• Finally, where mal-alignments are detected, and chiropractic care, physical therapy or massage is appropriate, it will be recommended. Integration of these modalities with acupuncture, nutrition, and even medical care may be recommended for problem cases. Many geriatric cases (dogs and cats both), referred to Dr. Johnson, have extensive bony/osseous bridging between spinal vertebrae (spondylosis and discospondylosis). These cases may not respond to adjustments, and these procedures may be contraindicated. When spondylosis occurs in a less advanced stage, chiropractic adjustments may be appropriate.

• Cases that cannot be adjusted, usually respond to integrated care utilizing acupuncture, clinical nutrition, herbology, homeopathy, physical therapy, and massage. On occasion, conventional medical care utilizing drugs in gradually decreasing dosages are indicated, especially when a patient has become dependent upon steriods (i.e.cortisone, prednisone), or potent non-steriodal anti-inflammatory drugs (i.e. Rimadyl, Carprofen).

• The decision of any veterinarian not to use specific chiropractic techniques does not mean that many other manipulative techniques are not available. In fact, patients presented with chronic, difficult problems accompanied by painful musculoskeletal and fascial restriction may respond to combining various manipulative therapies and acupuncture. Combining these two approaches is not new in either equine or in human medical practice.

• For the non-medical people reading this discussion, it is important to understand the vital role that the fascia, the connective tissue framework, plays in the structure and function of the body. In fact, if one were to imagine all the other tissues of the body removed except for the fascia or connective tissue, the body would still be somewhat recognizable (less so with a pet that has a thick hair coat). 

• Besides giving the body form. the superficial and deep fascia have  electrical properties which allow the entire body to be interconnected. The acupuncture energy channels also function along these fascial planes. The holistic practitioner must ascertain whether to direct the therapy to the outer shell of the patient, or whether specific organ functions must be addressed on a deeper level. Chiropractic techniques, Osteopathic techniques, Massage Therapy, Physical Therapy, Myofascial Release, Lymphatic Manipulation, and Craniosacral Therapy can all be combined with Acupuncture and Traditional Chinese Medicine to accomplish the goal of releasing superficial, deep or even organ related fascial restrictions. When these restrictions are released, the nervous, circulatory, and lymphatic systems can function more optimally. From a Traditional Chinese Medical standpoint, this release represents renewed cirulation of "Qi" (energy) in the meridians.

• The client who has a pet with chronic problems will want to consider these concepts, when reading the discussions under Manipulative Therapies, including the Chiropractic, Physical Therapy and Massage Therapy sub-sections.

• According to the A.V.M.A. Guidelines for Alternative and Complementary Medicine, "Veterinary physical therapy is the use of noninvasive techniques, excluding veterinary chiropractic, for the rehabilitation of injuries in non-human animals. Veterinary physical therapy performed by non-veterinarians should be limited to the use of stretching; massage therapy; stimulation by use of (a) low-level lasers, (b) electrical sources, (c) magnetic fields, and (d) ultrasound; rehabilitative exercises; hydrotherapy; and applications of heat and cold.

• The AVMA Guidelines also state that "veterinary physical therapy should be performed by a licensed, certified, or registered veterinary or animal health technician educated in veterinary physical therapy, or (2) a licensed physical therapist educated in non-human anatomy and physiology. Veterinary physical therapy performed by a non-veterinarian should be performed under the supervision of, or referral by, a licensed veterinarian who is provided concurrent care."

• The primary goal of physical therapy is the relief of pain. Another goal is to return full range of movement and strength to the injured part. Exercise is an essential ingredient of most physical therapy sessions. Ultrasound may be used to treat soft-tissue contractures, or even dense connective tissue. Light therapy (Laser or L.E.P.T.) may also be used to suppress pain when applied to acupuncture points.

• Animal physical therapy is an emerging profession. New training opportunities and ongoing research will establish veterinary physical therapy as a legitimate profession.

• The therapeutic electrical stimulator (TENS unit) is one of the most versatile modalities available to the physical therapist. Current electroacupuncture units, including the one that Dr. Johnson utilizes, also have this capability. These units relieve pain, stimulate absorption in edema, promote wound healing, and produce muscle contraction to retard atrophy and reduce spasm.

