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Chiropractic Journal of Australia : December 2011
132 Chiropractic Journal of Australia Volume 41 Number 4 December 2011 As a noted feature, the cases cited mostly highlight the specifcity of their examination, (primarily by palpation), and their subsequent adjustment. There was minimal reference to general manipulation and mobilisation techniques, as opposed to specifc adjustments. While anecdotes are not generally regarded as high level evidence, the American Veterinary Medical Association revised its Guidelines on Alternative and Complementary Therapies in 1996. It stated that “Suffcient clinical and anecdotal evidence exists to indicate that veterinary chiropractic can be benefcial.”4 The manipulative practices appear to have been adopted by a number of veterinary clinics before controlled or blinded studies into the topic - seemingly on the basis of clinical results and patient demand. In essence, this is a different policy to that taken by medicine in its recognition of a chiropractic model. In a further statement Taylor and Romano "... suggest that those highly sceptical or critical of veterinary chiropractic, while awaiting more research, explore the daily clinical aspect of chiropractic in animals. Anecdote can be useful and powerful. We simply invite you to see the clinical results for yourselves." 69 Early anecdotes with positive outcomes appeared in the Journal of the American Medical Association in 1921. They related the report of the successful sacral manipulation of a mule "that is down in the back and can't get up...," an apparent paresis of a Scotch Collie, and the adjustment of T6 and T8 on a cow with possible bovine bloating.70 While some may question the validity and value of anecdotes, this form of evidence has to be regarded as a starting point. Such reservations were refuted by Enkin and Jadad, they note that anecdotal evidence does have a contribution to make. They state that, "Anecdotes are powerful tools that humans use to make decisions. Despite their power and infuence, they are sometimes misused, and sometimes undervalued. Ignoring or under-estimating the role of anecdotal information in health care decisions is likely to hinder communication among decision makers, and to retard their uptake of research evidence. Anecdotal evidence should not be considered a replacement for, but as a complement to formal research evidence. If evidenced-based health care is to meet its potential, the important role of anecdotes must be acknowledged, studied and utilized." 71 Indeed, Stuebe opined that medically, the experience gained from Level IV evidence in the form of adverse anecdotes (i.e. adverse events), strengthened clinical judgement by experience and contributing towards subsequent patient care in a positive way. We would submit that positive anecdotal evidence does likewise, at least as an initial step in compilation of an evidence base.72 The following cases were drafted from reports submitted by various chiropractors. Case 1. Alsatian - Dysplasia Anecdotally, we are aware of a particularly intriguing case concerning an 8 year-old male Alsatian dog. This canine was losing the use of its hind legs -- a partial paralysis (paresis). The owner was not keen on the previously recommended surgery, and brought the dog to her chiropractor. After adjusting the dog's sacroiliac joints, the dog suddenly took off and ran a lap of the car park -- where it had been adjusted outside the clinic. The dog raced one lap, returned to the chiropractor, and jumped its front paws up onto his shoulders, licked the practitioners face (in what appeared to be a display of appreciation), Then took off for another lap. (McKibbin MR. Personal communication, 9 Nov 2009.) Case 2. Collie Cross - Low Back Dysfunction A six-year-old collie exhibited signs of being ill-at-ease, and was generally stiff in its normal movements - like an old dog. Initially, by 'chatting' to it, then with gentle patting, it allowed the chiropractor to conduct a spinal examination by palpation.. The owner had indicated that she thought the dog "had a crook back." After explaining the dog's apparent vertebral problems to the owner, and with their permission, the indicated areas were adjusted. Immediately, the dog was friendlier, less reactive to previously tender areas along its spine, moved with far greater freedom, and began wagging its tail. (McKibbin MR. Personal communication, 17 June 2011.) Case 3. German Shepherd - Dysplasia At about 4-months-of age, 'Gee' climbed out of the family car and just sat - suddenly unable to move. Subsequently, a veterinarian performed an x-ray examination and concluded that Gee had severe hip dysplasia, and should be 'put to sleep'. A second opinion confirmed the vet's diagnosis and recommendation. The owner then took Gee to the beach for swimming and carried out daily leg massages. As Gee was still struggling, she then took him to a chiropractor. The chiropractor carried out a spinal examination and a series of spinal adjustments, together with advice on exercises in the ocean and walking. Today, Gee is now 4-years-old, has fortnightly chiropractic care and apart from the very occasional relapse (especially when cold), has resumed a 'dog's life' with normal running and playing. (McKibbin MR. Personal communication, 24 June 2011) Case 4. Dog - Cross-Breed - Incontinence, Skittish, Falls Jess was a cross-breed about 8 years old. She had been abused by previous owners, and was quite skittish, even at just the sound of an Activator which was not in contact with her. She suffered dyspnea, bowel and bladder incontinence, would not wag her tail, and would sometimes fall over in trying to stand. All symptoms diminished considerably following just two spinal adjustments. (McKibbin MR. Personal communication. Letter and DVD, 10 June 2011.) Case 5. Labrador --"Archie" Lethargy, Tail Droop This 4.5 year-old Labrador was particularly lethargic, would not play, and just lay around all day. In addition, his tail was constantly down. It seemed he could not lift it. Following vertebral adjustments with an Activator, "Archie" ANIMAL PATIENTS IN CHIROPRACTIC ROME • McKIBBIN
CJA March 2012