Transcript Phlegm - Dog2Doc.com

TCVM Geriatric Food Therapy
ROGER CLEMMONS, DV, PHD, CVA, CVFT, ACVIM (NEUROLOGY)
GAINESVILLE, FL
[email protected]
What is aging?
“
At age 50 years old, the liver starts to decline, the lobe of the liver starts to become
thinning and eyes start unclearness.
At
age 60 years old, the heart Qi starts to decline causing worry and sadness, Qi and
blood is sluggish and weakness causing favor in lying down.
At
age 70 years old, the spleen Qi is deficient and the skin desiccates and withers.
At
age 80 years old, the lung Qi debilitates, the corporeal soul (po) is gone causing error
during talk.
At
age 90 years old, the kidney Qi parches, all other four zang organs and channels are
exhausted”
 Huang
 The
Di Nei Jing
Yellow Emperor’s Classic of Internal Medicine
TCVM Geriatric Medicine & Aging

Jing Deficiency

Zang‐fu organ function declines with age
 Kidney
is ruler of prenatal essence
 SP/ST is the origin of post‐heaven Qi

Generalized
 Qi
Deficiency Blood
 Qi stagnation/stasis
TCVM Geriatric Medicine & Aging



Combination of excess and deficiency

Deficiency: mostly Qi deficiency, then Yin Yang

Excess: mostly stagnation and phlegm
Zang‐Fu Qi activities

Heart: ability to circulate blood

Lung: respiratory actions to inhale/exhale

Kidney: ability to pull air down from lung, reproductive ability, bone growth
and metabolism control of sphincters (urinary/fecal)
Yang ability to warm the body as it declines (late stage)
What age is considered old?

Small/Medium breeds: dogs 7‐10 years and older

Large to Giant Breeds: 5‐7 years and older

Cats:7‐10 years and older

Chronic illness or Jing deficiency can make animals age before their time

Signs of illness or disease may be subtle or just energetic disharmony prior to
clinical symptoms

Multiple disharmonies or imbalances can occur at the same time
TCVM Geriatric Medicine & Aging
 Qi Deficiency: LU, HT, SP, Kid
General weakness
Exercise intolerance
Decreased appetite, anorexia
Muscle atrophy
Loose stool or too frequent defecation/ urination
Urinary or fecal incontinence
Dyspnea
 Tongue:
 Pulse:
pale, wet, thick
weak, thin
TCVM Geriatric Medicine & Aging

Yin Deficiency: LU, HT, LIV, KID
 Panting
 Cool seeking
 Thirsty
 Dry signs: eyes, mouth, skin, fur, nails
 Small/ fine flake dander
 Mental anguish (Heart Yin)
 Leads
to Yang deficiency when fluid is consumed

Tongue: red, may have coating

Pulse: thin, wiry, or choppy
TCVM Geriatric Medicine & Aging
Ya ng
Deficiency: Generalized
 Warm seeking
 Cold back
 Lethargy
 Food stagnation/
 Edema
Tongue:
Pulses:
stasis
pale, wet
deep, weak (R<L)
TCVM Geriatric Medicine & Aging
 Stagnation
 Sleep more, less active
 Difficulty getting up, painful
 Anxious, confused, unaware
 Vomiting or constipation
 Tongue:
 Pulse:
dark, purple
fast, wiry
TCVM Geriatric Medicine & Aging
Blood
Deficiency: SP, LIV, Kid
Chronic stagnation, Qi deficiency, Yin deficiency
Dull, dry fur coat with thick flake dander
Pale and dry pads and nails
Anxiety, depression, insomnia, poor memory
Muscle tremors
Tongue:
Pulse:
pale, dry, thin
deep, weak (L<R), choppy
TCVM Geriatric Medicine & Aging
Phlegm
Substantial
Secondary
excess pathogen in the lungs
Mass, growth, nodules
Non‐substantial
Physical‐
lymphadenopathy, arthritis, joint deformity
In Channels‐ numbness, tingling, dysfunction
In Heart‐ anxiety, depression, crazy in the mind mansion
In GB/ KID‐ stones (Kidney, Bladder)
Tongue:
Pulse:
thick, greasy, white coating (thin or thick)
slippery
TCVM Geriatric Medicine & Aging
Vital birth energy and fluid
Lowered metabolic rate
Less
are used up
activity
Less
energy requirement (up to 20%)
Increased stagnation in joints
Intestinal transit time decreased
Difficult to extract the same nutrients or energetics from food
Weak digestion, may not be able to handle whole grains
Lowered excretion of nutrients
Decreased organ reserves
Decreased body mass
Decreased ability to regulate blood
sugar
Takes longer for postprandial glucose to be metabolized
Receptor abnormality decreases insulin response
Decreased ability to metabolize carbohydrates
Geriatric Food Requirements


