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Herbsmith Rx Rehmannia Assist Kidney is a classical Chinese herbal formula recommended by holistic veterinarians to nourish kidney yin, tonify kidney essence (jing), and support healthy kidney function in dogs, cats, and horses with kidney yin vacuity from aging, chronic stress, or constitutional depletion. Also known as the veterinary adaptation of Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill), this six-herb formula is the foundational and most widely used kidney yin tonification formula in the Chinese herbal tradition, organized around the classical three-tonifying, three-draining structure: three herbs that tonify the kidney, liver, and spleen yin (Shu Di Huang, Shan Zhu Yu, Shan Yao) and three herbs that drain the dampness, heat, and stagnation that the tonifying herbs could generate (Ze Xie, Mu Dan Pi, Fu Ling). In Chinese veterinary medicine, the kidney is considered the foundation of life, housing the inherited essence (jing) that provides the constitutional vitality that all other organ systems depend upon. As animals age or experience chronic stress, the kidney yin and essence gradually deplete, leading to the characteristic cluster of kidney yin vacuity signs that aging pets commonly develop. The lower back and lumbar region is considered the mansion of the kidneys, and as the kidney yin depletes, the bones and marrow that the kidney nourishes become insufficiently supported, leading to hind limb weakness, lower back soreness, and reduced skeletal resilience. The kidneys open into the ears, so kidney yin depletion shows up as reduced hearing. Kidney yin depletion also generates vacuity heat (heat from insufficiency rather than excess), which produces the characteristic heat signs without true excess: a red tongue with little coating, restlessness at night, and heat-seeking behavior. Available as a concentrated powder mixed into food or feed. Dosing varies by species and body weight, and your authorizing veterinarian will provide specific guidance.
VETERINARY AUTHORIZATION REQUIRED: Submit Your Authorization Request or Request a TCVM Telemedicine Consultation
What It Supports
- Kidney yin and essence tonifying through Shu Di Huang as the chief herb: Tonifies the kidney yin, nourishes the kidney essence (jing), replenishes the blood, and provides the primary yin-tonifying substance that the formula is built around through Shu Di Huang (rehmannia, prepared Rehmannia Root). Shu Di Huang is the prepared (cooked) form of rehmannia, created by steaming the raw root (Sheng Di Huang) with rice wine until it turns black, which transforms its nature from cold and blood-cooling to warm and deeply tonifying; this preparation makes Shu Di Huang the most potent yin and essence-tonifying herb in the Chinese materia medica. Shu Di Huang's sweet, slightly warm nature enters the liver, kidney, and heart channels to directly tonify kidney yin and essence at the constitutional level, providing the foundational yin substance that all the formula's supporting herbs build upon. At high doses, or in animals with weak digestion, its rich, sweet, and cloying nature can impair the spleen's transforming function; Ze Xie and Fu Ling in the formula specifically address this tendency. Monitor animals with spleen yang vacuity or loose stools, where the cloying, rich nature could impair middle jiao function.
- Liver yin and blood tonifying and essence astringing through Shan Zhu Yu: Tonifies the liver yin and blood, nourishes the kidney essence, astringes the essence to prevent its leakage, and stabilizes the kidney's storing function through Shan Zhu Yu (cornus fruit, Cornus Fruit). Shan Zhu Yu's sour and slightly warm nature enters the liver and kidney channels to tonify the liver yin and blood that kidney yin vacuity depletes, and to astringe the essence, ensuring that kidney jing is consolidated and not lost through its astringing, essence-securing action. In the three-tonifying strategy of Liu Wei Di Huang Wan, Shan Zhu Yu tonifies the liver as the kidney's child organ, addresses the liver-kidney yin relationship, and ensures sufficient liver blood to support kidney yin replenishment. Generally well tolerated at standard doses.
