I ordered the herbal meds for Jue Excess seizures yesterday (Wu Mei Wan and Qing Ying Tang), which will hopefully arrive Monday. I have advised her on foods to cool and drain damp, but that isn't an option when he's out of the house. Are there acupuncture points that can specifically address Jue Excess, or just find points for shen calming, drain damp and cooling? Treat as excess or deficient?
Question Details
Seizures In A Dog
by
equinesportsmed
-
January 3, 2015 View Case Report
I ordered the herbal meds for Jue Excess seizures yesterday (Wu Mei Wan and Qing Ying Tang), which will hopefully arrive Monday. I have advised her on foods to cool and drain damp, but that isn't an option when he's out of the house. Are there acupuncture points that can specifically address Jue Excess, or just find points for shen calming, drain damp and cooling? Treat as excess or deficient?
Replies
by
naturevet
January 6, 2015
Hi Karen,
We covered this topic in a subsequent CIVT webinar on interpreting patient acupuncture points to determine an appropriate formula. You may want to check it out.
Essentially, your treatment goals are to:
- sedate the Jue Yin (to remove the Excess): use LV 3 and SP 6
- tonify the Tai Yin (to help balance the Jue Yin Excess): use LU 7
- tonify the Yang Ming to descend Yang: use ST 41
- sedate the Tai Yang to descend Yang: use GV 20
In addition, look for other acupuncture points that are active. In the end, use only points that improve the pulse.
Hope that helps. I'm looking forward to hearing how your dog does.
Remember there is a lag of a few weeks (potentially) between when herbs are instituted and when results are seen.
Also, it's perhaps a good idea to mix in some herbs to the WMW, given that this dog is not stable. I'd recommend getting about 20g of Tian Ma from Mona to mix into the WMW.
If you'd like to add more things, we use Dan Shen (12g) and Yi Mu Cao (15g). Technically, though, these additions may not be necessary, since it is the combined use with Qing Ying Tang that seems to kick things into gear.
In fact, the herbs may not be anticonvulsant at all. They may simply alter neuroplasticity in the patient. That's why they can need a few weeks to work. It takes time for structural changes to accrue.
Hope that helps you out!
Steve
We covered this topic in a subsequent CIVT webinar on interpreting patient acupuncture points to determine an appropriate formula. You may want to check it out.
Essentially, your treatment goals are to:
- sedate the Jue Yin (to remove the Excess): use LV 3 and SP 6
- tonify the Tai Yin (to help balance the Jue Yin Excess): use LU 7
- tonify the Yang Ming to descend Yang: use ST 41
- sedate the Tai Yang to descend Yang: use GV 20
In addition, look for other acupuncture points that are active. In the end, use only points that improve the pulse.
Hope that helps. I'm looking forward to hearing how your dog does.
Remember there is a lag of a few weeks (potentially) between when herbs are instituted and when results are seen.
Also, it's perhaps a good idea to mix in some herbs to the WMW, given that this dog is not stable. I'd recommend getting about 20g of Tian Ma from Mona to mix into the WMW.
If you'd like to add more things, we use Dan Shen (12g) and Yi Mu Cao (15g). Technically, though, these additions may not be necessary, since it is the combined use with Qing Ying Tang that seems to kick things into gear.
In fact, the herbs may not be anticonvulsant at all. They may simply alter neuroplasticity in the patient. That's why they can need a few weeks to work. It takes time for structural changes to accrue.
Hope that helps you out!
Steve
by
equinesportsmed
January 6, 2015
Thanks Steve. I hit most of those points on an AP treatment last Saturday, but not LV3. He's been pretty stable since that treatment, but the RV also bumped up the Zonisamide to 100 mg TID from 50 mg BID. No complaints yet on over-sedation. I'm going to go to a local TCM herb company to see if I can get some Tian Ma to add to my Wu Me Wan.
Do you recommend regular acupuncture treatments, or wait and see how he is on the herbs. He has had a lot of restless, pacey nighttime behavior since the fall, which I have interpreted as yin deficiency. I think he is sleeping better on the Zonisamide, but I am hoping enough of the behavior persists to see if the herbs are making a difference.
Do you recommend regular acupuncture treatments, or wait and see how he is on the herbs. He has had a lot of restless, pacey nighttime behavior since the fall, which I have interpreted as yin deficiency. I think he is sleeping better on the Zonisamide, but I am hoping enough of the behavior persists to see if the herbs are making a difference.
by
equinesportsmed
January 6, 2015
Since Saturday, she has been feeding him, on my instructions, home made diet that is cooling and for draining damp: Turkey, Spinach, egg whites, garlic, etc.
by
naturevet
January 6, 2015
Hi Karen,
I’ve answered your recently emailed questions on the forum here, so others can benefit. Please see below:
Q: I am not clear at all on what the herb dose per kg BW is! Can you give me a formula?
