In light of the recent proposal LD 1220, An Act to Allow Chiropractors to Treat Canines and Equids, the following case example of a canine patient treated by a human chiropractor is being presented:

A 5 year old spayed female Dachshund mix presented on an emergency basis for an acute onset of hind limb paralysis and spinal pain. The patient had been experiencing a 5 day history of hunching of the thoracolumbar spine which progressed to hind mild hind limb ataxia and intermittent knuckling of the left hind limb. She had been managed with gabapentin and strict rest by her primary care veterinarian and her condition had stabilized. A family friend, who was a human chiropractor offered to evaluate the patient.  An adjustment was performed (sudden forceful motion applied to the back) at which time the patient cried out sharply and suddenly collapsed on her hind limbs. When she attempted to ambulate, her legs were dragging behind her.  The patient’s primary care veterinarian was contacted and immediate referral to a neurologist was recommended.

On presentation to the Neurology Service, the patient was paralyzed and deep pain perception was absent. Hind limb spinal reflexes were normal and cutaneous trunci reflex ceased at ~ T13. Severe spinal pain was noted on palpation of the caudal thoracic spine.  Lesion localization was T3-L3 and the primary differential diagnosis was a type I intervertebral disc extrusion.

MRI confirmed a severe disc rupture at T13-L1 and a hemilaminectomy was performed at this site with removal of a large amount of calcified disc material and blood clot.

Unfortunately, the patient remained paralyzed following surgery and despite extensive home-care and physical therapy, she did not regain pain perception. Paralysis has remained 2 years following the incident and she is also urinary and fecally incontinent. Despite these challenges, she is still enjoying a good quality of life, spending time in her wheelchair and is unconditionally loved by her family.

The purpose of this case presentation is to highlight the concerns with chiropractic adjustments being performed by human practitioners without experience in veterinary medicine and why these procedures in particular are contraindicated in canine patients with intervertebral disc disease This case raises the following concerns:

• The chiropractor failed to recognize the clinical signs that indicated the presence of neurologic dysfunction (including ataxia and proprioceptive deficits) due to their lack of veterinary medical knowledge.
• Canine patients with intervertebral disc disease, particularly type I intervertebral disc disease have a degenerative condition (this is very different from intervertebral disc ruptures in most people). These canine patients have fragile intervertebral discs that degenerate at a young age and are very prone to rupture.  If one of these discs becomes damaged, the motion of a chiropractic adjustment can cause the disc to rupture into the spinal canal, which is what likely occurred in the example provided above.
  • Veterinarians are aware that the most important recommendation in patients with suspected type I intervertebral disc disease is rest and avoiding sudden movements which could lead to subsequent rupture of the disc. Chiropractic manipulations are a direct contraindication to this.
  • The pet’s spine in these instances is not “out of alignment”, there is rather an underlying disease process that causes the discs to degenerate and be more prone to rupture

While the chiropractor’s intentions were to help the patient, the unfortunate outcome is that this patient will never ambulate independently again and will remain incontinent. When the pathophysiology of intervertebral disc disease and the degenerative nature of this condition is understood, it becomes clear why chiropractic adjustments should not be performed in these patients.

Intervertebral disc disease is a common condition faced by veterinarians, particularly given the increasing popularity of breeds such as the French Bulldog.  Please know that PVESC’s Neurology Service is available to help answer questions as well as discuss diagnostic and treatment options for patients with intervertebral disc disease.

Normal MRI showing hydrated intervertebral discs

T2 weighted sagittal (A) and transverse MRI images (B)

MRI showing the patient’s intervertebral disc rupture and dehydrated intervertebral discs

T2 weighted sagittal (A) and transverse MRI images (B)

Authored by: Danielle Eifler, DVM, DACVIM (Neurology), Certified Veterinary Neurosurgeon