- Spleen qi tonifying and kidney essence supporting through Shan Yao: Tonifies the spleen qi, nourishes the spleen and lung yin, stabilizes the essence, and provides the middle jiao strengthening that the formula requires to process and distribute the deeply tonifying herbs through Shan Yao (dioscorea, Dioscorea). Shan Yao's sweet and neutral nature enters the spleen, lung, and kidney channels to strengthen the spleen's transforming and transporting function, ensuring the spleen can distribute the nourishment provided by Shu Di Huang and Shan Zhu Yu throughout the body and that the middle jiao is supported by adequate spleen qi. In the three-tonifying strategy, Shan Yao tonifies the spleen as the organ responsible for the post-heaven source of qi and blood that supports the kidney's pre-heaven essence. Generally well tolerated.
- Kidney fire draining and Shu Di Huang's cloying nature preventing through Ze Xie: Drains kidney fire generated by yin vacuity, leaches out dampness, and prevents the cloying and stagnating quality of Shu Di Huang from generating dampness and obstructing the middle jiao through Ze Xie (alisma, Alisma). Ze Xie's sweet, bland, and cold nature enters the kidney and urinary bladder channels to drain the vacuity fire that the depleted kidney yin generates and to leach out the dampness that the richly tonifying Shu Di Huang could produce in the middle jiao, ensuring the formula's tonification is clean and unobstructed. In the three-draining strategy, Ze Xie drains kidney fire and prevents tonification-generated dampness, making it essential to ensure the formula's nourishing action reaches the kidney without creating secondary dampness accumulation. Generally well tolerated at standard doses.
- Liver fire draining and blood-level heat clearing through Mu Dan Pi: Drains liver fire and vacuity heat from the blood level, cools the blood, and prevents the yin vacuity-generated heat from accumulating in the liver channel through Mu Dan Pi (moutan, Moutan Bark). Mu Dan Pi's bitter, acrid, and slightly cold nature enters the heart, liver, and kidney channels to drain the liver fire that yin vacuity generates and to cool the blood-level heat that the yin insufficiency produces, ensuring the vacuity heat component of the pattern is cleared alongside the yin tonification strategy. In the three-draining strategy, Mu Dan Pi drains liver fire and blood heat, complementing Ze Xie's kidney fire drainage. Paeonol content with mild anticoagulant and platelet-affecting effects; monitoring warranted in animals on anticoagulant or antiplatelet medications. Contraindicated in pregnant animals.
- Spleen dampness draining and middle jiao protecting through Fu Ling: Drains dampness from the spleen, supports the spleen qi, calms the shen, and prevents Shu Di Huang's cloying nature from overwhelming the middle jiao through Fu Ling (poria, Poria). Fu Ling's sweet, neutral nature enters the heart, spleen, and kidney channels to drain dampness that could accumulate from the formula's rich tonifying herbs and to support the spleen qi being tonified by Shan Yao, ensuring the middle jiao remains functional and undampened throughout the tonification process. In the three-draining strategy, Fu Ling drains spleen dampness and protects the middle jiao, working alongside Shan Yao's spleen-tonifying action to keep the spleen functional. Fu Ling's shen-calming action through the heart channel also addresses the mild shen restlessness from kidney yin vacuity. Generally well tolerated.
TCVM Principles
- Primary action - kidney yin vacuity pattern through the classical three-tonifying, three-draining structure of Liu Wei Di Huang Wan: three herbs tonifying kidney, liver, and spleen yin (Shu Di Huang, Shan Zhu Yu, Shan Yao) and three herbs draining kidney fire, liver fire, and spleen dampness (Ze Xie, Mu Dan Pi, Fu Ling): Rehmannia Assist Kidney addresses the kidney yin vacuity pattern through the classical Liu Wei Di Huang Wan structure. The three tonifying herbs rebuild the kidney yin, liver yin, and spleen qi from three angles: Shu Di Huang provides the primary kidney yin and essence tonification from the constitutional level; Shan Zhu Yu tonifies the liver yin and blood and astringes the essence as the liver is the child organ of the kidney in the Five Element relationship; Shan Yao tonifies the spleen qi and stabilizes the essence as the spleen is the post-heaven source of the qi and blood that nourishes the kidney. The three draining herbs prevent the tonification from generating stagnation, dampness, or fire accumulation: Ze Xie drains kidney vacuity fire and prevents Shu Di Huang-generated dampness; Mu Dan Pi drains liver fire and cools blood-level heat from yin vacuity; Fu Ling drains spleen dampness and supports the middle jiao. This three-tonifying, three-draining balance is the defining structural elegance of Liu Wei Di Huang Wan and ensures the formula tonifies cleanly without creating secondary obstructions. Treatment Principles: nourish the kidney yin, tonify the kidney essence, nourish the liver yin and blood, strengthen the spleen, drain vacuity fire, and address kidney yin vacuity.
