This six-year-old Great Dane with caudal cervical spondylomyelopathy responded well to medical acupuncture by a veterinarian, showing less pain, better posture, more fluid movement, and improved demeanor. What would have happened if it had been taken to a chiropractor first, i.e. without a prior veterinary assessment? Photo courtesy Erica Row, DVM Slowly but surely, doctor of chiropractic (DC) practitioners are targeting and toppling limitations to their scope of practice. Their goals? Acquire unrestricted access to animals, eliminate the need for veterinary supervision or referral, and stop “regulatory harassment” from veterinary medical boards and some of their fellow human chiropractors.1 Each year, they gain more ground. For example, the 2023 American Veterinary Medical Association (AVMA) State Legislative Update2 lists abundant activity on the topic of chiropractic in Arizona, Iowa, Missouri, New Hampshire, Oklahoma, and Texas. A few states, such as Colorado, have already capitulated to chiropractors, granting direct access after meeting minimum requirements.3,4 Once that happens, are animals better off? Are consumers happier and less “inconvenienced?” Did the need for a veterinarian to diagnose the sources of pain, lameness, and/or neurological abnormalities in animals suddenly disappear? The status quo Many veterinarians remain unaware of chiropractors’ advances until learning about it post hoc. Out-of-date online resources make it difficult to know what is currently happening and where.5 No state is exempt from chiropractic pressure; one of their early targets may be legislators whom they can convince animals deserve to be “adjusted” sans veterinary input. Persistence is key. Just recently, their representatives filed a bill for direct access in Texas. It had passed out of the Agriculture Committee and made it onto the House agenda. It failed because the session ran out of time, but personal communication with contacts close to the matter indicate another bill is destined to be filed for the next round. What is at risk when chiropractors replace veterinarians as the first point-of-contact for animal health? Timely diagnosis and effective treatment. In school, chiropractors study only one species—human. A couple hundred hours of additional education in animal chiropractic, offered by self-appointed certifying bodies, fail to equate with four-plus years spent in an accredited veterinary college, followed by postgraduate training. Chiropractic adjustments may make a joint move more freely, but for certain conditions (e.g. neoplasia, spondylosis, and cervical instability), rapid thrusts could fracture or kill an animal. Even for relatively healthy individuals, no reliable standards exist specifying how much force one can safely apply to an animal’s spine, joints, or head. Continuing education programs teaching animal chiropractic have varying “takes” on how much force a thrust should have and whether instrument-assisted treatment is acceptable.6 A review of history Make no mistake: This quest for unfettered rights to treat animals harkens back to the decades-long conflict between chiropractors and the American Medical Association (AMA) in the last century, 7 namely, Wilk v. American Medical Association. Plaintiffs in this lawsuit argued the AMA, the American Hospital Association (AHA), and other medical specialty societies violated antitrust law through restraint of chiropractors’ business practices. This fight was mentioned in a revelatory video, produced by the Chiropractic Defense Council (CDC). The seven-minute video8 encapsulates the struggle the veterinary profession is facing as chiropractors continue their battle against “the establishment,” similar to Wilk v. AMA,9 vowing to pressure states for as long as it takes to win. In Colorado, it took 16 years, but they finally won.10 As their successes mount, the time it takes to remove veterinary input is bound to shorten. Rarely do state laws change in the direction of protecting veterinarians’ scope of practice. How it impacts vet med Still, what happens when a veterinarian provides supervision or referral, and the animal is injured or dies from the chiropractic “adjustment?” Who gets reported to the state veterinary board? The veterinarian. What consequences does the chiropractor face? Typically, none. Did the veterinarian make a negligent referral? Who knows? We cannot even say what an appropriate referral is as virtually no studies exist to support any of the indications the American Veterinary Chiropractic Association (AVCA) lists as reasons to pursue chiropractic. Look for yourself! Can you find any papers on PubMed.gov justifying chiropractic for animals experiencing lameness, anesthesia, seizures, neurologic problems, advanced age, internal medical disorders, or difficulty chewing?11 Not likely. Further, clients taking their animals to a chiropractor first for a “quick fix” have no way to assess the chiropractor’s clinical skill or “diagnostic” ability. Sure, credentialing mechanisms should screen out those employing excessive force or performing adjustments incorrectly, but they do not. Once a DC achieves certification, essentially no oversight or monitoring takes place. Many chiropractors exude confidence in their abilities to diagnose and treat. Clients may become intimidated and hesitate to express concerns or