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. 

Sweet Itch aka Queensland Itch aka Culicoides hypersensitivity is one of the most common skin problem in horses and is also the hardest to treat.  It is a horse owner's worst nightmare ! 

Sweet Itch is an allergy to insect bites. Mosquitos, black flies and no-see-ums have all been implicated as the cause of extreme itching and scratching which can lead to hair loss of at the mane,tail and belly, self trauma, and multiple open wounds with secondary bacterial infections. 

The saliva of these little blood suckers contains allergens that cause an intense itching. The horses will try to scratch on anything available to relieve the itch and in doing so can cause deep wounds and hair loss. Once the itching has begun, it is very difficult to control so preparation and prevention is key. The biological process is similar to hot spots in dogs which is caused by an allergy to flea bites. See my blog post about hot spots in dogs. 
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Why do some animals have allergies to certain things and some do not ? The answer is that allergies are cumulative. You may have a tolerance for pollen and cats and dust if exposed to any one of those things alone, however, if you encounter all 3 at once, your immune system will over react. You will be pushed beyond your allergy tolerance threshold, your body will release inflammatory mediators like histamine and cytokines that cause watery eyes, itchy skin, hives, sneezing, coughing and if severe, may constrict your airway.  The same is true in horses. They are exposed to lots of allergens in their daily life, mold, dust, pollen and bugs but when the swarms of biting flies emerge in the summer, they are pushed beyond their allergy threshold. 

​Recognizing the symptom is key. The photos below show advanced stage disease. ​

Let’s talk about prevention. Before the fly season begins you can prepare your horse and barn with some diet and lifestyle changes. 

1. Reduce contact with Insects

I know easy to say, hard to do. Most biting flies have a feeding pattern. Culicoides and gnats favor dusk and dawn while mosquitos are most active from dusk through early evening. Keeping your horse in the stable with a strong fan with plenty of fly spray may help. Fly sprays are short acting but can provide some relief. Some natural alternatives are Eco-vet and Repel which is made with Oil of Lemon Eucalypus. Gnats and no see ums are not strong fliers and will avoid the turbulence of a fan. When they do go out, fly sheets and face masks are a great help. 

To reduce the number of biting flies in your stable area you can reduce the breeding ground areas like stagnant water, long weeds and manure piles. A natural way to reduce emerging larvae is to treat ponds, streams and standing water with BTI aka mosquito dunks. Bacillus thuringiensis subspecies Isralensis, is a naturally occurring bacteria in soil. It produces toxins that only affect the larvae of mosquitos, blackflies and gnats. It is safe for all other animals, insects and plants and approved for pest control for organic farms. Spray BTI in ponds, use dunks in running water or drainage ditches. Make traps with bti in buckets of water with grass clippings or pulled weeds. Mosquitos and gnats will lay eggs there but they will never hatch. Goldfish and mosquito fish may be available from your county free. Dump water troughs every few days and some shell or gravel around the trough will prevent muddy puddles from becoming gnat nurseries. 

2. Reduce contact with other allergens

Mold and Dust are part of a horse's daily life. To reduce exposure, do not sweep or blow the barn aisle when horses are inside ! This is one of the worst things you can do to your horse's immune and respiratory system. Feed high quality hay and wet it down or soak it in a net for a few minutes before feeding. Do a full cleaning of the inside of the barn before allergy season. 
Inflammatory Foods processed foods and an unbalance ratio of omega 6 to omega 3 fatty acids tend to contribute to inflammation. Black oil sunflower seeds are high in vit E but have a high level of Omega 6. This ratio can be balanced to the ideal level of 1-4:1 (meaning approx 1-4 parts omega 6 to 1 part omega 3) by adding Chia seeds which are very high in Omega 3s.  