- Secondary action - the kidney yin vacuity pattern with the full clinical picture: hind limb weakness and lower back soreness from kidney failure to nourish bones and marrow (the kidney governs bone and marrow), reduced hearing from kidney failure to open into the ears, dry coat and skin from yin and blood insufficiency, mild heat signs from vacuity heat (restlessness, heat-seeking, red tongue with little coating), and the wasting and aging presentation reflecting constitutional essence depletion: Rehmannia Assist Kidney is indicated specifically for the kidney yin vacuity pattern across all its clinical manifestations in aging or constitutionally depleted animals. The kidney governs bone and marrow in Chinese medicine, so kidney yin depletion leads to the commonly seen hind limb weakness, lower back weakness, and reduced skeletal resilience that aging dogs, cats, and horses develop. The kidney opens into the ears, so kidney yin depletion produces the reduced hearing commonly seen in aging pets. The kidney stores essence (jing), the constitutional foundation of vitality; as jing depletes, the aging process accelerates. Pattern differentiation from kidney yang vacuity (cold limbs, pale tongue, slow-deep pulse - requiring warming yang herbs rather than cooling yin nourishment) and from kidney qi vacuity (urinary incontinence, weakness without heat signs - requiring qi-astringing rather than deep yin tonification) is important. Your authorizing veterinarian will confirm the kidney yin vacuity pattern through tongue and pulse examination and clinical assessment.
Available Forms
- Powder - Canine Blend (for dogs and cats): Available in 75 g, 150 g, 500 g, 900 g, and 1200 g sizes; mix into food at the recommended dose for your pet's weight.
- Powder - Equine Blend (for horses): Available in 500 g, 900 g, and 1200 g sizes; mix into feed at the dose recommended by your authorizing veterinarian.
Suggested Use
For Dogs (Powder):
- Under 30 lbs: ½ tsp twice daily, or as prescribed
- 30-80 lbs: 1 tsp twice daily, or as prescribed
- 80-120 lbs: 1½ tsp twice daily, or as prescribed
- Over 120 lbs: 2 tsp twice daily, or as prescribed
For Cats (Powder): ¼ tsp twice daily, or as prescribed
For Horses (Powder): Dosing provided by your authorizing veterinarian based on body weight and clinical assessment.
Ingredients
Active Ingredients: Shu Di Huang (prepared Rehmannia Root), Shan Zhu Yu (Cornus Fruit), Shan Yao (Dioscorea), Fu Ling (Poria), Mu Dan Pi (Moutan Bark), Ze Xie (Alisma)
Inactive Ingredient: Flaxseed
VETERINARY AUTHORIZATION REQUIRED: Submit Your Authorization Request or Request a TCVM Telemedicine Consultation
Active Ingredient TCVM Actions
Rehmannia Assist Kidney is the veterinary adaptation of the classical Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill), a six-herb formula structured around the three-tonifying, three-draining principle: Shu Di Huang, Shan Zhu Yu, and Shan Yao tonify the kidney, liver, and spleen yin respectively, while Ze Xie, Mu Dan Pi, and Fu Ling drain the kidney fire, liver fire, and spleen dampness that the tonifying herbs could generate:
- Shu Di Huang (prepared Rehmannia Root) - Prepared Rehmannia Root / Cooked Rehmannia: Chief herb; tonifies kidney yin and essence (jing) from the constitutional level; the prepared (cooked) form is warm and deeply tonifying in contrast to raw rehmannia's cold blood-cooling nature. Its cloying, rich nature may impair middle jiao function in animals with spleen yang vacuity; monitor animals with loose stools or digestive sensitivity.
