|
I graduated in veterinary science from The University
of Queensland (UQ) in 1989 and in 1991 completed
a post graduate honours degree and thesis in
physiology. In my veterinary career, I was involved in
mainly small animal practice with some horse work
Having children in 1995, led me into part time work
and I became interested in how pain affected
behaviour, especially in horses. The effectiveness of
osteopathy and chiropractic treatment in dealing with
pain in my life, led me to the post graduate Animal
Chiropractic course at RMIT. During the course, I
became involved in practising chiropractic and was
amazed at the results and its wide applications. I was
more amazed than the clients often!
The
understanding that the body is “all connected” and
cranial problems drew me to study cranial osteopathy
and other osteopathic therapies developed to remove
restrictions around organs, nerves etc
Early 2003, I started as a visiting consultant in
chiropractic and physical therapy at the UQ Small
Animal Clinic and worked mostly with patients with
muscular and neurological deficits not successfully
treated with modern veterinary medicine. I was also
able to work with post surgical rehabilitation cases
My work extended to being consulted on various
cases where drugs or surgery offered no positive solution in animals at the UQ and other small animal
practices in Brisbane. This year I attended a canine
rehabilitation course in the USA to further my
understanding of rehabilitation and have since been
invited to be apart of the board of The American
Veterinary Physical Rehabilitation Association.
I
currently have opened my own practice in Brisbane.
My practice focuses on removal of restrictions in the
body to restore health and complement other
treatment. I am hoping to pursue studies in nutrition
next year. I have also published a paper on lick
granuloma in dogs in the AVP Dec 2003
The body’s ability to heal and correct continues to
amaze me and hands-on manipulative therapies have
made me more aware of the body and causes of
disease. “It is all connected” is greatly understated
Introduction
Chiropractic therapy has a very beneficial role in the maintaining and promoting of health in small animals. Much misunderstanding surrounds this therapy, yet if applied with knowledge and proper technique, it is highly effective in the diagnosis and treatment of a number of conditions in small animal practice. Vets who have been trained in this therapy all agree it has
improved their skills and broadened their ability to treat patients
Negative experiences?
The first time I saw “chiropractic” treatment on a horse, I was distressed.The horse did not seem to benefit and I had serious doubts about the person who was doing it, whom I later learnt had learnt from some guy up north
who did not seem to have any qualifications to speak
of either.
However, in my own life I had a number of falls and
road accidents which left me with a very painful back.
Unfortunately my pain was not relieved with
physiotherapy, so I turned to chiropractic for my back
pain and was given significant and lasting relief very
quickly. It was gentle (no one pulled my leg!) and I began to consider there must be different techniques that may
be useful for the relief of pain in animals. This lead me to
pursue the animal chiropractic course at RMIT
University in Melbourne which is a 2 year post-graduate
course for veterinarians, human chiropractors
and osteopaths
Entering the course, I was not sure what to expect or
even what chiropractors and osteopaths understood. I
was to be amazed at the depth of knowledge in
neuroanatomy and neurophysiology and wide
experience the human chiropractors and osteopaths
brought to the course
I originally had a very narrow perspective on the role of
chiropractic therapy – it was useful for sore backs! However after the first part of the course and following
units, I became aware that chiropractic therapy has a
very important role in the maintaining and restoring of
health in animals
What is chiropractic?
Chiropractic focuses on spinal manipulation. Spinal
manipulation dates back in records to 2700 BC in the
East and in the west, Hippocrates described it in his
books, especially one called “On Joints”.
Hippocrates described 2 techniques - one of which
required a patient to be on a table under traction when
the physician administered a spinal thrust. He
commented this technique was on par with drug
therapy and surgery.
He also wrote: “Look well to the spine for the cause
of disease”.
Indeed chiropractic philosophy embraces this in their
understanding today.
Chiropractic philosophy differs from other disciplines
which use manual therapy, in its belief that the body has
an” innate intelligence” or ability to heal and balance
itself.We understand this as homeostasis.
Homeostasis is controlled via the nervous system.
Therefore chiropractic is focussed on the nervous
system – predominantly the spine.
Any restriction to nerve conductions will effect its target
organ and the messages it relays back to the CNS.
Mild or initial restrictions to nerve conduction will cause
facilitation – irregular firing – and we see this in
increased muscle tone, changes in gland activity etc.
If there is prolonged restriction, there is a drop in nerve
conduction and we most commonly recognise this in
muscle atrophy, however all organs/glands etc can
be affected.
