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Veterinary Orthopedic Manipulation
by Jeff Grognet, DVM, BSc (Agr) and Louise Janes, BSc(Agr), DVM
Is your dog’s back out of alignment? Is it easy to tell if something is amiss? A technology, called Veterinary Orthopedic Manipulation (VOM), is helping diagnose and treat back conditions in our canine friends.
Though VOM is used primarily to treat a variety of spinal disorders such as disk disease, Wobbler's, lumbosacral disease, and degenerative myelopathy, it is also being employed as an adjunctive therapy for lick granulomas, cruciate injury, urinary incontinence, and other internal medicine disorders.
The founder of VOM, Dr. William Inman, is a veterinarian. After years of treating spinal disease with surgery, he became dissatisfied with the results of his labours. He started using a spinal accelerometer (called an activator) to treat vertebral subluxations. After treating thousands of cases, Inman established a treatment protocol that was predictable and repeatable. He now teaches his technique to veterinarians across the US and around the world.
The goal of VOM is to treat the vertebral subluxation complex (VCS) – a vertebral malalignment that is not visible on x-rays. This physical abnormality causes a functional defect that generates pain. It also impinges on the spinal nerve that exits between the vertebrae, reducing or shutting down the nerve's function.
Even a slight subluxation can put pressure on the spinal cord that runs inside the vertebrae and also on the nerve roots that exit between the vertebrae. Inman believes the resulting nerve disruption directly affects the function of the organs that the nerves supply. For example, if the impaired spinal nerve supplies the colon, its dysfunction may be a trigger for inflammatory bowel disease.
If a subluxation is long standing, bone changes may become evident on radiographs. The accompanying image, of a dog's lower (lumbar) spine, shows one joint that is misshapen. The extra bone growth (arrow), called spondylosis (also referred to as osteophytes, or in lay terms, calcium deposits) forms as the body attempts to stabilize the joint. It only becomes visible years after the initial instability develops. More importantly, it indicates there is inflammation present, and therefore pain, in that joint.
The advantage of VOM is that it can diagnose subluxations long before they become visible on radiographs. The VOM practitioner puts the activator on the top of each vertebra (on what is called the dorsal spinous process) and adjusts each one in turn, starting at the top of the neck and proceeding down to the pelvis.
The practitioner observes the patient closely, looking for a "read" – a contraction of the muscles that lie beneath the skin, a slight change in posture, or a head nod (when the neck vertebrae are activated), immediately after the activator thrust. Like a knee jerk reflex, the dog cannot prevent a read from happening. A read indicates that a subluxation, and therefore a compromised nerve root, is present.
Besides diagnosing the subluxation, the activator also helps correct it. Generally, a practitioner will make three passes over the spine from the front to the back, looking for reads that disappear. Inman likens nerve function to a circuit breaker. The original subluxation turns off the breaker by compromising the nerve. The practitioner then corrects the subluxation and allows the nerve to resume function (turns on the breaker). The only way it can be turned off is if the subluxation returns.
In general, it takes five to seven adjustments to complete the course of treatment in most dogs. Adjustments are done on day 1, 3, 7, 14, 28, 49, and, if needed, a maintenance schedule is created. Treatment schedules are individualized for each patient.
The reason more and more veterinarians are learning this procedure is that it is an effective drug-free way to restore joint mobility and normal nerve communication.
To Find a VOM Practitioner, Go to:
http://www.vomtech.com
Click on the choice "Find a Practitioner". Look for the two letter code for your province or state to find a doctor near you.
See VOM in Pictures, Go to:
http://www.lbah.com/vom.htm
Designed for client education, this site shows many pictures of VOM applied to dogs (and other animals).
Examples of VOM
Sasha is an 11 year-old German Shepherd with spinal arthritis and degenerative myelopathy. The function of her hind legs had deteriorated to the point that she could hardly walk without falling. Worse yet, Sasha could not remain active with her family. After just one VOM treatment, she was getting up easier and was more playful. She continues to receive scheduled treatments and though she still has a slight residual deficit in the nerves of her hind legs, she is much stronger and wants to go for walks.
Marley is a two-year-old Rottweiler-cross that fell out of a truck. She damaged her back and knees (both knees eventually required surgery for ruptured cruciate ligaments). Months later, her back deteriorated. She hobbled with a roached back and was in constant pain. Radiographs showed a proliferation of bone at the junction of her lumbar and sacral vertebrae. Marley was scheduled for a CAT scan and probable back surgery at a referral center. While her owners waited for the appointment, they decided to try VOM. Within two weeks, Marley was moving more freely and her back was no longer arched in pain. She too is being maintained with periodic VOM adjustments. Surgery was not needed.
For more information contact Dr. Jeff Grognet or Dr. Louise Janes at
Mid-Isle Veterinary Hospital,
5-161 Fern Road West,
Qualicum Beach, B.C.
Tel (250) 752-8969
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