Dr. Wendy's Talk At the Carriage Association of America's Winter meeting in Sarasota Jan 2019. 

After a brief overview of Traditional Chinese Veterinary Medicine, we explore the 5 Element Theory and learn how to determine the Constitutions and use that knowledge to develop more effective, harmonious training strategies for our horses. 

Dr. Wendy presented 2 papers at the 20th Annual International Conference on TCVM in November 2018 in Ocala. See Abstracts below. Full papers are published in Pain, Lameness, Neurological and Endocrine Disorders - TCVM Update through the Chi Institute bookstore

Abstract

Equine protozoal myeloencephalitis (EPM) is an important neurologic disease of horses most commonly caused by infection of the central nervous system by the protozoa, Sarcocystis neurona. Clinical signs can be focal or multifocal and are attributed to damage to neural tissues by invasion of the protozoa and concurrent inflammation. Many horses will test seropositive, however, only a small percentage will exhibit clinical signs which implies horses with a compromised immune system are susceptible to infection while horses with a healthy immune system are able to clear the parasitic infection without treatment. Traditional Chinese Veterinary Medicine theory views this disease pattern as a Zheng Qi Deficiency with Qi and Blood Stagnation. Premortem diagnosis in both Eastern and Western Veterinary Medicine involves a thorough neurologic exam and response to treatment. Treatment with acupuncture and herbal therapy alone or in conjunction with pharmaceuticals has a favorable prognosis. Food therapy and rehabilitation can assist the horse to return to full function. Recrudescence and reinfection when the immune system is challenged is a common sequela, therefore, long term care of EPM horses should include TCVM treatment during times when the Zheng Qi may be challenged.

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Abstract

Preventative veterinary medicine is an age old concept that is the basis of animal husbandry. As veterinary medicine continues to become more specialized, veterinarians delegate many of the preventative procedures; feeding, housing recommendations, parasite control, farriery, dental care, breeding and conditioning to paraprofessionals and caretakers. The majority of horse owners no longer come from agrarian backgrounds where husbandry practices for the local climate and forage was passed on from generation to generation. Media, funded by corporations that sell vaccines, pharmaceuticals, supplements and processed feeds, have become the largest source of educational material for our clients concerning the wellness of their horses. Many modern horses live in urbanized settings, have little turnout and are fed large amounts of concentrated feeds. Competition can be demanding due to travel, athletic expectations, emotional stress and artificial day lengths. Some horses are more sensitive to stress, temperature, training methods and foods. If we can recognize our patient’s weaknesses, we can be better equipped to help them. The 5 Element theory classifies a basic constitution of a horse and helps us recognize how a horse with a certain constitution reacts with his environment, lifestyle and rider. We can use the constitution to prepare a Traditional Chinese Veterinary Medicine treatment plan to support constitutional vulnerabilities to reduce the incidence of disease, lessen the risk of sports injury and keep the horse happy in its work. Educating our clients on basic care and wellness and considering constitution, diet, environment and seasonal factors will help our sporthorses stay strong in mind, body and spirit throughout their career.

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Anhidrosis is a common problem in sport horses training and competing in hot humid conditions. Horses reduce their body temperature during exercise mostly by sweating. As sweat evaporates from the body surface, the body heat is reduced. They can also dissipate heat by respiration. Cool air enters the lungs and cools the blood flowing to the muscles and hot air is exhaled. During hot and humid conditions, the rate of evaporation of sweat is reduced and breathing in hot, humid air does little to cool the blood. The horse's coat is also a great insulator and can act like a wet suit keeping a layer of heat next to the skin if the sweat is slow to evaporate or is not scraped off.  ​
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Sometimes it is difficult to know if  your horse is sweating enough. Some early signs may be reluctance to work, panting, sweating only under tack or a sticky dry coat. Some horses sweat more than normal in the months before they stop sweating. Horses with concurrent lung disease like heaves are at a greater risk of heat stroke because they have limited ability to cool themselves by respiration.
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The sweat glands are highly innervated and are stimulated by the sympathetic nervous system (fight or flight response). The mechanism of anhidrosis in horses has not been determined but In chronic cases, the sweat glands are atrophied, suggesting multiple bouts of heat stroke may lead to more severe symptoms over time.  

In people, some causes have included congenital, metabolic and autoimmune diseases, skin damage and drug induced causes. 

In TCVM, the Heart controls the sweat glands and the Lung controls the exterior of the body and the Wei Qi (immune system). The balance between Yin and Yang control the body temperature. The Yin is like the air conditioner while the Yang is like the furnace. Summer Heat is one of the 6 pathogens in TCVM and can damage the Heart and Lung Yin so we view anhidrosis as a Heart and Lung Yin deficiency. 

