Approximately 6 mos ago patient had 1 episode of urine leakage while working as a therapy dog at a nursing home. She was awake and dribbled small amount of urine. Diagnosed with UTI. Treated initially with acupuncture, VSMT, antibiotics, urinary supplement, and probiotics. Problem resolved then recurred 1 month later. UTI resolved and UA NSF.
Urine leakage is always while awake. Initially she would dribble a small amount of urine or lick her vulva excessively after urinating, especially when exercising. She does have a tucked up vulva so question of urine trapping was suspected. Treated with AP and VSMT to see if maybe inflammation at the origin of the iliopsoas could contribute to incontinence? She seemed to respond at first. But urine leakage/dribbling the recurred after another month. An associated put her on Proin which helped but may her twitchy and anxious. Patient is very anxious inwardly so even though she does not leak while asleep I tried San Piao Xiao San to see if that would help esp if there was an anxiety component. Likely everything else it helped only 1 month.
Now she leaks urine when pressure is applied to the bladder, when she seems relaxed awake, and when nervous/excited. Owner is in the middle of moving and says leaking seems worse. Only leaks small amounts. Bladder is never very large on palpation. Recheck UA on Saturday was WNL (SG 1.045, pH 5.5, quiet sediment), no protein. At the last acupuncture she dribbled urine afterward when owner was waiting to check out - she was very relaxed up front. Owner emailed me and is tapering the herb because she feels it is not helping. I did add in valerian root (Nutricalm) to see if controlling anxiety more helps - not sure how good of a test it is if she is stopping the herb.
TCVM Exam
[X] Shen: calm, quiet, but seems almost inwardly anxious
[X] Personality: Earth
[X] Heat/Cool: neutral
[X] Tongue: pink with slight purple/lavender hue
[X] Pulse: deep but full, slow, toned
[X] Active Acupuncture Points: LI11, HT7, BL20, BL23, BL26, BL40, SP6, SP10
[X] Diagnosis: HT-KID Disconnect, KID Qi Deficiency, Blood Deficiency
Any help would be greatly appreciated.
Thank you
Lisa