3. Increase your horse's allergy threshold
You can increase your horse's allergy threshold by increasing the levels of omega 3 fatty acids in the diet. As mentioned above, chia seeds are a great source of omega 3s and horses love them. Antioxidants can also help increase your horse's allergy threshold. Some foods therapy suggestions for horses are seaweed (kelp or spirulina), gogi berries, spinach, green tea, ginger and of course, Dr. Doug's favorite, turmeric. 

4. Avoid Immuno-stimulants
Vaccines stimulate the immune response to protect your horse from disease. Try to vaccinate early in the season before the emergence of biting flies. Killed vaccines and ultra purified vaccines do not cause as strong of an immune response as modified live and recombinant vaccines. 

So you have taken all the steps for prevention and your horse still has sweet itch. Now it is time to treat. Treat early in the course of the disease if possible when you first see the signs of hair loss and itching. 

The TCVM diagnosis is Wind (Itching) and Damp Heat (red crusty inflamed and infected skin) 

Acupuncture and Chiropractic Care can help reduce the itching and rebalance the immune system. To find a veterinarian trained in TCVM near you, search by your zip code at the Chi Institute page www.tcvm.com.

Herbal Therapy includes formulas to Tonify the Blood to stop itching and Clear Heat.

For Topical Treatment we recommend Dr. Ying's Sweet Itch Cream, a soothing blend of coconut oil, Chinese herbs and essential oils to relieve itching, soothe irritated skin, prevent secondary bacterial infection and repel biting insects.

We also have 2 herbal formulas to be given orally for Sweet Itch. The TCVM diagnosis from your veterinarian will help determine which is the right choice for your horse. 

Damp Heat Skin Formula or External Wind Formula can help relieve the itching and inflammation in the skin. 

Food therapy is a very important part of the treatment. As mentioned above, omega 3 fatty acids and antioxidants need to be included in the diet. Foods that Tonify Blood and Cooling foods can be beneficial. Apricots and dates Tonify Blood, Barley, cucumber and green tea can Drain Damp and are Cooling. 

So as you can see, sweet itch can turn into a mid summer nightmare for you and your horse. Do your best to prepare for the season and change the things you can control. You don't need to do them all. If you live next to a creek or if the barn manager refuses to turn the horses out before they blow the barn, well ok you have to live with it but at least you can add some food therapy treats or some herbs or sneak some BTI into your neighbor's pond to get you one step closer to a happier, healthier summer. 

Episode 295 : Turmeric Food Therapy with Dr. Doug English. 
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Australian Veterinarian, Farmer and Marathon runner Doug English has become a world leader in the use of turmeric to treat ailments in animals. His facebook group Turmeric User Group (TUG) has 250,000 members and his Turmeric life website is packed with informative articles and updates on his latest research. Listen in as he tells us about using turmeric in his practice, his current research and how you can become a part of his turmeric life community. 

TCVM segment begins at 28:30

Turmeric root, Jiang Huang or Yellow Ginger is a commonly used ingredient in Asian, Middle Eastern and Indian cooking. If you have ever eaten Tandoori, Curry, Satay or Singapore noodles, you have eaten turmeric. Turmeric alone is not spicy but it is usually mixed with spicy herbs and chili powder to give the dish a spicy kick. Food therapy principles for “Clearing Heat” are to use foods with Cold properties and then to Open the Exterior to allow the heat to escape. Curry paste, a blend of turmeric with cooling properties plus chili powder which causes you to sweat (open the pores) would be following these TCM principles. 
Many of our herbal formulas contain turmeric as a main ingredient. These issues all have a degree of Heat (inflammation and/or infection)  : 

• Golden Yellow Salve - topical formula for abrasions to combat infections and bruising
• Sarcoid Cream - topical formula to treat Sarcoids in horses
• Yu Jin San (Gold Jade Powder) - for Irritable bowel syndrome/chronic diarrhea
• Mume Powder - for Foal Diarrhea
• Liang Xue Jie du Tang ( Blood Heat Formula) to help control the crusts and erythema of Lupus
• Mu Dan Pi - for bleeding from the nose, subcutaneous bleeding or bleeding in the GI tract
• Lung Wind Huang - for Hives and swelling
• Xiao Huang San - for Cellulitis 
• ​Zhen Xin San - for severe anxiety (Fire and Phlegm Misting the Mind)

Incorporating Turmeric Root powder into your pet’s diet is a very good way to help control some of their most common ailments, like arthritis pain, itchy skin, diarrhea and anxiety. 

