Chinese Food Therapy was used to treat Spleen Qi Deficiency in a Labrador Retriever

By Anneleen Gielen DVM

Abstract

Chinese Food Therapy was used alongside acupuncture to succesfully treat and re-balance a Labrador Retriever suffering from Spleen Qi Deficiency with Damp excess and episodes of Damp-Heat accumulation.

History

In April 2020 Filo (Fig.1) was presented to me for acupuncture treatment for the first time. Filo is a 9-year-old male neutered Labrador Retriever of 41 kg. He has Earth constitution and is in general a happy, loving dog that enjoys going for walks and playing with the other dog in the family (Raffi, a 12-year-old male neutered Labrador Retriever). Over the last few months, the owner noticed that he is sleeping more and becoming less active. Sometimes he has a little trouble getting up from his pillow in the morning or after sleeping/resting but it seems to improve with movement. The regular veterinarian assigned these symptoms to degenerative joint disease and prescribed Metacam to be given as needed. Filo has a tendency of being reactive towards other dogs and can be very territorial when he is guarding the outside gate, chasing and barking at anyone passing by. There is a strong bond between Filo and his owner and he is very sensitive to her emotions/state of mind, picking up on every small change. 
Appetite is good, no changes are seen in drinking behaviour. Urination and defecation are normal. Stools are more loose and slimy most of the time and diarrhea is not uncommon. Vomiting is rarely seen. Filo is fed dry kibble and occasionally gets a dog treat. The owner measures his portion every time because she is trying to get him to lose some weight but despite this, he is not making any progress. Blood tests were done at the vet clinic several months ago and had revealed borderline hypothyroidism so Filo was prescribed Forthyron. Regular check-ups showed the T4 levels to be normal. Despite the medication, the owner noticed no difference in behaviour/energy level or weight loss.
Filo regularly has ear infections (itching, redness with greasy and smelly discharge) but local treatment using anti-bacterial/anti-fungal drops resolves this every time. His anal glands also regularly become full, itchy and uncomfortable causing Filo to obsessively lick there. Expressing them relieves the problem. In spring/summertime he gets itchy red skin (paws, groin area, inside of back legs). The owner then gives him some herbal treatment to relieve the symptoms but sometimes prednisolone needs to be added to this treatment. Green-yellow discharge of the preputium is also noticed regularly.

Clinical signs/ Diagnosis – TCM (Eastern)

To be able to make a TCM diagnosis on Filo I combined the information provided by the owner with the physical examination.
Filo’s coat is dull and very greasy and the hairs on the dorsal back/neck region are hard and rough to the touch. His tongue is short, swollen and moist with a normal to pale colour (Fig.2). Palpation revealed sensitivity at the Association (Back Shu) points of Liver (BL 18) and Spleen (BL 20) and at BL 47, the Liver point on the emotional Bladder meridian. The Alarm (Mu) points of Spleen (LR 13) and Liver (LR 14) were also reactive. No real preference for warm or cold places is noticed by the owner.

My TCM diagnosis was Spleen Qi Deficiency with Liver Qi Stagnation:

  • Sleeping more, no preference for warm or cold, stiffness/mobility issues getting better with movement → Qi Deficiency
  • Tongue diagnosis1: normal to pale colour (Qi Deficiency), short and swollen (excess Damp due to Spleen disharmony/Deficiency affecting its function of tranportation and transformation), moist (Spleen Deficiency affecting T&T function causing fluids to accumulate)
  • Greasy coat → due to Damp (Spleen Deficiency)
  • Dull coat, rough hairs → Qi Deficiency causing failure to transport fluids and Blood
  • Obesity → Damp Excess (Spleen Qi Deficiency affecting it’s T&T function)2
  • Gastrointestinal problems, loose stools, diarrhea → Spleen Qi Deficiency
  • Reactive behaviour → sign of Liver Qi Stagnation
  • Otitis/anal gland problems/discharge/skin allergies → Damp-Heat accumulation2,3
  • Constitution = Earth element → making Spleen more vulnerable
  • Lifetime of eating dry kibble → depletes Spleen and causes Heat
  • Reactivity of Liver and Spleen Association and Alarm points

Because Spleen is Deficient there will be a failure to nourish Lung (Earth is Mother of Metal element) leading to Wei Qi Deficiency (affecting the dog’s immune system) and causing the dog to be more vulnerable to invasion of External Pathogen Factors like Wind-Heat3. Liver will also have a tendency to invade the weakened Spleen (Liver Qi Stagnation) contributing to the gastrointestinal problems in times of stress/emotional imbalance.

