Returning to Sport Post-Abdominal Surgery Series: Understanding Traditional Chinese Veterinary Medicine (TCVM)

We are now at Day 13 post-operative abdominal surgery for Rainey.  Life remains very boring for her as she continues to allow her incision to heal, and heal it has.  Therefore, this week I will be very heavy on the theory of TCVM, in hopes for you to gain an understanding of how TCVM works.  I realize this can sound a little crazy, but bear with me.  And if you have a Western trained medicine brain, try to think of it as learning medicine in a different language.  It can be a little dry and a little confusing.  I will try to provide info that is pertinent, but we may get over our heads.

The first week after a major surgery is the hardest for an owner. Their usual lively pet is sedate, painful, and uncomfortable. They may not be eating the best. In Rainey’s case, she was very sick when she was taken to surgery. Her white bloods cells were elevated and she was dehydrated. Rainey started showing clinical signs of illness on Saturday, January 9th, 2021. She did not finish her breakfast and she was slightly lethargic. However, when the opportunity came to work on some fitness and running dogwalk training her attitude was all for it! Then she vomited her training treats that afternoon. I was told this was common week 3 of pregnancy behavior. And this is true, which makes differentiating normal morning sickness ​from illness so difficult. Sunday was a repeat of Saturday, ​with a little more lethargy.  

Rainey Day 1 post-op

Sunday afternoon was when I noticed her abdomen was painful, but no fever. She ate kibble if I hand fed her, but she wouldn’t touch her homemade diet. Monday morning, she wouldn’t get out of bed. I immediately took her into her reproduction veterinarian, who verified my worst fear - a uterine infection that would require an emergency spay to save her life. There was no hesitation in my mind that spaying her was the correct option. Rainey was placed on IV fluids, and surgery was performed later in the morning. Surgery was successful and Rainey was discharged to go home that evening. When I picked Rainey up that evening, she was tired and painful, and I could tell her body had been through a lot. When we got home, she did urinate, but wanted to spend the rest of the night being held. She ate if I hand fed her. Rainey was suffering a significant Qi and Blood Deficiency. The infection and the surgery had drained the literal life out of her.  My usual ‘hot’ dog was incredibly cold and lethargic.  

​In TCVM, Qi is your life force. Where there is Qi, there is life, and where there is no Qi, there is death.  A living being is born with Yuan Qi or Source Qi, which originates from Prenatal Jing.  Prenatal Jing is the foundation of life, and it is the lifeforce you accumulate from your parents.  Think your DNA, RNA, etc.  Then there are seven other forms of Qi – Zong Qi, Gu Qi, Ying Qi, Wei Qi, Zang-Fu Qi, Jing Luo Qi, and Zheng Qi.  For the purposes of this blog, I will only expand upon two forms of Qi – Gu Qi and Ying Qi.  Gu Qi is the nutrients that you absorb through your diet, and it replenishes your Yuan Qi, as well as provides the building blocks for all the other forms of Qi.  Gu Qi also provides your body with Postnatal Jing, which aids in keeping you healthy while building your defenses or immune system to prevent illness.   Have you ever heard the term ‘burning the candle at both ends’?  This refers to a person working so hard that they are literally burning up both their predetermined Prenatal Jing and their accumulated Postnatal Jing.  They will tire easily, and eventually burn out if they are not taking the proper steps to keep themselves balanced and healthy.  As you can imagine, a proper diet is one of the best ways to keep yourself healthy.

