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The Science of Veterinary Orthopedic Manipulation (VOM)
A Diagnostic Technology That Precedes
Clinical Disease.
By Wm. L. Inman BS, DVM
What is Veterinary Orthopedic Manipulation?
VOM (as it is abbreviated) is a diagnostic and treatment technology based on
reduction of the neuro-physiological phenomenon known as the subluxation. The
presence of this neurological interference is detected by eliciting a pathological
reflex that is easily seen grossly on the patient by the practitioner
and the client.
In the past 2 years the VOM Diagnostic and Treatment Technology
has received increased attention due to its successful application by trained
practitioners. To date there have been 3800 practitioners trained with this
method of diagnosis and treatment.
The VOM Technology has enjoyed widespread recognition by professionals and the
general public because of its ability to solve here-to-fore unsolvable
problems. The main value of the technology is found in its ability
to detect impending disease before it expresses itself as a
clinical entity.
History
Over the past 18 years and represented by over 45,000 clinical
cases (on file and available on computer) the patterns for over 250 disease
conditions have been recognized and tested for reliability.
This technology was extensively examined by the Veterinary Board in the author's
state and finally validated as a "valuable, safe, fast and effective
healing technology". In the last three years over 3800 practitioners have
been trained in seminar given by Wm. L. Inman BS, DVM, and were able to
effectively apply the technology the next day.
The author's training as a surgeon clashed with his client's reluctance for
surgical solutions to medical problems and out of this frustration arose a
"non-surgical approach to spinal disease and lameness".
VOM Seminar Modules One, Two and Three are offered nationally to present and
teach this technology and the completion of all three, and the passage of a test
including clinical competence, will confer an accreditation "Certified
Veterinary Chiropractitioner" (CVCP).
The Misunderstood Subluxation Definition
The application of chiropractic principles of care involve the
reduction of subluxations present in the neurological make -up of the pet.
Many practitioners including some veterinary neurologists doubt the existence of
the "subluxation" as a cause of disease.
This is unfortunate because this opinion not only invalidates all of
chiropractic care, (not to mention 80,000 chiropractors in the US alone), but
also blocks the treatment of the hundreds of disease states held in place by
subluxation.
There are, extant in the field, four definitions of this
term:
1. Veterinary Definition
In veterinary school we were taught that if a bone was out of the socket it was
termed "luxated", therefore by default, a bone that was partially out
of joint was then termed to be "subluxated". This can be seen (and
usually is) on x-ray. This is an incorrect definition.
2. Chiropractic-Straight Definition
Classic chiropractors choose to use a definition of subluxation that describes
pressure or trauma to the peripheral nerve and the effects that trauma has
caused or is causing.
3. Chiropractic-Mixed Definition
A newer interpretation of subluxation is defined by another group of
chiropractors as a phenomenon of neuronal interference that leads disease
states. These neuronal interferences are housed in the facilitated segments of
the spinal canal and are treated there.
4. VOM Definition
The VOM definition is one that agrees most with #3 above. The location of the
subluxation phenomenon is not the nerve or the bone, but it is the neuronal
interference that exists at the interneuron of the dorsal horn of the
facilitated spinal segment. It cannot be seen on x-ray, cannot
be imaged by ultrasound or MRI, but can be readily demonstrated with the
application of a simple diagnostic protocol using a hand-held device.
Radiographic evidence of the effects of the subluxation phenomenon can be
evaluated grossly and on x-ray only 40% of the time.
Palpation as a Diagnostic Technique
For years, manual palpation has been used to determine the
effects of subluxation through recognition of bony distractions, taught or
tender fibers, or limited range-of -motion.
This is the diagnostic technique taught and expertly developed by the American
Veterinary Chiropractic Association (AVCA), and the very fine work of Dr. Sharon
Willoughby and Dr. Pedro Rivera of that organization.
This approach is an acquired practice art and subject to individual
interpretation by each practitioner. This makes this approach more subjective
than the objective VOM Diagnostic Technology.
The VOM Technology reduces this diagnostic process to a totally objective and
readily duplicable system. Palpation as a means to diagnose is not then used.
Manual Palpation vs. VOM Reads
It is important to differentiate between manual adjusting motion
and the force delivered by the device. The former is too slow to
demonstrate the reflexive reads. The device thrust will always
demonstrate the pathological read if present. Manual techniques cannot
be used for diagnosis using pathological reflexes.
