Providing Animal Safety and Control in Emergency Pet Shelters
Obesity: a TCVM Approach CAPT R.M. Clemmons, DVM, PhD, CVA Obesity Body weight is 20% over ideal An intake of total dietary energy above that needed for maintenance and production or exercise over a long period of time Energy in is based upon Food intake Absorption Energy used is
Basic metabolic rate (thermoneutral condition) Exercise Lactattion Pregnancy Growth In >> Out Obesity: TCVM Classical Strategy (1) Yin Tonic Herbs (Remannia, Lycium etc) Decrease in appetite Decrease in food intake (2) Purgative herbs (Rheum, Cannabis Ma Zi Ren etc) Passing food faster through SI Less time to absorb nutrients Decrease in absorption
(3) Qi Tonic Herbs (Ginseng, codonopsis etc) Energy boosting Patient more willing to exercise Burning down Fat tissue Obesity: TCVM Etiology and Pattern Damp-phlegm Liver Stagnation Excess Blood Stagnation Spleen Deficiency Deficiency Kidney Deficiency Damp-phlegm Etiology Water/damp from food or environment
Other pathogenic factors Stagnation of Water-damp Spleen Qi Deficiency Phlegm under the skin Obesity Damp-phlegm Symptoms . Overweight . Swelling neck or belly . fast respiratory rate, or cough or asthma . Pulse: Fast, deep or slippery . Tongue: pale or red with thick coating . In people: obese smoker . Overall: not weak Treatment Strategy: Transform damp and resolve phlegm Acupuncture treatment 1) needling: ST-36/40, BL-13, SP-6/9 or Electro-acupuncture (F=30 Hz) for local
swelling area 2) Message: Abdomen and back, twice a day. Damp-phlegm Herbal Formula Citrus Pinellia Poria Coix Atractylodes Areca Benincasa Alisma Plantago Cyperus Phlegm Fat Formula (Citrus-Pinellia Compound) Chen Pi 8% Ban Xia 8% Fu Ling 10% Yi Yi Ren 20%
Cang Zhu 8% Da Fu Pi 10% Dong Gua Pi 8% Ze Xie 10% Che Qian Cao 10% Xiang Fu Er Chen Tang Resolve Damp 8% Liver Qi Master Damp-phlegm Max Formula For lipomas Fritillaria
Zhe Bei Mu Soften hardness and clear nodules Ostrea Mu Li Soften hardness and clear mass Prunella Xia Ku Cao Clear Liver Heat and resolve nodules Scrophularia Xuan Shen Clear Heat and cool Blood Trichosanthes Tian Hua Fen Clear Heat and promote body fluids
Platycodon Jie Geng Open the Upper Jiao and transform phlegm Rhubarb Da Huang Clear stagnation/stasis and clear Heat Angelica Bai Zhi Clear Wind-Cold and relieve pain Liver Qi Stagnation Etiology Emotional Stress Drug Stress
Liver Qi Stagnation Liver over-control Spleen Spleen fails to transform Damp Phlegm under the skin Obesity Liver Qi Stagnation Symptoms: . Overweight . Aggressive, or restlessness . Hypertension . irregular estrous cycling . exercise intolerance, lassitude . Pulse: Wiry and deep . Tongue: purple or pale with coating or without coating Treatment strategy: Acupuncture: Regulate liver, clear Fire and transform damp Sp-6/9, ST-40 Liv-3, GB-20 and GB-34
Liver Qi Stagnation Herbal formula: Picrorrhiza Prunella Cassia Rehmannia Rheum Cassia Picrorrhiza Compound* Hu Huang Lian Xia Ku Cao Jue Ming Zi Sheng Di Huang Da Huang Pang Xie Ye 18% 19% 18% 15% 15% 15% Clear Liver
Clear Liver Nourish Yin/Blood Purge LI Blood Stagnation Etiology Stress Other factors Qi stagnation Blood Stagnation Qi-blood stagnation Water/Damp retention in the body Obesity Blood Stagnation Symptoms: . Overweight . lump in the body surface . exercise intolerance, lassitude . Pulse: slow and deep . Tongue: purple with coating or without coating
Treatment strategy: Acupuncture: Invigorate Blood and transform damp BL-17/SP-10 LIV-3, GB-34, LI-4 ST-40/BL-40 Blood Stagnation Herbal Formula: Carthamus Ligusticum Olibanum Typha Rheum Stagnation Reliever Hong Hua Chuang Xiong Ru Xiang Pu Huang Da Huang
22% 22% 19% 1 9% 18% Move Blood, resolve stasis Move Qi & Blood Purge LI Spleen Qi Deficiency Etiology Overwork Water/damp from food or environment Chronic illness Spleen Qi Deficiency Phlegm under the skin
Obesity Spleen Qi Deficiency Symptoms: Overweight Diarrhea, or dry feces Hyperlipemia Eexercise intolerance, lassitude Pulse: Weak and deep Tongue: pale with coating or without coating Treatment strategy: tonify spleen qi and transform damp Acupuncture: ST-36/40/41, SP-2/3, and BL-20/21 Spleen Qi Deficiency Herbal formula: Nelumbo Alisma Poria Coix *Atractylodes Atractylodes Citrus Cassia