• Ultrasound is a heat-producing modality that can be effective for chronic injuries. When combined with range-of-motion exercises, ultrasound produces the best results. When gentle flexion and extension exercises are added after ultrasound, adhesions are easier to break down, and rehabilitation may be reduced. These same principles apply to acupuncture, acupressure, spinal manipulation, hot packs, and massage combined with range-of-motion exercises.

• Due to its ability to raise deep tissue temperature, ultrasound should only be used by trained personnel.

• Therapeutic heat is a time-honored method for increasing local circulation and relief of pain. Hot packs, infrared lamps, electric heating pads (caution), and warm water baths have all been used with success.

• Ice and compression should be used more often in our pets that suffer acute trauma, since the combination immediately reduces intertissue (not major arterial) bleeding and edema production. The use of cold and compression for as little as 15 minutes results in vessel constriction. This approach not only reduces swelling but has a local anesthetic effect. Heat can then be applied after 72 hours to increase blood flow, remove waste products from the traumatized area, and speed healing.

• Stretching exercises are part of injury rehabilitation and should only be done after heat, massage, acupuncture, acupressure, or other modalities are used to relax musculature. Manual stretching for pets should never exceed their pain-free range. Overstretching can cause damage and inflammation. Manual stretching should be avoided when acute inflammation is present. (CAVM)

• Therapeutic light therapy (Laser and L.E.P.T.) is designed to be used in contact with tissue. For large dogs, there may be some limitations to this modality, since light does not penetrate much past 3.5 cm., Dr. Johnson uses photoacupuncture (no needle) for many of his patients, especially cats, small dogs, and the extremities of larger dogs.

• Massage therapy is one of the oldest health care disciplines. Chinese medical texts referred to this therapy over 4,000 years ago. In the fourth century B.C., Hippocrates wrote, "The physician must be acquainted with many things and assuredly with rubbing" (the ancient Romans and Greeks referred to massage as rubbing).

Modern research indicates that massage therapy:

1. calms the nervous system and promotes muscle relation
2. helps break up scar tissue and adhesions which develop as a result of injury
3. effectively treats chronic inflammatory conditions by increasing lymphatic circulation
4. helps reduce inflammation and swelling from fractures or injuries
5. improves blood circulation throughout the entire circulatory system
6. can relieve certain types of pain, especially back pain
7. promotes recovery from fatigue and pain after hard exercise
8. promotes mucous and fluid drainage from the lungs by percussion and vibration techniques
9. can increase peristaltic action in the intestines to promote fecal elimination (HH)

• Before a therapist or pet owner administers massage to a pet, a complete diagnosis of the patient's health status must be obtained. This therapy is hands-on, so there must be communication and trust.

• Random movements of the hands are ineffective, so each stroke should have a purpose. The animal massage therapist or owner must be able to examine muscle for imbalances in tension, flexibility, strength, and weakness as well as detect areas of tension and spasm. (CAVM)

• Traditional European massage includes Swedish massage. The basic idea is that by stroking and kneading the top layers of muscle, you can improve blood flow through the soft tissues. Swedish massage and related techniques involve five different kinds of strokes, some of which have formal names in French such as long strokes (effleurage) kneading (petrissage), friction, vibration and percussion or tapping (tapotement). The idea is to relax muscles, stimulate circulation, and increase range of motion.

• Contemporary Western massage emphasize the "balancing of mind, body, and spirit" and includes:

Deep tissue massage. This massage takes aim at deeper layers of muscle than Swedish massage by directing strong, slow strokes against the grain of the muscle. This massage focuses on more specific areas than Swedish massage

Esalen massage. This method transforms Swedish massage techniques into slow rhythmic, and hypnotic stokes and combines them with gentle rocking and stretching movements.

Manual lymph drainage massage. This method is often used in any condition that blocks the lymph flow, such as edema.

Myofascial release. During this technique, the therapist uses gentle prolonged pressure to soften up connective tissue called fascia. Myofascial release is often used to treat chronic pain or to restore range of motion

Neuromuscular massage, trigger point massage, and myotherapy. These techniques are often used for pain control. Neuromuscular massage concentrates finger pressure deep into individual muscles to increase blood flow and release "knots" of tension and pressure on nerves. One form of this kind of massage is called "trigger point massage", because the therapist works on specific points on the body that trigger pain in other areas. If neuromuscular massage is used to control muscle spasms and other muscle related conditions, it's sometimes called "myotherapy." (AMFD).

