Transcript Providing Animal Safety and Control in Emergency Pet Shelters

Bleeding: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
Bleeding
•Primary Hemostasis
•Complex chain of events
involving interaction of
•Platelets
•Vessel Wall
•von Willebrand’s factor
•Fibrinogen
•Secondary Hemostasis
•Complex interaction of the
intrinsic and extrinsic
clotting cascades
•Stabilize the platelet plug
Primary Hemostasis
•Evaluated by the
bleeding time
•Platelet number
•Amount and Quality of the
von WIllebrand’s factor
VIII:Ag
•Fibrinogen concentration
•Other alterations due to
vessel wall disorders
Secondary Hemostatis
•Assessed by
•ACT (activated
clotting time)
•APTT (activated
partial thromboplastin
time)
•PT (prothrombin
time)
TCM Pathoetiology
•Heat
•Tongue
•Red & Dry
•Pulse
•Superficial (forceful)
& fast
•Spleen Qi Deficiency
•Tongue
•Pale & moist
•Pulse
•Deep & weak
(particularly on right)
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
Heat Hemorrhage
•Herbal treatment depends
upon location
•Bladder
•Red Front Door
•GI tract
•Sophora Powder
•Great Saussurea Coptis
•Red Back Door
•Pulmonary
•Red Lung
•Nose
•Single Immortal
•Uterus
•Wu Bei San
Spleen Not Controlling Blood
Prolonged Spleen Qi Deficiency
Spleen Fails to Hold Blood
Hemorrhage
General Signs
Chronic Hemorrhage
Darby
•Signalment
•5 yr FS Doberman
•History
•Generalized weakness
•Ecchymosis
•Abdominal bleeding
•TCVM Exam
•Tongue: pale
•Pulses: deep & weak
Dx: Spleen Qi Deficiency
(not holding blood in vessels)
Darby
•Western Rx
•Compressive
bandage
•Hemorrhage control
•Cryoprecipitate
•Whole Blood
•Thyroid medication
•TCVM Rx
•AP
•SP Qi Tonic
•BL-20/21, SP-6, SP-9
& CV-6
•Stop Hemorrhage
•Tian Ping & BL-17
•Herbal
•Yunnan Pai Yao
•Huang Tu Tang
Huang Tu Tang
Atractylodes
Bai Zhu
Strength Spleen & tonify Qi
Yellow Earth
Zao Xin Tu
Warm Spleen & stop diarrhea
Aconite
Fu ZI
Warm Spleen
Asinum
Er Jiao
Nourish Blood
Rehmannia
Sheng Di Huang Nourish Yin
Scutellaria
Huang Qin
Stop bleeding & prevent excess heat
Licorice
Gan cao
Harmonize
Muscle Wasting: a TCVM Approach
CAPT R.M. Clemmons, DVM, PhD, CVA
TCM Muscle View
•Muscle volume &
strength is under the
domain of the Spleen
•Spleen transforms food
and transports it to the
body to provide energy &
building blocks.
•Spleen Qi provides
muscle strength
•Liver blood provides
endurance
•Continued delivery of
Spleen Qi to muscles
Western View of Muscle Wasting
•Generalized Wasting
•Malnutrition
•Insufficient intake of materials
to support Spleen Qi
•Cardiac Cachexia
•Heart failure leads to stagnation
of blood
•Liver is unable to support
distribution of blood & Qi
•Leads to accumulation of Damp
in Spleen
•Results in Spleen Qi Deficiency
with failure to provide energy
and building materials to the
muscles
•Cancer Cachexia
•Tumor Necrosis Factor poisons
metabolism leading to Spleen Qi
Deficiency
•Diminished effective delivery
of energy to muscles
•Localized Wasting
•Trauma
•Local damage of muscle
•Disuse Atrophy
•Local stagnation results in Liver
failure to support
Spleen/Stomach
•Accumulation of Damp alters
Spleen function
•Local stagnation decreases
delivery of nutrients
•Neurogenic Atrophy
•Denervation leads to local liver
stagnation
•Results in failure to support
spleen Qi
•Leads to decreased delivery of
local channel energy
Wei Syndrome
Damp Heat
•Earth personality
•Obesity
•History of damp heat in skin or GI
•Muscle atrophy
•Weakness
•Lethargy
•Greasy wet tongue
•Fast pulse
Si Miao San
Qi/Yang
Deficiency
•Lethargy, shortness of breath,
weakness
•Too weak to get up to walk
•Loose lips
•Loose stool
•Anorexia & Emaciation
•Dry-burnt hair
•Edema
•Heat seeking
•Pale wet tongue
•Thready & weak pulse
Bu Yang Huan Wu
Qi/Yin Deficiency
•Emaciation
•Weakness in lumbar region
•Heat seeking
•Dry skin
•Pale or red & dry tongue
•Weak & thready pulse
Hindquarter
formula
Jake
•History
•Progressive weakness in
rear legs
•Cool seeking
•Rear leg muscle atrophy
•Dry hair & skin
•TCVM Exam
•Pulses deep & weak (< R)
•Red dry tongue
DX: Qi/Yin Deficiency
Jake’s Treatment
• AP
• EA
• SP6-SP9 (b), ST36 (b), LI10 (b), GV14-Bai hui
• DN
• BL20, BL23, BL26, KID3
• Aqua
• SP6, ST36, BL23, BL26
• Herbal
• Jia Bing Fang
Jia Bing Fang
Astragalus
Condonopsis
Polygonum
Rehmannia
Paeonia
Dioscorea
Prunella
Cyperus
Bupleurum
Sargassum
Huang Qi
Dang Shen
He Shou Wu
Shu Di Huang
Bai Shao Yao
Shan Yao
Xia Ku Cao
Xiang Fu
Chai Hu
Hai Zao
Laminaria
Kun Bu
Tonify Qi
Tonify Qi
Nourish Blood and Jing
Nourish Blood, Yin and Jing
Nourish Blood and soothe Liver Qi
Tonify Qi and nourish Jing
Soothe Liver Qi, clear Heat
Move Liver Qi and relieve nodules
Soothe Liver Qi
Transform phlegm, clear Heat, soften
the hardness
Transform phlegm, soften the
hardness, drain water
Sam
•History
•Chronic rear leg
weakness and muscle
wasting
•Dry hair
•Weight loss
•TCVM Exam
•Red dry tongue
•Weak thready pulses (< R)
DX: Qi/YinDeficiency
Sam’s Treatment
• AP
• DN
• GV20, BL20, BL23, BL26
• Aqua
• SP6, ST36, BL23, BL26
• Herbal
• Hindquarter formula (tea pills)
Hindquarter Formula
Eucommia
Du Zhong
Tonify Kidney & strengthen back
Achyranthes
Niu Xi
Tonify Kidney & strengthen the hind limbs
Lindera
Wu Yao
Move Qi and relieve pain
Astragalus
Huang Qi
Tonify Qi
Apis
Feng Hua Fen
Tonify Qi and Yin
Morinda
Ba Ji Tian
Warm and strengthen the back
Angelica
Dang Gui
Nourish Blood
Rehmannia
Shu Di Huang
Nourish Yin and Jing
Cinnamon
Gui Zhi
Warm the Channels and benefit the limbs