MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Chiropractic for animals?

Can’t be!

Yes, it can!!!

Animal Chiropractic “is a field of animal health care that focuses on the preservation and health of the neuro-musculo-skeletal system. Why? Nerves control everything that happens in your animals. Anything adversely affecting the nervous system will have detrimental effects that will resonate throughout the entire body. The command centers of the nervous system are the brain and spinal cord which are protected by the spine. The spine is a complex framework of bones (vertebra), ligaments, muscles and nerves. If the movement and biomechanics of the vertebra become dysfunctional, they can interfere with the performance of the nerves that are branching off of the spinal cord and going to the all of the muscles and organs. As this occurs, your animal can lose normal mobility; resulting in stiffness, tension, pain and even organ dysfunction. Additionally, when normal movement is affected, and left unattended, it will ultimately impact your animal’s entire wellbeing and quality of life…”

As you see, much the same nonsense as for human chiropractic is now also advertised for animals, particularly horses. Chiropractic for horses and other animals has become a thriving business; today there are even colleges that specialise in ‘educating’ animal chiropractors, and the ‘AMERICAN VETERINARY CHIROPRACTIC ASSOCIATION promotes “animal chiropractic to professionals and the public, and [acts] as the certifying agency for doctors who have undergone post-graduate animal chiropractic training. Members working together within their disciplines to expand and promote the knowledge and acceptance of animal chiropractic to their professions, the public and governments; locally, nationally and internationally.”

Recently I came across a remarkable website which promoted chiropractic specifically for horses. Here are a few paragraphs from the promotional text:

In recent years, the demand among horse owners for alternative equine therapies has spurred many veterinarians to explore therapies like acupuncture and chiropractic. Equine chiropractic techniques provide relief by restoring movement to the spinal column and promoting healthy neurologic functioning. In turn, the entire musculoskeletal system benefits, and the overall health of the animal increases.

Perhaps the greatest clinical application of chiropractic techniques is for animals with a vague sort of lameness that is not localized to any specific area, and for horses that experience a sudden decline in performance for seemingly no reason. These issues often relate back to musculoskeletal disorders that can be diagnosed through chiropractic techniques.

Some horse owners use chiropractic as a preventative measure. Subclinical conditions, meaning those that do not yet show symptoms, can often be detected by an equine chiropractor, as can abnormal biomechanics that could cause lameness down the road. Conditions that originate in the spine often result in a changed gait that can affect how force is applied to joints in the lower limbs. Over time, this shifted force can cause lameness, but chiropractic attention may help identify and deal with problems before they become a real issue…

Several situations can benefit from meeting with an equine chiropractor. The most significant sign that a horse could benefit from chiropractic treatment is pain. If the animal’s behavior suddenly changes or its posture seems abnormal, the horse may be experiencing pain. Similarly, reduced performance, refusing to jump, and tossing the head under saddle can indicate pain.

Owners should familiarize themselves with the many signs that a horse is experiencing pain. Some other indicators include chronic weight loss, sensitivity when being groomed, and difficulty turning. A chiropractor is a great option for identifying the issues leading to these behaviors and correcting them as quickly as possible — before the problems compound.

While pain is a great reason to seek equine chiropractic therapy, individuals may also want to consider the option if the horse is not responding to more conventional therapies. Chiropractors can also aid in recovery after significant trauma or lameness. However, horse owners should recognize that chiropractic therapy does not reverse degenerative changes already present, so working with a practitioner early in a disease’s progression can slow its advancement. Chiropractic may also help manage chronic conditions and prevent them from worsening…

END OF QUOTE

And where is the evidence for all this? I did a quick search and found virtually nothing to write home about. A review which I did locate made it clear why: “…only anecdotal evidence exists in horses…”

And that statement does, of course, prompt me to quickly remind everyone: THE PLURAL OF ANECDOTE IS ANECDOTES, NOT EVIDENCE!

 

29 Responses to Only fools and horses… and a few chiropractors

  • Beggars belief! Any chiropractor who pretends it works on animals should be made to demonstrate this on a non-sedated hippopotamus!

    • I doubt that the veterinarian who might prescribe manipulation for a hippo would allow his chiropractic colleague to perform it sans professionally administered sedation.

