(Early Detection, Treatment and Prevention)

By Wm. L. Inman BS, DVM, CVCP

 Introduction

As we all love our canine friends, we reserve a particular fondness for the larger of the dog breeds. They seem to be more interesting and portend more personality and vitality than their smaller cousins.

It is particularly common for veterinary clients to announce that they are not "small dog people" but rather prefer the larger or giant breeds. "They are ‘real’ dogs" as they will say.

The giant breeds also carry with them a very specific set of disease conditions. In some cases these conditions can be life-threatening and at the very least can be financially and emotionally devastating.

I will never forget the sight of one of my best clients, (a tall, stately man, always impeccably dressed, in a corporate power-suit and always looking in control). He was standing outside the doorway of my veterinary practice, covered in blood and vomitus, with the dead carcass of his beloved Great Dane, "Goliath" dangling in his arms.

Whenever I want to remember what significant personal loss is like, I always flash back in my mind to the expression of total helplessness and loss on the face of this man.

Goliath was a 6-year old male brindle Great Dane who 3 hours before was the love of this man’s life and the pride of his family. Goliath was very thirsty and after a big drink of water decided to engage in a good tug-of-war with his brother in the back yard. The gastric dilatation-torsion that occurred took Goliath’s life within two hours. By the time Goliath was noted as not feeling well and rushed to my hospital, he was terminal. Goliath died in the owner’s lap in the car on the way to my hospital.

Two months previously the same man and his family had presented the 9-month-old "brother" of the gastric torsion dog with painful limping in the right front leg. This was a black or sable Dane, and upon x-ray evaluation he was found to have defects in the bone at the top end of his humerus. He had Osteochondritis Dissicans (OCD) of the shoulder. Immediately, the other shoulder and the rear legs were radiographed to make sure that "Buster" was not just limping on the leg that hurt the most.

Buster was radiographically clear, so we opted to operate on the shoulder and remove the joint defect. The operation was a success. Within 6 weeks he was back terrorizing Goliath with incessant games of tug-of-war and wrestling matches. I can’t help but think that if I hadn’t done such a good job with Buster’s surgery that he wouldn’t have been active enough to roughhouse with Goliath on a full stomach. This tragic event may have been averted.

That hindsight did not change the fact that Goliath was now presented dead outside my hospital door. His 130# held up by his owner, wearing a ruined business suit and surrounded by his family. With a belly the size of a basketball and his tongue blue, Goliath had gone through the agonal throws of death in the car, while stuck in Seattle traffic and the whole family helplessly watching.

The patriarch of this family was a captain of industry and a multi-millionaire in the computer industry. He had a beautiful family and every blessing known to man. I believe he would have given them all up if I could have just helped Goliath. I pronounced his dog dead and this stately man broke down and began to cry like a child. It was he who had given the dog a large bowl of water and then turned both Danes out in the back yard to play.

Six months after Goliath died, he presented me with Buster who now was having trouble with the other shoulder. Radiographs revealed that he had developed OCD in the other shoulder and in the stifle and would need surgery in both places. At this point, my client had decided that enough was enough and that this breed was just too fraught with potential diseases to place any more emotional confidence. The cost of surgery was not an issue for this man. The emotional expense was too high, and against my recommendation he opted for euthanasia.

That is not the end. Three years later the eldest son added a black and white Great Dane puppy to his family against the advice of his father. At 18-months "Marmaduke" or "Duke" presented unable to stand in the rears. He had poor control of his front legs. Duke had experienced no trauma, fall or accident.

Further examination would reveal that Duke was a Canine Wobbler (caudal cervical instability) and even though the problem was in the base of the neck, it affected his rear legs and was progressing to his front legs. Regardless of medical therapy, Duke became a quadriplegic within 4 hours and the inevitable euthanasia would leave this family with 3 dead Great Danes in as many years.

Five years later I ran into father and when I asked how he and his family were doing, he offered that he had not gotten another dog since the death of his Danes. "Can’t afford ‘em" was his rationalization. "Those inbred dogs have too many problems. We’ve sworn of all dogs in our family". How depressing.

Discussion

Is the Great Dane genetically cursed? Have we inadvertently bred diseases into the giant breeds by line breeding and even outcross breeding? What is the cause of these three disease conditions? Could they all be the same thing and if they are could they be treated effectively? Better yet, would there be a way to detect these disease states before they actually produce a clinical problem? Is there an underlying secret that has escaped the veterinary community for the last 100 years?