Abnormal conduction affects every cell that has
innervation – organs/skin/glands/muscles etc
Chiropractic therapy involves:
• Removing restrictions to nerve conduction
(Within the body’s ability to respond)
• Allowing the body to send and receive the
messages necessary for proper functioning, balance
and homeostasis.
• Proper nerve function is essential for a body to
respond to pathogens/trauma/surgery/normal life.
The peripheral nerves can be affected
by multiple changes such as
• inflammation
• abnormal posture of the body affecting the spine
• injury to related structures of motor unit and
surrounding tissues
• muscle spasm
• abnormal joint positions and function
• arthritic change around joint facets
• tumour formation in/around the motor unit
• pressure/tension of vascular structures that support
the nerves
Any of these structures can be affected and all contain
high density of pain receptors
Restoration of proper nerve conduction can aid
restoration of health in all tissues of the body
Example:
“Lucy”, a female Cattle Dog cross (9-years-old)
presented for decrease in exercise tolerance. She would
lay on her bed all day and only rise to eat or toilet.
She had previous cruciate surgery on the left and right
stifles and both had arthritic change. She had been on
meloxicam (Metacam®) for over one year and it did not
seem to help her ability to get up and move
about anymore.
On examination, her arthritic stifles would seem to be
her problem. However, other findings included:
• pale mucous membranes and capillary refill time
2-3 sec
• her left chest had decrease motion
• poor femoral pulse strength
• restrictions in some of the ribs on the left chest
• restrictions in a few of the thoracic vertebrae
normal motion ( especially in rotation to the right)
• restrictions in some of the lumbar vertebra and the
sacro-iliac joints
• some restrictions in lower cervicals
• hips had good mobility.
After adjusting her chiropractically, as I was releasing some
of the tightness in the right hind eg musculature, I noted
• improved strength in femoral pulse
• mucous membrane colour pink and normal
• capillary refill time 1 sec
• good motion of the chest.
The owner reported that over the next few days the
membrane colour remained the same, however bloods
were taken which showed a mild regenerative anemia
and an abdominal ultrasound was performed to check
the spleen with no notable problems.
The dog over the next 2 weeks proceeded to be more
mobile, going for walks it had not previously done for
many months and even able to climb stairs it had not
even attempted for over a year and it was not on
Metacam (due to concern that the anaemia may be
caused from prolonged Metacam use).
Was this change purely because of changes from
adjusting the hind limb issues? Or the changes in the
vascular response and improved chest motion
improve circulation?
THE BODY IS ALL CONNECTED – ONE AREA
INFLUENCES ANOTHER
How does a trained chiropractor restore
function to nerves?
Diagnosis is the key.
I will discuss my approach to cases.
A. DISTANT EXAMINATION
Behaviour
Gait – a triangle assessment/backing/circles
Asymmetry of body and gait – noting
kyphosis/lordosis/muscle asymmetry etc
B. CLOSE EXAMINATION
Vet check
• Muscle palpation – tone/heat/cold /atrophy/
spasms/trigger points
• Examination of the spine – motion palpation – heat/cold/muscle spasms etc
• Neurological examination – as indicated
• Radiography (as indicated)
• Palpation is a key source of information for a trained
chiropractor.The feel of tissues gives a very good
indication of what may be occurring.
Motion of the joint facets and the “end feel” of this
motion gives a good indication of type of restrictions in
the area.
This palpation together with all other observations and
tests will then aid diagnosis and choice of treatment.
(NB My palpation skills underwent a great improvement
as a result of learning these skills and improved my vet
examination dramatically).
Techniques
There are multiple forms of chiropractic technique (over
117 systems of technique). Not all chiropractors will use
the same techniques.
• Choice of technique will depend on training,
preference and diagnosis and patient.
• Some techniques are quite passive and others more
forceful – knowledge is necessary to know the
application of various techniques.
• Age of the animal/condition/pain level etc will
influence the choice of the technique greatly.
Secondary problems in
compensated areas
Target organ weakened
Chiropractic adjustments require in-depth training
(the chiropractic undergraduate course is 5 years
full time!) and experience is necessary to help in
treatment decisions.
At RMIT, most of the technique taught is
• short lever (work over the restriction)
• low force (we don’t jam things back in place!)
• high velocity
• specific
• thrust/hold/recoil.
Multiple other techniques are taught which are also highly specific but not aggressive.
