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Urinary Incontinence And Arthritis

by ericahawker - October 17, 2009

Hi Steve--

I think this patient has a kidney yin deficiency and blood deficiency with stasis but am not sure if I have picked the right formula.

12 yr old FS Husky, 64 lbs with left cruciate repair in July and stiffness in rear limbs worsening since then. She developed urinary incontinence in the past few mths which has responded to PPA. The stiffness in rear limbs improves with movement and Deramaxx. Also the dog is been more clingy with owner recently.

Finicky eater, drinks lots of water, moderate to low energy, very active in AM with walks, restless in evenings. Prefer cooler weather and snow--dislikes rain, wind, heat.

Other medical history: tonsilitis in 2003, non-productive cough occas since a puppy. Owner thinks cough is because she licks her fur a lot.

On exam--slightly overweight, nuclear sclerosis, stiff in rear and always dislikes caudal abdomen being palpated. Tongue is pale pink, slight lavender and pulse is moderate strength and moderate to deep in locations.

So, I think Tian Wang Bu Xin Dan may fit all of this. Do you agree?

Thanks!
Erica

by naturevet

October 17, 2009

Hi Erica,

Here is how I interpret things.

First, the pulse sounds quite strong for taking a purely tonifying approach. In that instance, I would expect maybe a deep weak pulse. The wiry deep pulse suggests stasis.

So we want a formula that mobilizes peripheral circulation, (and can see how that would improve cognition by increasing blood flow to the head); improve circulation to the low back and legs; and maybe have an anti-tussive effect. In addition, it must somehow address incontinence.

Of the stasis formulas, the first one I think of is Xiao Chai Hu Tang (Minor Bupleurum). It addresses all the symptoms and could help incontinence both by improving cognition (via Ginseng) as well as by increasing the delivery of power to the lower burner, in the event the middle burner is somehow blocked.

If this thinking is correct, you should find active GB points on the dog. If you can't find any active points, at least needle or massage GB 34. If the pulse softens up, then XCHT should work. If it doesn't fully satisfy, we at least know all we need to do is build on or modify the formula.

Hopefully that works for you and that you understand the logic.

Steve

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