The Secret

It is not going to endear me to many of my colleagues to report that a huge medical phenomenon has been missed in the veterinary field. What has been found is that a neurological "interference" is present in all these disease conditions. This interference is caused by the traumas of normal life and manifests itself as most of the disease conditions we eventually see in our dogs.

This neurological phenomenon is called a "subluxation" and is recognized by over 100,000 chiropractors as the cause of disease. It is what chiropractor treat; it is what they reduce when they make an "adjustment".

Unfortunately veterinarians have used the term subluxation for years, but incorrectly. We vets think that if a joint is out of place, it is said to be "luxated". If it looks like the bones are less than completely out of joint, it must then be "sub-luxated". A subluxation is in the nervous tissue and not in the bone. A subluxation cannot be seen on an x-ray, yet on occasion, its effects can be seen on an x-ray as a partial dislocation. This is where the two terms get mixed up.

My profession labors under the misconception that a subluxation is anatomical instead of neurological. This explains why the two professions, veterinary and chiropractic, have not been able to get together. Chiropractors know that they are able to adjust the subluxations out of their pets and make them sound. Vets are looking at the x-rays and failing to see the "anatomical sub-luxations". They cannot figure out what the chiropractor is treating and so relegates the whole area to quackery.

At no point in any US veterinary teaching institution’s education curriculum is there any instruction on chiropractic care, neither theory, nor application. This is a travesty in that 80% of all animals have neuronal subluxations and most of those will eventually direct some form of disease condition.

A New Approach

The practitioners that embrace the possibility that subluxation can and does cause disease, has opened up a huge universe of here-to-fore untreatable diseases. He or she becomes a very busy veterinarian and continues to perform "miracles" with the VOM Technology, They soon find that this is a means of treating impossible cases and diagnosing most all of the others.

The vet soon realizes that these methods of rooting out the cause of the disease condition is possible not only after the dog has a problem, but in most cases can be done months to years before a problem is seen.

Here we have an invaluable treatment tool, but the diagnostic potentials are unlimited. Finally, the preventative value for finding subluxation before disease is seen and repairing them before the disease is expressed, is the crux of this article. It is also the incredible value of Veterinary Orthopedic Manipulation to dogs in general.

VOM began in 1982 and was developed by this author into a complete diagnostic, treatment and preventative specialty for the animal health care provider. Based on over 45,000 clinical cases (on file) the VOM Technology has trained in excess of 4200 practitioners in the US, Great Britain Sweden, Canada, Australia and New Zealand. It is the fastest growing veterinary specialty of any kind in the world and yet it is still relatively unknown to both pet owners and veterinarians alike. It has been called "the best-kept secret in veterinary medicine".

The Diseases

What conditions can the VOM Technology diagnose and treat? How does that involve the giant breeds and the Great Dane particularly?

In the Dane we see these conditions that can be diagnosed and treated:

1. Wobbler’s Disease
2. Anterior cervical instability
3. Cervical disk herniation
4. Mega esophagus
5. Gastric dilatation torsion complex
6. Ostechondritis Dissicans (OCD) of the shoulder, elbow and stifle
7. Ununited Anconeal Process (Elbow Dysplasia)
8. Ununited Coranoid and Coracoid Process
9. Pyloric Stenosis
10. K-9 Hip Dysplasia Syndrome
11. Anterior Cruciate Ligament Injury-Rupture
12. Many others

Many of these diseases are events that can be the beginning of the end for our dogs, and anything that could prevent them would be a Godsend. VOM can do that.

How is VOM Performed?

The VOM Diagnostic Technology is done with the use of a stainless steel spinal accelerometer, a sort of spinal hammer that provides a very tiny motion in a very short period of time. In all the history of the VOM Technology, there has never been an animal injured with the application of this device. This is also true of over 6 million applications on the human. The device cannot create an injury or a subluxation.

If the diagnostic pulse imparts a force to a spinal segment that has a neuronal interference associate with it, the pet elicits a pathological reflex unique to that subluxation.

One can evaluate the whole of the pet’s spine and in so doing a "blueprint" of the patterns of subluxations are seen. These patterns correspond to disease states, and are exactly reproducible among animals with identical diseases.

These reflexes are not subtle but are easily seen by the practitioner and the pet owner, taking all of the guesswork out of the diagnostic process. Previous chiropractic diagnostic techniques were particularly nebulous and subjective. VOM makes the diagnostic process completely objective and simple. Virtually, a child could do it.

