Godiva, a 3-year old, 60 poundb spayed female labrador retriever, had been seen by another vet for a problem with urinary incontinence, which began shortly after she was spayed as a puppy. She would leak urine while sleeping, leaving a large wet area on her bedding. She had been treated with phenylpropanolamine unsuccessfully. Her owner was eager to try a new approach and quite receptive to integrate TCVM into a thorough Western evaluation.
Based on Godiva's main problem of incontinence, I checked for causes such as diabetes, renal failure, cushings and bacterial cystitis. The blood work was normal and the culture was negative for bacteria. Because the urine was quite dilute and there was a slight increase in the number of wbc's, I treated Godiva with Clavamox, (c) at a dose of 375 mg. twice a day for 2 weeks, to be sure there wasn't an occult bacterial cystitis. No response was seen to the medication. I made the diagnosis of spayed female incontinence as being the most likely cause of the problem.
I believe that this young purebred dog suffered from urinary incontinence secondary to Kidney Qi deficiency. This conclusion is based on her symptom, preference for a warm environment, her deep pulses and pale, wet tongue. This problem may be more common in water constitution dogs, but perhaps the earth dog, grandmother to water, has some controlling influence over the water element and there may be underlying Spleen Qi deficiency contributing to the Kidney Qi deficiency. (1,4)
TCVM Treatment Principles
My goal of treating Godiva was to stop the urinary incontinence by warming the kidneys and dispersing cold, and expelling cold Qi in the bladder.
Formula and Herb Selection
I chose Jing Tang Chinese herbal formula, Suo Quan Wan (b). This formula warms and consolidates Kidney Qi. (1,2,4) I used teapills to make administration of the formula easier for the owner. We started with 3 teapills twice a day at a dose of 1.5 gms. twice a day. I instructed the owner to monitor Godiva for any change in appetite or vomiting or diarrhea. After one week at this dose, no adverse side effects were present and so I increased the dose to 5 teapills, 2.5 gms., twice a day. This is in the therapeutic dose range for a 60 pound dog, at 1.5 to 3 gms. twice a day.
The herbs in this formula and their main actions:
1. Alpinia Yi Zhi Ren
This herb warms the spleen and kidney. It is acrid and warm, grasping and storing, and warms rebellious Qi of the Kidney so that it returns to its base. It is a tonic. (2,3,5)
2. Lindera Wu Yao
This herb expels cold and warms the bladder, consolidating Kidney Qi. It is a Qi regulator. (2,5,6)
These two herbs complement one another and warm the kidneys and secure the urine, making them useful for treating urinary incontinence due to Kidney Qi deficiency. (5)
After about 3 weeks on the formula, Godiva stopped having urinary incontinence. She continued on the Suo Quan Wan for another 6 months without any signs of urinary leakage.
This case demonstrates the efficacy of a very simple two herb formula in treating a common problem I see in my small animal practice. The herbs had no adverse side effects in this case, were extremely effective and also of modest expense to the client. Years ago, estrogen (d), was commonly used to treat spayed female incontinence. Due to many adverse side effects including bone marrow suppression and inducing cancer, this treatment is not currently advisable. Phenylpropanolamine is now commonly used for treating incontinence. It has side effects in some dogs of increased heart rate and agitation. It was a good experience for me to try Suo Quan Wan, and have such fantastic results with no side effects. I realize that depending on the TCVM diagnosis, there may be other formulas more appropriate for certain cases, but I am looking forward to trying this or other formulas in future cases.
Phenylpropanolamine Hydrochloride, Contract Pharmacy Co., Hauppauge, NY
Suo Quan Wan, Dr. Xie's Jing-Tang Herbal, Inc. Reddick, Fla.
Clavamox TM, Pfizer Animal Health, Exton, Pa.
Diethylstilbetrol (estrogen), Wedgewood Compounding Pharmacy, Swedesboro, New Jersey
- Beebe S. Westcoast Veterinary Herbology Course Module 1, April 2007. Chinese Medicine Approach to Diseases of the Urinary Tract; 205-208.
- Xie H. Chinese Veterinary Herbal Handbook, ed. Preast V. Reddick, Fl: Chi Institute of Chinese Medicine, 2004; 69
- Deng S. Westcoast Veterinary Herbology Course Module 1. April 2007. Top 20 Yin, Yang Tonic herbal materia medica; 403,411
- Xie H. Traditional Chinese Veterinary Medicine, Fundamental Principles, ed. Preast V. Reddick, Fl: Chi Institute of Chinese Medicine, 2007; 374
- Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. rev. ed. Seattle, Wa: Eastland Press Inc. 2004; 534, 789, 790
- Yamate M. Westcoast Veterinary Herbology Course Module 3, May 2009.Herbs that Regulate Qi; 191-192, 198-199