Question Details
Urinary Incontinence In A Dog
by drwells - January 16, 2023    View Case Report
Thoughts please:
4-year-old MN Fire Border Collie mix with acute onset of urinary incontinence since neutering at 3 1/2 years old.
Prior to neutering, he would dribble occasionally when excited. He is a very nervous fear biter kind of guy.
Now he dribbles a significant amount when he is laying down and sometimes while he is walking.
No urgency or straining to urinate
Post-neutering, he did attack a dog in the household (unusual)
Polydipsia: Always the case since a pup
Low-grade itching: no skin infections.
Diet: raw chicken, beef , sardines, bone broth, dehydrated Honest kitchen veggie mix
Exam: Minimal
Sensitive to BL23,22
Prefers warmth
Tongue: pale, lavender
Pulses: bilaterally weak and thin, better with GB34, no change with SP4
TCM: Shao yang disharmony and perhaps kidney yin def.
Start Ba Wei Di Huang Wan and XCHY , acupuncture: BL22 and KI3/BL60 (that's all I could do)
Initially improved but not 100% better: water consumption was more normal, holding urine at night except if expelled a lot of energy
Continued XCHYT and added BZYQW:
Was doing better than suddenly not great (around holidays)
O requested we start Proin.
Since Proin: Doing better but still occasionally dribbling

Notes:
I was convinced that this case would respond to BZYQw but seemingly not as much as I thought. He is on 3/4 tsp BID (35 lbs dog). I don't think this is a low dose but maybe?
TCM:
Kidney qi def with cold signs (worse when he is tired, prefers warmth although drinks a lot)
Spleen qi sinking: so added BZYQw
Since doing well with Proin or better at least: what does that mean from a TCM perspective?
Looking back, did better with Rehmannia eight. Maybe that is the key?
Thoughts
Thanks again
Hannah
Replies
by naturevet
January 17, 2023
Hi Hannah,

I agree that a Kidney tonic approach seems important to fully explore. One option is You Gui Wan. It is a Kidney Yang tonic and has more herbs in it for incontinence. Proin addresses Heart Kidney disconnects by increasing the amount of Heart Yang (i.e., catecholamines) that is delivered to the Kidney Yin, to generate steam which reins in Heart Yang, which steams Kidney Yin, etc. When it doesn't quite work, it means Kidney Yin tonification might also be needed, which You Gui Wan does well. Rehmannia Eight is a good choice, too, for this, but it doesn't have quite the herbal line up for incontinence that You Gui Wan has.

Your doses seem fine. The response to GB 34 suggests it was helpful, maybe in opening up communication between the Heart and the Kidney. You can continue it or see if the dog gets by on just the YGW.

Hopefully this helps!

Steve
Reply to this question.
You must be logged in to reply