Veterinary chiropractic

Veterinary chiropractic also known as Animal chiropractic, is an emerging subspecialization for Doctors of Veterinary Medicine (DVMs) and Doctors of Chiropractic (DCs) to provide spinal manipulation, manual therapy and other holistic and conservative techniques for animals. In concert with conventional veterinary care, the complementary use of veterinary chiropractic is primarily used for common neuromusculoskeletal conditions.^[1] This reflects the use of complementary and alternative veterinary medicine which continues to grow within the veterinary community.^[2] Proposed benefits of animal chiropractic include, enhanced performance, function and quality of life. Currently there are uneven regulation and licensing standards across North America with certain juridictions, such as Ontario,^[3] who have regulated the practice of veterinary chiropractic.

Scope of practice

Traditionally, all animal care fell under the exclusive juridiction of veterinarians. With the emergence of veterinary chiropractic, both doctors of chiropractic (DCs) and veterinary medicine (DVMs) can take additional training to become certified in veterinary chiropractic. The minimum standard for practice appears to be a minimum of 210 hours according to the Animal Chiropractic Accreditation Commission ^[4] although, in Australia, a 3 year Masters Degree in Chiropractic Science (Animal Chiropractic) is offered to licensed doctors of chiropractic, veterinary and osteopathic medicine.^[5] Where regulated, typical restricted acts include diagnosis and spinal manipulation. In some locations, a veterinarian must supervise the treatment provided by the veterinary chiropractor ^[6] Veterinary chiropractors typically treat working horses, racing greyhounds, and pets; and recently have been used more extensively to treat ongoing and chronic pain caused by conditions of the neck and back.^[7] Those that specialize in horses are referred to as "Equine Chiropractors."^[8] There has been discussion over who should perform animal chiropractic. Veterinarians, chiropractors, or both.[1]

Clinical practice

Before working on an animal, a veterinary chiropractor procures a detailed case history of the animal including prior diagnoses, therapies, and X-ray or laboratory analyses^{[citation needed]}. The American Veterinary Medical Association guidelines recommend that a veterinarian should examine an animal and establish a preliminary diagnosis before any alternative treatment, like chiropractic, is initiated.^[9] Before performing a chiropractic adjustment, the doctor examines the animal's gait, posture, and the vertebrae and extremities. In addition to spinal manipulation, other adjustive procedures can be performed to the extremity joints and cranial sutures.^[10] Veterinary chiropractors also make neurological evaluations.^[10]

History and present status

Chiropractic treatment of large animals dates back to the early 1900s and is common in dogs and popular in horses.^[11] Animal chiropractic was formalized in 1989 by Sharon Willoughby, with a 100 hour post-graduate course.^[12] The American Veterinary Chiropractic Association (AVCA) is the primary national credential for this field in North America. Certification was developed based upon input and oversight from both professions.^[13] Several complementary and alternative veterinary medicine (CAVM) presentations were given in the 2007 annual convention of the American Veterinary Medical Association, including chiropractic care and acupuncture.^[11] As of 2008, chiropractors and veterinarians are trained side by side in the Masters Degree in Chiropractic Sciences (Animal Chiropractic) in Australia and the North American AVCA certified programmes, such as Parker College of Chiropractic.^[14]

Education, certification and regulation

Pre-requisites

North American applicants must have graduated from an accredited veterinary school or CCE-accredited chiropractic school and hold current licenses from their respective provinces or states.^[15] In Australia a first professional degree in chiropractic, osteopathic or veterinary medicine is required for admission into the Masters of Chiropractic Science program.^[5]

Education

Most veterinary chiropractic programs are a minimum of 210 hours of additional training following the completion of veterinary or chiropractic school, and subsequent licensure. Practitioners will be able to complete an appropriate history, physical examination, communicate a diagnosis and plan of management, and provide care where indicated within their respective scopes of practice.^[16] Though there is variation, common topics covered in veterinary chiropractic programs can include:

