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If you have a dog, cat, or horse, you may find yourself invited to have its spine "adjusted." Before taking any such plunge, here's what you should know.
No part of chiropractic education deals with animals, and no part of veterinary education deals with manipulative forms of physiotherapy. In most states, the practice of chiropractic is, by definition, restricted to humans (a definition supported by a 1998 decision of the appeals court of the state of Michigan). Nevertheless, some chiropractors purport to be able to ply their trade on animals [A, B} and some veterinarians [B].say that they can perform chiropractic adjustments. One Wisconsin chiropractor, for example, says that "Chiropractic care offers a natural, drug-free adjunct to . . . total health care" and is suitable for cats, dogs, and horses with: back, neck, leg, or tail pain; carpal tunnel syndrome; degenerative arthritis; disc problems; head tilt; injuries resulting from slips, falls; TMJ problems, difficulty chewing; pain syndromes; sciatic neuralgia; sudden changes in behavior or personality; uneven muscle development; uneven pelvis or hips; weight loss due to pain; "a look of apprehension or pain in the facial expression"; and various other problems .
A few doctors hold both chiropractic and veterinary degrees. There also appear to be many animal "chiropractors" who are neither veterinarian nor chiropractor but assert that they have experience.
From a legal perspective, practicing on animals is restricted to veterinarians in all states. Technically, chiropractors may work on animals under the direct supervision of a veterinarian if the veterinarian feels that such treatment is warranted. However, in doing so, the chiropractor is working as an unlicensed veterinary technician. Under the same umbrella, a chiropractor might also be able to draw blood or take x-rays of an animal if properly supervised. Accordingly, anyone manipulating animals who is not a veterinarian or working under direct veterinary supervision is likely to be breaking current laws. The attorneys general of about half the states have warned "animal chiropractor Daniel Kamen, D.C., not to conduct his seminars in their states, because services he performs during his seminar would constitute the illegal practice of veterinary medicine. After Kamen defied the authorities in Nevada, the Nevada Attorney General filed suit .
The American Veterinary Chiropractic Association (AVCA) "certifies" DVMs or DCs after 150 hours of coursework and also offers "advanced" courses. The idea that 150 hours can provide a chiropractic or veterinary education seems odd, and the Association does say that its certification is just the beginning. As scanty as 150 hours may seem, one-day seminars are offered on animal adjusting. What would the response be if members of the veterinary profession started giving one-day clinics on human chiropractic?
Sadly, many of human chiropractic's unscientific aspects are being applied to animals. For example, in a chapter in 1998 textbook intended for veterinarians, AVCA founder Sharon Willoughby, DVM, DC, states:
Chiropractors identify subluxations of the spine during clinical examinations and then proceed to correct these lesions by specifically adjusting the involved segments. . . . An adjustment is a specific physical action designed to reinforce the biomechanics of the verterbral column and indirectly influence neurologic function. . . .
For the veterinarian who understands the elements of holistic practice and the philosophy of chiropractic, every patient becomes a possible chiropractic patient. Every examination should include a spinal examination, and every treatment protocol should include an adjustment if necessary .
Some "veterinary chiropractic" advocates assert that spinal problems result in problems with other organ systems. In the above-mentioned texbook, "holistic veterinarian" Joyce C. Harmon, DVM, writes:
Many practitioners believe that the spine is not worth checking unless a musculoskeletal problem is being examined; however, every cell in the body has a nerve supply originating in the nervous system. The nervous system is therefore important to the health of all organ systems, and a chiropractic examination is advised for every patient. . . .
Chiropractic is an excellent way to build a veterinary practice because it includes preventive care after the initial problem is solved .
Some organs and cells function independently of nerve supply; and there is no reason to believe that spinal adjustment in humans does much besides loosening tight spinal joints. But even if chiropractic's subluxation theories were completely valid, it should be obvious from a mechanical standpoint that the forces on the spine of an animal that walks on four limbs are quite different from those of humans who walk on two. Thus, even if human chiropractic theories were plausible, direct application to animals might not be warranted. For example, since the vertebrae of horses are the size of the adult fist and surrounded by muscle, tendon, and ligament layers several inches thick, it seems reasonable to wonder whether equine vertebrae can actually be manipulated.
Of course, all of these concerns beg the question of whether "adjusting" dogs, cats, or horses really works. No scientific studies show that chiropractic adjustment does anything useful in any animal. It may be reasonable to surmise that moving an animal's limbs around, massaging its muscles, or giving it any sort of attention might be well-received by the animal, but there is no evidence that such attention can improve health. Furthermore, no published study has ever shown how a chiropractic-related problem can be diagnosed in animals or how treatment success can be determined.
There are also potential dangers. Chiropractic manipulation in humans usually entails short, thrusting movements applied at segments of the spine or at specific joints. Horses have been injured by overly aggressive maneuvers described as animal "chiropractic." Manipulating the spine of a dog with a degenerative disk carries the risk of severe and permanent harm to the spinal cord. No part of chiropractic theory suggests that mallets, hammers or boards -- devices that have made an appearance in the horse world -- should ever be used. (Indeed, the chiropractic-veterinary group itself decries the use of such devices.) Dramatic movements that stretch beyond the limits of normal range of motion -- for example, the lifting of a horse's hind leg over its back -- are potentially harmful. Nor should any animal be manipulated under tranquilization or general anesthesia.
It's easy to see how owners who want to do the "best" for their pets could be convinced by unscrupulous or naïve professionals that "people need adjusting -- animals must, too!" The human-animal bond is strong. However, that bond should not be abused under the guise of unproven "therapy." There is no scientific evidence that any animal ailment is amenable to spinal manipulation. The current state of affairs should be as embarrassing to chiropractors, at least those that are ethical and/or science-minded, as it is to ethical and science-minded veterinarians. Sadly, the animals stand mute.
AMVA is now considering guidelines which state that the use of "complementary" or "alternative" methods should be based on scientific evidence of safety and effectivess. The proposal states:
Claims for the safety and effectiveness of CAVM ultimately should be proven by the scientific method. Such proof can be established only by study of a specific therapy in a specific set of circumstances. Veterinarians should be cautious when using studies from one species or set of circumstances as a basis for therapy in another species or another set of circumstances. Such extrapolations might suggest useful veterinary therapies, but they cannot be done with complete assurance of safety or efficacy. Certain limitations, including money, time, and personnel, may mean that the current state of scientific data relative to CAVM is less-than-desirable. Until such data is obtained, veterinarians should be careful in their advocacy of unproven practices. Veterinarians should ultimately discard practices and philosophies that are ineffective or unsafe .
Dr. Ramey, who practices in Glendale, California, specializes in equine medicine and surgery. He is also co-chairman of the National Council for Reliable Health Information's Task Force on Veterinary Medicine. His recently published book, Alternative Therapies for the Horse, provides an incisive look at veterinary "alternatives" and quackery. His Alt Med Primer provides links to many pertinent articles.