The Device
A hand-held device called a spinal accelerometer is used to
illicit pathological reflexes in all quadrupeds. It looks like a mechanical
doorstopper and makes a very low motion, very high-speed pulse (1-4
milliseconds).
VOM Pathological Reads
The VOM reads seen by eliciting a reflexive response with a
spinal adjusting device are seen in every case of neuronal
subluxation. They are called Neurological Subluxation Sign (NSS). It is this
means of detecting 100% of all subluxations and evaluation of their reduction by
ablation of these reads. This is the basis of the VOM Technology, diagnosis and
treatment.
Application to Disease Processes and Diagnosis
In every musculoskeletal disease that we see in veterinary
medicine today, we can see a distinct pattern of subluxation as portrayed by
specific diagnostic reads.
These patterns are predictable and are reproduced every time a disease process
is seen. It is the detection and recognition of these patterns that gives rise
to the diagnostic power and reproducibility of the VOM Technology.
Site of Subluxation
The location of the subluxation phenomenon is the interneuron
of the facilitated spinal segment. It is at this location that the
recurrent loop of the subluxation is held in place.
The chemical mediators of subluxation, such as, lactic acid, serotonin,
bradykinins, H+ ions, prostaglandins, P-substance etc., propagate the
subluxation phenomenon.
The pain and swelling caused by these mediators of subluxation create more pain
and swelling and thereby promote a vicious recurrent loop that will stay in
place for the rest of the animal's life.
Finally, the animal fuses the bones involved, fails completely with the affected
organ system, or the animal dies from the effects of chronic subluxation. This
process takes years and is detected from the very first onset of
injury using the VOM Diagnostic Protocol.
Effects of Subluxation
With the chemical mediators of subluxation to help the body's
response to a subluxation is to cause vasoconstriction and increase
skeletal muscle tonus via the Golgi tendon apparatus and skeletal muscle
fixation. These effects cause joint fixations, muscle and bone
distractions, pain, swelling and lack of function. If allowed to persist,
paresis, paralysis and bony changes will ensue.
Mechanism of Subluxation Reduction
Subluxation is only a switch that can potentially be turned back
on. This is simply done by providing adequate force to the
interneuron through the mechano-receptor inputs into the dorsal horn. (Please
see diagram). Note: this is mechano-receptor force, not motion,
thus the process is inherently safe and amazingly effective.
Anatomical Subluxation Sign (ASS)
This sign on the patient is evaluated with palpation as depicted
above and is limited by subjectivity. It is important to note that only 40%
of all subluxations demonstrate anatomical subluxation signs.
Neurological Subluxation Sign (NSS)
All subluxations produce neurological subluxation signs. Thus
100% of all subluxations can easily and objectively be located and evaluated
using the VOM Diagnositic Technology and neurological subluxation
signs. The VOM Technology reduces this diagnostic process to a totally
objective and readily duplicable system.
Force and Sensitivity of the Device
The device can elicit a pulse that can detect subluxations in
pets from the size of a hamster or a parakeet, up to a draft horse.
The variability of the device's force is due to the micro-adjustable collar that
can titrate the force from 27.6 lbs. down to almost zero.
It is interesting to note that the pulse needed in a very large horse is often
the same as is needed for a very small dog.
An Equine Adjusting Tool (EAT) is also available for large horses and
adjusting the pelvis and the caudal cervical areas of the equine. This device is
identical in size and shape to the original device except it delivers 48.3 lb of
force, within 1 millisecond
Application of the Device in the Human
The device is really a dental instrument created to split teeth.
It has been modified and used in humans for chiropractic adjustment for over
twenty years.
It cannot be used in the human for diagnostic purposes, as diagnostic reads are
not present in the human due to the presence of the common recurrent
meningeal nerves. These nerves are not present or are not
functioning the same in the quadruped, which is fortunate, as this situation
allows the reflexive pathological reads that the VOM Diagnostic Technology is
based.
Accuracy
The VOM Diagnostic Technology is amazingly accurate. Diagnostic
reading patterns are demonstrable weeks to years before
radiographic and other diagnostic technique will verify. In some species,
such as the cat, radiographic findings are not as readily seen making VOM reads
a more reliable diagnostic protocol. When applying the VOM Diagnostic
Technology the practitioner is made aware of disease conditions that would
otherwise go undiagnosed, often months to years before disease will appear.