• Bodywork for Animals: Bodywork is everywhere you go today. The various names have exotic sounding names, however bodywork is just a form of massage (sometimes without actual skin contact or movement instruction that aims at both physical and psychological well-being of the patient. Sometimes the term "bodywork" means certain Western based techniques that emphasize body structure and movement. These techniques are called structural, functional, and movement integration. Sometimes "bodywork" can also mean certain Asian massage approaches and/or bio-energetic approaches such as therapeutic touch and polarity therapy. Sometimes "bodywork" can mean all of the above, plus conventional massage techniques.

Almost all the "evidence" proving that these "bodywork" techniques do what they claim to do are anecdotes or personal testimonials. It is clear that some of these techniques free up stiff muscles, improve coordination and balance, and can aid the patient to relax. There is no scientific evidence to prove that these techniques can cure arthritis, asthma, heart problems or any other chronic disease.

The point is this: if conventional physical therapy, or other medical or more conventional alternative approaches aren't helping, you may want to give one or more of these techniques a try. As a general statement, they will not hurt you or your pet, and there are plenty of these "bodywork professionals" available around any major city in the United States.

• Bodywork from Asia: Acupressure and Shiatsu: Let's start out with these techniques, since in this practitioners experience, it has been successful in his animal patients. Acupressure is essentially acupuncture without the needles. It is a form of massage, during which the practitioner uses fingertips or hands, to press specific points along the meridians that affect the flow of "Qi" (energy) (visit our Acupuncture page).

Acupressure massage requires a working knowledge of the acupuncture point locations, and the interrelationship of these points with their related organs. Acupressure massage and trigger-point massage are similar in technique, but different in theory. The acupressure treatment approach centers on the Chinese meridian theory, which postulates that all organs of the body are connected by a network through which energy ("Qi") flows. A high degree of correlation exists between the location of acupuncture points and trigger points on the skin (CAVM). The reader can check out the discussion on our Acupuncture page for better understanding.

Acupressure can be an excellent follow-up to acupuncture, resulting in augmentation of the therapy. This is particularly helpful in patients that really need acupuncture three times a week, but whose owners can afford it, only once/week. Also, it has been this practitioners experience, that even those that can afford acupuncture three times/ week can not logistically swing that many appointments, either in the office or house call environment.

Acupressure has a number of variations including: Shiatsu (deep finger pressure), Tui Na (acupressure mixed with tapping, vibration, rubbing, and kneading), An-mo (combines bodywork, diet, vitamin supplementation, and herbs), Jin Shin Do (method emphasizes tension in one part of the body affects other parts), Jin Shin Jyusu (after pulse analysis the practitioner gently touches two of 26 specific acupuncture points to clear the meridian affected).

For humans, Qi Gong and Tai Chi belong in this general category. Many clients are familiar with these terms.

Therapeutic touch, which is essentially touch-free massage, is taught at over 100 prominent medical and nursing schools and is used around the world to treat problems ranging from cancer to burns. Healers say they they "manipulate" a patients energy field merely by passing their hands over the patient's body and feeling compassion for them. The term "therapeutic touch" has two meanings depending on who you're talking to. Some people use therapeutic touch to mean the vague healing power that comes from massage, hugs, and general human contact. Other people use the term to mean a specific kind of bodywork during which a therapist manipulates a patient's invisible energy fields by moving his or her hands over them without actually touching the patient. (AMFD).

Polarity therapy, Reiki, and Reflexology fall into this category. Many of Dr. Johnson's clients are either clients of Reiki practitioners, or are actual Reiki Masters. The point for any veterinarian viewing this website is this: these modalities are not only being used on humans, but many clients believe these methods also benefit their pets.

• Crainosacral Therapy: Craniosacral therapy manipulates the bones of the skull to treat a range of conditions, from ear infection to stroke, spinal cord injury. There is a rhymical motion in the craniosacral system created by the rise and fall of cerebrospinal fluid pressure. The cranial therapist is trained to "palpate" or feel with his or her hands, the motion of the craniosacral system.