Nelumbo Compound* He Ye (Lotus) Ze Xie Fu Ling Yi Yi Ren Cang Zhu Bai Zhu Chen Pi Jue Ming Zi 13% 13% 13% 13% 13% 12% 10% 13% Eliminate Damp, Strengthen SP Drain Damp Resolve stagnation, clear Liver Herbal Formula: Astragalus-atractylodes-lycium
Astragalus Atractylodes Lycium Huang Qi Cang Zhu Gou Qi Zi 34% 33% 33% Kidney Qi Deficiency Etiology Chronic illness Other factors Kidney Qi Deficiency Water retention Phlegm Obesity
Ageing Kidney Qi Deficiency Symptoms: . Overweight . Often occurs in the aged patient . Difficulty in walking or standing, or chronic back pain . Bone degeneration or osteoporosis . Pulse: Weak and deep . Tongue: pale with coating or without coating Treatment strategy: tonify Kidney qi and transform damp Acupuncture: Bai-hui, Shen-shu, Shen-peng, Shen-jiao Bl-23/26, SP-6 and Kid-3 Kidney Qi Deficiency Herbal formula: Psoralea Notoginseng Rheum Cassia
Psoralea Pill Bu Gu Zi Tian Qi Da Huang Fan Xie Ye 32% 9% 30% 29% Tonify Kid Qi/Yang Move Blood Purge LI Kobe 9 yr MC Siamese Obesity (14 lb) Less playful and less activity after moving to a new place 3 weeks ago Warm-seeking Tongue: pale & swollen Pulse: deep & weak
Kidney Qi Deficiency Rx: Psoralea Pill Henrietta 12 yo FS Dachshund Overweight Able to get around with support Pants a lot with slight cough Pulse: Fast & deep Tongue: red Damp-Phlegm Rx: Phlegm Fat Formula Constipation: a TCVM Approach CAPT R.M. Clemmons, DVM, PhD, CVA Regulation of Colon Function Colon is like the urinary bladder Innervation by
Sympathetics from L2-3 Parasympathetics from S1-3 Filling Phase Sympathetics Yin Emptying Phase Parasympathetics Yang Propranolol @ 0.25-0.5 mg/kg TID Constipation Definition: Constipation Infrequent or incomplete bowel movements Feces are drier or harder Obstipation Intractable
Stool Dry On/Off Small/Thin Dry Mucus Yes No No No/Yes Thirst Yes No
No Yes Urination Short Normal Long Short Abdm. Pain No Flank No No Mouth odor
Foul No No Slight Preference Cool None Warm Cool Purple Pale Pale/Red Tongue color Red
T. Moisture Dry Normal Wet Dry T. Coating Yellow Normal No No Pulse Fast/Wiry Wiry
Weak Weak/Thready Constipation/Megacolon Heat Acute onset of colic Hot ear & nose Cool seeking Thirsty Foul breath Swollen Swollen upper palate Red Red & dry tongue Fast Fast pulse Da Chang Qi Tang Qi Stagnation Sub-acute onset of colic Bloat & abdominal fullness Gaseous bowel movements
Anorexia Purple Purple or red tongue Wiry, Wiry, fast pulse Xiao Zhang San Qi Deficiency Chronic constipation or colic Anorexia Loss of body mass Weakness Weakness Pale Pale tongue Deep Deep & weak pulse Fan Xie Ye Yin/Blood Deficiency Very chronic megacolon with impaction
Dry flaky skin Weak or geriatric patient Pale Pale or red, dry tongue Fast, Fast, weak & thready pulse Dang Gui Cong Rong Acupuncture Heat Qi Stagnation Qi Deficiency Blood/Yin Deficiency Points LI-4 LI-10
GV-1 BL-21 ST-37 LIV-3 GV-1 GB-34 ST-36 SP-6 B-21 BL-15 SP-6 SP-10 GV-1 Method q d 3d 1-3 times q wk 2-4 times q wk
2-5 times q wk 3-7 times Kitty Little 15 yr FS Persian Chronic constipation with impaction Dry flaky skin with dandruff General weakness Tongue: red & dry Pulse: deep, weak & thready Yin/Blood Deficiency Rx: Dang Gui Cong Rong Molly 13 yr FS Maine Coon Earth personality Frequent constipation with impaction Colon cleaning under anesthesia 5 times in past 2 years Recent inappetence
Vomits undigested food with impacted Rx: Lactulose & Cisapride First visit: No BM for 5 day Abdomen filled with fecal balls Dry haircoat Warm seeking Tongue: red & dry Pulse: weak Molly Dx Earth personality No BM Dryness Red & dry tongue Earth element (SP/ ST) Yin Deficiency Weak pulse
Anorexia Decreased thirst Qi Deficiency TCVM Dx: SP/ST (LI) Yin & Qi Deficiency Molly Rx Acupuncture: DN: GV-20, CV-12, ST-25 EA: (10 minutes @ 20 Hz & 10 minutes @ 80-120 Hz) BL-21, BL-25, ST-36- -ST-37 (bilaterally) Owner reported that Molly defecated a long firm stool 10-16 hours after acupuncture and continued to have BMs every 2-3 days. Stool still dry & still warm seeking. TCM Herbal: Ma Zi Ren Wan + Fan Xie Ye
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