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Evidence-Based Chinese Herbal Therapy for Equines

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The use of traditional Chinese therapies such as acupuncture
and herbs has long been documented in veterinary medicine.
Acupuncture for the treatment and prevention of disease in
animals is believed to have been fi rst described before 600
BC in Bo Le Zhen Jing (Bo Le’s Canon of Veterinary Acupuncture).1
The development of Chinese herbal therapies, meanwhile,
followed along with the development of veterinary medicine
– there was a particular focus on equine medicine, since the
Emperor’s horses were the foundation for his army’s strength
in battle.2

The fi rst comprehensive equine textbook, Yuan Heng Liao Ma
Ji (Yuan-Heng’s Therapeutic Treatise of Horses), was created in
1600 AD. It spread widely throughout China and provided
recommendations for treating various conditions and common
ailments in horses.1

Since the creation of these therapies, herbs and herbal formulas
have continued to be utilized throughout China as well as
in other countries around the world. Despite the anecdotal
evidence supporting these therapies, the literature describing
their benefi ts is limited. However, some case reports and clinical
trials are available, and may begin to provide a foundation for
evaluating the use of these therapies in Western practice.

TRIALS AND REPORTS
Many equine conditions have been treated with Chinese herbal
therapy.

• Lameness, one of the most common maladies in horses, is
well documented as responding to acupuncture,3,4 and it may
also benefi t from the addition of herbal therapy. A case report
describing the response of a ten-year-old thoroughbred
gelding to the modifi ed herbal formula Tian Wang Bu Xin
Dan, cites the resolution of pelvic limb shifting leg lameness
of four weeks duration, and idiopathic head shaking of one
week duration, after two months of treatment.

• Tendonitis, or interosseous muscle desmopathy, is a common
injury in performance horses and may play a role in other
injuries. The herbal formulas Chai Hu Shu Gan and Bu Gan
Qiang Jin San have been described to not only treat these
injuries, but to prevent them from occurring in predisposed
animals.5

• The use of Chinese herbal formulas for treating various
respiratory diseases in horses is well described. Multiple case
studies have suggested success in treating acute and chronic
equine respiratory conditions with herbal formulations such
as modifi ed Bai He Gu Jin Tang, Ge Jie San, and Si Jun Zi Tang.6

A pilot study involved six horses with recurrent airway
obstruction treated with a proprietary herbal blend; they
were found to have signifi cantly decreased respiratory
rates compared to the untreated horses.7

The phytochemical compounds of 23 herbs found in
commonly used herbal formulas for respiratory disease
were evaluated and reviewed for their biological effects
– including specifi c antimicrobial, antioxidant, antiinfl
ammatory, antihistamine, or antitussive properties –
when used alone or in combination. The results supported
the use of these herbal drugs for the treatment of recurrent
equine airway obstruction and summer pasture-associated
obstructive pulmonary disease.8

• Four reports highlight the promising role of Xin Yi San
for treating chronic sinusitis in horses.9-12 As well, in a
clinical trial in which Zhi Sou San was used to treat chronic
coughing in 50 horses, clinical signs resolved in 90% of the
animals.13 A similar response rate was reported when Wei
Jing Tang was used to treat pneumonia. In this study, 19 of
23 patients (14 horses) responded to six days of high-dose
administration of this herbal formulation, although the
primary causative agents were not identifi ed.14

• The use of New Xiang Ru San has been described for the
treatment of equine anhidrosis, or non-sweating syndrome,
common to horses living in southern states.15 A retrospective
analysis of 32 horses revealed that 18 patients treated with
acupuncture and Chinese herbal medicine had signifi cantlyreduced
clinical signs associated with anhidrosis, compared to
horses that were only treated symptomatically. Although
further controlled, prospective studies are
necessary to confi rm these fi ndings,
this integrative approach to
equine anhidrosis is often
pursued in practice, since
no specifi c conventional
therapy exists for the
treatment of this
condition.

• Fibrous osteodystrophy or “rubber jaw” can result in diffi cult
mastication, emaciation, lethargy and pain. A prospective,
blinded, controlled clinical trial was performed to evaluate
the 60-day outcomes of 146 horses with confi rmed fi brous
osteodystrophy who were treated with Chinese herbal
medicine. The recovery rates for horses treated with
appropriate herbal therapies were signifi cantly higher
than those in horses from the control group. Treatment
responses were also greater in horses treated with Chinese
herbal therapy when compared to controls (97.03% versus
83.3%), citing resolution of clinical signs and reversal of
bone loss.16

Chinese herbal medicine is becoming increasingly popular
and requested both by Western-trained equine veterinarians
as well as the clients they serve, thanks to an interest in more
natural-based therapies with minimal side effects, and the
cost of conventional treatment. In contrast to acupuncture
and Tui-na (massage) techniques, which make up the other
sectors of Traditional Chinese Veterinary Medicine, herbal
therapy can be harmful if given in the wrong dosage or
duration; if contaminated products are administered; or if the
incorrect formulas are prescribed to a patient. Consultation
with or referral to a veterinarian formally trained in traditional
Chinese herbal therapies is recommended to help you provide
your patients with the most benefi cial and appropriate herbal
treatment options available.

