The Dead-end Pathway for Urinary Incontinence

I received an email from one of my holistic vet colleagues today that discussed the topic of urinary incontinence in our pets.  It was a very detailed and scientific-oriented discussion about the most likely causes and what is used conventionally to treat the condition by most vets.  Then, being a holistic vet, she discussed the possible side effects of the two most common drugs used to treat the problem and then, offered some more natural options that might be just as effective.

Urinary incontinence, is a very common problem in dogs, and occasionally a problem in cats.  It is the inability for the pet to hold their urine.  This mostly happens during sleep, but will sometimes happen when they are awake.  I have seen pets wake up in the morning with their bedding soaked in urine as well as dogs that will be leaking urine while they are standing.

I remember years ago when I was in vet school and the clinicians teaching us about urinary incontinence.  We were told that in young, spayed female dogs that urinary incontinence occurs in 5% of all spayed dogs.  The conditioned is called estrogen-responsive urinary incontinence because when we spay a dog, we remove both ovaries.  The ovaries are responsible for estrogen production and estrogen is a factor in the control of the urinary bladder sphincter.  Like some human post-menopausal women, when estrogen is no longer produced, urinary incontinence will occasionally become a symptom.  Synthetic estrogen has been used for many years to control this problem, both in the dog and in the human.

Now, this seems very reasonable, but when I was sitting in my class in vet school, I couldn’t help noticing the white elephant in the room that no one else seemed to notice.  If 5% of all dogs that were spayed developed urinary incontinence due to the lack of estrogen, why didn’t ALL spayed dogs develop this problem?  Even today, no one seems to be asking this question.

I looked at the list of all of the causes of urinary incontinence in younger dogs, all of which I have seen over the years, that were listed by the holistic vet  All together, they make up less than 1% of the causes of urinary incontinence in young dogs.  The article stresses the importance of looking for underlying problems, such as the 1% of the other diagnosis, but more often than not, there is no underlying factor determined and the vet makes the diagnosis of urinary incontinence and treats with standard drug therapy.  Which, she also mentions, have severe potential side effects.  DES, synthetic estrogen, has been taken off the market in humans for its link to cancer and bone marrow suppression (it can do the same for the dog) and Proin (PPA) has been taken off the market in humans for its deleterious effects on the heart and cardiovascular system (same in the dog).  However, the FDA has not seen fit to do the same in the pet.  So, many young female dogs less than two years of age are put on Proin to be used twice a day for the rest of their life.  Good for business, but not good for the dog.

So, if only 5% of spayed female dogs develop this condition and if less than 1% of all spayed female dogs have the other listed possible causes (pudendal nerve damage, ectopic ureters, urinary calculi, etc.), then what is the real underlying cause?  From a conventional perspective, we don’t know.  What the reasoning, intellectual mind tells us is that there is at least two factors involved, otherwise all of the spayed dogs would develop this problem.  But, what is the other factor?  Again, we do not know.

Once again, when conventional medicine does not give us an answer that we can hopefully resolve, instead of just treating symptoms with toxic drugs, let’s jump over to the other side of the fence and go with an alternative perspective.  Hey, what do we have to lose?

From a Chinese medicine perspective, urinary incontinence is caused by a kidney qi deficiency.  And, guess what?  We can treat kidney qi deficiency with acupuncture and Chinese herbs.  From this perspective, we can explain ALL causes of urinary incontinence.  This includes estrogen-responsive urinary incontinence, genetic defects, senior dog incontinence, pudendal nerve impingement and even calculi formation.  How cool is this?

Many of these young dogs that come in with the diagnosis of estrogen-responsive urinary incontinence, get treated a few times with acupuncture and placed on some Chinese herbs for this imbalance, will often RESOLVE the problem completely and the dog lives happily ever after without any symptoms.  No drugs, no acupuncture, no herbs.  Resolved.

The article did mention using acupuncture for helping the pudendal nerve function, but this approach is using a Chinese medicine modality from a conventional perspective and usually results in a poor response.  The nervous system, including the pudendal nerve, is under the influence of he kidney in Chinese medicine.  Surprise. Urinary incontinence always involves kidney qi imbalances and if not addressed, will not be resolved.

Urinary incontinence in senior pets, as mentioned in the article, can be a symptom of diseases such as diabetes, Cushing’s disease and others.  Treating these diseases will help with the symptoms, but will not resolve the problem.  But, if a Chinese medicine perspective is taken, it will easily explain how the imbalances created all of the symptoms, including the conceptual disease as well as the symptoms.  In senior pets, urinary incontinence, usually accompanied by increased water intake is always associated with kidney energy imbalance.  It may be a kidney yin or yang deficiency, but if the pet is leaking urine, it always includes a kidney qi deficiency.   This is the same for both dogs and cats

If the pet with urinary incontinence problem, early in life, is dealt with from a Chinese medicine perspective, it will not only likely eliminate the symptoms and underlying problem, but will prevent kidney and bladder problems down the road that are all caused by an underlying kidney imbalance, the OTHER factor that no one is looking for.  If the pet is a senior pet with urinary incontinence, a Chinese medicine perspective will usually help strengthen and restore balance to the kidneys, resulting in elimination of symptoms and prolonged longevity of viable, functioning kidneys and urinary tract.

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