Spleen Qi Deficiency leads to the accumulation of Damp and Phlegm. When Heat is added to this there will be Damp-Heat accumulation which causes the skin problems/otitis and anal gland issues3.
Heat can be caused by3:

  • External origin: invasion of EPF (Wind-Heat in Spring/Summer time) which will be easier if Wei Qi is affected
  • Internal origin: unbalanced emotions causing Liver Qi Stagnation (Stagnation produces Heat)
  • Poor diet (dry kibble), chemical toxicity (excess medication, vaccinations, flea products…)

Hypothyroidism in TCM is defined as a malfunctioning of the thyroid gland linked to Liver Qi Stagnation and Spleen Qi/Yang Deficiency4.

Treatment with TCM medicine

Treatment principle:

  • tonify Spleen and harmonize Liver
  • build and move Qi and Blood
  • resolve Stagnation
  • drain Damp

Treatment sessions

In April 2020 I first used acupuncture to treat Filo with good results. He was a lot less reactive, was getting up without any problem and was more active in general. He no longer had gastrointestinal problems or diarrhea and his coat had improved drastically.

In August 2020 he returned with more severe symptoms. Raffi, the family’s other dog, was euthanised a few days before and this was a very sad and upsetting time for Filo and his owners. Filo was depressed and lost most of his appetite. After his meal he would get uncomfortable and his belly was visibly distended and hard. He did not want to be touched in that region. Occasionaly he would vomit and the diarrhea had returned as well. He only wanted to lay down in cool places. There was a lot of green/yellow discharge of the preputium and the skin on his head and around the ears was red, swollen and itchy with a few inflamed nodules. This time the Damp-Heat accumulation was probably a result of the warm weather combined with a Liver Qi Stagnation due to the heavy emotions (of both Filo and his owner, who was very upset). The gastrointestinal symptoms and hypochondric sensitivity also were a sign of this severe Liver Qi Stagnation.
After 2 acupuncture sessions, the symptoms were resolved again.

In November 2020 Filo had another flare-up of symptoms. This time it began a few days after he received his annual vaccinations and flea control products (Heat due to chemical toxicity). The owner had recently switched to another veterinarian and they had reviewed Filo’s medical history. It was decided that Filo didn’t really need the hypothyroid medication so this was stopped.
Again, Filo’s symptoms were quickly resolved using acupuncture.

In February 2021 I decided to add Food Therapy to Filo’s treatment strategy because I had just finished the BEVAS Chinese Food Therapy course and was confident this could help keeping his symptoms under control and prevent flare-ups as much as possible.

Food Therapy Treatment

Filo has been eating dry kibble his entire life. The owner switches between different brands but she generally chooses kibble based on chicken or lamb. She carefully measures out the amount of kibble he can eat based on the recommandations written on the bag, and even reduces this quantity a little bit more, hoping to achieve some weight loss. Filo is now 41 kg and overweight. Occasionally he gets a dog treat (variety of snacks/protein sources, although chicken is a favourite again). He gets 2 meals/day.

Quantity5

So how much food does Filo need in grams/day?
Dogs need 2 – 3% of their (ideal) body weight, depending on activity level, age, lifestyle and breed. Larger breeds tend to need a lower percentage because of their slower metabolism. Overweight dogs generally need more 1 – 1,5%. Start off with a certain percentage and assess every 2 to 4 weeks (Is the dog losing weight? Is he still very hungry after his meal?…).