Treatment principles in TCVM include acupuncture, herbal and food therapy in addition to environmental modification like monitoring body temperature during exercise, working in cooler weather, taking frequent breaks in the shade, and cooling with water and scraping to help speed evaporation. During pasture and stall time, horses should always have access to shade, fans, salt, electrolytes and cool fresh water. 

The NOAA heat index chart can help you determine when it is unsafe to work your horse if he is prone to anhidrosis. In south Florida, we are in the extreme caution zone for most of the summer. Due to our high humidity, even in the early morning or late evening. You may have to be vigilant about cooling before, during and after your horse's work out or you may choose to give them some time off during the summer. 

Herbal therapy in combination with acupuncture has shown great promise in helping non-sweaters. Our recommendation is to start treatment in the late spring and continue through the summer until the heat index consistently falls below 90. This could include acupuncture once per month plus herbal and food therapy daily. 

New Xiang Ru San is Dr. Xie's Herbal Formula made specifically for horses with anhidrosis. It contains a blend of Bian Dou (hyacinth bean), Xiang Ru (mosla), Hou Po (magnolia bark), Lian Qiao (forsythia) and Jin Yin Hua (honeysuckle flower). 

Food therapy includes cooling foods to tonify the Heart Yin and pungent foods that tonify the Lung and increase sweating. A variety of foods from this list can be added to the horse's diet as treats or mixed into the feed. You can also check out our recipe for "green tea" ice pops on the feeding seasonally blog post. 

Alfalfa
Dark Malt based beer (Guiness)
Cucumber
Celery
​Chia Seeds
Kombu (Kelp)
Spirulina
Lemon
Watercress
Yam
Lettuce
Peppermint
Radish
Aloe

Listen in to the new Driving Radio Show on Horses in the Morning for more TCVM info ! This month our Tremont training tip from Keady Cadwell is how to teach your horse to drive safely in a group, Katie Whaley recaps the Lexington Carriage Classic at the Kentucky Horse Park and Abbie Trexler has some great news about the new ADS vest rule. Plus in the TCVM update, Dr. Wendy talks about non-sweating and managing your horse through the summer heat.  

Heart worm preventative can be started at 8 weeks.
Puppies under 6 months, do not need a heart worm test before starting preventative. 
Puppies over 6 months require a heart worm test before starting preventative. Dogs require an annual heart worm test to renew your prescription. 

We recommend
Iverhart plus or Heartgard plus which are oral chews given every month for heart worm preventative and to kill intestinal parasites. 

Flea Prevention can be started at 8 weeks. 
Nexgard is an oral chew given every month for fleas and ticks

Bravecto is available for puppies over 6 months of age and is an oral chew given every 3 months for fleas and ticks

Combined Heart worm preventative plus Flea protection
Trifexis is an oral tablet that is given every month for heart worm prevention and kills intestinal parasites and fleas. 
Revolution is a topical liquid applied once per month for heart worm prevention and flea control. 

8 weeks
Parvo/Distemper Vaccine
Deworming 

12 weeks
Parvo/Distemper Booster Vaccination
Kennel Cough Intranasal Vaccination
Deworming 

16 weeks
Parvo/Distemper Booster Vaccination
Rabies vaccination with county license
Deworming

1 year
​Parvo/Distemper Booster Vaccination
Rabies vaccination 
Deworming

Booster Vaccinations are recommended every 3 years 
Titer testing is available for Parvo/Distemper however rabies vaccination is required by law and titer test results are not accepted.
We use a thimerosol free vaccine.

Optional Vaccinations dependent on lifestyle
If your dog leads an active lifestyle and goes to the dog park, lunch with friends and Sarasota dog meet ups, we recommend intranasal kennel cough boosters annually. 

If your dog likes to play in the woods, go swimming and kayaking in the rivers and bays, we recommend leptospirosis vaccination annually. 
 
If you are boarding your pup, please check with the kennel to determine what vaccines they require at least a month before your stay. 

These recommendations are in accordance with the current AAHA Canine Vaccination Task Force guidelines. For more information on vaccines, visit the American Animal Hospital Association website.

Cat Wellness Recommendations

​The first Driving Episode of HITM with Dr. Wendy and Glenn.  The training tip with Keady Cadwell of Tremont Farm covers setting goals and standing still, we learn about the Florida Whips, learning to navigate and Abbey from the American Driving Society.  Plus, the Traditional Chinese Medicine Update reviews seasonal food therapy for horses.  Listen in…

HORSES IN THE MORNING Episode 1948

Spring - Wood Element

Spring is the time of birth and growth. Foals are born, seeds germinate, sprouts begin to push through the ground and the days become longer. Spring is the time of Yang activity with Qi ascending and expanding. Fresh greens, herbs and fast growing plants are in abundance and are good choices during spring time to move Qi upward and outward to support the Wood element.