​In TCVM, Blood contains and circulates Ying Qi through the vessel of the body.  Ying Qi or Nutrient Qi is derived from, you guessed it, Gu Qi – what you eat.  It makes sense, from a Western standpoint, that what you eat promotes healthy blood circulation and improves your overall health.  The function of Blood in TCVM is to nourish and moisten, as well as carry Qi.  Nourish and moisten makes sense, if you consider how blood travels through your body, but let’s take it one step further.  In TCVM, we have meridians or channels.  I feel this is common knowledge.  But what may not be common knowledge is that each of the channels is associated with an internal organ.  Now, I do not want to go down this rabbit hole, as I could provide hours of reading for you about each Zang-Fu organ and how they corelate and relate.  Therefore, for the topic of discussion we will stick with identifying the Liver and the Heart.  But wait (do you feel like you’re on a made for TV infomercial yet?) we need to break into the 5 Element Theory and Yin-Yang BEFORE we can talk about the Liver and the Heart.  I will try my best to keep this as simple and concise as possible.  As most of my clients and friends are aware, I have a tendency to be long winded and go off on tangents.  We will revisit Blood in a moment…..

The 5 Element Theory and Yin-Yang – in TCVM I assume most of you are familiar with Yin and Yang.  You cannot have Yin without Yang, and vice versa.  One is light (Yang), while one is dark (Yin).  One is hot (Yang), one is cold (Yin).  One is feminine (Yin), one is masculine (Yang).  When you combine the two, you are whole.  But sometimes one dominates (Excess) or one is weak (Deficiency).  The five basic principles of Yin-Yang are:

1.  Everything in the universe has two opposite aspects – day (Yang) vs night (Yin);
2.  Any division of Yin-Yang can further be divided into Yin and Yang aspects – a sunny day (Yang) vs a rainy day (Yin tendencies);
3. Yin and Yang control each other – on a cold (Yin) day you may turn the heat (Yang) on (adding Yang to Yin to rid the cold);
4. They mutually create each other – for the scientific minded, during gluconeogenesis, the body uses energy (Yang) as it creates glycogen (Yin, nutrients); this can also go the opposite direction where normal physiological balance is destroyed (Excess or Deficiency)
5. They may transform into each other in certain circumstances – when Extreme Heat (fever from an infection – Yang Excess) consumes and damages the Yang Qi the persistent fever will produce Cold (Yin) signs, leading to a Qi Deficiency.  This can leave a patient weak, with a decreased ability for the body to function for normal activities.  It can be generalized or specific to an organ.

​The Five Element Theory was born when the ancient Chinese observed the world, and became fascinated by the seasonal changes. As everything in the universe can be divided into separate Yin and Yang categories (there is a long list of this if you want to search it), the ancient Chinese also divided the seasonal changes into five forces – Wood, Fire, Earth, Metal, and Water.  Taking this a few steps further, the theory of Five Elements was born and everything in the universe can fit into five categories.  Various items such as seasons, directions, climates, colors, tastes, and body parts were grouped together under a common element, with a Yin and a Yang organ accompanying them.  This later became the foundation for TCVM.  When used appropriately, the Five Element Theory can describe the complex relationship between the body’s internal organs, as well as the body’s relationship with the natural world.  Combine Five Element Theory with Yin-Yang theory, and a practitioner can produce a clinical diagnosis and treatment plan individualized for the patient.

Rainey talking about my bad handling at Schnauzerpalooza 2019

Using the Five Element Theory, we will explain Rainey.  Rainey is a Fire dog.  The Fire Element represents all things associated with summer, heat, and redness.  Fire’s organs are the Heart, Pericardium, Small Intestine, and Triple Heater (there is no equivalent in Western Medicine, and it is the hollow passages of the body which Qi flow) – these are the organ systems most likely to suffer in this Constitution.  The Heart dominates the blood and vessels, it houses the mind (Shen).  A Fire personality (or constitution used interchangeably) is lively and playful, but also sensitive.  A Fire constitution loves attention, they ​​desire to be the center of it​, and they will talk their way there.  