So how do you get started ? Read on for Dr. Doug's recommendations about preparing golden paste and dosages for pets and horses. For more info about Turmeric and to read Dr. Doug’s latest research, subscribe to Turmeric Life. 

Here is some great advice from Dr. Doug about using Turmeric as Food therapy for your animals. 

GOLDEN PASTE for - Humans - Dogs - Cats - Birds – Reptiles – Fish

We are all animals and turmeric benefits all !

Start humans and dogs at ¼ teaspoon 2 to 3 times a day, with food. Small dogs and cats 1/8 tsp. If your gut biota does not tolerate it, you will get some diarrhea. If ok, double dose every 3 or 4 days until you are at 1 teaspoon doses with food and 3 to 4 times a day.

To make Golden Paste (GP):

Ingredients:

• 1/2 cup (125 mls/60gms) turmeric powder
• 1 cup water (250 mls) PLUS 1 cup water in reserve, if needed
• 2-3 teaspoons freshly ground black pepper
• 1/3 cup of one of the following oils: coconut oil (raw probably best), Linseed (flaxseed), Olive oil, palm oil palm but any digestible oil will dissolve the oil soluble polyphenols – just that some oils are better than others regarding high levels of omega 6 fatty acids distorting the ratio of omega 3 to omega 6 which preferably should be 1:3 and not 1:23 like common cheaper seed oils.

Can add the oil now or later when consuming.
Place turmeric and water in pan, bring it to the boil then reduce to a simmer. Stir over gentle heat until you have a thick paste. This should take about 7-10 minutes. 

Or if you are adding turmeric powder to a stew, it is exactly the same as making golden paste and it will be assimilated into the food. 

Move from stove, let it cool down, add the pepper and oil at the end of cooking. 

​Preferred oils are coconut, olive. You do not have to add oil now because it can be added later when consumed. Some like to put it all together at preparation though.

Stir well (a whisk is ideal) and allow to cool. Ideally store in sterilized glass jar, or purpose designed plastic and refrigerate. 
Will keep for 2 weeks, refrigerated. You can freeze portions if you think you have too much and it will keep for a year, at less than 0 degrees C.

Horses 

Start slowly with 1 tsp of Golden Paste or dry powder.
Standard dose is 2 tsp of Turmeric Powder, 2 tsp Oil, 16 grinds freshly ground Black Peppercorns 2 times a day. 
Horses may or may not do better on GP and there is a lot of evidence that they assimilate dry powder very effectively. Being a herbivore it is a given that they digest plant matter much better than humans or dogs.
Maximum will be a half cup of GP or powder at any one time but good results are seen with a lot less and normally 2 teaspoons of GP or even 2 teaspoons of powder are sufficient.

For sarcoids at least a tablespoon of powder is needed once or twice daily.

Ruminants small and large ( goats, sheep, llama and cows)
These do just as well on neat turmeric powder because of their very efficient ruminal digestion. 1 teaspoon.

Chickens
They do very well on it: mix a ¼ tsp (or more if preferred) per bird into a small amount of grain. Pour boiling water to wet well, mix and sit for an hour. Feed out.

In Episode 294 : GMHA and Dr. Coggin's Test
We talk to Dr. Oscar Fletcher who was the Dean of NCSU-CVM from 1992-2004 (my Dean from way back in the 90s) to share his memories of Dr. Coggins and his insights on the history and importance of Dr. Coggins' Test.

TCVM segment starts at 29:35

In our practice, we sometimes have clients ask... 