In developing techniques for my use, most owners comment
that it seemed so gentle and painless. I do not crank necks around etc and I have had many owners who have had
experience with other manual therapy practitioners say“I could not believe the results when you seemed to
not be doing much – it all seemed so gentle”.
Contraindications
There are a few contraindications to chiropractic thrust
techniques:
• Tumours – eg multiple myeloma/osteosarcoma
• Acute fractures
• Hypermobility of the joint
• Severe sprains
• Unstable spondylolisthesis
• Severe disc lesions
Therefore there are many conditions for which
chiropractic therapy is beneficial.
Conditions Aided by Chiropractic
Technique
1. PAIN
• multiple techniques aid the reduction of pain all
over the body
2. MUSCULOSKELETAL CONDITIONS
• Arthritis
• Imbalance in musculature – from injury/irritated
nerves
• Muscle atrophy
• Muscle spasm – tight tendons eg superficial
digital flexors
• Cruciate treatment
• Old fractures and imbalance in the body
• Abnormal gaits
See Magnum
3. NEUROLOGICAL CONDITIONS
• pain along spine
• disc compression
• signs of abnormal nervous function
4. URINARY INCONTINENCE
Pudental and parasympathetic nerves to bladder – have
had some great success with dogs restricted around the
L-S area.
See pictures of Natasha
5. SKIN — trophic changes to skin
• Skin has a very high concentration of nerves –
don’t overlook
• Tightness around skin can decrease blood supply
and metabolism and inflammatory response can be
influenced. See pictures of Holly
• Lick granulomas – 9/10 cases of lick granuloma I
have seen have restrictions around the peripheral
nerve root.These responded well to chiropractic
treatment. See Rosie
• Note changes in coat colour/oiliness/dullness etc –
these may indicate poor nerve conduction.
See pictures of Holly and Jelani
6. DIGESTION PROBLEMS
• Noted occipital restrictions with intermittent/difficult
to diagnose vomiting (consider the Vagus nerve) and
improvement after adjustment.
• Pain around the T10-13 area associated with gut
problems (liver/intestines etc)
7. BEHAVIOURAL PROBLEMS
• PAIN – undiagnosed pain can be a source of
sudden poor/aggressive behaviours – numerous
animals treated chiropractically have improved their
behaviour and obedience.
8. DRY EYE
Consider the sympathetic pathway from the thoracics to
the eye/lacrimal gland.
Every day benefits in veterinary practice
• Post surgically ... improved healing of wounds/faster
recovery by improving circulation/nerve function to
soft tissue/organs/muscles etc
• Improving function of circulation for better delivery of
systemic drugs to target site
• Improving chest motion for respiratory and
heart conditions
• Aid digestive problems
• Aiding skin treatment
• Improving immune function
Vets And Rehabilitation
Veterinarians interested in rehabilitation are limited in
formal training in Australia. The Animal Physiotherapy
course at UQ Gatton is only open to graduates of a
human physiotherapy course. Veterinarians are not
eligible unless they also have a human physiotherapy
degree. Chiropractic therapy offers very useful training
in rehabilitation.
Recently I spent six weeks in the USA completing a
course in canine rehabilitation and visiting various
rehabilitation practices.The diagnostic and treatment
skills gained from learning chiropractic therapy were
commented on as being very effective and highly
developed by various practitioners.
Sounds Great – Where Is The Proof?
Evidence based medicine has made an impact on
chiropractic therapy. In the last 30 years there has been
much research into how and why chiropractic
manipulation techniques work. Comparisons have been
done with other therapies as well.
Chiropractic studies have led the way in understanding
spinal manipulation.
There are so many articles available – a good concise
review can be found in the textbook Principles and
Practice of Chiropractic edited by Halderman,
Degenaise et al ISBN 0071 375 341. Alternatively the
web and databases like Medline have numerous articles
to review.
Worthy of Great Consideration
Despite the scepticism by modern medicine, my daily
practice of chiropractic technique has influenced me
deeply.The results are amazing and so rewarding.
I solely practice chiropractic, osteopathic and manual
therapy four days a week in my veterinary practice. I
would not have moved into this area if the results were
not significant.
From October 2004 to March 2005, I had been asking
my clients to fill in a questionnaire on the return visit as
to whether their animal had improved/not changed/
became worse after therapy.Two animals showed no
improvement on the first treatment. No animals became
worse from chiropractic treatment and all other animals
improved.This data has yet to be published, however, it
was so heartening to see that this therapy has a
significant role to offer animal health and rehabilitation.
