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July: Toxic Heat

Thursday, 01 July 2021 09:00

For half the world it is summertime! That means picnics, beaches, outdoor activities, and very hot weather! It is very easy to overheat in summer from Excess Heat (Summer Heat), or when Heat becomes trapped in the body and the body is unable to expel that heat. So, don’t forget your sunscreen, hat, sunglasses and some water before you walk out the door.

Animals such as dogs, have a limited capacity to sweat and pant to release heat from their body or find cool areas to lay down on. A dog overexposed to external heat, being in a hot car, can suffer from Excess Heat or Toxic Heat. External Heat invades the body’s surface and is a Yang Pathogen. Extreme Heat with Damp causes the skin pores to close which prevents an animal, such as an equine, from being able to sweat to cool off, which leads to more serious complications.

Horses can completely lose their ability to sweat in hot and humid conditions, leading to a condition called anhidrosis, the Western medical equivalent of Toxic Heat. This can be a life-threatening situation to be in and requires immediate attention. Eastern medicine offers treatment options to address Toxic Heat.

Hypothetical Case 1 

toppng.com bull dog png english bulldog dog 254x400Species: Canine
Breed: American Bulldog
Age: 3 years
Gender: M

Clinical Diagnosis (conventional): Heat Stroke

Conventional Indications:

American bulldog, male, 3 years old, called Jack, a sunny fire constitution, living just outside Atlanta, Georgia, is enjoying  a summer joy ride with his mom, Hillary, who receives a call from her pharmacy to pick up a prescription while out. She decides to quickly run into the store and leaves Jack in the car for "only a few minutes", with the windows cracked. Mom returns after 10 minutes to find her beloved Jack in utter distress: panting, drooling open mouth breathing with loud snorting noises and his nose and gums beet red. Fortunately her regular vet's office is around the corner and the medical team jumps into action as soon as Hillary pulls into the parking lot. Jack's body temperature is over 104.5 F and his heart racing. The nurses are pouring rubbing alcohol onto Jack's paws and belly, placing an IV catheter and running cool iv fluids right away, while the TCVM certified veterinarian applies acupuncture in strategic points: Midazolam is administered IV to reduce anxiety and Jack is placed on a cooling blanket with fans on him.

Jack calms down fairly quickly and the staff monitors his temperature normalizing to 101.5 within 90 minutes. Hillary is relieved to bring her baby boy back home safely and vouches to never, ever leave him alone even for minute in the car on a hot summer day - or any day!

Traditional  Indications:

Jack’s body is hot to the touch. He is hyperthermic with a body temperature of 104.5 F. His Shen is disturbed. His breathing is labored with red gums and tongue.

Tongue: Red

Pulse: Full

TCVM Diagnosis:  Summer Heat (Mild Heat Stroke)

TCVM Assessment:

  • Hyperthermia- Heat
  • Shen Disturbance-Heat/ Fire disturbing the Mind
  • Red gums-Heat
  • Red tongue- Heat
  • Full pulse- Damp and Heat

Treatment Principles:

  • Clear Heat
  • Resolve Damp
  • Release the Exterior

Acupoint Prescription:

Hemoacupuncture: Er-jian and Wei-jian

Dry needle: GV-14, LI-11, LI-4, BL-40, TH-1, LI-1

  • The acupoint prescription is aimed at clearing Heat.

Chinese Herbal Prescription:

New Xiang Ru San

  • Dose at 0.5g/ 10 lbs of body weight twice daily.

Note: There is a distinction between Summer Heat (Mild Heatstroke) and Extreme Heat (Severe Heatstroke).  With severe Heatstroke the depression is more severe including coma and muscle fasciculations with temperatures greater than 105 F. The acupoint prescription is similar.  The Chinese Herbal Medicine is Bai Hu Tang. This can be mixed with water and administered rectally at the dose of 0.5g/10 lbs of body weight.

 

Hypothetical Case 2 

Species: Equine
Breed: Dutch Warmblood
Age: 6 yearspngwing.com (1) Gender: Mare

Clinical Diagnosis (conventional): Anhydrosis

Conventional Indications:

Dutch warmblood mare, Lady of Amsterdam, 6 years old, performance dressage horse, bred and raised in Holland, exported to Taiwan last winter showing difficulties adjusting to the local climate. The trainer notices sweat only in patches on her neck initially after intense training, but eventually no sweat is observed even when working the mare hard. She becomes increasingly more exercise intolerant as the summer months approach and both heat and humidity increase in Tainan. Her appetite is decreased and her performance has decreased.  She is more irritable (wood constitution) and takes a long time to return to her resting heart rate of 32 after being exercised.

Traditional  Indications:

Progressive decrease in sweating during exertion with increased respiratory rate, heart rate, and hyperthermia. Patient is a Wood constitution. Can also include fatigue and anorexia.

Tongue: Red and dry

Pulse: Fast

Summer Heat with Heart Yin/Blood DeficiencyTCVM Diagnosis: 

TCVM Etiology and Pathology:

The Heart dominates sweat. The Heart Yin and Blood provide fluid to the sweat.  Sweat and Blood come from a common pool. The Lung controls the Wei Qi and this dominates the opening and closing of the pores and the sweat glands.

These actions are under the regulation of the TH, Heart and Lung. Summer Heat can invade the body and obstruct the flow of Qi.   This is further aggravated in the presence of Yin Deficiency or Lung Qi Deficiency.

Treatment Principles:

  • Clear Summer Heat
  • Nourish Yin
  • Regulate Wei Qi

Acupoint Prescription:

Hemoacupuncture: Er-jian, Wei-jian, Tai-yang, TH-1, LU-11, HT-9

Dry needle: KID-3, HT-7, BL-22, BL-23, LI-4, GV-14, LI-11, BL-40

  • Er-jian, Wei-jian, Tai-yang, TH-1, LU-11, HT-9 all clear Summer Heat
  • KID-3, HT-7, BL-22, BL-23 tonify Yin
  • LI-4, GV-14, LI-11, BL-40 open the pores

Chinese Herbal Prescription:

New Xiang Ru San

  • Dose at 30 grams PO BID for two weeks, then decrease to 15 grams PO BID for two months.
  • Monitor Yin and Qi

  Edited by Alex Kintz-Konegger, DVM, CVA, CVTP. Hypotherical Cases by Alex Kintz-Konegger, DVM, CVA, CVTP and Greg Todd, DVM, CVA