- Shan Zhu Yu (Cornus Fruit) - Asiatic Cornelian Cherry Fruit / Cornus Fruit: Tonifies liver yin and blood and astringes the kidney essence to prevent leakage; addresses liver-kidney yin relationship and consolidates jing. Generally well tolerated.
- Shan Yao (Dioscorea) - Chinese Yam / Dioscorea Rhizome: Tonifies spleen qi and stabilizes the essence; provides the post-heaven spleen support that distributes the formula's deep tonification. Generally well tolerated.
- Ze Xie (Alisma) - Alisma Rhizome / Water Plantain Rhizome: Drains kidney vacuity fire and leaches out dampness generated by Shu Di Huang's cloying nature; ensures clean and unobstructed tonification. Generally well tolerated at standard doses.
- Mu Dan Pi (Moutan Bark) - Moutan Bark / Tree Peony Root Bark: Drains liver fire and cools blood-level heat from yin vacuity; clears the vacuity heat component of the kidney yin vacuity pattern. Paeonol content with mild anticoagulant effects; monitoring warranted with anticoagulant and antiplatelet medications. Contraindicated in pregnant animals.
- Fu Ling (Poria) - Poria / Hoelen / China Root: Drains spleen dampness and protects the middle jiao from Shu Di Huang's cloying nature; supports the spleen qi alongside Shan Yao and calms the shen. Generally well tolerated.
Potential Drug Interactions
Rehmannia Assist Kidney has a generally favorable drug interaction profile for a deeply tonifying formula, with the primary concern centered on Mu Dan Pi. Mu Dan Pi's paeonol content has mild anticoagulant and platelet-affecting effects; animals on warfarin, heparin, aspirin, clopidogrel, or other anticoagulant or antiplatelet medications warrant veterinary review before initiating this formula. Mu Dan Pi is contraindicated in pregnant animals. Shu Di Huang's richly cloying nature warrants monitoring in animals with pre-existing spleen yang vacuity, loose stools, or digestive sensitivity, as the cloying quality can impair the middle jiao function even with Ze Xie and Fu Ling's draining presence in the formula; animals with significant digestive weakness may require spleen-supporting adjunct management under veterinary supervision. Ze Xie's mild diuretic action warrants monitoring in animals already on diuretic medications where the combined fluid-moving effect could affect fluid and electrolyte balance.
Medication categories warranting extra caution: anticoagulant and antiplatelet medications (Mu Dan Pi paeonol - primary concern), diuretic medications (Ze Xie mild diuretic action), and medications in animals with compromised kidney function where the formula's deeply tonifying and mildly draining actions require veterinary monitoring of kidney values over time. Because kidney yin vacuity can overlap with conventional kidney disease (chronic kidney disease, renal insufficiency), veterinary monitoring of kidney function values (BUN, creatinine, SDMA) throughout the treatment course is important in animals with known kidney disease. This formula supports the TCVM approach to kidney yin vacuity and is used alongside, not in place of, appropriate veterinary kidney function monitoring and care. Your authorizing veterinarian will determine appropriateness based on your pet's condition, kidney values, current medications, tongue quality, and pulse character.
VETERINARY AUTHORIZATION REQUIRED: Submit Your Authorization Request or Request a TCVM Telemedicine Consultation
Frequently Asked Questions
What signs of kidney yin vacuity does Rehmannia Assist Kidney address in TCVM?