"Why does my old retired horse need a coggins, he doesn’t go anywhere ?"
or they say, " Have you ever seen a positive ?"  

Well thankfully no, I have never seen a positive and I hope from routine testing, I never will. With our ever increasing urbanization of the USA, even horses who don’t travel, live in close proximity to others so we have to think about herd health on a large scale. 

To understand the necessity of the Coggins Test, let's look at the history of Equine Infectious Anemia and the man who's pioneering work developed the test, Dr. Leroy Coggins.  

What is the Coggins Test ?

The coggins test looks for antibodies for equine infectious anemia in the horse's blood by using the Agar Gel Immunodiffusion (AGID) test. Equine Infectious anemia is a lentivirus in the same family as HIV and FIV. These are retroviruses meaning they insert themselves into the host cell's DNA to replicate. Because of this, horses are infected for life and there is no cure and any horse with antibodies to EIA is infectious to other horses. 

The virus is spread by biting flies such as horse flies or deer flies. Because the bite is so painful, a fly may bite one horse and then be swatted off only to come back immediately to finish their meal. EIA can also be spread by contaminated needles, blood products and dental equipment. In 2015, an outbreak in racing quarter horses in California resulted in 34 horses being infected. 250 more horses on 19 farms were exposed and had to undergo 60 days of quarantine and testing.

The 3 phases of infection

The acute phase begins within 3 days to 2 weeks after infection. Horses will have a high fever, edema, be lethargic and anemic. 30 % of horses will die. These horses carry a high viremic load and 1 ml of their blood can infect 1 million horses ! A horse during the acute phase may test negative on the coggins test because he has not made antibodies to the virus yet. 
The 70 % who survive can be chronically infected or become inapparent carriers. 

Chronically infected horses may show general signs of weakness, weight loss, depression and a recurring fever. Very general signs right ? These horses will test positive on a coggins test and 1 ml of their blood can infect 10,000 horses !

The inapparent carrier state as the name implies shows little if any sign of infection. In these cases only 1 horsefly in 6 million will transmit EIA.  However stress or another illness can cause a relapse and these horses can revert back to the chronic or acute phase and their viral load will increase. 

History

I bet you didn't know that there really was a Dr. Coggins behind this test.

Dr. Leroy Coggins was one of the founding administrators of NCSU College of Veterinary Medicine. He was the head of the department of Microbiology, Pathology and Parasitology. He was a well loved and respected researcher, professor and mentor. Read more about Dr. Coggins at the NCSU-CVM site

EIA has been reported in all parts of the world and was 1st recognized in the US in 1890. Outbreaks were usually noted at racetracks because infected horses were brought into close quarters with other young, stressed horses. There were states designated as "hot zones" which included the southeast. At the time, the vector had yet to be determined but horses who were infected seemed to live or come from hot, damp climates and EIA was given the common name of “swamp fever”.

During the 1960s, Dr. Leroy Coggins was working on his PhD in virology at Cornell University when a major outbreak occurred on Standardbred Farms in New York. By 1970, Dr. Coggins had developed a test using the AGID method to detect antibodies to Equine Infectious Anemia. Previously, a donor horse inoculation test was the only test available to screen chronically infected or exposed horses which took 4 to 8 weeks and was very expensive both monetarily and morally.

In 1973, the USDA made the Coggins test the gold standard for determining exposure and prohibited any “positive reactor” from moving across state lines. Individual states determine the requirements for entry and that same year, Florida was the 1st state that required any horse being sold, moved, raced or shown to be tested and for positive horses to be quarantined or euthanized. Of course this was a shock to many horse owners who had inapparent carriers. Their horses did not look sick and there was little educational material for the general horse owner about Equine Infectious Anemia. 

Thankfully the Florida Department of Agriculture had the foresight to enforce these regulations to attempt to control the spread of EIA using Dr. Coggins’ Test. In 1970, 12 % of horses tested in Florida were positive. By 2000, this number dropped to 0.016% and there were zero cases of EIA in Florida in 2016 !

