Question Details
Urinary Incontinence
by ROBINSON - January 25, 2010
! am seeing a 14.5 yr old, spayed female, australian shepard who is starting to have incontinence issues. She leaks small amounts of urine while she is sleeping or just resting. She is immediately aware of this and cleans herself. She is slowly starting to develop heat intolerance and exercise intolerance. She is mildly overweight and an easy keeper. She is a deep sleeper and snores alot. She is mostly deaf. She has a great appetite which may be slightly increased. Normal thirst and urinary habits. She is on a raw, grain-free diet. Has overall been in good health with only mild arthritis. Her tongue is a pale lavendar, wet with minimal coating with wrinkles, the back is thick and the tip is thin and slightly more reddish purple. Her pulses feel deep, soft and slippery. I am confused about her tcm diagnosis and wondering which herbs may help her ki qi, incontinence and sp qi.
Thanks Wendy
Replies
by naturevet
January 26, 2010
Hi Wendy,

I take it a urinalysis has been done and is normal? Assuming so....


There seems to be a major role played by cognition in incontinence during sleep. Many of the formulas that work possess either phytoestrogens or increase cerebral blood flow, or both. Some basic phytoestrogen approaches include plain old Alfalfa tincture (Medicago) or supplementation with soy isoflavones.

A formula that does both of the above, is indicated for incontinence and addresses Spleen deficiency is Bu Zhong Yi Qi Tang (Ginseng and Astragalus). It's not big in the Damp draining department, which you dog seems to be manifesting (weight, slippery pulse, inflammatory tendencies, heat intolerance, wet pale tongue).

A formula that fits her picture, and would aid incontinence where due in part to urinary urgency would be San Ren Tang. It doesn't have a pronounced effect on cognition, though, but you could maybe team it with something that does like Alfalfa.

A formula that does, and which fits the weak slippery pulse, heat tendencies, arthritis, and Damp is Yi Yi Ren Tang. It does also have some phytoestrogen content, and would conceivably also help if there was an urgency component (i.e. role being played by inflammation). It might be the best overall choice for the dog, but again you could pair it with Alfalfa for the best chance of benefits.
Hope that helps!

Steve
by ROBINSON
January 31, 2010
Thanks Steve,

I think I will start with the Yi Yi Ren Tang and alfalfa tincture and see how it goes.

I always appreciate your help.

Wendy
by ROBINSON
January 31, 2010
HI Steve,

Is there somewhere I can read about the properties of Yi Yi Ren Tang. I couldn't find any info in your catalog or website. I would like to read more about it.

Thanks again, Wendy
by naturevet
February 5, 2010
Hi Wendy,

Sorry for the delayed reply. I had to wait until I was at a computer that had a blurb on Yi Yi Ren Tang on it. Here it is:

Yi Yi Ren Tang (Coix Decoction)


Gui Zhi Cinnamon Twigs
Bai Shao White Peony
Gan Cao Licourice Root
Du Huo Angelica pubescens
Yi Yi Ren Coix
Cang Zhu Black Atractylodes
Bai Zhu White Atractylodes
Dang Gui Angelica sinensis
There have been several different formulas over the centuries with this name. This one treats arthropathies due to Wind Damp invasion. The patient must be prone to Damp to be invaded by Damp. To do a proper job in reducing pain and inflammation, the formula thus also supports the Spleen to reduce Dampness production internally. Regardless the source, with prolonged Damp, obstruction of Qi and Blood flow occurs, creating pain. The formula thus also contains Blood movers.

Just as the formula is a bit of a mixed bag, so is the animal benefiting from it. Stasis (deficient) shows up as fixed lesions that are better with movement. Qi deficiency creates symptoms that are worse in the morning and from overuse. On occasion, this animal, too, is elderly.

Spleen Qi deficiency symptoms are also seen on occasion such as a low appetite, muscle wasting, soft or mucoid stools, and a pale tongue. Dampness may be manifest systemically, or as pronounced joint swelling.

The clinical finding with the highest specificity in indicating this formula is a frail and superficial pulse in even the largest dogs. They may also have a history of being worse from prolonged cold exposure.

Yi Yi Ren Tang may be especially helpful in elbow joint arthropathies of various types.

Dang Gui contributes phytoestrogen content.
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