For Filo I chose to start with 1,5 % of his estimated ideal body weight of 36 kg, meaning he could be fed 540 grams of food every day (270 grams per meal 2x/day).

Ratio5

  • 60 % protein from animal sources: 40 % muscle meat (make sure 90 % is lean meat) – 10 % raw bone – 5 % liver – 5 % other organ meat (secretory organs or others)
  • 10 % starches/carbohydrates from grains/pulses or root vegetables
  • 30 % leafy or surface vegetables and fruits

When using herbs/spices it is best to start with just a small pinch added to the meal and increase the amount gradually if the animal likes the taste (up to ½ teaspoon per +/- 450 gram or 2 cups of food for each herb/spice, combining no more than 3 herbs/spices together).

Calculating this ratio for Filo:

  • Protein: 216 grams of muscle meat – 54 grams of raw bone – 27 grams of liver – 27 grams of organ meat
  • 54 grams of carbohydrates
  • 162 grams of vegetables and fruits

Instead of measuring everything in grams, we can also use “standard baking cups”.
For Filo this would mean he gets around 1,5 cups of cooked food twice daily.
When preparing the food and calculating the ratio of ingredients this measuring system is easy to use. One cup = 10 % so for Filo this would mean:

  • 4 cups of muscle meat – 1 cup of raw bone – 0,5 cup of liver – 0,5 cup of organ meat
  • 1 cup of carbohydrates
  • 3 cups of vegetables/fruits

Of course this will be more than 1 day worth of food (about 3 days) but this can be stored in the fridge.

Ingredients

In TCM the Spleen is the central organ of digestion and responsible for producing Qi (post-natal energy). Therefore we have to make sure that the diet we feed our pets is strenghtening the Spleen. Only then will nutrients be optimally extracted from the food6.

In the West we are taught to look at quantities (proteins, carbohydrates, fats, vitamins, …) to balance a diet. In TCM the approach to nutrition relies more on the physiological activity of the entire food, focusing on the qualities of food based upon their energetic properties which describe the actions the food has on the body. Ingredients are chosen based on these inherent properties which can address the characteristics of the inbalance presented in the animal. There are different categories of food properties6:

  • temperature: cold, cooling, neutral, warming and hot
  • flavours, taste of the food: pungent (opens and closes the pores), sweet (tonifying), sour (prevents fluid loss), bitter (transforms Damp), salty (moistens, softens, detoxifies) and bland (edema)
  • direction: food can induce an upward or downward energy, can disperse or concentrate and store energy
  • channel influence: food is said to enter particular meridian pathways which guides the food towards a specific channel or organ
  • colour: describes the organ affinity → red (Heart), yellow/orange/brown (Spleen/Stomach), white (Lung/Large Intestine), black (Kidney/Bladder) and green (Liver/Gall Bladder)
  • specific actions of food7: tonifying (nourish Qi, Blood, Yin, Yang or Jing) or reducing (reduce Cold or Heat, move Qi or Blood, drain Damp)

Diets can be matched by constitution of the animal. When facing a Deficiency period we can tonify the element with element foods and add in some food related to the Mother element. For Filo this means we tonify Earth (Spleen) and add in some Fire foods (Heart, red – bitter foods for example). Limit damp, raw and cold foods, dairy (creates Dampness) and too much starchy foods5,8.

In accordance with our previously described TCM diagnosis and treatment principle, we can now begin to compose a balanced diet for Filo7,8,9,10.

  • Tonify Spleen: foods that have affinity with Spleen/Stomach meridian, sweet flavour (tonifying and nourishing), yellow/orange/brown colour, neutral to warming
  • Build and move Qi: neutral to warming foods, sweet flavour
  • Drain Damp: bitter flavour, specific action of draining Damp
  • Clear Heat: cooling foods. In acute situations: cold and pungent food

Rotation of ingredients is the key for balance over time. Not every meal will be completely balanced so it is important to rotate source ingredients every week. Use 1 source of protein, 1 source of carbohydrates and several sources of vegetables at a time each week.

