Veterinary Orthopedic Manipulation (VOM)

A Diagnostic Technology That Precedes Clinical Disease.
By Wm. L. Inman BS, DVM

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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”,

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therefore by default, a bone that was partially out of joint was then ermed 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 the difference 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

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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 only40% 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 Diagnostic Technology and neurological subluxation signs.

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 beforeradiographic 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.

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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 articleVOM 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.

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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 sointent 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

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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.

Referral Relief

On a final note, it is always good medicine to refer cases that are out of a practitioner’s scope or cannot be diagnosed. Unfortunately, these clients are usually lost to the referring practitioner according to recent AAHA facts.
This is a devastatingly expensive situation to a practice and is effectively avoided to a large extent with the VOM technology as an option.

Invitation for VOM Materials and Training

ore extensive study and data is available through the International Association of Veterinary Chiropractitioners (IAVCP) and the series of hands-on

VOM Seminars offered by VOM Seminars Inc. More information and registration for VOM Modules 1-2 & 3 can be obtained by contacting Wm. L. Inman BS, DVM at 1-888-935-4866 or on the Internet at drbill@vomtech.com.
Additional information can be found regarding the VOM Technology, practitioners, training, application, seminars, equipment and materials on the web at www.vomtech.com.

Certified Veterinary Chiropractitioner (CVCP)

Certification is available and has become quite popular. Certification through the IAVCP is accomplished by completing the VOM Modules 1,2, & 3, and by passing an accreditation exam, and submitting ten clinical cases.
Clinical cases must establish veterinary affiliation with a veterinary practitioner licensed in the state the pet is treated. Questions or for referral should contact Dr. Inman’s office at 208-772-4360, 9-5, PST M-F

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