stop the adjustment when they see their animal struggling to escape, trying to bite, or crying out during treatment. Further, DCs with direct access may add numerous other modalities and recommendations, including dry needling, shockwave, electrotherapeutics, nutritional therapy, herbal medicine, and more. How many hours of education did their human chiropractic college dedicate to teaching about the risks, indications, and contraindications of these methodologies when applied to animals? None. In fact, what chiropractic schools do espouse is a set of “universal principles,” also called the “The 33 Principles of Chiropractic.”12 These quasi-religious tenets emphasize the significance of the “subluxation” and help explain why eliminating subluxations occupies so much of a chiropractor’s focus. Here are a few of the most notable: “A Universal Intelligence is in all matter and continually gives to it all its properties and actions, thus maintaining it in existence. The expression of this intelligence through matter is the Chiropractic meaning of life. In order to have 100 percent Life, there must be 100 percent Intelligence, 100 percent Force, 100 percent Matter. The function of intelligence is to create force. The amount of force created by intelligence is always 100 percent. The function of force is to unite intelligence and matter. There can be interference with transmission of universal forces. Matter can have no motion without the application of force by intelligence. There is 100 percent of Innate Intelligence in every ‘living thing,’ the requisite amount, proportional to its organization. The forces of Innate Intelligence operate through or over the nervous system in animal bodies. There can be interference with the transmission of Innate forces. Interference with the transmission of Innate forces causes incoordination of dis-ease (sic). Interference with transmission in the body is always directly or indirectly due to subluxations in the spinal column.” In short, adjust the spine, make it move, and restore the trinity, so to speak.13 If you encounter an obstacle, push through it. Why bother with blood work and the expense of a veterinary visit when thrusting the spine can supposedly resolve the issue? What is more, no published evidence attests to the safety of chiropractic adjusting for non-humans or even clearly defines a “subluxation.”14,15 This brings us to a critical step veterinarians need to take to expose the real-life consequences of animal chiropractic—the creation of a national database of veterinarian-reported outcomes and injuries. We need to gather data about what animal chiropractic can and cannot do, then publish the findings in reputable journals. Together, we can promote the safe and effective treatment of animals based on science and evidence, thereby countering thus-far unfounded claims about chiropractic cures. Narda G. Robinson, DO, DVM, MS, FAAMA, practices osteopathic medicine and veterinary medicine. Dr. Robinson taught science-based integrative medicine at the Colorado State University College of Veterinary Medicine and Biomedical Sciences for 20 years. In 2016, Robinson established her own academy in Fort Collins, Colo., where she teaches medical acupuncture, integrative rehabilitation, medical massage, and other integrative medical approaches. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News. References OneChiropractic. Animal Chiro Landing Page Video. Accessed on May 6, 2024 at https://www.youtube.com/watch?v=VoygdMCRByQ&t=1s https://www.avma.org/sites/default/files/2024-04/SLU-2023-Annual-Report.pdf https://leg.colorado.gov/sites/default/files/2018a_239_signed.pdf Colorado General Assembly. Animal Chiropractic and Reporting Requirements. SB18-239. Accessed on May 4, 2024 at https://leg.colorado.gov/bills/sb18-239 Thompson K. Chiropractors treating animals. Animal chiropractic laws state by state (Updated September, 2019). Accessed at https://kellythompsondc.com/states.html on May 6, 2024. Personal communication with veterinarians certified in animal chiropractic. Johnson CD and Green BN. Looking back at the lawsuit that transformed the chiropractic profession part 6: Preparing for the lawsuit. J Chiropr Educ. 2021 Sep; 35(Suppl 1): 85-96. OneChiropractic. Op cit. Chiropractic Defense Council website. Preserve the Practice of Animal Chiropractic Care. Accessed at https://www.defendchiropractic.org/animalchiro/ on May 6, 2024. Colorado Department of Regulatory Agencies Office of Policy and Research. Animal Chiropractors 2002 Sunrise Review. Accessed at https://cmu.marmot.org/Record/.b35059217 on May 5, 2024. AVCA Find a Doctor Website. Accessed at https://www.animalchiropractic.org/find-a-doctor/ on May 5, 2024. Stephenson RW. The thirty three principles of chiropractic. Accessed on May 6, 2024 at https://www.pmaworks.com/main/uploads/the_thirty_three_principles_of_chiropractic1.pdf Pure and Powerful website. The 33 Chiropractic Principles. Accessed on May 6, 2024 at https://pureandpowerful.com/welcome-2/the-33-chiropractic-principles/ Keating JC. D.D. Palmer’s Religion of Chiropractic. Accessed on May 6, 2024 at https://chiro.org/Plus/History/Persons/PalmerDD/PalmerDD's_Religion-of-Chiro.pdf Marcon AR, Murdoch B, and Caulfield T. The “subluxation” issue: an analysis of chiropractic clinic websites. Archives of Physiotherapy. 2019l 9:11.