  • “Veterinary chiropractic” is not recognized by the American Chiropractic Assn. as being chiropractic. 40% of the US states require veterinary AND chiro degrees to treat animals. Virtually all US states require direct referral by and/or coordinated care with a veterinary medicine doctor when manipulation is being considered as a treatment option for an animal. I wonder why this latest rant of Edzard’s features the word “chiropractic” so repetitively?

    It would seem that Edzard’s lament should be more accurately directed toward the veterinary profession since it is what predominantly drives the use of manipulation to treat animals. Unfortunately, Edzard is no more qualified to tell a vet how he should approach treatment of an animal than he is to tell a neurosurgeon how to remove an acoustic neuroma. Edzard simply doesn’t have the veterinary qualification.

    • I wonder why this latest rant of Edzard’s features the word “chiropractic” so repetitively?

      Do you think this might be because most of it is a long quote from a chiropractic website.

      the veterinary profession since it is what predominantly drives the use of manipulation to treat animals

      Really? Any evidence for that assertion?

      Edzard simply doesn’t have the veterinary qualification.

      I don’t have a veterinary qualification either. However, if someone told me that I could treat (say) distemper, by plunging the dog’s paws into boiling aqua regia, I would know it was wrong. I wouldn’t necessarily know what is right, but I would know what is wrong. Similarly, anyone with a rudimentary knowledge of mammalian anatomy and physiology (and possessed of sufficient neurones to form a synapse) can tell that what the chiros propose has no basis in anything akin to logic or evidence.

      • Steve, re-read my comment regarding the veterinary profession’s driving of manipulation’s use for non-human animals. If you have evidence to refute it, present it.

        Please try to focus, Steve. Your last sentence was so non-contextually written that it can’t be understood whether you were referring to SMT generally or if you were specifically referencing manipulation for animals(non-human). Please clarify.

        Regarding your comment regarding distemper and scalding a dog’s paws for treatment, I agree with you that such would be bogus. However, you should discuss your concerns about animal manipulation with veterinarians who prescribe it.

        • So, no evidence for your assertion, then? Guessed as much.

          Oh, and unsurprised at your attempt to shift the burden of proof. Nice try, but rumbled. Bad luck.

          • I see that Steve again has deflected from proving his point; no surprises here! My comments were essentially a priori. I’m sorry that reality is so difficult for Steve to accept. Be well.

        • Your last sentence was so non-contextually written that i it can’t be understood whether you were referring to SMT generally or if you were specifically referencing manipulation for animals(non-human). Please clarify.

          The contextual clue that you apparently missed was that the blogpost is about chiropractic for animals.

          you should discuss your concerns about animal manipulation with veterinarians who prescribe it.

          I don’t know any veterinarians who prescribe it; all the vets I know subscribe to evidence-based treatments. YMMV.

          And from your later post:

          My comments were essentially a priori.

          Obviously, but a priori comments are not worth a heck of a lot if the “priors” are flawed, are they?

          Clues: The premises on which you are basing them are refuted lack of actual evidence for (a) chiropractic being useful for anything other than lower back pain in humans and (b) your silly assertion that the “veterinary profession […] is what predominantly drives the use of manipulation to treat animals”.

          • Steve claims he knows no vets who prescribe manipulation for animals. Well, there you have evidence-based commentary at its finest! Steve stated this so it must be accurate; uh….nope! The majority of US states require direct referral/co-management by vets for animal manipulation. If such is not the case outside the US, I admit that I’m unaware of same. Ergo a priori exists even if Steve refuses to accept this easily referenced statement.

            I have to lol at Steve’s “contextual clue” about this thread’s being about chiro for animals in defense of his obtusely written last sentence in his post of 9/29. Nowhere in my posts did I mention chiro for humans yet Steve waxes innocent regarding the nebulousness of his words. Of course he exposed a “tell” in his most recent post when he referred to what he erroneously alleged I was basing my statements: that I had founded my opinion on evidence that chiro is effective for non-human animals.