The Wood’s Zang organ is the Liver which stores the Blood and governs Qi flow. After a long, cold winter with Qi sinking to the interior, the direction of Qi must transition to moving upward and outward. If this transition is not smooth, the Liver can become Stagnant. Sour foods such as citrus, rose hips and apple cider vinegar can clear Liver Qi Stagnation. Sweet and pungent flavors can help develop a “spring within”, with sweet foods such as honey and carrots to tonify Qi and pungent foods, like peppermint and mustard greens to move Qi upwards.

Infused waters are a great way to introduce whole foods to the horse and are easy to prepare for the owner. The Mu Ma Spa water can be a refreshing treat for a Wood horse in the spring.

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Summer - Fire Element

Summer with its long days and abundant growth of plants and fruits is also a Yang season. Rising external temperature and high humidity can damage the Yin. Anhidrosis is a common problem with competition horses in the Southeast US. The inability to sweat causes episodes of heat stroke and further damages the Heart and Lung Yin.  

Cool and bitter foods such as alfalfa and celery can tonify the Yin and keep the body cool. Adding some pungent foods like mint and fennel can help open the exterior and encourage sweating. A wide variety of fresh fruits and vegetables as treats can help replenish minerals lost in sweat. Frozen green tea ice blocks with lemon, mint and cucumber can be added to water buckets to give horses a refreshing drink on hot days.

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Mika Ingerman from Team Snazzy Goat joins us to give us an update about her Cashmere pair Harry and David, Fiona Delfino recaps Nature Coast CDE at Black Prong Equestrian Center. Plus, Dr. Wendy talks about Food Therapy for Cold. This episode is brought to you by Purina Mills. Listen in.....

​The TCVM segment starts at 32:24

 We all know about Yin and Yang in TCVM. Yin is the cold and Yang is the hot and we need to stay in balance to be healthy. In TCVM we also talk about disease in terms of the 6 pathogens(Wind,Cold,Summer Heat,Damp,Dryness and Fire). These pathogens attack the body and disrupt the Yin and Yang balance and block the flow of Qi and Blood. When Qi and Blood are Stagnant, we feel pain and are susceptible to disease.

Qi is the body's energy and the Blood (in TCVM terms) are the body's fluids, (white and red blood cells, lymph, stomach and intestinal fluid, intercellular fluids and other body fluids.) We can think of Qi as metabolic energy and the Blood as the immune system and circulatory system. Cold causes blood vessels to contract and slows metabolism. For example, when you have an acute injury, you ice the area to reduce the swelling and relieve pain by dulling the pain receptors in the skin. 

Cold is obviously associated with Winter. Cold can combine with other pathogenic factors such as Wind, Dryness and Damp to invade the body and attack the body's warming element - Yang. When the Yang is damaged, the body has to work harder to keep warm which can consume the Qi (including the Wei Qi - immune defenses) making the animal vulnerable to disease. 

In horses, Cold conditions can manifest as cold extremities, arthritic pain and joint stiffness, muscle pain and stiffness, lethargy, respiratory disease and impaction colic. 

What can we do to help our horses with Cold ? 

Horses tend to drink less water if it is Cold. Horses with dental issues, especially geriatric horses can experience tooth pain with extremely cold water and will drink less. Warming the water either with a tank heater, bucket warmers or adding a few kettles of hot water to their tank can help them drink more. Adding their favorite electrolyte can help too. If they like cinnamon flavor, adding a stick of cinnamon and a few slices of ginger (both warming foods) can make the water more appealing too. 

The basic theory of Food therapy is to eat seasonally and to use food as medicine to balance the Yin and Yang. For Cold conditions, this would involve decreasing Cool food in the diet and increasing Warming foods. 

Before changing anything in your horse's diet, consult with your veterinarian to avoid exacerbating any metabolic conditions. 

So what are Cooling foods for horses ? Some common ones that may be in your horses diet now are : 

• Alfala
• Barley
• Wheat Bran
• Flax seed oil
• Kelp and Seaweed
• Peppermint
• Honey
• Green Tea

You may want to reduce the amounts of these foods in the diet during the cold months and you might want to add some of these warming foods. 