• Anatomy
• Basic and advanced Neurology
• Rehabilitation Therapy
• Complementary and alternative medicine modalities
• Philosophy
• Basic and advanced chiropractic manipulative techniques

Currently, the Animal Chiropractic Accreditation Commission (ACAC) is the defacto accrediting body for veterinary chiropractic. All accredited programs must meet ACAC's minimum requirement of 210 hours. A passing grade of 75 in both the written, theoretical and the clinical competency examination is required for certification. Continuing education requirements of the ACAC are 30 credits every 3 years for recertification.^[4] Though few U.S. veterinary schools offer educational or research programs in complementary and alternative veterinary medicine (CAMV), in a survey, 61% of faculty believe that chiropractic should be included in their school's curriculum.^[17]

Efficacy

A recent review investigated the role of manual therapies in equine pain management and found limited evidence supporting the effectiveness of spinal manipulation or mobilization in reducing pain and muscle hypertonicity in horses. The authors concluded that the efficacy of specific equine manual therapy techniques is unknown.^[18] The American Animal Hospital Association and the American Association of Feline Practitioners have stated that there is currently insufficient evidence to make specific recommendations about the use of chiropractic intervention for dogs and cats.^[19] A recent survey has suggested that the use of allied health therapies, including animal chiropractic, for the treatment of competition race horses is widespread and many riders or trainers perceived it to be beneficial.^[20] One study has suggested that chiropractic manipulation might increase pain thresholds in healthy horses.^[21] Another small study has suggested that chiropractic manipulation can cause changes in thoracolumbar and pelvic kinematics in healthy horses, however, it is not yet known if these changes are beneficial.^[22]

Safety

Veterinary chiropractic methods can potentially cause injury through the use of inappropriate technique or excessive force.^[23] In addition, there is some degree of risk associated with even skilled manipulation in animals as the potential for injury exists with any technique used.^[24][25] Ramey et al. (2000) states that there is an increased risk in the presence of structural disease, such equine cervical vertebral malformation or canine intervertebral disk disease.^[24] A reply by Taylor and Romano (2000) states that veterinary chiropractic has been shown clinically to be safe and effective for those conditions.^[25]

