. There was a lateral and downward strabismus to the lefteye.

TCVM EXAM July 26, 2014:History: The major complaint was ataxia. In Chinese Medicine,ataxia would be considered Wind which is associated with theLiver element. She bossed the other cats around. Her personalityis Wood which is part of the Liver element. She was not onmedications and there was no change in the disease course for thepast 4 months.

Examination: There was a depression at BL-18. She had a LiverWind and possible Shen disturbance with the head tilt and ataxia.The tongue was slightly red and dry with no coating,and had adeeper red on the sides, associated with the Liver area. Pulses werestrong and wiry, but slightly weaker on the right. Her urination,feces, voice, sleep, respiration ears, gums, appetite, and waterintake were normal. There was a lateral downward strabismus tothe left eye, and a 60 degree head tilt to the right. The walk wasslightly ataxic. She circled to the left. She fell down if sheattempted to jump.

Diagnosis:The ataxia, circling, depression at BL-18, Wood consti-tution, wiry pulses, red tongue with a deeper red on the sides (Liverarea) indicate a Liver issue with Wind. The Shen disturbance withthe head tilt, downward and lateral strabismus indicate Blood and/orQi Stagnation in the head. Therefore the diagnosis is Blood Stagna-tion in the head with Liver Wind.

Treatment: Dry needle acupuncture was done at the followingpoints:

GV-14/20, GB-20/21/25, GB-25, BL-18/20/21/23/60,KID-3, and An-shen bilaterally 20 mg Depo Medrol was divided between BL-18/21 bilat-erally 0.45 ml of Convenia was given at left GB-25

She went home on Stasis in Mansion of Mind 0.2 gm capsules BIDfor 6 weeks. It was chosen to break down Blood stasis in the brainand to transform Phlegm. For the first 3 days she had greatlyimproved with much less head tilt. She was as the owner put it,“able to stick her landings” after she jumped. She was now jumpingoff of the table without fear.

Examination August 2, 2014:Her gums were pink. There was less of a head tilt and a more mildstrabismus. She had deep pulses which were weaker on the right.Her tongue was pink with a hint of purple. There were slightdepressions at BL-18/21/23.

Treatment: Dry acupuncture needles were given at the followingpoints:

BL-18/21/23/60, GB-21, GV-3/14/17/20, KID-3, and Shen bilaterally 0.45 ml Convenia was given at left GB-25.3 cc B12 was given at GB-21 bilaterally GV-14 20 mg Depo Medrol was divided betweenBL-21 bilaterally

The owner was instructed to continue to give Stasis in Mansion ofMind 0.2gm bid and return in 2 weeks.

Follow up telephone conversation September 3, 2014:The cat isnormal without a head tilt or ataxia. The owner decided the cat isdoing so well that she no longer needed her third acupuncturetreatment. She is still giving the herbal Stasis in the Mansion ofMind, which is almost finished.


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HISTORY AND PHYSICAL EXAMA 5 month old, American Quarter Horse colt,was presented for gait evaluation of his rightforelimb. Two months prior to presentation, hewas kicked by another foal and suffered atraumatic injury to the cranial aspect of hisright distal humerus and proximal radius. Theinjury healed by second intention, but theowner noticed intermittent buckling of the right

carpus while the horse was standing or in motion.There was severemuscle atrophy of the Extensor Carpi Radialis and Common DigitalExtensor Muscles of the right forelimb. The circumference of theradius, measured distally to the lateral metaphysis, was 27cm on theright forelimb and 40cm on the left forelimb. At a walk, a severe,intermittent buckling of the carpus (knee) was noticed. Bucklingwas also elicited by a light touch applied at the caudal radius. Thesame response was not elicited from the left radius. Radiographicevaluation concluded presence of fibrotic tissue at the previous siteof trauma with no evidence of associated bone or joint abnormality.An electromyogram demonstrated decreased insertional activity andnumber of motor unit action potentials of the right antebrachialextensor muscles (when compared with shoulder muscles and ante-brachial flexor muscles).

These findings were consistent with fibrosis of the right antebrachialextensor muscles. Ultrasonographic evaluation displayed a mixtureof hyper- and hypo- echoic areas, as well as, a significant decreasein cross sectional area of the right antebrachial extensor muscleswhen compared with the opposite limb. The diagnosis was neuro-genic muscle atrophy of the Extensor Carpi Radialis and CommonDigital Extensor muscles of the right antebrachium as a result ofneuropathy of the cranial cutaneous antebrachial and superficialbranch of the radial nerves.

OCTOBER 10, 2014TCVM EXAMINATION

TCVM DIAGNOSIS AND STRATEGY: Spleen Qi Deficiencyand Qi Stagnation localized to the right forelimb extensor muscles.(R) TH-15 indicates shoulder or front limb pain. Weak pulse onright indicates Qi Deficiency. The strategy was to activate Bloodand ease tendons and muscles; tonify the Qi, and invigorate themeridians.

Dry needle: Right: SI-10, SI-11, GB-21, LI-4, LI-10,LI-11, LI-15, TH-5, TH-9, TH-10, BL-13Aqua-acupuncture: 3 cc of undiluted Vitamin B12 onRight SI-9, SI-10, TH-14, and LU-1.

OCTOBER 23, 2014The colt appeared stronger at the carpus when pressure was appliedto the caudal-distal radius. Gait deficit was improved by 50%.

Dry needle: Bai-hui, GB-21, Qi-hai-shu, BL-20, BL-21Electro-acupuncture Intermittent wave: f1=0; f2>0 for30 minutes. SI-10 to GB-21, SI-11 to LI-10, TH-15 toBL-13, TH-9 to TH-15, LI-4 to LI-11, SI-9 to LU-1, SP-20to SP-20.

The acupoints for electro-acupuncture were chosen following therecommendations for the treatment of Paralysis of theRadial Nerve in Xie’s Veterinary Acupuncture. Xie, H; Preast, V.Blackwell Publishing 2007.Ch. 8-6. Pg.254 and the frequency,duration and intensity were chosen following recommendations formuscle atrophy of the Electro-Acupuncture Stimulator JM-2A.Wuxi Jiajian Medical Instrument, Inc., Wuxi, China.

NOVEMBER 06, 2014The colt’s gait continues to improve. A significant increase instrength of the extensor muscles was noticed.

Dry needle and electro-acupuncture: Same acupoints asprevious visit.Pneumo-acupuncture: 100 of air were injected subcuta-neously over each affected muscles.

NOVEMBER 20, 2014The strength of the extensor mus-cles continues to increase.Dry needle, electro-acupunctureand pneumo-acupuncture: Sameas previous visit. Herbal medi-cine: Qi Performance 15g. POBID.

DECEMBER 4TH, 2014The owner reported that no buckling of the carpus has been noticed. The strength of the extensor muscles was about 80%compared to the normal limb. The circumference of the radius was34cm (7cm increase since the beginning) on the right side and 40cmon the left. Dry needle, electro-acupuncture and pneumo-acupunc-ture and Herbal Medicine: Same as previous visit. The colt wasdischarged with the instructions to continue with herbal medicinefor 6 more weeks and unrestricted exercise activities.

Body Condition 6/9Back Temperature Cold/normalTongue Color Normal pinkBody Scan (R) TH-15+Constitution MetalEar Temperature Cold/normalTongue moisture/coating Moist/clear normalRight Pulse Weak

Resolving Muscle Atrophy 11/20/14 Pneumo-Acupuncture 12/04/14


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