Muscle meat7,8,9,10:

→ (grass fed) beef, duck, mackerel, sardines, turkey, tuna, white fish, rabbit

Raw bone11,12:

→ provides protein, fat, water, vitamins, minerals, fatty acids and has a proper calcium-phosphorus ratio. Chewing on raw bone is the perfect toothbrush for dogs.

→ never give a heated or cooked bone, only raw bone can be safely chewed. Provide bones that are a manageable prey size for the dog. Offer them after one of the 2 meals.

→ chicken or turkey necks/wings/thighs, lamb neck, beef tail, goat rib

Organ meat & liver:

→ 5 % liver and 5 % organ meat variety (kidney, spleen, pancreas, thymus, heart, gizzard, tripe)

Carbohydrates/starches7,8,9,10:

→ barley, brown rice, (sweet) potato, pumpkin, lentils, corn, chickpeas, adzuki beans, kidney beans, cannellini beans, oats, quinoa

Vegetables and fruits7,8,9,10:

→ mushrooms, red cabbage, beetroot, carrots, broccoli, zucchini, cauliflower, radish, celery, mustard leaves/greens, turnip, bell pepper, tomato
→ apple, blueberries, pear, pineapple, apricot, figs, dates, raspberry, kiwi, grapefruit

Herbs/spices7,8,9,10:

→ parsley, garlic, ginger, turmeric, thyme, black pepper, oregano, rosemary, basil, fennel

Preparation11

The process of digestion involves breaking food down into a warm soup in the Stomach. Soups and stews are therefore the most Spleen supportive meals. The weaker the Spleen, the more these cooking methods will be useful. It means less work for the digestive system and nutrients will be more easily absorbed. Raw food is cold and reducing which can be well-tolerated in hot and excess dogs or young dogs with a strong Spleen energy. However, if the TCM examination/diagnosis reveals a weakened Spleen, raw and cold food should be avoided. For sufficient intake of anti-oxidants and vitamins however, it is still recommended to give a portion of the vegetables/fruits raw (about 1/3 of the portion).

Put all the ingredients (except the raw bone and a portion of the vegetables) in a large steel pot or slow cooker. Measure these in grams or cups, but make sure the ratio is correct. Add the spices and then cover everything in filtered water or broth (2 flat fingers above the ingredients). Bring it to boil and then immediately reduce heat, cover it with a lid and let it simmer for 1 to 2 hours. Stir it every 15 minutes. Make sure the starches are completely cooked through. If necessary you can add a little more water.
Certain carbohydrates like rice, oats or beans will double in volume once cooked so reduce the amount by half when added to the mixture in the beginning.

It is possible to cook larger amounts each time so less cooking is needed. Just make sure the ratio is respected at all time.

Vitamin/mineral supplement5

Healthy dogs that are fed a wide variety of fresh foods in appropriate amounts might have no need of supplements, though they might still benefit from them. The less variety is given, the more necessary supplements are. Cooked diets are more likely to need supplements because the cooking process destroys or reduces some nutrients, vitamins and minerals.

Recipe for homemade vitamin/mineral blend (to be given once a day, mixed in with the food):

  • 4 eggs each week, spread over 4 meals (can be given raw)
  • 170 gram of sardines or salmon a week, spread over 4 meals
  • 2 teaspoons flax/linseed oil when using chicken or turkey – 2 teaspoons hemp oil if beef is used – 2 teaspoons of rapeseed oil if fish or other meat is used
  • 1 teaspoon of super green rotation (alfalfa, kelp, spirulina, chlorella, wheatgrass, nori seaweed,…)
  • 1 teaspoon of organic apple cider vinegar mixed with 1 teaspoon raw honey
  • 2 teaspoons fresh crushed garlic every other day
  • 2 teaspoons of tahini or ground sesame seeds (keep them in an airthight container in the fridge for max 1 week after grinding)
  • 2 teaspoons ground watermelon or pumpkin seeds
  • 4 teaspoons of a mix of ground flax seeds/chia seeds/oat bran/coconut crunch (stored in a jar in the fridge for max 1 week)
  • 3 to 4 teaspoons of nutritional yeast

Discussion:

We are in charge of our pet’s health and vitality and providing them with a healthy and balanced diet is a very powerful tool to restore and maintain balance and make them thrive. Fresh and wholesome food is safe, non-toxic, supports the body’s own immunity and can cure disease without destroying.
Dry kibble is highly processed and cooked at high temperatures which leads to the formation of toxic by-products. Poor quality ingredients, fillers and chemicals are used and most brands have a high carbohydrate/sugar content that allows the pellets to be formed/shaped13,14,15. Therefore this is not recommended if health and balance is the goal.