Validation by Other Diagnostic Techniques
When VOM is compared with other diagnostic technologies such as
Contact Reflex Analysis (CRA), Applied Kinesiology (AK) and many others, it is
found that these energy techniques reflect the exact reads that VOM
demonstrates, validating the VOM. Radiology, Myelography, MRI, ultrasound
and other imaging techniques will eventually (in most cases) demonstrate
pathology. The problem with these methods is that it may be months
to years after the VOM reads are available to the practitioner that
these imaging techniques are valuable. Accurate clinical records taken by
the author have proven that the reading patterns will eventually produce
specific radiographic evidence. Other diagnostic techniques will show pathology
but again the delay is clinically disastrous.
VOM Diagnostic Window
A window of availability exists for diagnosis using the VOM
Technology that is unique in the industry. We are able to diagnose and apply
possible treatment to a disease condition in most cases weeks to years
before clinical disease is discovered by conventional means. This is the
amazing diagnostic value of the VOM Technology and cannot be understated. The
VOM Diagnostic window extends from the onset of injury to well past the onset of
clinical disease (this could be months to years).
Case Study #1
In 1985 a four-year-old dachshund "Red" was presented
for crying out in pain for no apparent reason. Upon examination, no tenderness
was found and x-rays also were negative. Neurological exam was normal.
The VOM Diagnostic pass elicited pathological reading reflexes at L-3. The
reflex was the familiar panniculus response.
The owner was advised of potential problems down the road and a program of VOM
Treatments was recommended.
The owner opted to wait and see and was sent home on phenylbutazone. One
year later, Red presented for annual exam. The owner knew of no current
problems. Red had reads at L-3 and L-2 at this time and a schedule of VOM
treatments were advised but refused by the owner. In 1987 Red presented
without clinical disease and had reads at L-3, L-2, and now at L-4. Again, Red
was given the same VOM recommendation and again the polite refusal. We did
not see Red for two years after that, but when we did he presented with acute
paralysis, down in the rear and losing deep pain.
This is your basic veterinary orthopedic nightmare.
His reading patterns were again at L-2-3-4-5 and after the client had
been apprised of a surgical solution and ruled it out, we adjusted Red with the
device in standard VOM fashion. We repeated the next day and within 24 hours Red
was up and walking again. We continued his adjustments on schedule for the
next 5 adjustments and he remained both non-clinical and non-VOM reading until
his death by liver failure at age 16.
Discussion
Q. Did we injure Red with the device?
A. Absolutely not! To date countless cases have been administered without
any hint of iatrogenic injury.
In research studies directed at the possible damage that the device might cause,
laboratory rats were pulsed with the device one thousand times with the
mechanism set at its highest and the rat was then sacrificed to reveal no
neurological damage. There was not enough motion to cause injury.
Q. Would Red have gotten better on his own?
A. Maybe,… miracles happen every day. It just so happens however that
five more "miracles" just like this one occurred that month due to
application of the VOM Technology.
After a while you have a tendency to credit science instead of fate.
Q. Was the initial read at L-3 a harbinger of a spinal failure to
come?
A. Of course it was! We have hundreds of similar situations and
case studies that conclusively indicate that the spinal segment that fails or
exacerbates a clinical disease will show typical pathological reflexive reading
patterns months to years ahead of the clinical emergency.
This is of course the purpose and the main point of this article
VOM Treatment Window
This then gives rise to the conclusion that there exists a VOM
diagnostic window that encompasses the VOM Treatment window and extends well
after the disease is diagnosed by conventional methods. The obvious value of the
VOM Diagnostic Technology lies in the utilization treatment within the
diagnostic window and before clinical disease is expressed.
Case Study #2
Boru, a 5 year old, 120# purebred Newfoundland and an American
and Canadian obedience champion, became reluctant to jump over the required
barriers and the resultant trip to the vet left the owner with a diagnosis of
Canine Wobbler's Disease and a decision as to opt for the necessary surgery or
euthanasia. Boru had acute pain when he was patted on the head and could
not rotate his head to the left. Upon presentation for a second opinion as
to whether VOM could help, it was found that an instrument pulse at C-5-6 would
drop Boru 's shoulders down 2-3 inches. The presence of subluxation was obvious.
The previous vet had radiographed the caudal cervical area and no radiographic
signs were seen. A myelogram that followed also was negative. Knowing from the
VOM Diagnostic pass where the problem actually was, x-rays were done at our
hospital and they too were non-diagnostic. A schedule of VOM treatments was
recommended and immediately applied. Boru left the hospital the next day
doing much better and was able to return to the show ring within 7 days.
