Hi Kevin,
ZBDHW drains Damp as part of its action. So it has a descending sort of action. The response of the dog thus tells us we need the opposite effect, which is one of lifting or raising.
If the dog was incontinent at night during sleep, then a biomedical goal is to reduce the depth of sleep and improve cognition. To improve that, we have to improve cerebral blood flow, which once again means lifting Qi or Blood to the upper burner.
That brings to mind the use of BZYQT. There's some recent research to suggest the formula's benefits in allergic dermatitis. Certainly if the cutaneous inflammation was actually due to Blood deficiency or even just a persistent low grade infection, the formula should help, given its vascular and immune-potentiating effects.
The formula also fits the pulse and tongue, since it mobilizes the circulation peripherally, and deals with a stasis condition.
Lastly, we have the restlessness in the evenings. Often that is due to Empty Heat, as you surmised. This is because, as the Kidneys reach high tide, their deficiency of Yin becomes keenly felt. The pericardium also reaches high tide in the evenings, however, and supplies Blood to the Heart. Thus, a Heart Blood deficiency, which BZYQT remedies, can also be more keenly felt then, too, following the same logic.
Hope that is useful advice. I'd give it a try, anyway. Owners usually understand the cognition thing. You can also assure her that, because of the formula's phytoestrogen content, it will interact synergistically with DES rather than against it. A common side effect of PPA is restlessness. Maybe some of that is going on as well.
Steve