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Urinary Incontinence In A Dog

by Holisticpetvet - October 6, 2025 View Case Report

Hi everyone,

Lila, a 3-year-old FS French Bulldog mix (8.1 kg) with urinary leakage during rest and sleep without awareness. UA was normal — no bacteria, crystals, or inflammation. Urethral sphincter mechanism incompetence (USMI) was suspected.
Relevant history: Prior atopy/environmental allergies; responds well to Cytopoint (not on it currently).

Tongue: pale-lavender, moist, thin white coat.
Pulse: deep, thin, slight “finger-lift.”
TCM Dx: Spleen Qi sinking with mild Kidney Qi deficiency.

Diet: lightly cooked/rehydrated base with yams, broccoli, carrots, Greek yogurt, cranberries.

Tx history: Trial of Sang Piao Xiao San ? restlessness/irritability (owner also reported aggression); discontinued.

Current plan:
Bu Zhong Yi Qi Tang ? tsp BID in food.
Alfalfa tincture (Nature’s Answer 1000 mg/mL) 1 mL TID.
Progress to date: 1 week on BZIQT + alfalfa; no side effects, no improvement yet.

My question is how long until improvement is typically seen? Does this seem like a reasonable plan? Anything I should tweak? Very new to TCVM!

Thanks,
Martha

by naturevet

October 8, 2025

Hi Martha,

It's unfortunate you have such a tough case to figure out when you're just getting started. Know that I would have taken the same steps as you. Maybe that doesn't leave you feeling too encouraged! LOL!

I do have some ideas, though. The unexpected aggravation from SPXS tells us (because the formula internalizes and tonifies) that this case either needs Draining or it needs mobilization. The deep toned pulse can actually fit either.

If mobilization is needed, BZYQT is a good choice. You can help it work better using a Minor Bupleurum derivative. The two together help vent trapped Qi and Yang. Minor Bupleurum (XCHT) is also an immune modulator, so its efficacy might be hinted at by the history of atopy.

The other possibility is that the patient is Damp. Dampness can bind the flow of Qi and produce a deep toned pulse. A Damp animal might have lingering urge incontinence that is resisted except when unconscious, producing the nocturia.

A Damp animal can also have 'allergies', though it is really just diet-driven inflammation that responds readily to a change to a real food diet (not dried, baked, freeze-dried, kibble or canned). Those latter items are all potentially Dampening just because they are processed. An improvement from a diet shift would tell you for sure the pet is Damp.

If Dampness is where you land, then San Ren Tang is a not bad formula to start with, perhaps with added Shi Chang Pu to help raise mental awareness of the need to urinate. Otherwise, Damp patients can sleep very deeply, and totally not register the urge to urinate.

One of those two suggestions should work for you. Hopefully, you can turn a trouble some case into something very satisfying!

Steve

by Holisticpetvet

October 14, 2025

Thank you so much Steve! She hasn't had any incontinence in a week now since being on the BZYQT and alfalfa. She only had one accident today 2 hours after taking her on a 1 hour walk. I think I will add the XCHT if needed next.

by naturevet

October 18, 2025

Sounds good! An accident after a long walk suggests Qi deficiency, which BZYQT should slowly rectify. Well done, Martha!

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