Yin Chen Hu Gan San and hepatitis
Nineteen Chinese Mongolian working horses
with hepatitis were compared for their response
to standard supportive care or treatment with
Yin Chen Hu Gan San.20 Other conditions such
as colic,6 seizures,17 behavioral disorders,18
infertility19 and liver disease have been described
in additional reports.

After five consecutive days of treatment, the
icterus in the horses of both groups had resolved
and liver test parameters returned to the normal
range. Horses in the conventional treatment group
experienced residual weakness, reduced appetites
and incomplete digestion as compared to those in
the Yin Chen Hu Gan San group. Although liver test
parameters returned to the normal range in both
groups, the mean values were significantly lower
(P< 0.01) in the Yin Chen Hu Gan San group.

It was concluded from this study that Yin Chen
Hu Gan San is an effective treatment for acute
non-infectious hepatitis, and may be superior to
the standard treatment of glucurolactone, glucose
and vitamins.

Case Report – Mare with melanoma
Chinese herbal formulas are also used for
the treatment of neoplasia. An amelanotic
melanoma of the mandible in a seven-yearold
Arabian mare was treated with modifi ed
formulas Nei Xiao Luo Li San, Nei Xiao Wan
and Si Jun Zi Tang.21 The mass was reported
to completely resolve within four months
of treatment, despite an originally poor
prognosis given the rapid progression of
the tumor and its location above the parotid
gland, making the mass surgically unresectable
at the time of diagnosis.

1Xie H, Preast V. Xie’s Veterinary Acupuncture. Blackwell Publishing, 2007, 33-34.
2Xie H, Preast V. Traditional Chinese Veterinary Medicine Vol 1, Reddick FL, Jing Tang, 2002.
3 Schoen A. “Equine acupuncture: incorporation into lameness diagnosis and treatment”. Proceedings
of American Association of Equine Practitioners, 2000, 46:80-83. (http://www.ivis.org/proceedings/
aaep/2000/80.pdf).
4 Alfaro A. “Correlation of Acupuncture Point Sensitivity and Lesion Location in 259 Horses”. AJTCVM, 2014,
9(1):83-87.
5Pasteur C. “Treatment of Tendonitis in Equines”. AJTCVM, 2007, 2(1):71-74.
6 Shmalberg J. “Acupuncture and Chinese Herbal Medicine for Treating Horses”. Vetlearn.com, Compendium:
Continuing Education for Veterinarians, 2011.
7 Pearson W, Charch A, Brewer D, Clarke AF. “Pilot study investigating the ability of an herbal composite to
alleviate clinical signs of respiratory dysfunction in horses with chronic airway obstruction”. Can J Vet Res, 2007,
71(2):145-151.
8 Tangjitjaroen W. “The Therapeutic Actions of Traditional Chinese Herbal Medicine Used for the Treatment of
Equine Respiratory Diseases”. AJTCVM, 2009, 4(1):7-21.
9Tao H. “Integrative therapy for the treatment of chronic sinusitis [Chinese]”. J Tradit Chin Vet Med, 2007, 26(4):74.
10 Zhang Y, Shi Z, Li D. “Bi Yuan Tang cures equine chronic sinusitis [Chinese]”. J Tradit Chin Vet Med, 2002, 21(4):38.
11 Sun D. “How to diff erentiate equine laryngitis from sinusitis and their therapies [Chinese]”. J Tradit Chin Vet
Med, 1998, 17(4):23-24.
12 Zhang X. “The clinical research on Chinese herbs curing sinusitis [Chinese]”. J Integrative Med Technol, 2004,
11(10):2033-2035.
13 Li D, Zhao Y. “Eff ect of Zhi Sou San on chronic cough in large animals [Chinese]”. J Tradit Chin Vet Med, 2007, 21(1):22.
14 Li J. “Wei Jing Tang modifi cation for the treatment of pneumonia [Chinese]”. J Tradit Chin Vet Med 2007,
21(4):67.
15 Atria S. “Acupuncture and Chinese Herbal Medicine Treatment of Eighteen Florida Horses with Anhidrosis”.
AJTCVM, 2010, 5(2):25-35.
16 Fu BD. “Pattern Identifi cation and Chinese Herbal Medicine for Fibrous Osteodystrophy in 146 Horses”. AJTCVM,
2013, 8(2):41-48.
17 Harman J. “Long-Term Follow-Up of Seizures in Three Horses Treated with Chinese Herbal Therapy”. AJTCVM,
2008, 3(1):47-52.
18 Harris L. “Treatment of a Mare with Behavioral Problems with Chinese Herbal Medicine”. AJTCVM, 2007,
2(1):63-67.
19 Zhong X. “Traditional Chinese Veterinary Medicine Diagnosis and Treatment of Acquired Infertility in Female
Horses and Dogs”. AJTCVM, 2014, 9(1):95-100.
20 Wei X. “Therapeutic Eff ects of Yin Chen Hu Gan San (Capillaris Hepatoprotective Powder) for Acute
Parenchymatous Hepatitis of Horses”. AJTCVM, 2012, 5(1):21-28.
21 Ortiz-Umpierre C. “Treatment of an Amelanotic Melanoma in a Horse with Acupuncture and Chinese Herbal
Therapy”. AJTCVM, 2006, 1(1):36-38.