After 2 ½ months and 5 more adjustments, Boru was done with his treatments and
the owner continued to campaign her dog for three more years when she chose to
retire him while he was still winning.
Discussion
Boru had a clinical expression of one of the most commonly missed
disease conditions that we are able to find and treat with the VOM Technology.
Most pets that have reads in the caudal cervical area do not show clinical
disease. In the author's opinion, it is the most commonly missed disease
condition in veterinary medicine. This subluxation complex gives rise to
lower lumbar subluxations and often goes undetected. In Boru's case it was
obviously a clinical problem and also easy to treat as indicated. The
important point here is that this case showed no radiographic evidence and hence
a concrete diagnosis that would direct treatment could not be made without the
VOM Technology.
Case #3
Bandi, a 7 year-old neutered male Domestic short hair cat,
presented with a chronic dermatological problem that covered his back.
Bandi had been chewing the hair off his back and was also creating a secondary
pyoderma that was a clinical problem for the last 3 years. When touched on
the back, Bandi would either try to bite you or would respond with a reflexive
pattern of biting, licking or head spasms that could be elicited like a reflex
every time a stimulus to the skin over the back was made. Just just holding your
hand over his back could even fire this reflex. Bandi read from T-10 thru L-5,
and as the pulses were made, he did not calm down or get quiet as is the case
with most animals. As the VOM technology was applied out to the 30-day
interval, it was kept at that interval for 10 more months before the reading
patterns were gone and the disease was cured.
Discussion
Bandi's condition is a common and frustrating one that we see in feline
practice. It is thought to be an infectious problem, a hormonal imbalance,
a dietary allergy, an inhalant allergy, a psychogenic disease, or who knows
what. Its treatments are also as nebulous as its etiology. These animals
all have reading pattern similar to Bandi's and respond in the same fashion.
Bandi's unique reflex is named "Feline Skin-Spinal Reflex or FSSR"
in the VOM Technology for lack of a better term. This condition seems to
be a result of para-esthesia or anesthesia of the dorsal spinal cutaneous
branches of the segmental nerves. This hyper, hypo, and an-esthesia is held in
place by subluxation and reduction of that subluxation reduces, then relieves
these disease complexes. This approach is important in VOM in that it is
the exception to the rule that all disease conditions held in place by
subluxation will resolve in 5.75 adjustments. These cases often take up to
12 adjustments to resolve. The good news is that the client is often so intent
on solving these chronic and frustrating disease conditions that they will stay
the course of the treatment.
Case #4
Buck, an 11-year old dressage thoroughbred, was presented with
some minor bowed tendons in the forelegs and the owner complained that he was
reluctant to "change leads" while in the ring. Buck had seen a
manual veterinary chiropractor and had been immediately benefited by manual
adjustments to the anterior neck. Unfortunately, he always returned one week
after the adjustment was made, with the same complaint. Upon VOM
examination, Buck was found to not only have reading patterns at the atlanto-occipital
area, but also at C-4, C-6-7, T-5-6-7, L-2-3, and the left Posterior Superior
Iliac Spine (PSIS). The owner was able to see grossly all
the reading patterns as the practitioner discovered them and was also able to
see them cleared as Buck was adjusted at all those points and at the first
sternabrae. The owner was convinced that Buck was immediately improved and
could not demonstrate gait anomalies in the ring.
One week later he was adjusted again and at that time he still did not have gait
problems, and the tendon swellings were down. Two weeks later, another
adjustment, and the legs were almost normal. Buck was finished up in the
VOM approach with a 3-week interval followed by a 4-week interval and at that
time he was asymptomatic and did not show any VOM reads.
Discussion
Buck's problem is very common for dressage horses and also for cutting and
racehorses. Caudal cervical subluxation will hold in place a myriad of
disease conditions and gait problems. Unfortunately, until the advent of the VOM
Diagnostic Technology and the application of the Equine Adjusting Tool (EAT),
these subluxations could not be discovered and evaluated manually. Also, these
horses may respond clinically to manual adjustment, but care is discontinued as
soon as clinical signs are gone. We have seen that the diagnostic
reads persist several adjustments after clinical signs ablate, and it is
the extinguishing of these indications of neuronal subluxations that confers
healing.
The equine is the easiest of all the quadrupeds to adjust and
the average horse can be adjusted in less than 5 minutes.