Once a diagnosis is reached, the treatment technology is applied. That is done with the same instrument and the presence of the diagnostic "reads" or pathological reflexes are negated one by one. On occasion, the reading patterns change and do not disappear for several more adjustments. This is due to the complex and chronic nature of how the subluxations get there in the first place. Suffice to say, the reads are reduced, the subluxations are gone, the animal now has full neuronal capability and the pet is able to complete healing on its own.

How Many Adjustments Are Needed?

A common concern of clients who consider this care is that if the animal is treated in this fashion, will they have to continually return for more adjustments? The answer is no. The average amount of adjustments per case is 5.75 or essentially six adjustments over a four-month cycle of healing.

The good news is that after this cycle is done, like in the case of a broken bone healing back stronger than before, the area that has been healed does not have problems again. This imparts a cure as apposed to a temporary fix that previous medical and surgical treatments provide.

How does a subluxation work?

Think of it as a compact disc that becomes severely scratched and at some point in the music it is only able to send gibberish to the receiver. The music tract becomes locked in an endless loop that it cannot escape. It will continue this loop until something acts on the system to free it or until the equipment fails.

The scratch is the subluxation caused by some injury. The gibberish is the pain impulses sent to the spinal cord by the peripheral nerves. The receiver that will misinterpret and amplify that gibberish is a segment of the spinal cord. The equipment that will eventually fail is the body. Note that the brain is not really involved.

How does the device reverse the subluxation?

The body doesn’t give us anything we do not need. Unfortunately, in the case of the subluxation phenomenon, it doesn’t know when to stop, and a subluxation will continue until the animal dies or an outside force acts upon it. The injured area of the spine that has a subluxation is "frozen" or "fixed" for future repair and this is the real reason the body has this mechanism.

When a cat wakes up, it always stretches. This is an example of subluxations being reduced automatically and the feline is fortunate to be able to do so. Cats unfortunately have plenty of subluxations that they cannot spontaneously reduce.

As the neuronal impulses of pain hold in place the subluxation as described above, the mechano-receptive impulses (motion and force) will reverse the subluxation at the cellular level of the spinal segment. In short, a mechanical force directed at the involved spinal segment is all that is needed to reverse the subluxation phenomenon. This is what all types of musculo-skeletal manipulation, VOM, Acupuncture, Acupressure, and many other modalities have in common and why they all work!

Why not use your hands like a chiropractor?

It is too slow. The body can resist motion on the spinal reflex level down to 20 milliseconds. The fastest that a person can move a joint is 80 milliseconds, which is four times too slow. The device operates at 2-4 milliseconds which is 5-10 times faster than need be, and the animal gets the subluxation reduced whether he wants to or not, each time, every time. Manual application of force can be applied to reduce subluxation but the patient has to be very relaxed and cooperative.

Canine Wobbler’s Syndrome

Let’s look at caudal cervical instability from the standpoint of current veterinary medical disease application.

The pet has had an injury in or around the cervical vertebrae. This has caused a subluxation and is compromising the muscles that surround the spine, pulling them out of alignment (very commonly not detectable on radiographs) and the ensuing pressure on the spinal cord is causing acute pain and loss of function to the rear legs. This dog is in big trouble.

Initial presentation to a veterinary clinic will find this dog getting large doses of corticosteroid and pain medication to try to slow down the swelling of the spinal cord that is accelerating the problem.

Once stabilized, and after myelography where a radio-opaque dye is injected into the spinal canal, a decision to operate and stabilize the vertebrae that are impinging on the nerves is made. The surgery is quite extensive and tricky. Only the finest of veterinary surgeons will attempt this procedure. The unstable vertebrae will be fused together using plates, screws and surgical bone glue.

When the big dog wakes up, he wakes up screaming. The surgery is very painful post operatively. Often the surgeon will pre-medicate the pet with pain medication to avoid this situation.

Before the surgery the veterinarian makes sure that the owner realizes that even if the surgery was a supreme success, in 8-10 months the exact same condition could recur in the vertebral segments in front and behind the fusion. In this scenario, the surgery has saved the dog’s life but only postpones the problem for 8-10 months.

With this type of reoccurrence rate, the decision is often made to spare the giant breed from this temporary fix and the client opts for euthanasia. Thus, a diagnosis of K-9 Wobbler’s Disease becomes the kiss of death, particularly in the giant breeds.