            Please focus, Steve. Your linguistic gymnastics might impress some on this site, but they are based on your lack of comprehension relative to my past comments. Where have I mentioned in this thread anything about evidence-based manipulation for animals? My comments didn’t broach that topic. Why do you impute positions to me when I have not stated them? You have become quite boring, Steve.

            Be well.

    • Logos-Bios, to assess whether the scientific evidence of a treatement is solid or not one does not need to have experience in this treatment. One has to have experience in probabilistic, statistical and study design methods. For chiropractic, the verdict is by and large damning.

      As for your arguments like “off label prescription can harm patients”, or “conventional MDs do that too” this is again point missed combined with tu quoque and hence an F. We are not discussing this here. You are like someone who dismisses the advice of a chain-smoking MD to quit smoking to avoid lung cancer. The fact that the MD is a chain smoker doe NOT invalidate the argument. So please stop with your tu-quoque arguments.

      • Dear Thomas,

        I agree with your first sentence. Therefore I take it that you agree that off-label prescribing practices are not always countenanced by objective evidence, especially since you were kind to note the benefits of “probabilistic, statistical, and study design methods.” Of course such methods are not ubiquitous relative to off-label prescribing practices, are they?

        I also agree with the potential validity of prescriptive advice when such is advice that just happens to not be followed by its giver. I suggest that you proffer your Tu Quoque advice to the majority of this forum as its participants are largely ignorant of mainstream chiropractice in the US. There is nothing bogus about the manner in which I treat or diagnose neuromusculoskeletal injuies; I have never used or accepted the term “subluxation” since having begun practice 30 years ago. When I accept or give a referral to a PM&R, neurologist, dermatologist, or surgeon, that referral has a legitimate medical diagnosis. When bone densitometry is indicated, I don’t include a diagnosis of subluxation. When MRI is indicated, my order is to rule out a specified pathology; subluxation(doesn’t exist) is not mentioned. Yet the dogmatic, anti-chiro zealots on this site wax on about this mythical subluxation as though mainstream chiro doctors worship it as the central(only?) condition which chiros treat.

        I note that you steered clear of justifying the high rates of off-label prescribing by MD’s with little or no scientific support, to recapitulate from my earlier post. You must find it more comfortable to criticize a profession about which you largely know little than to defend unscientific practices within your own profession.

        • Logos-Bios, I did not “steer clear” of justifying the high rates of off label prescriptions. I steered clear of your attempt to distract by bringing up a topic that is not discussed here. We discuss about chiropractic and not about off label prescriptions. According to the data, chiropractic may help in some cases of lower back pain, but that’s it.

          • Yawn……according to the article I mentioned, some MD’s are practicing hocum when prescribing off-label meds. Remember, Thomas, I simply mentioned my concern for such practices by MD’s…and my comments were in the same plea for evidence justifying such practices as that noted by the assumed creator of this blog. As a reminder, Edzard stated, “and where is the evidence……”? It appears that you are not aware that what is good for the goose is good for the gander.

            Be well, Thomas

          • As I said, the discussion was NOT about off label prescriptions but about chiropractors. Whether you intentionally or unintentionally tried to change the topic does not matter. I simply didn’t go for it.

  • One simply has to marvel at the chiro haters on this site who wail on about the lack of science in chiro yet regale “modern medicine” as a scientific altar at which to worship. What a joke! It’s interesting to read of the off-label prescribing practices of many pediatric MD’s. While such practices do sometimes help patients, they come at great risk.

    Off-label prescribing can also harm patients, however. According to a report in Archives of Internal Medicine 2006; 166(9): 1021-1026, the potential for harm is greatest when an off-label use lacks a solid evidentiary basis. A 2006 study examining prescribing practices for 169 commonly prescribed drugs found high rates of off-label use with little or no scientific support. Researchers examining off-label use in U.S. children’s hospitals concluded, “[W]e still have incomplete knowledge about the safety and efficacy of many medications commonly used to treat children across a range of drug classes and clinical diagnoses.” More than half the respondents in a survey of academic medical centers reported that innovative off-label prescribing raised concerns in their institutions, such as lack of data, costs, and unfavorable risk-benefit ratios. When substantial uncertainty exists about off-label applications, patients are at risk of receiving harmful or ineffective treatments.

