Veterinary Medical Manipulation Erica Johnson, DVM, CVMM S
Chiropractic vs. VMM S Chiropractors perform manipulations on humans and have the letters DC (Doctor of Chiropractic) after their names S A veterinarian that is licensed for manipulation is NOT a chiropractor. Chiropractic is a human specific term. S CVMM’s cannot perform manipulations on humans and DC’s should not manipulate a dog or cat without the appropriate training. Do not allow your chiropractor to adjust your dog or cat unless they have had the proper training.
The Activator S Common tool used by human chiropractors S This tool is not recommended in the veterinary practice of manipulation S It can be set for different strengths but has too much force for companion animals S Do not recommend allowing this tool to be used on companion animals. S Anyone can get certified to use this tool
Who needs VMM? Everyone!!!!
Terms to Know Subluxation: This is the manipulable lesion (the area that is S “out of place or out”) – lack of range of motion S HVLA: Type of thrust that we use to manipulate (High Velocity Low Amplitude) S Listing: Descriptive name for the restriction – diagnosis S Hypomobility: Decreased movement felt with palpation S Hypermobility: Increased movement felt with palpation
Effects of Restrictions The effects of restrictions can be divided into 3 categories: S 1. Local effects S A. Cartilage degeneration S B. Adhesions S C. Circulation (decreased) S 2. Nervous system effects S Decrease in cortical stimulation S Decrease in sympathetic and pain inhibition S Pain S Peripheral nerve function S Compensatory effects S Adjacent motion units S Muscles S Tendons S
Conditions That Need Spinal Manipulation Spondylosis S Grade 1 and 2 medial patellar luxation S Osteoarthritis S IVDD (once things are calmed down) S Agility dogs S Trauma S Lick granulomas S Idiopathic epilepsy (reduce frequency) S
Lick Granulomas S Most lick granulomas are due to restrictions of the vertebrae S Based on where they are licking can determine the exact nerve that is affected and its associated vertebrae S Instead of using a conventional medication we should perform medical manipulation to see if that resolves the issue
What To Expect During The First Session S Get an attainable goal in line for your pet S Watch them walk around outside, in the room, see how they sit and naturally carry themselves S Perform physical exam and motion palpation S Depending on what is felt may perform k-laser, cold laser or acupuncture prior to manipulation S Perform the manipulation/adjustment
The Manipulation Process *Pelvis and Sacrum* S Start with the pelvis and sacrum S Pelvis can be posterior or anterior Palpating the anterior part of the S pelvis can be painful. They may vocalize or turn with touching this area. Iliopsoas in this area as well. S Sacrum has a base and apex Base: Dorsal, right or left S Apex: Right or left S
The Manipulation Process *Lumbar Spine* S Lumbar spine has 7 vertebrae S Lumbar vertebrae can be dorsal, right or left S This is where most dogs have spondylosis. S Support system of the lumbar vertebrae is all muscle!!
The Manipulation Process *Thoracic Vertebrae and Ribs* 13 Thoracic vertebrae S 13 associated ribs pairs S Thoracic vertebrae can be S dorsal, right or left Ribs can be dorsal, cranial or S caudal 12 ribs have cartilage S connecting them (sternum) and the 13th rib free floating Ribs can be painful with S palpation and manipulation. Be prepared for a reaction.
The Manipulation Process *Cervical Vertebrae* 7 cervical vertebrae S C1 is the atlas S Atlas is cranial or dorsal S C2 is the axis S C3-C5 typical vertebrae S C6 and C7 are transitional segments S C2-C7 are either body left or right S
The Manipulation Process *Thoracic Limb* S Scapula S Humerus S Radius S Ulna S Accessory carpal bone/Carpal bones S Metacarpals S Digits
The Manipulation Process *Pelvic Limb* S Femur S Tibia and Fibula S Calcaneous S Metatarsals S Digits
The TMJ S The most important joint in the body! S It has very important sensory/proprioceptive value as it has more neurologic receptors than any other joint in the body! S Periodontal ligaments are innervated and give constant feedback about position of the mandible and head Need to be adjusting all pets after S dental procedures especially with extractions as we have completely altered their feedback system
The TMJ S This can be a painful location to manipulate! S Typically not going to do an HVLA manipulation but more traction because of the pain and sensory input in this area S TMJ has a few listings: Dorsal compartment left or right (lateral S movement) Ventral compartment rostral or caudal S (open/close)
The TMJ – Most Predisposed Patients to TMJ Issues S Animals with dental disease and/or recent dental procedure S Animals with little or no remaining teeth S Working dogs that train to bite or are using a tug/chew/ball (agility) S Previous trauma to the TMJ/Mandible
Nails, Nails, Nails! S Nail length is the #1 most important thing that we can control to prevent arthritis S If the nails are too long will alter their gate completely. This leads to issues up the limb and into the spine. S It also weakens the flexor and tendons leading to tendon laxity S Keep nails trimmed!!! Atrium can help!!
Additional Modalities K-laser S Cold laser S Acupuncture S Tu-ina (massage) S Assisi loop S Hemp Rx S Herbals/Homeopathics S
Therapeutic Laser S Typically will use this prior to manipulation especially with tight and spasming musculature S Uses: Wound healing S Analgesia S Edema S Inflammation S Muscle spasm S Increases circulation S
Assisi Loops S PEMF (Pulsed Electromagnetic Field) S Causes nitric oxide release which causes immediate anti-inflammatory effects and decreases edema S Improves wound and tendon healing S More rapid neovascularization (increases circulation) S Do 2-4 treatments per day!
HempRx Extracted from the hemp plant and is the S purest form of hemp oil (better than CBD) Use liquid CO2 extraction so purify the S product of heavy metals, solvents or pesticides Used for pain control, seizures, nausea, S stress, anxiety and cancer symptoms. No side effects with proper dosing and safe S for patients with organ dysfunction NASC seal!!! Do not use products without S this seal
Herbals/Hemeopathics S Body Sore S Devcor mobility S Mobility Flex S T-relief S Essential Oil Blend S Lavendar + Copaiba
Additional Support Acupuncture S Conventional Medication S Rimadyl or Metacam S Gabapentin S Tramadol S Methocarbamol S Rehab with Kathy and Allyson S Tu-ina S Exercise and strength conditioning plan S Therapeutic Ultrasound S UWTM S
Agility Gone Wrong S https://www.youtube.com/watch?v=A4N7G29GWQI
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