Nation wide, the value of the Coggins test was similar. In 1972 about 4% of horses tested nationwide were positive. By 1980, this number dropped to less than 1%. There are still occasional outbreaks reported. However mandatory routine testing seems to be keeping the prevalence to a minimum. 

Now that you know some details about EIA are you rethinking the importance of your coggins test ?

For more info about EIA check out these links

USDA-APHIS Federal Guidelines
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USDA-APHIS EIA discussion group notes 2015 

Florida Department of Agriculture

In Episode 253 : Vaccine Induced Lyme Syndrome, Artist and Horse Trainer, Aeron Mack of Middleburg, VA tells us about her Vaccine induced Lyme Syndrome research and shares her story of bringing her horses back to health. You can also find great resources about Lyme disease and Vaccine Induced Lyme Syndrome on Aeron's blog page. 

The TCVM segment starts at 40:30.

What is Lyme Disease
Lyme disease is caused by the bacteria, Borrelia Burgdorferi and is transmitted to horses, dogs and people by the deer tick (Ixodes scapularis). For more tick info, visit the "Tick Guy", Thomas Mather at the University of Rhode Island's Tick Encounter Resource Center.

Lyme is often classified as a syndrome because many general symptoms of malaise like weakness, behavior changes, body pain, joint pain and swelling and heart problems lead us to suspect Lyme on our differential list. Signs can be mild at first and you may not have seen or remember a tick bite on your horse or dog. As the disease progresses, the most common presentation in horses is pain and sensitivity over the large muscles of the back and limbs, swelling of multiple joins and lethargy. A horse who normally looks forward to riding time with his person will gradually become more resistant to work and may even avoid grooming time. In dogs we will see shifting limb lameness or a lameness that comes and goes. They may have a low grade fever and may lose their appetite. 

B.burgdorferi is a corkscrew shaped bacteria (spirochete) and is in the same family as Leptospira, implicated in abortions, moon blindness and kidney disease and Treponema responsible for Syphilis in humans. These bacteria do not produce toxins and are usually found in low numbers in the blood and tissues. They cause such wide ranging symptoms because they can evade the immune system and cause autoimmune symptoms many months and even years after infection. 

The Lifecycle of the deer tick shows when your chances of encountering tick bites and exposure to Lyme's is highest. ​

How is it Diagnosed

Some of the things we consider when diagnosing Lyme disease is if the horse or dog was living or traveled to an area endemic for Lyme, did they have a tick bite, clinical signs and ruling out other diseases. A blood test we can run in the clinic can tell us if they have antibodies to Lyme and a more quantitative test can be run at Cornell's veterinary diagnostic lab to tell us if the disease is chronic, acute and/or the vaccination status. For more info about Cornell's veterinary research, click here. 

​TCVM Diagnosis and Treatment

The TCVM diagnosis of the acute stage is a mixed pattern of Wind-Heat Toxin (infection/fever) with Qi and Blood Stagnation (pain).

In the chronic stage, the Zheng Qi (immune system) is damaged and we see Qi and Yin Deficiency (weak immune system, lethargy, pain, intolerance to warm weather, panting, anxiety)

In most Lyme cases, dry needle acupuncture is painful so these animals will be treated with a Chiropractic adjustment followed by laser acupuncture and a course of Herbal Therapy. 

Herbal Therapy

In the acute stage, if we have a red tongue and surging pulse, a fever, hot swollen joints we recommend  Jing Tang's Ba Wei Yu Peng San (Jade Screen Eight formula). This formula comes from the combination of 3 formulas used to treat acute febrile diseases, Yin Qiao San, Huo Xiang Zheng Qi San and Yu Ping Feng San. This formula was used extensively to treat and control the SARS (severe acute respiratory syndrome) epidemic in China in 2002. We would use this for 30 - 60 days to balance the immune system and kill the bacteria.  