Longterm feeding of kibble will weaken the Spleen and generate internal Heat, depleting all Yin of the body. In Filo’s case it was obvious something needed to be changed about his diet in order for him to become and remain balanced and healthy. He was suffering from Spleen Qi Deficiency with Damp excess and had frequent episodes of Damp-Heat accumulation. He was fed kibble based on chicken or lamb most of the time and these 2 proteins are very warming in itself too and should really be avoided for Filo when dealing with skin or ear problems and in summertime7. We changed his diet to fresh, wholesome food and chose ingredients that support and tonify his constitution (Earth-Spleen). To help with the Damp excess bitter and Damp-draining foods were added to the rotation. Switching over from dry kibble to fresh food will already take away a lot of Heat from his body, but to further support this we can use cooling and pungent ingredients to add in his meals. In spring/summertime (and at times when he is showing more Heat signs) the rotation of ingredients can include more of these cooling ingredients in order to keep the balance right.

Filo has been enjoying his freshly cooked diet for about 6 weeks now and he has already lost 3 kg, without going hungry. The owner reported that he is looking much happier in general, is more active and energetic and is getting up and moving around with ease. His coat is soft and shiny, his stools are normal and the discharge of the preputium is gone. No distended abdomen after eating and no redness/itchy skin or otitis yet. There have been a few times when Filo did get some chicken and after this, the owner could see he started getting some redness in his ears and groin area and was looking for cooler places to lay down in the evening. The owner is amazed how much difference this diet has already made and says she has not seen Filo this alive in a very long time…

I will continue to monitor Filo to adjust his diet and amount of food when necessary but I am already very happy about his progress and the results. In the future I will try to incorporate Food Therapy more and more as a vital component of my TCM treatment.

References:

  1. Morgan, J. and Grant, H. Yin & Yang Nutrition for Dogs. Maximizing Health with Whole Foods, Not Drugs. USA: Thirty Six Paws Press, 2017. 56-59
  2. Decaestecker, J. Chinese Food Therapy 7th Course, BEVAS Course Notes (2020)
  3. Decaestecker, J. Chinese Food Therapy 8th Course, BEVAS Course Notes (2020)
  4. Decaestecker, J. Chinese Food Therapy 10th Course, BEVAS Course Notes (2020)
  5. Decaestecker, J. Chinese Food Therapy 5th Course, BEVAS Course Notes (2020)
  6. Decaestecker, J. Chinese Food Therapy 2nd Course, BEVAS Course Notes (2020)
  7. Decaestecker, J. Chinese Food Therapy 3rd Course, BEVAS Course Notes (2020)
  8. Morgan, J. and Grant, H. Yin & Yang Nutrition for Dogs. Maximizing Health with Whole Foods, Not Drugs. USA: Thirty Six Paws Press, 2017. 120-139
  9. Middle, C. Natural Prescription Diets for Dogs and Cats. Real food recipes to prevent and heal disease. Bibra Lake: Animal Healing, 2016. 37
  10. 92-97
  1. 51-54
  2. Middle, C. Real food for dogs and cats. A practical guide to feeding your pet a balanced, natural diet. Fremantle: Fremantle Press, 2008. 31-32
  3. Morgan, J. and Grant, H. Yin & Yang Nutrition for Dogs. Maximizing Health with Whole Foods, Not Drugs. USA: Thirty Six Paws Press, 2017. 12-15
  4. Decaestecker, J. Chinese Food Therapy 1st Course, BEVAS Course Notes (2020)

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