Diseases Diagnosed and Treated with VOM
A. Canine Diseases and Reading Patterns:
1. Canine Hip Dysplasia Syndrome, T-8-9-10, 4mo.-6yr.
2. Canine Wobbler's Disease, C-5-6-7-8, 6mo.-11yr.
3. Anterior cruciate rupture or pre-rupture, L-4-5, 2yr.-14yr.
4. Medial Patellar Luxation, L-4-5, 6yr.-14yr.
5. IV disc disease (all types), C-2 thru S1 as indicated by reads, 4mo-16yr.
6. Urinary and fecal incontinence, L-4-5, L-7, S-1, 6yr.-14yr.
7. Avulsion of the brachial plexus, root signature, C-5-6-7-8-T-1, 6mo.-10yr.
8. Degenerative Myelopathy Syndromes, T-10 thru L-7, 8yr.-18yr.
9. Fibro-cartilaginouis embolism, As indicated by reads, 4mo.-10yr.
10. Esophageal Achalasia, Megaesophagus, T-5-6-7, 8mo.-8yr.
11. GI hyper-hypo-motility disease,1yr.-12yr.
12. Chronic Ear and Eye Infections, left or right A-O joint
13. Lick Granulomas, C-5-6-7-8 or L-4-5-6-7
14. Many others including somato-visceral
disease
B. Feline Diseases Diagnostic Patterns:
1. Feline Hip dysplasia-like syndrome, L-3-4-5, L-7-S-1, 2yr.-21yr.
2. Anterior Cervical Instability, AORA, AOLA, C-2-3-4, 2yr.-10yr.
3. Caudal Cervical Instability, C-6-7-8, 3yr.-10yr.
4. Mid-Thoracic subluxation patterns/somato-visceral disease. T-9-10
5. IV Disc Disease, T-10 thru L-7
6. Caudal lumbar disease and urinary incontinence, L-4-5, 5yr.-18yr.
7. Sacral Disease and FX trauma, LSIS, RSIS, L-6-7
8. Stifle Disease in the Cat, L-3-4-5, 5yr.-14yr.
9. Neurodermatitis, Milliary Eczema, T11 thru L-7, 4yr.-13yr.
10. Feline hyperesthesia Syndrome, T-11 thru l-7, 4yr.-13yr.
11. Flea susceptibility, T-10 thru L-7, 4yr.-18yr.
12. Feline Kidney Dysfunction and FUS, T-8-9-10-11, 3yr.-15yr.
13. Megacolon, AOLA, AORA, LSIS, RSIS, S-1, 8-12yr.
14. Feline Infectious Diseases (See VOM Module 3)
15. Feline Endocrine Disease (See VOM Module 3)
C. Equine Disease Diagnostic Patterns:
(Note: Equine reading patterns and treatment adjustments are applied to the
affected tissue, as in bowed tendons or in the affected leg like at the carpus
and the hock, but are found to be held in place in the axial spine The following
is a list of equine maladies treated at the site of injury, the extremity, and
finally at the axial spine that holds the problem in place.
1. Bowed tendons
2. Bog Spavin
3. Bone Spavin
4. Bucked Shins
5. Splints
6. Chip and Avulsion Fractures
7. Osslets
8. Ringbone
9. Sidebones
10. Bicipital Bursitis
11. Shoulder Sweeney
12. Curb
13. Thoroughpin
14. Spinal Strain-Sprain (back)
15. Sacroiliac disease
16. Many others
VOM-Aided Diagnosis in the Quadruped
VOM as a diagnostic technology has and is being used
internationally as an adjunct to conventional diagnostic techniques. It is
being used by itself due to its exacting accuracy and its ability to diagnose
disease months to years before clinical disease is seen. This author still
uses other techniques to diagnose but uses VOM for a quick and accurate
"view" on what is happening or what is going to happen. VOM is sort of
a diagnostic crystal ball.
VOM Treatment Application
Of course, the goal of all diagnosis is the possibility of quick
and adequate treatment. The continued application of the VOM Treatment
Technology is a logical extension of this diagnostic process. A number of
practitioners have been using the VOM Diagnostic technology to find out what to
treat and then use a manual manipulation technique to affect healing.
Over a short period of time they have been found to resorting to the VOM
Treatment Technology more and more and the resultant "combination" of
techniques provides a hybrid technology that may in itself be a better approach
than either by itself.
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