TCVM for Hit by Car Accident in a Geriatric Cat
Princesse Theresa, DVM, CVA 

History:

A 11 year old castrated male domestic short hair cat was involved in a hit by car accident and subsequently developed mild swelling of the left hind limb from the thigh distally. He was difficult to stand up and walked normally and he was in pain. His front limb are found normal but his lower back to hind limb were stick to the ground. He tried to walk as he was very stubborn, by pulled his body glides to front with his front limb. He was fed kibbles and 1 can of 85gr wet food daily. His appetite was good, no urine and defecating since the accident (2 days).

Western Examination:

The patient was unable to stand with his pelvic limb, paraparesis, and no decreased muscle tone found. The hair on the caudodorsal aspect of the back was ripped off due to the accident. The hock joint of the left pelvic limb found injured. So, he was limping when he tried to walk. There was a mild open wound at bottom part of left limb, and there was hematoma signs on the belly flap or primordial pouch. Radiographs of the spine and hind limb were made at the time. There was no evidence of bone abnormalities found.

TCVM Examination:

The patient is an alpha cat in the family. He is very aggresive and very strict about his territory. He is a dominant cat (Wood constitution). He has an athletic body, and is fearless. TCVM examination found he has wiry pulse on left limb, and weak pulse on the right. His tongue was pale, and the tip of the ears were cold and the back also felt cold. He like to sleep on the couch or chair. Sensitive points include BL-26, Large Intestine Shu point (BL-25), Bladder Shu point (BL-28), and local sensitivity the permission point Bai-Hui.

TCVM Diagnosis and Treatments

The problem in this patient was a Kidney Yang deficiency with Blood and Qi stagnation at lumbar area. The blockage of Qi can occur from a trauma at a particular location.⁵ The weak pulses and pale tongue color indicated that Qi and Blood stagnation was the reason of the lumbar pain. The wiry pulse on left limb means Qi stagnation. Pale tongue means either Qi deficiency or blood deficiency and also Kidney Yang deficiency. Cold ears and back means excess cold or Yang deficiency. He was showing signs of deficiency like prefer to sunbathed, and took nap on the carpet or couch. He is in the geriatric age which would make Kidney Yang Deficiency problem more likely especially after a major stress event. This case is exterior pattern, because the sudden onset of symptoms and came from external attack of exogenous factor.

Plan strategy including Tonify Kidney Yang, move Blood and disperse Qi. Eight confluent channel/ special channel used are Dai-Mai GB-41 for lumbar area. Pattern points used are BL-26 for Kidney Yang/ Qi deficiency, BL-40 master points back and hips, BL-54 master points hind limb, ST-36 major point for tonifying Qi and Blood point in pelvic limb and KID-3 to Tonify Kidney and also a Yuan source point for Kidney. Local points applied is Bai-hui, local point for lumbar pain.

Combination of dry needles, Electro acupuncture of 20 Hz for 15 minutes was performed. Treatments are 5 sessions in total, once a week. TCVM herbal formulation was prescribed Tendon Ligamen Formula, and Bu Yang Huan Wu that useful for tonify Qi and strengthen the rear weakness⁴, once daily for a month.

Clinical Outcome:

The local points were the most important points in this case. They were to stimulate nerves and to support blood circulation. It takes one to two acupuncture treatments to see an improvement. The patient showed good response to TCVM treatments. On the fourth month after last session, He was back to his nature trait. Aggresive, chase away cats whose come to his territory, and fight. He finally is happy and get his quality life back.

Reference:

1. Cahyono, T. Comparison of Conventional Medical Treatment to Electro-Acupuncture Combined with Chinese Herbal Medicine for the Treatment of Hind Limb Paresis and Paralysis in Dogs and Cats: A Retrospective Study. American Journal Traditional Chinese Veterinary Medicine. 2020 (15): 1
2. Negrin A, Schatzberg S, Platt SR. The Paralyzed Cat: Neuroanatomic Diagnosis and Spesific Spinal Cord Published 2017 Feb 3. doi:10.1016/j.jfms.2009.03.004.
3. Khan C, Line S. The Merck Manual for Pet Health Home Edition. 2007. Merck and Co Inc: Westford, MA.
4. Cahyono T. The use of Chinese herbal medicine and acupuncture for neurological disease unresponsive to Western medications in 94 small animal cases. Am J Trad Chin Vet Med 2015; 10(2):43-61
5. Xie H, Preast V. Traditional Chinese Veterinary Medicine: Fundamental principles.