The majority of the damage to the body from an autoimmune disease is sometimes referred to as a "cytokine storm". The pathogen stimulates the immune system's white blood cells and cytokines (pro and anti inflammatory mediators like interleukins and free radicals) to respond but the reaction gets out of control. Just think about when you have the flu and your body hurts, you are sweaty then freezing, you have so much mucous in your nose and lungs you can barely breathe. This is your body trying to get rid of the virus. Many of the deaths we see from influenza, bird flu, SARS, Ebola and even graft vs host disease are due to the body not being strong enough to tolerate the immune system battle or becoming confused and attacking itself. 

In the chronic stage when we are treating the pain and restoring the immune system, we use Dr. Xie's Lyme formula which is a combination of Du Hou Ji Sheng Tang (Angelica and Loranthus Powder) and Yu Ping Feng San. Du Hou Ji Sheng Tang is one of the most popular formulas for treating arthritis in people and animals. It is for Wind-Cold-Damp arthritis so for chronic whole body pain and stiffness that is worse in the cold weather. Yu Ping Feng San is a formula for cold and flu and has recently been shown to block the expression of iNOS and COX-2 so has NSAID like activity in addition to stimulating the immune system. 

Food Therapy

In the acute stage, you want cooling foods that tonify Qi.

For horses, this can include alfalfa, dandelion, pear, sweet potato, figs, goji berries and chia.

For dogs, foods like turkey and barley with eggs, string bean, spinach and shiitake mushrooms made into a congee with bone broth can stimulate the appetite and tonify the Qi. 

In the chronic stage you want to keep building the immune system and relieve the aches and pains but can add some warmer foods. 

For horses add some Turmeric, orange peel, ginger and garlic to the recommendations above.

For dogs, add some Turmeric and ginger plus a sardine which is high in omega 3 fatty acids.

Homework
Get Guineas ! 
https://www.youtube.com/watch?v=PXfEEf8B5j8

What is Vaccine induced Lyme Syndrome

Lyme disease has become so prevalent in some areas of the country that veterinarians have been using the dog lyme's vaccine in horses as common practice. I did this myself when I lived in Virginia. I had to retire a horse with Lyme and at the time, given the research available to me, I thought I was protecting my horses and my clients horses. For dogs, there are a few FDA approved vaccines that are considered to be safe and the AVMA recommends vaccination in endemic areas. 

Aeron Mack a horse trainer in Middleburg, VA, had an experience with her horses last year that has changed my mind about the Lyme vaccine. Evidence in humans implies that vaccination may be implicated in causing a "Lyme like Syndrome". If what we know about spirochetes and the immune response is true, this makes a lot of sense however, there is currently no research indicating this is the case in horses and dogs.

TCVM Diagnosis and Treatment
is similar to what we discussed above.  Presentation may be acute or chronic and we would treat what we find with an emphasis on relieving pain and controlling the immune response.
 
If you suspect your dog or horse has Lyme disease or vaccine induce Lyme syndrome, contact your veterinarian for an exam and consultation. Do not make this diagnosis on your own or begin treatment without veterinary advice.

If you are looking for a TCVM trained veterinarian in your area, go to http://www.tcvm.com/Resources/FindaTCVMPractitioner.aspx and enter your zip code to find veterinarians from the Chi Institute of Traditional Chinese Veterinary Medicine. 

Listen to Aeron's story on the TCVM segment on the Driving Radio show on the Horse Radio Network.

Listen in to the Traditional Chinese Veterinary Medicine segment of the Driving Radio Show.

We have 2 shows about EPM.

In Episode 253 : EPM part 1, Dr. Ellison of Pathogenes, Inc in Ocala Florida tells us about her EPM research and novel treatment strategy. The TCVM segment starts at 36:22.

In Episode 288 : EPM part 2, Dressage trainer, Karen Abbattista shares her rehab protocol for horses post therapy. The TCVM segment starts at 49:04.