The dog that goes down acutely is a candidate for the surgery. This is a means to save his life. The dog that can walk into the veterinary hospital, (in the experience of this author), is not only a VOM case, but now the prognosis is excellent.

Not only are we able to quickly treat these cases, we can get them back into their normal activities and keep them from reoccurring. The reality is that we actually induce the system to repair itself completely as opposed to creating an artificial and temporary "fix".

Prognosis of this disease is excellent if found early. That is the key. If we wait until the dog becomes paralyzed we will have lost the war. Early diagnosis and treatment is imperative. Radiographic changes are rarely apparent in the obvious cases, much less the cases that are not showing clinical signs.

The good news is that subclinical cases will show obvious VOM reads as far ahead as weeks to years before the disease precipitates. Of course this give rise to an early warning system and also allows us to treat the disease before it comes to pass. The giant breeds, particularly the Great Dane, are always screened in a VOM Practice to uncover a potential disaster waiting to happen. This usually takes seconds within the body of the examination and is one of the very best things we can do for the 5-month and older Dane puppy.

Canine Hip Dysplasia Syndrome

Go to a shopping mall and do this. Walk up to 100 strangers and ask them what they think is the most common veterinary disease that they know. Their answer will be hip dysplasia 95 out of 100 times. Now ask them how Hip Dysplasia in the dog is treated and you will be astounded. Their response 87% of the time will be euthanasia!

Yes, Hip Dysplasia is the most common disease condition known in my profession by the general public. It is thought to be a disease that is treated by putting the dog to sleep. If a pet owner is asked what the justification for euthanasia would be, he responds that K-9 Hip Dysplasia is a genetic disease. A dog from a sire or dam with the disease is so painful that the only humane thing to do is to put the animal out of its misery.

But wait, we know of dogs that have K-9 Hip Dysplasia Syndrome and have parents that are OFA Dysplasia free. We also know that animals that are "stress-fed" as pups have a greater tendency to the syndrome. Male dogs that rapidly develop are also more prone to develop the disease as opposed to the smaller, less physically aggressive females. Vitamin C (and the collagen growth that it directs) also seems to have an effect on the progression of the disease.

Hip Dysplasia is categorized as a polygenetic, autosomal recessive trait with incomplete penetrance. Which means that essentially it occurs or doesn’t, when it wants to or doesn’t anytime or never. Very confusing.

Hip Dysplasia does not act like a genetic disease at all. As we have selected OFA negative parents in the breeding cycles, it would take only five generations to show a significant decrease in the incidence of the disease. In the last 20 years of breeding dogs in this selective fashion, the incidence of the K-9 Hip Dysplasia Syndrome has not decreased at all, but in most studies has increased in incidence.

Hip Dysplasia acts like an acquired disease. Some pups in susceptible litters develop the disease and some do not. The males that are more aggressive are more prone than the females and well-fed litters that are given "hot" diets are also more prone.

When you see these pups at 5-12 months, they will seem normal but when evaluated with the VOM Diagnostic Technology, some of the pups will show reading patterns at T-8-9-10 in the middle of the back. The reflexive response is obvious to the practitioner and the client. These pups will continue to develop laxity of the hip joints that will lead to K-9 Hip Dysplasia Syndrome if not treated with VOM.

VOM treated pups will be treated at one week, two weeks after that, three weeks after that, and be done with pathological reads (and the disease) four weeks after that.

These treated pups will then "dodge the bullet" of Hip Dysplasia by having early diagnosis and VOM Treatment. This would then prove that this condition was an acquired disease held in place by subluxation. The genetic component of the disease is due to the genetic predisposition to subluxation and thereby the disease.

An early diagnosis and treatment regimen becomes simple when the cause of Dysplasia Syndrome is subluxation. The VOM Diagnostic and Treatment Technology is used to isolate these young dogs at risk, and treat them before they suffer irreparable changes in their hips.

Without this approach we are forced to wait until it is too late and surgery and other techniques are just salvage operations… or euthanasia.

Gastric Dilatation-Torsion Complex

Gastric Dilatation-Torsion of Volvulous, as it is called, is the potential disaster that most Dane owners dread. People who have owned Danes have sited this condition as one that they grew weary of being careful of.

Their complaint was that they could never let their Dane alone around an unlimited source of water as they might gorge themselves, twist their stomachs, bloat and die.