• Oats
• Sweet Potato
• Squash
• Pumkin
• Sunflower Seeds
• Fennel
• Ginger (Powdered Ginger is warmer than fresh)
• Clove
• Star Anise
• Nutmeg
• Turmeric

Looks like the ingredients from the pumpkin spice oatmeal at Starbucks right :) 
Some neutral foods for horses include : 

• Grass Hay
• Corn
• Soy Bean
• Beet Pulp
• Green Peas
• Apple
• Carrots
• Dates
• Radish

As with any dietary change, start slow, use common sense and consult with your veterinarian. 

Resources 
For Turmeric info listen to my interview with Dr. Doug English of Turmeric Life
For Bulk spices -  Nuts.com
Black Sunflower seeds Tractor Supply

Episode 305 : Treating & Preventing Thrush in Horses
Coach Jenn and Dr. Wendy explain how to treat and prevent thrush in your horses the holistic way. These methods may also be used for foot rot in cows, goats, sheep, llama and potbellied piggies. 

​TCVM segment starts at 42:48

Does your horse have stinky feet ?

Of course he does. Its the nature of horses. Sometimes we can't avoid a few months of muddy wet conditions. In Florida, it is a constant battle against moisture vs skin and hooves.

When you pick your horse's feet, you remove the dirt from the lateral and central grooves of the frog. A black smelly discharge can indicate thrush. A bacterial infection with Fusobacterium necrophorum is the most common cause but it can be a mixed infection with other bacterial and fungi. Horses can be lame and sensitive to palpation of the sole and heels if the infection travels deep into the foot. Thrush can invade the central sulcus and work its way up between the heel bulbs. In the photo above, this horse has a deep thrush infection in his central sulcus that extends to the hairline.

Nerd alert : Latin translation of Fusobacterium necrophorum is the "spindly bacterium of death".

In Chinese medicine, we view infection as Heat. This is chronic infection and is black and smelly so we also view it as Damp so we classify thrush as Damp Heat of the hoof.

F.necrophorum and other thrush causing organisms tend to be anaerobes, meaning they don't like oxygen. Fungi likes to grow in moist, dark conditions.

So knowing all that, our treatment strategy will involve debriding, cleaning and balancing the hoof, reducing exposure to wet muddy conditions, and using a topical treatment to clear the Damp Heat.
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A regular schedule with your farrier and good hoof hygiene is the first step. An unbalanced hoof and/or sheared heels can contribute to deep sulci and make a horse more prone to thrush infection. In cattle, small ruminants and potbellied pigs, we see a similar condition called foot rot between the toes if they don't have regular foot trims. Your farrier will balance the foot and expose any pockets. This will allow you better access to clean the hoof with a stiff brush and an antiseptic solution such as dilute iodine(weak tea color). If there are deep pockets between the heel bulbs and in the lateral sulci, Hydrogen Peroxide can help by introducing oxygen and the bubbling effect can help mechanically remove bacteria and debris.

There are thousands of thrush treatments and they all have varying levels of effectiveness and toxicity. We have an herbal formula that is safe and effective that we make here at 5 Elements for Animals called Thrush Thrasher ! Thank you Dr. Kyle for that great name.

Thrush Thrasher liquid contains an herbal formula to clear Damp Heat along with Eucalyptus and Tea Tree oil to help increase the antibacterial and anti-fungal action.

and now we also have Hoof Honey Salve for Thrush which has the same active ingredients in Thrush Thrasher liquid but in a thick beeswax base that can be packed in between heels and in deep pockets of thrush. Its water repelling action helps block out moisture to allow the tissues to heal. 

The herbal formula in Thrush Thrasher is based on Dr. Xie's Golden Yellow Salve and contains the following :
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Bai Zhi - Angelica - In Chinese herbology, we use 3 different species of Angelica roots, Bai Zhi (A. Dahurica), Du Huo (A. Pubenscens and A.Laxiflora) and Dang Gui (A. Sinensis) and each have a different action. Bai Zhi is warm and pungent so its actions can expel Wind, drain Damp, open the orifices(vessels,sweat glands, nasal passages), reduce swelling and drain pus. It is used orally for headaches, flu and infections and topically for ulcers and wounds. The extract of Bai Zhi has shown to have antibacterial effects and increases wound healing by stimulating keratinocytes (the cells that make up the outer layer of skin).

Cang Zhu - Atractylodes Refers to 3 species, (A.lancea, chinensis, japonica). In TCVM, we also use another species of Atractylodes, Bai Zhu (A. macrocephela). They have similar actions of draining Damp, but Cang Zhu has a stronger astringent action due to its higher concentration of volatile oils to help dry out the infected tissues, while Bai Zhu has more Qi Tonifying actions. The oils of Cang Zhu root when cut appear red giving it it's common name of red atractylodes. Many of these compounds are also found in Hou Po - Magnolia bark.