A: Do you have the new textbook I wrote, published by CIVT. In the chapter on Case Management I have a dose chart. It’s not a straightforward “dose per kg” relationship for herbs. Looking at that chart, though, I’d give 1 tsp of each formula TID for a 50 lb dog. That ends up giving a full daily dose (and then some) of each herb.
Q: I may be able to get some Tian Ma from Blue Light, a local herb company. Add 20 grams into the Wu Mei Wan bottle?
A: Yes, if it’s a granular extract. Otherwise, if it’s ground dried herbs, don’t mix the two. Just give in addition at a dose of 2 tsp TID
Q: The dog is currently on zonisamide (100 mg TID) from referral center, which seems to be holding him— a lower dose did not. He had a single seizure in October, then nothing until New Years Day, when he had 3. I was still thinking he was Yin Deficiency, because he was restless at night. But then when he broke with three in one day, I had Mona change my order to the other meds. When he has been established on the herbs for a month, should I try reducing the dose of zonisamide?
A: As mentioned in the recent CIVT webinar on seizures that I presented, don’t be in a big hurry to change the anticonvulsants. Basically, if a dog goes 60 days or so, then has three seizures, his seizure interval is 20 days. I would wait until that’s quadrupled before reducing doses in this dog, which at best is about three months from the last seizure. Assuming you make it the three months, that should also put you in a more favourable season (since Jue Yin is in decline), when it should be safer to reduce dosing anyway.
A cont'd: Seizure free intervals gradually increase in dogs over time on this protocol, as the structural changes slowly accrue in the brain. So progress is seen over many months or even years. This is not what we’re used to with anticonvulsant drugs, where we expect instant impacts, so we need to educate the clients on this fact.
Q: Is there a way to track the seizures like you showed in the seminar on CuredCases.com?
A: Not yet, but it’s not a bad idea for a feature someday
Steve
I’ve answered your recently emailed questions on the forum here, so others can benefit. Please see below:
Q: I am not clear at all on what the herb dose per kg BW is! Can you give me a formula?
A: Do you have the new textbook I wrote, published by CIVT. In the chapter on Case Management I have a dose chart. It’s not a straightforward “dose per kg” relationship for herbs. Looking at that chart, though, I’d give 1 tsp of each formula TID for a 50 lb dog. That ends up giving a full daily dose (and then some) of each herb.
Q: I may be able to get some Tian Ma from Blue Light, a local herb company. Add 20 grams into the Wu Mei Wan bottle?
A: Yes, if it’s a granular extract. Otherwise, if it’s ground dried herbs, don’t mix the two. Just give in addition at a dose of 2 tsp TID
Q: The dog is currently on zonisamide (100 mg TID) from referral center, which seems to be holding him— a lower dose did not. He had a single seizure in October, then nothing until New Years Day, when he had 3. I was still thinking he was Yin Deficiency, because he was restless at night. But then when he broke with three in one day, I had Mona change my order to the other meds. When he has been established on the herbs for a month, should I try reducing the dose of zonisamide?
A: As mentioned in the recent CIVT webinar on seizures that I presented, don’t be in a big hurry to change the anticonvulsants. Basically, if a dog goes 60 days or so, then has three seizures, his seizure interval is 20 days. I would wait until that’s quadrupled before reducing doses in this dog, which at best is about three months from the last seizure. Assuming you make it the three months, that should also put you in a more favourable season (since Jue Yin is in decline), when it should be safer to reduce dosing anyway.
A cont'd: Seizure free intervals gradually increase in dogs over time on this protocol, as the structural changes slowly accrue in the brain. So progress is seen over many months or even years. This is not what we’re used to with anticonvulsant drugs, where we expect instant impacts, so we need to educate the clients on this fact.
Q: Is there a way to track the seizures like you showed in the seminar on CuredCases.com?
A: Not yet, but it’s not a bad idea for a feature someday
Steve
by
naturevet
January 6, 2015
If his stress level is not too high visiting the clinic, regular acupuncture is probably a good idea until the herbs kick in
S
S
by
drkarenmarsden
January 6, 2015
If the dog is just 16 lbs, I'd use 1/2 tsp TID of granular extracts of the two core formulas
S
S
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