Chiropractic therapy practised by trained practitioners
is very beneficial and worthwhile to offer all animals in
need of improved health.
For more information on animal chiropractic and
trained practitioners, the Australian Veterinary
Chiropractic Association can be contacted on the
web: www.avca.com.au
Ref. Post Graduate Foundation in Veterinary Science of the University of Sydney Perspective 55, Mailing 241 23
CANINE CASES
Golden Lab – “Holly”
Holly’s leg before treatment Holly’s leg after treatment
Holly was brought to me for the skin lesion on her right
hock.The lesion had received various topical treatments
including antibiotic ointments and antifungals. On
examination the lesion was clean and no obvious
infection, however the owners were told a biopsy was
needed to diagnose the problem and they were
reluctant to do this.They sought an alternative opinion.
On examination Holly’s sacrum was rotated and the
hamstring on the right side was very tight.There were
other pelvic and lumbar restrictions.The gastrocnemius
was very tight too and I wondered if there was a
decrease in nerve and blood supply to this region and
that was delaying any healing.
I adjusted Holly and immediately the hamstrings became
less tight. I also stretched her hind leg muscles.The
owners were encouraged to stretch her too which was
done occasionally over the next three weeks.
I visited her four weeks later to take this last photo.
Please note the changes in the whole coat and skin –
the trophic changes were amazing.
“Natasha” – Incontinence
Natasha sitting before beginning treatment.
Natasha sitting after her last treatment. Her body is now
almost straight compared to the first photo. Owner reports
she’s now jumping into the car and standing on her hind
legs etc – behaviour not exhibited prior to treatment.
Natasha was a 4-year-old Irish Wolf hound with
incontinence. She had been incontinent since 3-4
months old – spayed around 8 weeks old. She was
unresponsive to Stiboestrol® and only mild improvement
on ephedrine. Her own chiropractor had adjusted her
initially with some success and then over the next three
treatments showed no improvement.
She had a thorough work-up at the University of
Queensland Small Animal Clinic as a young dog. She
suffered repeated urinary tract infections and often
very low specific gravity (SG) noted. A pelvic bladder
was noted.
On my examination I noted multiple body imbalances
especially in the pelvis and sacrum. She could not sit
straight and walked with an awkward gait – mild short
stride L hind. Abdominally the bladder palpated more on
the right and the caudal abdominal contents were more
obvious on the right. I palpated adhesions in dorsalmiddle
caudal abdomen.
Natasha was adjusted and I worked on the restrictions
in the abdomen.
In short, after the first treatment there was
improvement in the incontinence and this continued.
Natasha has been continent for over 12 months without
medication and has not had repeated UTIs.
After treatment her SG was consistently higher
than previously.
NB Natasha is not the only incontinent dog I have
treated with success using chiropractic and osteopathic
manipulations.
“Rosie” – Lick Granuloma
Rosie’s lick granuloma resolved after one treatment.
Rosie had an acute lick granuloma on the left chest wall.
The lesion was larger than a 20 cent piece. She was
very persistent in the licking and had to be restrained
from licking to examine the lesion.There was
hyperaesthesia up the thoracic wall and restrictions in
motion of T4-5. After adjustment, she stopped licking
immediately. No other treatment was given – not even
cleaning the wound with water.There was total healing
and no licking behaviour was seen again (even up to
two years after the problem).
I have treated many dogs with chronic lick granulomas
that have restrictions around the nerve that serve the
dermatome in which the lick granuloma is seen.
Back Pain – “Beau”
Beau before treatment.
Beau’s best stand before treatment.
Beau after treatment.
Beau standing after treatment
Beau had severe pain in the lumbar region of the spine.
As seen in the photos, Beau could not stand straight or
sit straight.
Adjustments were made to the spine and immediately
Beau could stand and sit straight. After another
treatment, Beau did not show any symptoms of pain for
over a year.
Neck Pain – “Rosie”
Rosie’s uneven ilia.
Rosie able to turn neck post treatment.
Rosie had neck pain (especially on lateral flexion to the
left) and radiographs revealed a degenerated disc. She
was prescribed Rimadyl® and had needed Rimadyl®
continually.When I examined Rosie (11 months after
initial diagnosis of neck lesion), she was severely
restricted in her lower cervicals and after the first
treatment she had full range of motion of her neck
(see photo).
Rosie has not been on any medication for her neck for
two years (since treatment) and has maintained full
range of motion of neck.