    It seems our medical brethren are quite guility of “hocus pocus” practices when it suits them…or when their drug reps buy them expensive lunches while extolling the virtues of their peddled products for off-label use. Never mind the lack of large-scale RCT’s, or even small RCT’s; somethimes even a decent cohort study is lacking in support of “physician judgment” sans evidence-based criteria for treatment. I can’t wait for one of Edzard’s Padawans to inject a claim of tu quoque, a practice of which many of this site’s cynics are often guilty even though they selectively forgets their own use of it.

    I must say I find it entertaining to read the many twisted comments of chiro haters on this site. They cling to their biases so steadfastly that they fail to realize that their criticisms of chiro can be found in their own “scientific” profession. Make no mistake, I respect the medical profession and not simply because my daughter is a Med-peds resident. Unfortunately, most of the medical professionals on this site are spinsters and chiro antagonists; and they are grossly uninformed relative to the conditions which US chiropractic physicians(and apparently, veterinarians) diagnose and manage, let alone how they manage them. Such ignorance has again been evinced in the snark of this particular topic regarding veterinary medicine and manipulation.

    Evidence of efficacy of various treatments is important. Perhaps medically biased cynics should address quackery(non-evidence-based procedures) in their own profession before they comment on veterinary recommendations from a position of essentially zero veterinary training.

    Be well.

    • I’ve seen no evidence that people here hate other humans. On the contrary, they hate pseudoscience and misinformation. In this sense, medical practitioners and subluxation-based chiros are not “bretheren”, but come from entirely different universes.

      COnventional medicine is based on the clinical sciences – with an understanding of diagnosis, and basis of treatment, based in the demonstable and measurable knowledge arising from physiology, anatomy and pathology. SUbluxation-based chiros may learn anatomy, but their diagnosis and therapy are based on a mistaken, and discredited, model.

      Off-label use of medication is not “hocus pocus”. The fact that an approved drug is not put through a whole new regulatory procedure by its manufacturer does not mean that legitimate new uses won’t be found. Providers who use medication are held to account for the safety and outcomes.

      You speak of “spinsters” and accuse others of being uninformed, although apparently you have a smart daughter (perhaps she has a very bright mother?). Your comments are off the mark in so many ways.

      • I don’t think my comments are out of line, Sue. My post reflects the reality that some MD’s do practice non-evidence-based hocum; this is indisputable. Yet many of the folks(you) on this site deflect that reality into an attack on chiropractice. How typical!

        I didn’t state that this forum’s posters hate other humans. Are you having comprehension problems? “Chiro-haters” refers to the hatred of the chiropractic profession, FYI.

        I do appreciate your specific reference to “subluxation-based chiropractors.” Such language suggests that you might be aware of the fact that most US chiropractic physicians do not base their practices on that dubious concept.

        The posters on this site ARE, by and large, spinsters who choose to rant about the negatives of the profession as though no positives exist. Of course you apparently fit into the same mold as you have here defended the traditional use in medicine of prescribing medications even when there is no solid science to support them for off-label uses.

        BTW, I do have a very bright daughter of whom I’m very proud. I encouraged and supported her decision to enter the medical profession because I do respect it; and I respect you for having entered a largely wonderful and challenging field to benefit the sick. I don’t, however, respect hypocrites who slander a profession for non-evedence-based practices while concurrently defending those practices in their own profession.

        Be well.

  • @Logos-Bios

    “Veterinary chiropractic” is not recognized by the American Chiropractic Assn. as being chiropractic.

    Well, it certainly is recognized by the American Veterinary Chiropractic Association.

    The AVCA explains how chiropractic works.
    “The bones of the spine and joints are maintained in a specific alignment.
    The nerves which surround each joint and vertebral articulation are in constant communication with the central nervous system, brain and all organs.
    When even a subtle change in the alignment occurs, it is called a subluxation.
    Subluxations affect the nervous system, local muscles, joints and even distant organs, glands and body functions.”

    You said

    40% of the US states require veterinary AND chiro degrees to treat animals.

    Perhaps; but nevertheless the AVCA will help you find an animal chiropractor in 47 of the 50 States. Many, if not most of them are DVMs. They ought to be ashamed of themselves.