To listen to other episodes of our podcast visit ​The Driving Radio Show and you can find even more equine, pet and health shows on The Horse Radio Network, the voice of the horse world ! 

What is Equine Protozoal Myeloencephalitis - EPM ?

EPM is a syndrome caused by single celled organisms (protozoa) that infect the horse and cause inflammation and pain in the brain, spinal cord and muscles. This inflammation can cause clinical signs like lameness, weakness, a behavior change, stumbling, muscle atrophy.

The definitive host, the opossum is infected by eating infected muscle tissue from his prey or road kill that happens to be an intermediate host. Intermediate hosts have been identified as armadillos, cats, skunks, racoons, sea otters and harbor seals. The parasite then replicates inside the opossum to an infective stage and is released upon the world in opossum poop. The horse becomes infected when he ingests sporocysts from food or water that has been contaminated with opossum droppings.

The horse is a dead end host for the parasite, meaning the horse's body is not the right environment for the protozoa and it eventually dies off before completing its life cycle. These dead parasites can cause damage to any part of the nervous system so any neurologic sign is possible. Symptoms can be acute or chronic, severe or mild so it is a very difficult disease to identify and diagnose.

How is it Diagnosed ?

Owners usually notice a change in behavior as the first sign, maybe the horse is now all of a sudden spooky on trails or has started bucking. Sometimes the signs can be as subtle as muscle atrophy and/or poor performance. In these cases we will typically be called in a few months later when many common issues are ruled out and the neuro signs start to become more evident.

EPM can sometimes present very suddenly with a downed horse and diseases like neurologic rhino or Eastern Encephalitis or West Nile need to be ruled out and aggressive supportive care needs to be started immediately. These cases will go into a clinic and diagnostic test may include a spinal tap which is the gold standard for diagnosis for EPM. In the early stages with mild symptoms, conventional diagnosis can be a positive response to treatment such as Rebalance or Marquis.

TCVM Diagnosis and Treatment

In our practice each exam starts with tongue and pulse diagnosis plus an acupuncture point scan follow by standing and moving evaluations. A horse with EPM will usually be very painful in his whole body and have some level of neurologic abnormality. The scan may reveal other concurrent diseases such as ulcers or arthritis.

The TCVM diagnosis is a mixed pattern of Qi Stagnation (pain) and Qi Deficiency (weakness).

If we suspect EPM we take a blood sample and send it to Dr. Ellison at Pathogenes to screen for EPM and Lyme's Disease. Dr. Ellison has developed some novel tests and protocols to diagnose and treat EPM. You can read more about it on her website and listen to her interview on the TCVM seg of the driving radio show ....scroll down for the player. *** Many Thanks to Kate McCaffery for encouraging us to participate in Dr. Ellison's program****

Acupuncture and Chiropractic Care would focus on relieving the pain, tonifying the Qi and supporting the immune system. The points I use will be based on the exam but because there is an autoimmune component to these cases I always include hemo-acupuncture which involves injecting some of the horse's own blood into certain points.

Herbal Therapy
Herbal Therapy is very helpful in these cases for 3-6 months after the initial diagnosis and treatment.
Qing Hao San - "Artemisia Powder"
Tonifies the Qi, strengthens the immune system and eliminate the parasites.

Dr. Xie developed Qing Hao San based on Dr. Tu's nobel prize winning research using Artemisia to treat Malaria (also a protozoa like Sarcocystis), combined with of 2 traditional formulas, Guan Zhong San (Dryopteris Root powder) and Si Jun Zi Tang (4 Gentleman). Read more about Dr. Tu's research here.

To Order Qing Hao San, follow this link

Food Therapy
Our food therapy recommendation include foods that are high in vitamin E and antioxidants.

