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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. It is a treatment that we have offered at our hospital for years and a day does not go by when we are adjusting a dog or cat.

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.

Veterinary Chiropractic versus Veterinary Orthopedic Manipulation

The originator of VOM, Dr. Bill Inman, states that VOM is a treatment technique distinct from chiropractic. In fact, to separate it from "chiropractic", Inman describes someone who practices VOM as a "veterinary neurologic adjuster".

Chiropractors use motion palpation to detect areas of the spine that are out of alignment. Each of these vertebrae are then adjusted in a specific direction, manually or with an activator, to get them back in their proper positions.

VOM adjusters use only an activator on the vertebrae to make an adjustment. Unlike chiropractic, which is applied only to vertebrae that are identified as subluxated, VOM addresses every vertebra. This difference is the basis for a fundamental argument between chiropractors and VOM practitioners. Chiropractors believe that only subluxated vertebrae should be treated. More importantly, they believe it is unwise to move vertebrae that are already in alignment.

VOM practitioners say it's better to adjust every vertebra. They argue that a chiropractor can only diagnose 40 percent of all subluxations. VOM finds every vertebra that is subluxated and adjusts each of them.

The other point of contention between VOM and chiropractic is "line of drive" – the direction that the vertebra is adjusted. Chiropractors believe that the adjustment must be made in the just the right direction to correctly realign the vertebrae.

The theory behind VOM is that movement in the joint (created by an activator) stimulates mechanoreceptors that release the interneurons (the nerves trapped by the subluxation). According to Inman, the direction does not matter; it is the motion that is needed, and this is supplied by the activator.

Is one system superior to the other? Each "side" can successfully argue that their method is better. No matter how you assess a vertebral subluxation or how you correct it, restoring spinal health has a positive effect on general well-being. Both forms of treatment offer a simple, drug-free form of therapy that can help dogs have healthier and more comfortable lives. Isn’t that what it's all about?

What Can VOM Treat?

Routinely treated are conditions such as:

1. Acute and non-acute lameness
2. Progressive lameness
3. Hip Dysplasia-like syndromes
4. IV disc disease
5. Progressive myelopathies, (down in the rears dogs)
6. Urinary and fecal incontinence
7. Unilateral lameness
8. Wobbler’s Disease
9. Diseases of the knee
10. Esophageal disease
11. Increased or decreased GI mobility disease
12. Digestive disorders
13. Performance problems
14. Behavioral problems
15. Agility dysfunction
16. Endocrine disease

There is a very good description of VOM at the following web site: http://www.lbah.com/vom.htm

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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