Veterinary chiropractic

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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 is uneven regulation and licensing standards across North America with certain juridictions, such as Ontario,^[3] who have regulated the practice of veterinary chiropractic.

Contents 1 Scope of practice 2 Clinical practice 3 History and present status 4 Education, certification and regulation 4.1 Pre-requisites 4.2 Education 5 Research 6 Safety 7 References 8 External links

[edit] 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]

[edit] 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]

[edit] 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.^{[citation needed]} 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, including at schools of chiropractic such as the Canadian Memorial Chiropractic College and Parker College of Chiropractic.^{[citation needed]}

The profession of animal chiropractic is controversial.^[12] The policy of the American Chiropractic Association, the largest professional association of chiropractors, is that the term veterinary chiropractic is a misnomer and should not be used to refer to applying manipulative techniques to animals, and that the term does not describe what is commonly defined by the ACA and most U.S. states as chiropractic. This policy has been in effect since 1994.^[13] Consequently, more than simple manipulative techniques constitutes veterinary chiropractic.^{[original research?][citation needed]} The AVCA program may address this issue by including applied neurology, biomechanics, philosophy, rehabilitation and other subjects that traditionally fall under a chiropractic curriculum.^{[citation needed]}

[edit] Education, certification and regulation

[edit] Pre-requisites

North American applicants must have graduated from an accredited Veterinary School of Medicine or CCE accredited Chiropractic School and hold current licenses from their respective provinces or states.^[14] In Australia a first professional degree in chiropractic, osteopathic or veterinary medicine is required for admission into the Masters of Chiropractic Science program.^[5]

[edit] Education

Most veterinary chiropractic programs are a minimum of 210 hours of additional training following the completion of veterinary and 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.^[15] 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 and the clinical competency examination is required for accreditation. Continuing education requirements of the ACAC are 30 credits 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.^[16]

[edit] Research

A study found chiropractic manipulation increased pain thresholds.^[17] Another study found that there were significant changes in thoracolumbar and pelvic kinematics after chiropractic manipulation in horses, and gave the opinion that "Some of the changes are likely to be beneficial, but clinical trials with increased numbers of horses and longer follow-up are needed."^[18] There is currently insufficient published evidence of efficacy to make specific recommendations about the use of chiropractic intervention for chronic pain in dogs and cats, as well as a lack of research into efficacy of chiropractic care on horses.^[18][19]

[edit] Safety

Veterinary chiropractic methods can potentially cause injury through the use of inappropriate technique or excessive force.^[19] 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.^[20][21] 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.^[20] However, a reply by Taylor and Romano (2000) states that veterinary chiropractic has been shown clinically to be safe and effective for those conditions.^[21]

[edit] References

[edit] External links

• Animal Chiropractic Veterinary Association