This acts as a self-fulfilling prophecy in that the "carefully watered" Dane becomes eager to gorge when given the opportunity. It has been a reason that pet owners have opted not to get another Great Dane.

We are led to believe that we have bred a line of dogs that cannot freely drink water when they become dehydrated. This is diametrically apposed to survival and makes no sense. What is happening here?

The stomach, esophagus and pylorus all are controlled by nerves that increase or decrease their function. In normal digestive operation they maintain a certain tone and function level.

In some animals these organs have compromised function and hang loose in the abdomen. Food and water stagnate in the stomach, as it is not being moved through the gastro-intestinal tract normally. The pendulous stomach then has the opportunity to flip over and twist off the esophagus and the pylorus. The disastrous bloat that results is life threatening.

Why do some of these dogs have this problem and some do not? For years we thought it was an inbred genetic faux-paus.

We know now that when we have a dog with a mega-esophagus that we have subluxation at T-5-6 and when reduce them with VOM the pet is cleared of the condition the next day.

In Volvulous, we see the same situation. Reduction of the subluxations at T-6-7-8 will restore normal functionality and tone to the stomach, esophagus and pylorus and prevent this disease.

We also use this technique after we have to untwist the stomach in a Dane that has bloated. No amount of VOM will untwist a torsed stomach and surgical stabilization may be required to hold the organ in place.

Untwisting the gut can save the life of the dog. Surgical stabilization can in most instances prevent another torsion, but the subluxation that caused the condition is still in place and needs to be handled.

It is seldom after a torsion is reduced and the subluxations are treated, that surgical stabilization will be necessary.

The good news is that these big dogs have subluxations that can be reduced months to years before they bloat. The bad news is that these subluxation sites are ones that involve the autonomic nervous system and do not give rise to the classical reflexive reads that are so easily seen in musculo-skeletal disease.

With this in mind, a routine check-up of one of these "dogs at risk" would involve a VOM Pass in the T-6-7-8 area and if a subluxation is present it will be effectively reduced. If not present, no harm will come of the adjustment.

An important point of the VOM Technology is that it can and will only reduce subluxations and can only turn a switch that is "off" to "on".

In 18 years of application the device and the application of VOM has never harmed a pet. It just does not produce enough motion to do so.

Osteochondritis Dissicans (OCD)

OCD, as it is called in veterinary medicine, is a bone development problem that occurs in the shoulder of the young rapidly growing dog. The Dane is a classic case. At 7-14 months the dog presents favoring one of the front legs, or on occasion the rear leg. It is often seen on both sides but the dog chooses to favor the one that hurts the most.

Veterinarians usually diagnose this condition by using a specific x-ray positioning technique that can show the divot of bone at the end of the humerus or femur that has refused to undergo normal ossification.

Bone first appears as cartilage and then as the young dog ages, is converted to bone.

In the case of the giant breeds, we have increased weight and stresses unique to these breeds due to their size. This added to their incredible growth rate, coupled with metabolic "encouragement" by using diets and supplements designed to enhance and accelerate grow, you have the potential for micro trauma at the ends of the bones.

This micro trauma results in a section at the end of the bone not getting the blood supply that it needs to undergo this cartilage to bone transformation.

The key here is blood supply. Something is compromising the blood to these tissues and for years we thought it was the direct trauma of weight bearing.

We know that these animals always have subluxation reads at the caudal cervical areas of C-6-7-8. The effects of subluxation are vaso-constriction (impeded blood supply) and accumulation of the by-products of subluxation that are chemical that will further degrade the developing tissues and cause pain. Those by-products are:

Lactic Acid

H+ ions

Serotonin

Bradykinins

Prostaglandins

P (pain) Substance

Others

Whether these substances induce the problem with ossification, or they cause the miss-ossification and the resultant OCD, is not known. Whether this event causes the subluxation reads or is caused by this event is also not known.

In any event, these animals are easily and definitively diagnosed with the VOM Diagnostic Passes; long before radiographic bone changes are evident, allowing early subluxation reduction and possibly avoidance of this condition.

In Danes, and other giant breeds prone to this problem, we begin routinely screening them at 6-months of age and see them monthly until 14 months.

A "normal" Dane developing this condition will present without lameness. However, when the area in the caudal cervical area is tested with the device, the pup will almost drop to the floor. He will act as though he is being instantaneously "shut off" and then, without experiencing pain, will be normal again. Radiographic findings will not be seen for weeks to months, if at all. This makes this early detection system the fastest and most effective to date.

