Veterinary Medical Manipulation Erica Johnson, DVM, CVMM
Chiropractic vs. VMM Chiropractors perform manipulations on humans and have the letters DC (Doctor of Chiropractic) after their names A veterinarian that is licensed for manipulation is NOT a chiropractor. Chiropractic is a human specific term. 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 Common tool used by human chiropractors This tool is not recommended in the veterinary practice of manipulation It can be set for different strengths but has too much force for companion animals Do not recommend allowing this tool to be used on companion animals. Anyone can get certified to use this tool
Who needs VMM? Everyone!!!!
Terms to Know ubluxation: This is the manipulable lesion (the area that is out of place or out ) lack of range of motion HVLA: Type of thrust that we use to manipulate (High Velocity Low Amplitude) Listing: Descriptive name for the restriction diagnosis Hypomobility: Decreased movement felt with palpation Hypermobility: Increased movement felt with palpation
Effects of Restrictions The effects of restrictions can be divided into 3 categories: 1. Local effects A. Cartilage degeneration B. Adhesions C. Circulation (decreased) 2. Nervous system effects Decrease in cortical stimulation Decrease in sympathetic and pain inhibition Pain Peripheral nerve function Compensatory effects Adjacent motion units Muscles Tendons
Conditions That Need pinal Manipulation pondylosis Grade 1 and 2 medial patellar luxation Osteoarthritis IVDD (once things are calmed down) Agility dogs Trauma Lick granulomas Idiopathic epilepsy (reduce frequency)
Lick Granulomas Most lick granulomas are due to restrictions of the vertebrae Based on where they are licking can determine the exact nerve that is affected and its associated vertebrae Instead of using a conventional medication we should perform medical manipulation to see if that resolves the issue
What To Expect During The First ession Get an attainable goal in line for your pet Watch them walk around outside, in the room, see how they sit and naturally carry themselves Perform physical exam and motion palpation Depending on what is felt may perform k-laser, cold laser or acupuncture prior to manipulation Perform the manipulation/adjustment
The Manipulation Process *Pelvis and acrum* tart with the pelvis and sacrum Pelvis can be posterior or anterior Palpating the anterior part of the pelvis can be painful. They may vocalize or turn with touching this area. Iliopsoas in this area as well. acrum has a base and apex Base: Dorsal, right or left Apex: Right or left
The Manipulation Process *Lumbar pine* Lumbar spine has 7 vertebrae Lumbar vertebrae can be dorsal, right or left This is where most dogs have spondylosis. upport system of the lumbar vertebrae is all muscle!!
The Manipulation Process *Thoracic Vertebrae and Ribs* 13 Thoracic vertebrae 13 associated ribs pairs Thoracic vertebrae can be dorsal, right or left Ribs can be dorsal, cranial or caudal 12 ribs have cartilage connecting them (sternum) and the 13th rib free floating Ribs can be painful with palpation and manipulation. Be prepared for a reaction.
The Manipulation Process *Cervical Vertebrae* 7 cervical vertebrae C1 is the atlas Atlas is cranial or dorsal C2 is the axis C3-C5 typical vertebrae C6 and C7 are transitional segments C2-C7 are either body left or right
The Manipulation Process *Thoracic Limb* capula Humerus Radius Ulna Accessory carpal bone/carpal bones Metacarpals Digits
The Manipulation Process *Pelvic Limb* Femur Tibia and Fibula Calcaneous Metatarsals Digits
The TMJ The most important joint in the body! It has very important sensory/proprioceptive value as it has more neurologic receptors than any other joint in the body! Periodontal ligaments are innervated and give constant feedback about position of the mandible and head Need to be adjusting all pets after dental procedures especially with extractions as we have completely altered their feedback system
The TMJ This can be a painful location to manipulate! Typically not going to do an HVLA manipulation but more traction because of the pain and sensory input in this area TMJ has a few listings: Dorsal compartment left or right (lateral movement) Ventral compartment rostral or caudal (open/close)
The TMJ Most Predisposed Patients to TMJ Issues Animals with dental disease and/or recent dental procedure Animals with little or no remaining teeth Working dogs that train to bite or are using a tug/chew/ball (agility) Previous trauma to the TMJ/Mandible
Nails, Nails, Nails! Nail length is the #1 most important thing that we can control to prevent arthritis If the nails are too long will alter their gate completely. This leads to issues up the limb and into the spine. It also weakens the flexor and tendons leading to tendon laxity Keep nails trimmed!!! Atrium can help!!
Additional Modalities K-laser Cold laser Acupuncture Tu-ina (massage) Assisi loop Hemp Rx Herbals/Homeopathics
Therapeutic Laser Typically will use this prior to manipulation especially with tight and spasming musculature Uses: Wound healing Analgesia Edema Inflammation Muscle spasm Increases circulation
Assisi Loops PEMF (Pulsed Electromagnetic Field) Causes nitric oxide release which causes immediate anti-inflammatory effects and decreases edema Improves wound and tendon healing More rapid neovascularization (increases circulation) Do 2-4 treatments per day!
HempRx Extracted from the hemp plant and is the purest form of hemp oil (better than CBD) Use liquid CO2 extraction so purify the product of heavy metals, solvents or pesticides Used for pain control, seizures, nausea, stress, anxiety and cancer symptoms. No side effects with proper dosing and safe for patients with organ dysfunction NAC seal!!! Do not use products without this seal
Herbals/Hemeopathics Body ore Devcor mobility Mobility Flex T-relief Essential Oil Blend Lavendar + Copaiba
Additional upport Acupuncture Conventional Medication Rimadyl or Metacam Gabapentin Tramadol Methocarbamol Rehab with Kathy and Allyson Tu-ina Exercise and strength conditioning plan Therapeutic Ultrasound UWTM
Agility Gone Wrong https://www.youtube.com/watch?v=a4n7g29gwqi
Questions?