In Traditional Chinese Veterinary Medicine, the kidney yin vacuity pattern produces a characteristic cluster of signs that are commonly seen in aging dogs, cats, and horses. The kidney governs bone and marrow in Chinese medicine, so as kidney yin and essence deplete with age, the bones and marrow become insufficiently nourished, leading to the hind limb weakness, lower back soreness, and reduced skeletal resilience that aging pets commonly develop. The kidney opens into the ears, so kidney yin depletion produces the gradual hearing loss commonly seen in older animals. The kidney stores constitutional essence (jing), the foundation of vitality; as jing depletes, aging accelerates, reflected in a thinning coat, reduced energy, and decreased resilience. Kidney yin vacuity also generates vacuity heat - heat from insufficiency rather than excess - which produces mild heat signs without true fever: a red tongue with little or no coating, restlessness at night or difficulty settling, and heat-seeking behavior. The pulse is characteristically thin and rapid, reflecting yin insufficiency and vacuity heat. These signs distinguish kidney yin vacuity from kidney yang vacuity (cold limbs, pale tongue, slow pulse) or kidney qi vacuity (incontinence, weakness without heat signs), which require different formulas.
How is Rehmannia Assist Kidney administered to dogs, cats, and horses?
Mix the powder into food or feed at the dose recommended for your pet's species and body weight. The Canine Blend (75 g, 150 g, 500 g, 900 g, 1200 g) is used for dogs and cats; the Equine Blend (500 g, 900 g, 1200 g) is used for horses with dosing provided by your authorizing veterinarian. Because this formula contains Mu Dan Pi with mild anticoagulant effects, veterinary review of all current medications is important before use in animals on anticoagulant or antiplatelet medications. In animals with known kidney disease, veterinary coordination to monitor kidney function values (BUN, creatinine, SDMA) throughout the treatment course is recommended. Animals with significant digestive sensitivity or loose stools should have their veterinarian monitor Shu Di Huang use, as its richly cloying nature can occasionally affect middle jiao function in animals with pre-existing spleen yang vacuity.
How long does it take to see results with Rehmannia Assist Kidney?
Because it addresses deep constitutional yin vacuity and essence depletion, Rehmannia Assist Kidney requires sustained treatment before you see meaningful improvement. The kidney yin and essence are the deepest and most slowly replenished resources in the body, reflecting the classical TCVM understanding that yin and essence take considerable time to rebuild. Some improvement in the more superficial signs of kidney yin vacuity (mild reduction in heat signs, slight coat improvement) may be seen within 4 to 6 weeks as the formula's yin-nourishing herbs begin to address the acute vacuity heat component. More meaningful improvement in the root kidney yin and essence levels, reflected in improved hind limb strength, better hearing, improved coat quality, and reduced aging signs, typically requires 2 to 4 months of consistent use. Long-term maintenance use under veterinary supervision is often appropriate for aging animals in whom kidney yin and essence depletion is a constitutional and age-related condition rather than an acute imbalance. Your authorizing veterinarian will monitor tongue quality, pulse character, and clinical signs throughout treatment.
Can Rehmannia Assist Kidney be used in animals with conventional kidney disease?
Rehmannia Assist Kidney is often used in animals with conventional kidney disease (chronic kidney disease, renal insufficiency) to provide TCVM support for the kidney yin vacuity pattern that commonly accompanies kidney disease in aging animals, but this requires coordinated veterinary supervision between the conventional and TCVM veterinarians. The formula's deeply tonifying herbs (Shu Di Huang, Shan Zhu Yu, Shan Yao) support the kidney yin from the TCVM perspective, while Ze Xie's mild diuretic action and Mu Dan Pi's heat-clearing action address the vacuity fire component. In animals with compromised kidney function, monitor kidney values (BUN, creatinine, SDMA, phosphorus) throughout the treatment course to ensure the formula's action matches the animal's current kidney function. Ze Xie's mild diuretic action warrants coordination with conventional diuretic management if the animal is already on diuretics. Because the TCVM kidney yin vacuity pattern and conventional chronic kidney disease often coexist in aging animals, these two approaches to kidney support can complement each other with proper veterinary coordination. Your authorizing veterinarian will determine appropriateness and monitoring needs based on your pet's kidney values, clinical status, and complete medication profile.
QUESTIONS & ANSWERS
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dosage of this product for cats?
Hi, thank you for your question!
Here's the standard dosing for Cats: ¼ tsp. twice a day, or as prescribed. Please be informed that we require vet authorization for all our TCVM herbs.
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