References

1. ^ "CACCP". http://www.veterinarychiropractic.ca/index.html. Retrieved 2008-04-15. 
2. ^ Bolt, E (Dec 2002). "Use of complementary veterinary medicine in the geriatric horse". Vet Clin North Am Equine Pract. 18 (3): 631–6. doi:10.1016/S0749-0739(02)00035-4. 
3. ^ "Chiropractic Care of Animals". College of Chiropractors of Ontario. April 25, 1998. Archived from the original on 2008-04-22. http://web.archive.org/web/20080422173535/http://www.cco.on.ca/standard_of_practice_s-009.htm. Retrieved 2008-04-17. 
4. ^ ^{a b} "American Veterinary Chiropractic Association - chiropractic, spinal, manipulation, chiropractor, animal care, animal adjusting". animalchiropractic.org. Archived from the original on 2008-03-26. http://web.archive.org/web/20080326194143/http://www.animalchiropractic.org/animal_chiropractic_education.htm. Retrieved 2008-04-22. 
5. ^ ^{a b} "RMIT - Animal Chiropractic – Master of Chiropractic Science incorporating Graduate Diploma". Royal Melbourne Institute of Technology. http://www.rmit.com.au/browse;ID=MC030. Retrieved 2008-04-22. 
6. ^ "State Legislative Resources - Issues". www.avma.org. http://www.avma.org/advocacy/state/issues/la_cavm_state_reg_models.asp. Retrieved 2008-05-19. 
7. ^ Kayne, Steven (2004). Veterinary Pharmacy. Pharmaceutical Press. p. 143. ISBN 0853695342. http://books.google.com/?id=EGusLMlx6nsC&pg=PA143&lpg=PA135. Retrieved 2008-04-22. 
8. ^ Landers, Theodore (2002). The Career Guide to the Horse Industry. Thomson Delmar Learning. pp. 120–1. ISBN 0766848493. http://books.google.com/?id=bW6Px7v-onUC&pg=PA120&dq=Equine+chiropractic. Retrieved 2008-04-23. 
9. ^ avmajournals.avma.org/doi/pdf/10.2460/javma.2001.218.1729
10. ^ ^{a b} Ellen Shenk (2005). Careers with Animals: Exploring Occupations Involving Dogs, Horses, Cats. Stackpole Books. ISBN 0811729621. http://books.google.com/?id=SSN0jWhVP70C&pg=PA187. Retrieved 2008-04-23. 
11. ^ ^{a b} "Complementary and alternative veterinary medicine—such as acupuncture, herbs and chiropractic—becoming more mainstream" (Press release). American Veterinary Medical Association. 2007-07-14. http://avma.org/press/releases/070714_comp_alt_med.asp. Retrieved 2008-05-30. 
12. ^ ttp://www.animalchiropractic.org/Dr._Sharon_Willoughby-Blake.htm
13. ^ http://animalchiropractic.org/animal_chiropractic_certification.htm
14. ^ http://parker.edu/animal-chiropractic-program.aspx
15. ^ "Canadian Animal Chiropractic Certification Program". http://www.veterinarychiropractic.ca/index.html. Retrieved 2008-04-15. 
16. ^ "Animal Chiropractic". Canadian Memorial Chiropractic College. Archived from the original on 2008-04-20. http://web.archive.org/web/20080420232641/http://www.cmcc.ca/CE/AnimalChiropractic.htm. Retrieved 2008-04-22. 
17. ^ Schoen AM (2000-02-15). "Results of a survey on educational and research programs in complementary and alternative veterinary medicine at veterinary medical schools in the United States". Journal of the American Veterinary Medical Association 216 (4): 502–9. doi:10.2460/javma.2000.216.502. PMID 10687004. 
18. ^ {{cite journal |journal=Vet Clin North Am Equine Pract|year= 2010| volume=26| issue=3| [pages=579-601| title=The role of manual therapies in equine pain management.| author=Haussler KK.
19. ^ The American Animal Hospital Association and the American Association of Feline Practitioners. Pain Management Guidelines for Dogs & Cats. https://www.aahanet.org/Library/PainMgmt.aspx. 
20. ^ Meredith K, Bolwell CF, Rogers CW, Gee EK (2011). "The use of allied health therapies on competition horses in the North Island of New Zealand". NZ Vet J 59 (3): 123-127. PMID 21541885. 
21. ^ Sullivan KA, Hill AE, Haussler KK (2008). "The effects of chiropractic, massage and phenylbutazone on spinal mechanical nociceptive thresholds in horses without clinical signs". Equine Vet J 40 (1): 14–20. doi:10.2746/042516407X240456. PMID 18083655. 
22. ^ Gomez Alvarez CB, L'ami JJ, Moffat D, Back W, van Weeren PR (2008). "Effect of chiropractic manipulations on the kinematics of back and limbs in horses with clinically diagnosed back problems". Equine Vet J 40 (2): 153–9. doi:10.2746/042516408X250292. PMID 18089466. 
23. ^ 403 Forbidden
24. ^ ^{a b} Ramey D, Keating JC, Imrie R, Bowles D (March 2000). "Claims for veterinary chiropractic unjustified". Can. Vet. J. 41 (3): 169–70. PMC 1476296. PMID 10738593. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1476296. 
25. ^ ^{a b} Taylor L, Romano L (March 2000). "Claims for veterinary chiropractic unjustified - A reply". Can. Vet. J. 41 (3): 169–170. PMC 1476304. PMID 17424592. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1476304. 

External links

• American Veterinary Chiropractic Association

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