I have treated many back and neck pain dogs with
chiropractic and osteopathic therapy. Many of the neck
pain dogs have root signature and often nerve deficits
and even these have responded very well.
Anal Glands – “Jelani”
“Jelani”
Jelani’s right hind skin prior to treatment
Jelani post treatment
Jelani was presented for gait problems but he had
repeated anal gland infections (every 2-3 months back
at the vet) and also a strange skin lesion pattern on
right hind.
On examination there were sacral and pelvic restrictions
especially on the right.After adjustments the skin lesions
disappeared and Jelani has not had a repeat of anal
gland problems in over two years since treatment.
How is this possible? I considered the nerve function of
the anal glands but also the muscles involved in squatting
and compressing the glands – chiropractic treatment
helped the function of both.
“Magnum” – severe arthritis in elbow
Magnum on first treatment – note the angle on the left elbow
and the hind leg stance.
Magnum two treatments later – note the elbow and the hind legs.
Magnum was referred for treatment for stumbling and
knuckling on left fore. He was having difficulty getting up
and was lying around most of the time. His gait was very
stiff and uneven in hind. His left elbow had severe
osteoarthritis and his flexion of the elbow was around
110º; extension around 165º. Had been treated
conventionally with NSAID, Cartrophen® and glucosamine. He was unresponsive to accupuncture.
Other issues included spondylosis in the lumbar and
thoracics and numerous vertebral restrictions.
Chiropractic therapy was used on the spine and
osteopathic techniques were used on the elbow. After
the first treatment, Magnum ceased knuckling on the left
fore and was able to step up and down one stair
without stumbling (he would fall down if doing this
before treatment).
Magnum flexing elbow
Exercises and passive range of motion exercises were
given to help maintain Magnum. He received a
treatment once a month to help keep him mobile.The
elbow joint itself improved dramatically in its range of
motion and the fluid feel of the joint increased.
Molly – Left hip O-A
Molly was lame in the right hind.This leg had patella
surgery a couple of years previously with no rehabilitation
work done. On the radiographs the severely
degenerated hip is actually her left hip – not the right.
Her difficulties were mostly soft tissue; however there
were spinal restrictions due to the length of
compromise and her spondylosis.
Molly could not sit with her right hind tucked up before
treatment.After 2 treatments, Molly could sit more
comfortably and her lameness was significantly improved.
After 4 treatments Molly's owner was so pleased with
the results she elected to exercise her at home and no
longer came for treatment.
Molly, sitting well post treatment.
I feel good! Typical reaction of dogs after chiropractic is to give
their body a really good shake.
FELINE CASES:
“Karla” – Foreleg Lameness
Cat able to sit after treatment
Chocolate Burmese 4-year-old Desexed Female
presented 1/7/03 lame in left fore; restriction in
cervical 7-thoracic 1 on left; unable to laterally flex neck
to left; triceps in spasm; adjustment of (c7-t1) vertebra –
immediate relaxation of triceps; after treatment in
consult room – inconsistent lameness.
15/7/03 much improved – walking without limp/lameness.
No further report of lameness to date.
“Remington” – plucking hair from side
Burmese Blue 16-year-old female desexed.
7/8/03 plucking hair from right side of body for a week.
8/8/03 overnight progressed to removing large lumps of
fur from right chest and abdomen.
Exam – thickened around Thoracic 12-11 vertebra on
right at rib joint and reduced mobility of chest wall; right
hind decrease in stride and mild loss of muscle bulk in
right hind.
Previous Xrays revealed extensive spondylosis in
thoracics and lumbars.
Spine was treated with modified chiro adjustments and
some fascial work to help release the chest.
12/8/03 – plucked hair once since last treatment and
very mild; chest motion improved.
Treated again and no plucking seen again till 11/03 and
this was after a cat fight.
N.B. Another cat (“Millie”) I treated had a lick
granuloma over its right ribs 11-12-13 that had
developed one month after a hit by car (HBC) accident.
It had received various treatments over the following
two years with no resolution.The licking was incessant
and the area licked was now hairless and fibrotic. On
examination there was considerable restriction in the rib
heads and fascial restriction along the ribs.After working
on these restrictions both chiropractically and
osteopathically, the cat gradually stopped licking over the
next three weeks and ceased licking three weeks after
the initial treatment. I have seen this cat for another
reason but the owner reported no further licking of this
area more than 12 months post treatment.
|