Higher Protein

Compensates loss of lean body mass

Decrease protein turnover rates
Decreased Fat


Enhanced Antioxidants


Helps maintain body weight
Supports declining immune systems
Omega-3-Fatty Acids

Helps with joint and kidney function
Goals of Treatment
Increase
the QUALITY OF LIFE
Slow
Disease Onset or Progression
Warm the middle burner
Nourish Kidney Essence
Prevent too much Qi or Blood consumption
Help the body breakdown, digest, assimilate,
disperse and use as many vital nutrients as possible
For
the Mind, Body and Soul
Goals of Treatment
Feed
moderate amounts of food, often
Nutrient extraction
Glucose assimilation
Prevent Stomach Qi
Feed
stagnation
easily digestible food
Well cooked‐ middle Jiao cannot heat
Food preparation‐ finely chopped
Sprouts of grains, grasses, legumes and
Soups, stews, congee
Digestive enzymes & probiotics
Feed
nutrient rich foods
Feed
warming foods
Organic‐ greater nutrient
Non‐processed foods
Energetics
Temperature
composition
seeds
Goals of Treatment
Avoid
pro‐inflammatory foods
Nightshades: bell pepper, eggplant, white potato
Goiterogentc: cruciferous‐ raw: broccoli, kale, cabbage,
canned food
Feed
turnip, radish, horseradish, rutabaga,
anti‐inflammatory foods/supplements
Alternate lower meat diet‐ lower
Lower saturated fats‐ lower PG
PG
Increase
omega‐3 FA‐ lower PG/leukotrienes
Increase
Vitamin C
Cold
water fish, mackerel, trout, salmon, tuna
Also generates collagen
Cantaloupe, strawberries,
Supplements
MSM,
peppers, cranberry
to help alleviate arthritis pain
SAM‐e, alfalfa, dandelion, turmeric, white willow bark
Goals of Treatment
 Treat imbalance or disharmonies as early
 Older animals take longer to heal or recover
 Use
as possible
½ to 2/3 dose of herbs for longer time (maybe for life)
 Avoid very strong herbs or
 Too bitter: Coptis (Huang Lian)
 Too cold: Gypsum (Shi Gao)

Bitter‐cold herbs cause Yang‐Qi damage

Hot‐pungent herbs consume Yin
use them for short periods of time
Too hot: Aconite (Fu Zi)
 Too pungent: Ephedra (Ma Huang)

 Select Tonic herbs or mild regulating herbs
 Tonic: Codonoposis (Dang Shen), Angelica (Dang Gui)
 Movers & shakers of Qi: Citrus (Chen Pi)
 Moving Blood to resolve stagnation: Ligusticum (Chuan Xiong)
 Transform phlegm: Fritillaria (Chuan Bei Mu)
 Don’t
forget about tui‐na, acupressure, acupuncture and daily EXERCISE!!!!!
Qi Tonics

Energetics: Neutral to warm

Meat: beef, chicken, duck, goose, lamb, quail, eggs, catfish, carp, eel, herring, trout

Grain/Legumes: brown rice, coix, glutinous rice (caution with digestion), millet,
lentils, soy bean, string bean

Vegetables/Fruit: peas, potato, sweet potato, yam, shiitake, cherry, date, lychee,
fig

Nuts: chestnut, coconut, peanut, walnut

Other: molasses
Qi/Yang Tonics

Energetics: warming or hot

Meat/oil: chicken, liver (esp. chicken, lamb), kidney (esp. lamb), mutton, venison,
beef, shrimp, catfish, anchovy, trout, olive oil

Grains/Legumes: oats, white rice, corn, quinoa, broad bean

Vegetables/Fruit: carrot, squash, winter squash, pumpkin, ginger, garlic, pepper,
apricot, citrus, peach, plum

Nuts: walnut

Other: brown sugar, rice vinegar, cinnamon, cloves

Avoid: cold food‐ cereal grasses (wheat grass, barley grass), seaweed
Blood/Qi/Yin Tonics

Neutral foods:

Meat: pork, eggs, goose, duck, catfish, salmon, sardine, tripe, quail

Grains/Legumes: corn, sweet rice, soy bean, string bean

Vegetables/Fruit: yam, sweet potato, white potato, grapes

Other: green tea
Blood Tonics

Energetics:

Tonify SP to help digestion and absorption of nutrients to
make more blood



Digestive enzymes, probiotics
Chicken, duck, goat, rabbit, carp, eel, aduki, rice, winter
squash, carrot, turnip black bean, peas, sweet potato,
nutmeg
Tonify KID Blood/ Jing
 Dark foods with salty flavor (not too much)
Blood Tonics

Generalized

Meat/ Dairy: beef, bone marrow, liver, duck, goat, goose, salmon,
sardine, eggs, milk (goat/ sheep)

Grain/Legume: amaranth, barley, coix, rice, wheat germ/ grass,
aduki bean, black bean, soybean, tempeh

Vegetables/ Fruit: reishi, shiitake, alfalfa sprout, artichoke,
spinach, sweet potato, chard, kale, watercress, apricot, avocado, fig,
date

Other: sesame/ sunflower seed, parsley, microalgae, bee pollen,
miso, molasses
Stagnation

Focus: Improve Qi/Blood Flow

Meat: chicken, lamb, venison, shrimp, crab

Vegetables/Fruits: carrot, radish, watercress, mustard greens,
hawthorn berry, citrus inc peel,

Other: vinegar, ginger, garlic, turmeric, clove, dill, coriander,
chestnut
Phlegm
• Focus: Strengthen spleen, drain damp, transform phlegm
• Strengthen Spleen: beef, salmon, tuna, millet, oats, rice, sweet
potato, pumpkin, apple, cherry, dates & jujube, winter squash,
ginger
• Drain Damp: barley, rye, mung bean, soy bean, alfalfa, celery,
radish, mushroom, lemon, garlic, horseradish, mustard green
• Transform Phlegm: Clam, oyster, apple, pear, citrus and peel,
seaweed, garlic, thyme, pepper, peppermint, almond
• Avoid: thick, damp, sticky food: dairy, fat, raw, too yin, alcohol
Treatment of CCD

Selegiline
 0.5-1
AM
 FDA

mg/kg QD
approved
 Up

 69%
improved vrs
52% placebo
Westlab Pharmacy
1-800-4WESTLA
[email protected]
Vitamin E (& other
antioxidants)
to 50 mg/kg
Ginko biloba
 1-2
mg/kg BID
extract

Acetylcysteine
 5-25

mg/kg BID
St John’s wort
 2-4
mg/kg