Unfortunately, radiologists and surgeons who will direct their excellent skills to treating the bony problem once it can be isolated on x-ray, will tend to relegate this approach to "mumbo jumbo" or "black magic". The veterinary teaching institutions have not discovered these techniques, not yet.

We have taken on the responsibility of breeding this disease into our Danes and the giant breeds we love so much. We have explained their predilection to OCD and other diseases of this nature to a "genetic destiny" mandated by our breeding.

I feel this is far too harsh and somewhat irresponsible. To conclude that these diseases are the result of improper genetics because we cannot understand them is a "cop-out" and not worthy of these magnificent animals.

Conclusion

We know that certain breeds are predisposed to subluxation. We know that subluxations cause these diseases and that these subluxation patterns show up before the disease is seen. We know that when we do see the disease we always find the same pattern of subluxations and we know that the reduction of these patterns eliminates the disease or the progression of the disease.

We have in our hands now a means for early diagnosis and treatment. One that is fast, easy and inexpensive. As the VOM Technology grows and is accepted in the veterinary community, the link between subluxation and disease will become more evident. Diseases will be diagnosed and treated in this fashion and our beloved pets will live much happier lives. They can become free of the "medical disasters" that plague the lives of these magnificent creatures and, of course their owners.

Epilogue

Wm. L. Inman BS, DVM, CVCP is the founder and developer of the International Association of Chiropractitioners (IAVPC). The IAVPC is dedicated to eradicating disease in the domestic animals and uses exclusively the patented VOM Technology that Dr. Inman discovered and developed in 1982.

Based on over 45,000 clinical cases, the VOM Technology (through VOM Seminars Inc.) has trained over 3800 practitioners in the US and has become the most common means of subluxation diagnosis and treatment in the world

Dr. Inman gives professional seminars throughout the US and is available for lectures, presentations and mini-seminars to interested groups. Non-professionals are allowed access to the professional courses on an individual basis, based on background, veterinary affiliation and the veterinary practice acts of the state they would be practicing in

Dr. Inman and the IAVCP can be reached at 206-523-9917, 206-522-7512 fax, email at drbill@vomtech.com, and on the web at www.vomtech.com.

Bibliography

Akeson WII, Annie P., Savio LY: Immobility Effects on Synovial Joints, the Path mechanics of Joint Contracture, The 3^rd International Congress on Biotheology:95-110, 1980.

Chrisman CL: Problems in Small Animal Neurology- 1982

Dishman R: Review of the literature Supp. A Scientific Basis for the Chiropractic Subluxation Complex. JMPT 8(31): 163-174.

Denslow JS: An Analysis of the Variability of Spinal Reflex Thresholds. Journal of Neurophysiology 1: 207-215

Duell ML: The Force of the Activator Adjusting Instrument. Chiro Econ. Nov/Dec 1984.

Fuhr AW, Smith DW: Accuracy of Piezoelectric Accelerometers in Measuring the Distance of a Spinal Adjusting Injury Instrument. J.M.P.T. 9(1) 15-21, 1986.

Giteiman R, Fitz-Ritson D: Somatovisceral Reflexes. ACA Journal 8(4) 640-671, 1984.

Haldma S: The Pathophysiology of the Spinal Subject. Journal of CCA: 5-11 Sept 1975.

Hall MC: Cartilage Changes after Experimental Immobilization of the Knee Joint of the Young Rat, Journal of Bone and Joint Surgery 35A(1) 36-44, 1963.

Kirk RW: Current Veterinary Therapy-Small Animal Practice. 739-836, 1986.

Kirkaldy-Willis: The Relationship of Structural Pathology to the Nerve Root. Spine, 9(1): 49-52. 1984.

Oliver JE, Lorenz MD: Handbook of Veterinary Neurology, Saunders Co. Second Edition, 1993.

Slosberg M: Understanding the Role of Diagnosis Within the Scope of Chiropractic. Chiro. Econ. Jan/Feb 70-75 1984.

Vannerson JF, Nimmo RL:Specificity ans the Law of Facilitation in the Nervous System. The Receptors 21(1): 1-8, 1971.

Wyke BD:Articular Neurology and Manipulative Therapy. Glasgow ed. Aspects of Manipulative Therapy, 72-77. 1988.

Please visit Dr. Inman's site at www.vomtech.com for more information about Veterinary Orthopedic Manipulation and to find a chiropractitioner near you.