Black Sunflower seeds - high in Vit E and omega fatty acids
Chia Seeds - High in Vit B and omega 3s, Black sunflower seeds have an imbalance of omega 6 to omega 3, the chia can help balance that ratio.
Lyceum berries (goji berries) high in Vit C and antioxidants
Spirulina immune booster by stimulating IgG antibody production

My favorite sources are
Sunflower seeds - TSC
​Chia - US Chia
Lyceum berries and Spirulina - nuts.com

Homework
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What can you do to help your horse recover and reduce the chance of reinfection.

• Do not leave feed tubs in stalls or in the pasture overnight and wash feed and water buckets daily.
• Avoid leaving pet food in the barn your barn cats can eat mice !
• Review your wellness program with your vet to make sure you are helping and not harming your horse's immune system

Coming soon - rehab exercise videos

In part I we talked about the benefits of food therapy so now we will discuss how to incorporate these principles into your daily routine.

Some things to remember : 

• Variety is the key to balanced diet.
• Fresh whole foods have the maximum nutrients
• Plan meals with a balance of Yin and Yang Energies
• Add foods to address specific conditions 

A good base diet consists of 30% grain/starch, 40% protein and 30 % veggies plus supplements like sardines, hard boiled egg, flax based supplements, herbs and spices. You can pick and choose a neutral, warm or cool diet from the chart below. 

Suggestions for a dog with a Qi and Yang deficiency during the winter months would be 30% brown rice, oats and/or sweet potato, 30% chicken, beef, beef liver, venison and/or lamb and 30 % dark green leafy veggies like chopped spinach, kale and kelp. Other veggies you might try are green beans, carrots and green and yellow squash. 

For a dog with a Blood deficiency (dry flaky skin, itching and general weakness and malaise) choose a neutral diet of ground beef and kidney beans with carrots and peas but add in foods that Tonify the Blood like liver. Sardines and hard boiled eggs also Tonify the blood and are high in omega 3 fatty acids. 

For a dog with a Kidney Qi deficiency choose a base diet like sweet potato, turkey, spinach and kale and add in foods that will help the kidney like lamb's kidney, kelp, kidney beans and black sesame seeds. 

As a general rule I add turmeric paste (see recipe below), fresh ginger, salt and local honey to each meal and then top it with a splash of apple cider vinegar and either a sardine or hard boiled egg. 

Here is an example of how I make a base diet for my dogs at home : 

1. Add 1/4 cup of coconut oil to a pot on med heat
2. Brown meat or fish
3. Add Ginger and salt
4. Add grain or starch
5. Cover with water and cook on med low until grain or starch is cooked (approx 20 min)
6. Add chopped veggies and nuts or seeds
7. Mix together and cook on low for 5 more min
8. Add local honey
9. Let cool and pack in serving size portions for the fridge and freezer

Then at each feeding I add some turmeric paste, a splash of apple cider vinegar, any herbs or supplements they may taking and either a half a sardine or half a hard boiled egg with the shell. Big dogs can have a whole sardine or whole egg. I add a little warm water to dissolve the turmeric paste, give it a stir and it's ready to eat. 

One of the roadblocks to start home cooking is the worry that your dog will not have a balanced diet. With lots of variety, a balanced diet over time is easy to achieve but you can always add a high quality supplement to be sure. I like Platinum Performance CJ. It is a flax based supplement made in the USA and developed by veterinarians. You can order this from our website or from platinum performance directly. http://www.platinumperformance.com/platinum-performance-canine-cj-supplment

As with any food change start very slowly and discuss it with your veterinarian first. If your dog has been on kibble his whole life, changing to home cooked food can be very hard on his stomach. Start with a few bites of home cooked food on his regular food and slowly incorporate more over a month's time. Some dogs love their kibble or 100% home cooking  is not an option and that is ok. You can just top your dog's food with some home cooked food and he will still get the benefits of fresh food and omega 3 fatty acids.

If you are looking for some great whole food dog treats based on chinese medicine principles, check out Doggone good goodies. ​https://www.facebook.com/DoggoneGoodGoodies/

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