Transcript Providing Animal Safety and Control in Emergency Pet Shelters

Oral Cavity Disorders: a TCVM
Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Oral Cavity Diseases (Western)
•Local damage
•Electric shock
•Chemical damage
•Thermal damage
•Periodontitis
•Tooth tarter
•Systemic disease
•Metabolic disease
•Nutritional disease
•Immune disease
•Infectious disease
•Treatment
•Remove offending
cause
•Steroids
•Antibiotics
•Clean teeth
TCM Spleen Disease
•
•
•
Spleen Physiology
Spleen Pathology
Gingivitis/Stomatitis
Earth
•Sound
•song
•Emotion
•sympathy
•Direction
•center
•Opening
•lips/gums
•Climate
•Body Part
•humid
•muscles
•Season
•late summer
•Zang/Fu
•SP/ST
TCM SPLEEN Physiology
•Governs Transportation &
Transformation
•Food & Water
•Controls Blood
•Dominates the Muscles
•Opens in Mouth
•Lips & Gums (ST)
TCM 24 Hour Clock
LIV
GB
TH
1-3 AM
LU
3-5 AM
LI 5-7
11-1AM
9-11 PM
PC
7-9 PM
KID
BL
ST
7-9 AM
SP
9-11 AM
HT
5-7 PM
3-5 PM
SI
AM
1-3 PM
11-1 PM
Spleen Pathology
Spleen Pathology
• Damp is the Enemy of the Spleen
• Damp-Cold
• Damp-Heat
• Spleen Qi Deficiency with Damp
Spleen Pathology
Usually combination of excess & deficiency
External or Internal Pathogen
Damp-Heat
Damp-Cold
Obstructs Spleen Qi Flow
Spleen fails to Transform & Transport Gu Qi
Spleen Qi Deficiency
Spleen Pathology
Cold Food
or Drink
Cold
Environmental
Conditions
Cold-Damp in Spleen
Disharmony of Qi Flow
Transform & Transport Disorder
Spleen Pathology
Damp Hot
Food or
Drink
Accumulated
Heat & Damp
Damp Hot
Environmental
Conditions
Damp-Heat in Spleen
Disharmony of Qi Flow
Transform & Transport Disorder
Spleen Qi Deficiency
Illness
Overeating
Overwork
Starvation
Under Work
Spleen Qi Deficiency
Disturbed Qi Flow
Failure to Transform & Transport
Spleen Not Controlling Blood
Prolonged Spleen Qi Deficiency
Spleen Fails to Hold Blood
Hemorrhage
General Signs
Chronic Hemorrhage
Spleen Qi Sinking
Illness
Overeating
Overwork
Starvation
Under Work
Chronic Spleen Qi Deficiency
Failure of Holding
Chronic Diarrhea
Prolapses
Incontinence
Spleen Pathology
Cold Food
or Drink
Chronic Spleen
Qi Deficiency
Spleen Yang Deficiency
Disharmony of Qi Flow
Transform & Transport Disorder
Yang Deficiency Signs
Stomach Pathology
Cold
Environmental
Conditions
Cold Food
or Drink
Cold in Stomach
Disharmony of Qi Flow
Transform & Transport Disorder
Inhibition of Yang
Stomach Cold
Cold Food & Drink
Cold Environment
Stomach Cold
Receiving &
Decomposing
Anorexia
Cold Signs
Altered
Qi Flow
Lassitude
Cold Ear/Nose
Hypersalivation
Pale-Purple Tongue
Deep-Slow Pulse
Stomach Pathology
Damp Hot
Environmental
Conditions
Hot Dry
Food or
Drink
Heat in Stomach
Heat Signs
Transform & Transport Disorder
Stomach Heat
Pathogenic Heat
Yin Deficiency
Stomach Heat
channel
Gums
organ
grandchild
child
Cystitis
Ulcer
Colitis
Stomach Food Stagnation
Overeating
Indigestible Food
Retention of Food in Stomach
Disturbed Qi Flow
Failure to Transform & Transport
Stomach Yin Deficiency
Stress
Liver Qi Stagnation
Chronic Febrile
Illness
Transformation
to Heat/Fire
Impairment of Body Fluids
Stomach Yin Deficiency
How to Use Acupuncture for Gingivitis in
Small Animal Practice
Zang Fu Physiology
• Teeth correspond to bone
• Bone is controlled by the kidney
• Malocclusion, oligodontia are examples
of Kidney Jing Deficiency
• Gums are influenced by the stomach
Meridian Theory
• Oral cavity has two main channels
that influence the teeth and gums
• Large Intestine meridian
• Stomach meridian
Pattern Diagnosis
• Stomach Heat Pattern
• Excess pattern, seen more often in
younger animals (cats)
• Stomach Yin Deficiency + Empty Heat
• Stomach loves moisture
• Moisture balances Yang function
• Lack of Yin (fluid) allows Yang Fire to
rise
Stomach Heat Pattern
•Fluffy: 4yr FS DSH
•Primary complaint: Bad
breath, eating poorly
•History: Stray, no
vetcare, dry food diet
•Exam: Body & coat
condition-normal; vital
signs-WNL
•Oral Exam: Putrid odor, upper and lower
arcade have severely inflamed gingiva, with
spontaneous bleeding, minimal calculus
formation
•Lab Data: Elevated WBC, FELV/FIV=Neg
•Diagnosis: Hemorrhagic gingivitis
•Treatment: Clindamycin 25mg PO BID x 10
•Dental prophylaxis followed by
Clavamox 62.5 mg BID x 10
TCVM Exam & Diagnosis
•Constitution: Water/Wood
•Tongue: body=reddish purple; no coat
•Pulse: Bilaterally superficial rapid
•Body Condition: Dry nose; Body Temp
Normal
•Mouth: Stink smell; bloody red gums
Pattern DX: Stomach Heat (excess
condition)
TCVM Treatment Strategy
•Clear the Stomach Heat, Cool the Blood, & nourish
Stomach Yin
•Acupuncture Point Selection:
GV 14; Tian Ping; ST 4,6,34,44; LI 4,11; SP 10
•Herbal Medicine: Yu Nu Jian ( Jade Lady)
shi gao, shu di huang, zhi mu, huai niu xi
2 teapills TID or 1/8-1/4 tsp granules TID
•Topical Care: Aloe Gel ( Warren Laboratories)
Case Outcome & Discussion
•After 3 weeks of therapy inflammation
substantially reduced
•Cervical line lesions which compromised several
teeth were removed
•Fluffy is maintained on Aloe oral gel and herbs
with only periodic acupuncture therapy
•Long term expectations: depend on owner
compliance
•Other herbals: Wei Qi Booster; Slippery Elm
Stomach Yin Deficiency & Empty Heat
Pattern
• Tess: 10 yr, FS, Mix Breed
• Primary Complaint: Bad breath, dirty teeth,
and periodic vomit/regurge
• History: Commercial dry food diet, periodic
dental prophylaxis, absent dental
homecare, gums remain inflamed and
plaque builds quickly
• Western Dx / Tx: Gingivitis with periodontal
deterioration. Requires 6 month recall for
prophylaxis
TCVM Approach
•Exam:
•Treatment Stategy:
•Constitution- Water
•Tongue- Violet, dry, no
coat
•Pulse- Deep, thready, and
quick
•Nourish Stomach Yin and
Clear Heat
•AP= CV 12 (aqua); SP 3,6;
ST 36,44; LI 4,11
•Herbs= Qing Wei San
•Gums- dry/breath
scorched
•Topical= Aloe Gel
•Coat Quality-Dry
•Diet: Fresh cooked food/
fish-pork-beef-eggsveggies