Chen Pi - Tangerine peel What makes the peel of citrus fruits smell so good ? Essentials oils like Limonene and pinene. These essential oils are used routinely in cleaners because they smell great and act as a solvent remove oils and are less hazardous alternative to turpentine. Tangerine peel also contains flavonoids, which are plant pigments. Flavonoids have many functions in plants, like producing colorful flowers to attract pollinators, fixing nitrogen, acting as chemical messengers between cells like our neurotransmitters and are secreted by plant roots to combat fungal infections. Tangerine peel is warm, pungent and bitter and is a strong mover of Qi and can Dry Damp.

Da Huang - Rheum Chinese rhubarb (Rheum palmatum, Rheum tanguticum) has been used as a medicinal plant since 3000 BCE for diarrhea, constipation and infections. It has a strong astringent and antibacterial action due to its high levels of tannins, flavanoids and anthraquinones. Used topically, it can clear Damp-Heat and has antibacterial and antifungal properties. 

Gan Cao - Glycyrrhiza (G.uralensis, G.inflata Chinese Licorice and G.glabra English Licorice) Is sweet and can Tonify the Qi. It is used in many Chinese herbal formulas to harmonize ie. act as a catalyst for the other herbs and to distribute the herbal energy to all 12 meridians. It is used topically for abscesses and boils. One of the chemical compounds in Gan Cao is mannitol, used in conventional medicine for its osmotic effect. Recent studies on mannitol suggest it decreases antibiotic resistance in many species of bacteria commonly found in skin infections like MRSA and Pseudomonas. 

Hou Po - Magnolia(Magnolia officinalis) The sweet smell of magnolias in bloom alert you to its high concentration of essential oils. Magnolol and Honokiol are the 2 major phenolic compound isolated from magnolia bark and have been studied extensively for their antibiotic and anti inflammatory effects to treat acne in humans. Eudesmol which has antifungal properties is present in smaller quantities in Hou Po and is also found in red atractylodes.

Huang Bai - Phellodendron (Phellodendron amurense) - Bark of the Amur cork tree contains compounds with antibacterial activity and has antioxidant activity comparable to Vit E. It also acts an an insect repellant which is alway useful in wound care for animals ! Herbal "SWAT"

Huang Lian - Coptis (Coptis chinesis,deltoidea,teeta) - Is the root of the Chinese goldthread plant. It is our first choice to treat Damp Heat as it is Bitter and Cold. Berberine is one of the alkaloids shown to have antibacterial activity and the isolated compound is being studied as a possible treatment for MRSA infections. Berberine is also found in Turmeric, goldenseal, California poppy and Amur cork tree.

Jiang Huang - Curcuma- Yes turmeric ! I have discussed the antibacterial and antifungal activities of turmeric with Dr. Doug English of Turmeric Life. Listen here.

Tian Hua Fen - Trichosanthes (T.kirilowii) is the root of the Chinese cucumber aka snake gourd. It helps to reduce Heat and swelling and helps wound healing.

Congee aka Chinese rice pudding is a staple in Chinese Food Therapy. Congee is most commonly made with rice but can be made with other grains like millet and corn as well. Congee made with bone broth is easy to digest and provides lots of nutrients for your sick puppy. When the congee is done, you can add other foods to add additional beneficial nutrients like Sardines or eggs for protein and omega-3s, Goji berries for antioxidants, mushrooms for immune support, green leafy veggies to support the liver, ect. 

The basic theory of congee is a small amount of rice with 6 times as much water cooking low and slow with occasional stirring until a thick soup forms.

Ingredients :
1 cup of rice ( I like med grain )
6 cups of Bone Broth ( water or any stock is fine) 
Dr. Ying's bone broth recipe  
1 teaspoon of soysauce
a few slices of fresh ginger

Optional Garnishes : 
Cooked turkey or beef
mushrooms
goji berries
blue berries
hard boiled egg
sardines
cooked green leafy veggies such as kale or bok choy
​seaweed Kelp/Kombu or wakeme 

Directions : 

1. Rinse rice in a strainer under cool water 

2. Combine rice, broth, salt and ginger in a large heavy bottomed pot

3. Bring to a boil.

4. Reduce heat, partially cover with lid allowing most of the steam to escape and simmer for 1.5 hours stirring occasionally until a yummy brothy porridge forms. 

5. If the congee becomes too thick during cooking, add more water or broth.

Add in some optional garnishes to make it even more nutritious.