They love to be held and petted,  but on their terms.  As such, sometimes it is difficult to work on a Fire animal.  They may accept it, or they may absolutely refuse.  As a Fire animal, Rainey LOVES to work or perform.  Working is her joy.  But she can get frustrated, and when she does, she lets me know by barking, but she is relatively harmless.  Rainey must be the center of the party.  If another dog is getting attention, she will literally push them out of the way.  She is a difficult dog not to love!  Wood is the Mother of Fire, and Fire is the Child of Wood, when discussing the Five Element Theory (it goes in a circle – Wood – Fire – Earth – Metal – Water – back to Wood).  Wood organs are the Liver and Gall Bladder.  In TCVM, the Liver nourishes tendons and ligaments and maintains smooth flow of Qi.  When the Fire element is weak, whether from illness or overwork, it drains from its Mother, and when left unchecked, the Mother (Liver) can become Deficient.  We can see drying of body fluids (Blood), and in the case of tendons or ligaments, they may become dry and brittle, resulting in tears or fraying.  This can be seen in overworked sport dogs.  The majority of sport dogs are Fire or Wood constitutions.  Aside from mental issues (whether overarousal, anxiety, or irritability), we see a lot of tendon and ligament injuries in these dogs.  Yes, it is the nature of the game, but WHY a PARTICULAR dog over another?  What was different about Dog A from Dog B – same breed, same attitude, same training, but different diet, different body work, different supplements, different feedback loop on the Five Element Cycle.  TCVM can explain it.  A balanced dog, one who receives the proper nutrition, supplements, herbals, etc will be less likely to suffer an injury.  However, if the injury was a true accident, TCVM can help bring this acute Excess back into balance.  This may raise a question – then why did Rainey, the dog of a TCVM veterinarian, develop a life-threatening uterine infection?  Were you not taking the precautions to keep her as balanced as possible to prevent such a thing?  The answer is yes and no.  During pregnancy you want to preserve Blood, you do not want to move Blood.  As you can imagine moving Blood would sound a lot like a miscarriage.  Therefore, a lot of things need to be stopped during pregnancy that would otherwise prevent bad things from happening.  And sometimes, no matter how hard you try, fate, and sometimes genetics, have other plans.  The best you can do is the best you can do in the moment.  

​In TCVM, there are a number of cycles that can play out and one thing can undoubtedly be related to another.  Without going further into depth on this topic, I will say if you’d like to know more, I’d be happy to discuss.  I would guess at this point you’re wanting me to get on with things, if you’ve stuck around this long.  I promise, in another week or two we will be getting to the ‘sexy’ stuff.  But, as always, to understand the sexy stuff, you must first understand the foundations.  There are topics I desperately want to share with you.  I would like to expand on Rainey’s diet and why I made the choices I made for her.  I would like to discuss my findings for her pulse and tongue the night she came home and the following days, and how these guided me to adjust her herbals and diet.  And I would like to discuss the herbals she was on in the beginning and the herbals she is on currently, and what these do.  However, this post is currently over 2,000 words and I fear I have lost some of ​you. 

Rainey receiving laser therapy

Do not worry – from a rehab standpoint you are still not missing a thing.  Rainey is still on restriction from ​running, jumping, playing, and stairs.  She remains in her kennel when we are gone.  Her sutures were removed at day 11 post-op.  She continues to receive laser therapy for cellular healing and regeneration every 3 days, but the use of the Assisi Loop to stimulate cellular healing as been discontinued.  I fear I do not have enough space throughout this series to dive further into those modalities, but I also know some weeks will run short, and we may revisit them then.  For now, I will let you go with the promise that next week we will discuss how nutrition plays a roll in recovery, how herbals can stimulate healing and recovery, what role acupuncture and Tui-Na play, and how on week 3 post-abdominal surgery we will begin to return to function and what signs you should look for that your dog is not ready!

Take care and may the Qi (now that you know what that is) flow freely for you!
Dr. Shantel Julius, DVM, CCRP, CVA, fCoAC, CVSMT, CVFT, CVTP, CVCH, CTCVMP
 
References:
Xie, H., Preast, V.  Traditional Chinese Veterinary Medicine Fundamental Principles.  Chi Institute Press.  Reddick, FL.  2016.