Acu in Practice: Kidney Disease and the TCM Triple Heater

Welcome to Acu in Practice! Kidney disease is a common health problem for veterinary patients and is frequently addressed with integrative care including acupuncture and herbal therapy. Most commonly in pets we see kidney deficiencies related to aging. However, it is important to keep in mind that there are many causes of kidney disease, including Excess Patterns that may be less common, but equally important. Triple Heater obstruction is one of the Excess Patterns that can lead to kidney disease and will eventually lead to Kidney Deficiency among other problems if left untreated. In Western terms, the renal pathology seen with TH obstruction is glomerulonephritis and/or protein losing nephropathies. These syndromes can be tied to antibody-antigen complexes that lodge themselves in the glomerulus and are the result of an infection or marked inflammatory response in the body. In TCM, the pattern will be diagnosed as TH obstruction or Damp Heat in the kidney depending on the specific history and clinical signs of the patient. Once the pattern is diagnosed, the veterinary acupuncturist will select acupoints and herbs to counteract the pattern and balance the body.



The Triple Heater (also known as the Triple Burner) is a conduit for the body – connecting the Upper, Middle and Lower Burners. This is how the organs within the different burners are able to communicate and assist each other in operating the body. The TH plays a role in immunity, the endocrine system, and water metabolism. When Damp accumulates or Phlegm is produced in the body, it can result in a TH blockage. The way that this effects the Kidney is that the TH is unable to maintain its role as “gatekeeper.” Essence or Yin is unable to enter the Kidney to be stored for later use and Yang from the Heart is unable to be sent down to the Kidney where they join to form Kidney Qi. Conversely, Kidney Yin is not able to ascend to the Upper Burner to join with Heart Yang and produce Heart Qi. Over time, a general Qi deficiency will develop.


A patient with TH obstruction renal disease will often present with fairly normal energy and Western exam. Also, keep in mind that Phlegm can be “insubstantial,” meaning that there may not be obvious or physical forms of Phlegm present. In the case of patient who have recovered from infectious diseases, the insubstantial phlegm or heat toxin may still be present and circulating in the body while they are living a fairly normal lifestyle. However, there will be clues and changes in the TCM exam and on labwork. For example:


Serology/Urinalyisis:

Azotemia – moderate to marked, NOT a gradual increase as seen with renal insufficiency

Moderately elevated ALP

Possible increase in Cholesterol

Elevated Urine Protein: Creatinine ratios


TCM exam:

Tongue often lavender or purple

Pulse deep and possibly wiry

**increased warmth or swelling at major TH and GB points – GB 25, BL 19, BL 22, GB 34

Oliguria

Stiffness or lameness due to obstruction in TH and/or GB channel

Progressive Hind limb weakness

Signs of rebellious Qi

Signs of Yang trapped in Upper Burner

Acu points for TH obstruction type Renal Disease:

GB 25, GB 34, BL 19, BL22, BL 23 – direct effects on TH, GB and KID

SP 6/ST 36 – move Qi and Blood to resolve obstruction/restore flow

ST 40 – resolve Phelgm

KID 3 – tonify Kidney


Herbs used for TH Blockage:

Xiao Chai Hu Tang – modified version for animals, such as Kan Herb or Natural Path. Human version is not correctly balanced for animals.


Avoid the Rehmannia Kidney formulas that are used in deficiency cases at least until Stasis or Damp is cleared.


This post is created by Nell Ostermeier, DVM, CVA and is intended for informational use, not to replace medical advice.

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