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Kidney Qi Deficiency Leading to Urinary Incontinence and Hind end Weakness

Kidney Qi Deficiency Leading to Urinary Incontinence and Hind end Weakness

By Mitsie Vargas DVM, CVA -Winter Haven, FL

Author: Chi Institute/Monday, November 1, 2010/Categories: Student Case Reports, TCVM Newsletter, 2010 Winter Issue

This case presented as a consult to evaluate quality of life and possible euthanasia of a 13.7 year old female spayed miniature Schnauzer named Muffin. Six months prior to presentation she experienced pancreatitis and was hospitalized for one week. The owner noticed progressive urinary incontinence and hind end weakness with muscle tremors since then... She had a western diagnosis of osteoarthritis which was being managed with Rimadyl 25mg daily, methocarbamol 250mg twice daily and Osteo 3 chewables (joint supplement) once daily. The urinary incontinence was being mostly controlled using Proin 25mg tabs twice daily. 
The patient’s constitution is Earth. Her Shen was normal and she was food motivated. Her gait was worse in the morning. The tongue was pale, moist and had teeth marks on sides. The pulses were weak and deep, the right one is slightly weaker. Extreme sensitivity noticed at Shen shu, Baihui, BL54 and ST 36 on the right side.
The TCVM Diagnosis suggests the main problem is a Kidney Qi deficiency with a possible underlying Spleen Qi deficiency. This diagnosis correlates with her weak back and knees as Kidney controls bones. It also explains the incontinence since kidney controls the bladder/urethral sphincter function. 
Since Muffin appeared very weak and elderly only a handful of points were used for the first treatment. I discussed 6 weekly treatments and re-evaluation at that time. In addition, Muffin was put on a weaning schedule for Proin to be tapered from 25mg sid for 2 weeks then 12.5mg sid for 2 weeks and re-evaluation of incontinence problem. The herbal formula Suo Quan Wan was started. In addition, Muffin was put on Wei Qi Booster formula. 
The 1st treatment was on 3-30-2010 dry needles were left for 12 minutes on GV20,GV14,ST36, BL23-52-40-54 and Baihui. I surrounded the dragon on the rt stifle. At her 2nd treatment I added KID3 to tonify her kidneys and LIV 3 to help the pain. I also used LI10 for Qi tonification. Previous points were again stimulated using dry needles for 12 minutes. SP3 was attempted but she shook needle pretty fast. 
At the time of her 3rd treatment on 4-13 Muffin was much more active and completely ambulatory. Weight bearing on her right leg and her owner reported 95% improvement in mobility. Her owner also reported that Muffin’s personality had changed into a more assertive, playful and active dog. She also noticed Muffin was jumping on the couch which she had not done in years. The owner reported 100% resolution of incontinence and by her 4th treatment on 4-20 she was weight bearing on right hind leg with 95% resolution of the leg tremors. The owner was very pleased and reported that Muffin jumped out of the car to come in the office that day. 
This case represents a common problem in elderly dogs that usually results in Euthanasia due to quality of life issues. The pain and hind end weakness resulting in incontinence was not being optimally managed by western medicine. The reluctance of the owner to try invasive procedures and her consideration for Euthanasia made acupuncture the only viable option. Muffin responded immediately after her first visit even though not all points considered were used. Curiously her personality changed during the course of treatment to a more active, friendlier and playful (Fire) rather than the laid back nature (Earth) she had exhibited in the previous year. 
The addition of Wei Qi Booster and Suo Quo Wan proved to be a catalyst to improve Qi and resolve the incontinence issue. There were many other points considered but due to old age and the squiggly nature of  the patient, I could not use them. Muffin is currently receiving monthly acupuncture treatments and the hind leg musculatures have tonified and strengthened. She lost 2 lbs and is now a vibrant 24.2 lb Schnauzer with a new lease on life!

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