    • I admit I know NOTHING about manipulation of non-human animals’ joints. There were three licensed vets in my graduating chiropractic-college class, though. As I recall, they were all from CA; I’m not positive about this, however.

      I didn’t know there was such a thing as the AVCA. It’s explanation(as you typed it) seems hokey, and I don’t like the word “subluxation” as such terminology is quite “yesteryear” and nondescript. I personally don’t know any chiropractic physicans(per ACA) who use the term.

      • It’s explanation(as you typed it) seems hokey

        I didn’t type it: I copied and pasted it. I linked you to the page. Go see for yourself. Chiropractic websites are rife with ‘subluxations’. It’s the basis of chiropractic as pulled out of the ass of a crook called Palmer. If you ‘spinal manipulation therapists’ want to ‘reform’ chiropractic you’ve a helluvan uphill struggle. Why not accept that, for all your good intentions, you’re supporting a name that comes with far too much adverse baggage ever to gain credibility among thinking people.

        ‘Chiropractic’ is founded in bullshit. The majority of its practitioners (including the vets, as we’ve now seen) seem to relish in the occult aspects of what they do. Why not accept that what you practise is a form of physiotherapy? Seek to put it on an evidence-based foundation if you can. Disassociate yourself from unenlightened colleagues who delight in calling themselves ‘doctors’ even though they’re not medically trained. The opprobrium you pick up from comments in this blog will vanish if you grasp the simple point that what you’re defending is fundamentally indefensible.

        • Frank, please demonstrate where I’ve defended any pseudo-science or hocum within chiropractic. I haven’t, although I’m happy to occasionally play devil’s advocate on some of the issues discussed.

          Unfortunately, the calumnious verbiage on this site against chiropractice IN GENERAL belies a plenary understanding of how chiropractic is practiced by mainstream doctors in the US. Posters here rail against the negatives in the profession(subluxation, horse adjusting under the auspices of vet-chiros, etc.) and blind themselves to the positives. Of course they don’t favor discussing the negatives in their own profession very much! lol

          Chiropractic practice is NOT PT, although there is some overlap in the views of how to treat NMS disorders. I understand well the similarities/differences in education of both since my wife is a PT(in fact, the senior PT at a very large hospital) of 35 years experience. There are a number of areas of specialization within PT, but diagnosis is generally not included in the DPT curriculum; nor is X-ray interpretation, emg/ncv, etc. The PT education is not as complete as that offered in mainstream US chiro colleges, although PT education regarding rehabilitation is quite robust. The bottom line is that the two professions are simply not a form of one or the other.

          Chiropractic is of the occult, you claim. How do you define “occult”? There are many defintions of this word. How are you using the term to descirbe chiro? Please advise, and I will assess your response to be either informed or uninformed.

          • L-B, ‘occult’ as I use it refers to hidden or paranormal knowledge. Palmer’s ‘subluxations’ (which I appreciate you don’t hold with) and ‘innate intelligence’ (vitalism) I regard as occult. Too many chiropractors, including those training for the ‘profession’ (Chiropr Man Therap. 2015 Feb 2;23(1):4.) still hang on to subluxation theory as an essential component.

            BTW, if chiropractic were to expunge all consideration of subluxations from its training and literature, it still has a huge task ahead of it to provide robust evidence for its efficacy. (And, yes, I know that’s a valid complaint for physiotherapy as well.)

          • @Frank Odds

            You have made very good points. Thank you for your thoughts.

  • Any feelings on this group Edzard, mostly physical therapists from what I can tell.

    http://www.spinalmanipulation.org/

  • A useful site for consideration of alternative therapies and chiropractic in horses are Dr.David Ramey’s website and FB page. So far as I can see, there is no evidence whatever that chiropractic is helpful for horses and at least one commentator has pointed out that human strength is not adequate for the adjustment of equine bones.

  • One of the big german Animal Chiroptacticions who then started also “treating” people was Tamme Hanken. He recently died and they are celebrating hime right now in Germany.

    See https://de.wikipedia.org/wiki/Tamme_Hanken

    It is unbelievable.

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