Question Details
Sporitrichosis In A Horse
by bfellis - November 7, 2022
15 yr mule gelding that could be insulin resistant (large credit neck, fat pad on tail head) with draining lesions on limbs, axilla, groin, caudal abdomen/prepuce that are non painful, non pruritic and non healing. I started on organic iodine at 1tsp bid. Would Xian Fang Huo Ming Yin with Si Miao San be a good place to start? Mule is used for trail riding, not very excessive at all-good for exam, palpation. Pulse was difficult to palpate and could represent a Qi deficient pulse? Thank you
Brett Ellis
Replies
by naturevet
November 9, 2022
Brett, I love your ideas. I would use Xian Fang Huo Ming Yin +/- Si Miao San, as you suggested. Note that Damp patients with secondary Stasis can have weak pulses. As we described in VT, think of it as a situation where Damp/Phlegm is obstructing the channels (like a "fat berg" in a sewage pipe) creating very weak pulses due to very little Blood and Qi getting through the obstruction.

If that doesn't help, then consider a Wei Qi tonic of some type, since the weak pulse and unrelenting infection can signal immune deficiency. Overall, though, from what you describe, SMS + XFHMY seems more likely to help, especially if you can somehow lean out the diet a little

Steve
by bfellisdvm
November 11, 2022
I love the “fat berg” metaphor! We have had a surprisingly good response to organic iodine powder alone, will follow up in a couple of weeks to see if XFHMY is indicated. Thanks again!
by bfellisdvm
November 17, 2022
Patient is continuing to improve with lesions on organic iodine alone. I’m going to try to get him on Si Miao San to help his overall glutinous condition. I’ll let ya know how that goes. Thanks !!
by bfellisdvm
November 17, 2022
Patient is continuing to improve with lesions on organic iodine alone. I’m going to try to get him on Si Miao San to help his overall glutinous condition. I’ll let ya know how that goes. Thanks !!
by naturevet
November 20, 2022
Sounds good!
by bfellis
December 21, 2022
The mule has resolved damn near all the lesions on organic iodide alone. Going to continue with that for at least 4-8 weeks after resolution. I’m sure his Damp Heat will flare again in the Spring when cortisol levels rise. How is the ebb and flow of cortisol in the horse relate to the circadian rhythm? Is that just Yang becoming more exterior in the Spring and Summer? To eventually go back inside during the late fall/winter? Then a Shao Yang disharmony appears secondary to Yin being trapped inside? Add in some Damp Heat with processed grain and Liver Qi stagnation from being underworked /over stalled and you get the fat angry pleasure horse? As I now educate nearly every dog cat owner about nutrition and evils of processing, where do we go with horse feed other than low starch diets? Which are still highly processed? Or does the lack of animal proteins not make them as evil? So many damn questions.

Cheers ????
Brett
by bfellis
December 21, 2022
Ahhh, I see question marks appear when I type an emoji-it was the beer glass clinking emoji for clarification. I was always wondering if my dumb thumbs were typing question marks. Now I know. Keep the emojis in the text message, not cured cases! Laughing emoji
by bfellis
December 21, 2022
Ahhh, I see question marks appear when I type an emoji-it was the beer glass clinking emoji for clarification. I was always wondering if my dumb thumbs were typing question marks. Now I know. Keep the emojis in the text message, not cured cases! Laughing emoji
by naturevet
December 21, 2022
Hi Brett!

Congrats on yet another success

Thanks for explaining the question marks. I was wondering!

Cortisol correlates with the Yang Ming, which essentially governs metabolism including mitochondrial activity. If an animal eats too much, cortisol increases post-prandially, as does mitochondrial activity, creating a digestive 'heat' that, if repeated, begins to dominate clinical appearance and be known as Damp Heat.

For horses, Damp Heat is aggravated by the richness of the fodder. Grain concentrates, high bioavailability (e.g., fresh grass in spring) and lots of alfalfa hay are Dampening influences as the produce that over nutrition state and the associated heat signs. Fiber is the main defense against Damp in horses. As long as they have to work for their food, they are less prone to Damp

Hopefully that answers your questions!

Steve
by bfellis
December 22, 2022
I was wondering about the elevations in ACTH that occur in April/May and extend through October in horse in the northern hemisphere. Does that correlate with a six phases/circadian rhythm explanation?
by naturevet
December 22, 2022
Hmm. There's no one phase that correlates with that whole period. Tai Yang almost correlates for the whole period. That would mean Yang Ming would be deficient for almost the whole period. Since Yang Ming is the correlate of metabolism and thus cortisol, it might be that when Yang Ming (i.e., cortisol) is high, there is no call for ACTH. When Yang Ming is low, then ACTH levels rise in response to the associated natural tendency for cortisol to subside in that same period.

If it was April/May for one surge, and then October for another surge, that would correlate with the Shao Yang.

I don't know if that makes sense with what you're seeing clinically...

S
by bfellis
December 22, 2022
Yes. Just trying to work things out in my mind for all metabolic horses- so I was trying to extrapolate the rise of ACTH to the metaphor that Yang energy is more external spring through summer, that’s because I was viewing Cortisol as a Yang substance. But what I am understanding is that cortisol is more Yang Ming than Tai Yang. I think my brain locked into putting cortisol as a fight or flight/sympathetic/Yang energy type of substance. Thanks again for your help!! Have a wonderful holiday!!

Brett
by naturevet
December 22, 2022
Just to complicate or maybe explain things, anything with a steroidal structure like cortisol is actually a form of Yin. So we have Yin (cortisol) naturally high in the morning, from which Yang (Ming) energy arises or emerges.

Following that logic, then the rise in ACTH and presumably cortisol in spring thru autumn must equate to the rise of Tai Yin energy, which makes sense because if we have too much of it, then we get Damp Heat, which is the main diagnosis behind Cushings

S
by bfellisdvm
December 23, 2022
Ahhhh…thank you. I will now sleep well. This is definitely a question you can’t google !

Brett
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