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Chiropractic Findings in Dogs with Urinary Problems

Clinician's Brief (Capsule)

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In chiropractic medicine, vertebral subluxations (ie, segmental hypomobilities in chiropractic terminology) are thought to encroach on the intervertebral foramen or the adjacent spinal canal, alter the afferent input to the CNS, or lead to distortion of neural impulses in the spinal cord through interactions via the denticulate ligament. However, there is no fully accepted mechanism of action in chiropractic medicine and no fully accepted mechanism by which intervention works. 

This retrospective study examined the chiropractic findings of dogs that were presented to a single clinician over a 6-year period for urinary problems. Of the 543 canine chiropractic patients examined during the study period, 22 were presented for urinary problems, 18 had signs of urinary incontinence, and 4 had urinary retention. Urinary patients were significantly more likely to have chiropractic abnormalities at L3, L4, and L5 than nonurinary dogs. Additionally, urinary patients were significantly less likely than other patients to have chiropractic abnormalities associated with the ilium. 

It was postulated that hypomobility of the facet joints in the lumbar spine could cause edema, which could cause increased pressure on nerves responsible for sympathetic innervation to the bladder, thus leading to urinary incontinence and retention. The author concluded that chiropractic evaluation is a valid supplement to conventional veterinary diagnostics in dogs with urinary incontinence and dysuria.

Global Commentary 

Veterinary chiropractic, or spinal manipulation, therapy shares features of other manual assessment and treatment modalities. In small animals, however, it has been largely absent from conventional scientific literature. 

I frequently encounter questions from owners about chiropractic medicine but have little training in this area, so any contribution is important to informing current knowledge. The “subtle changes in joint mobility” detected in the investigation, however, rely almost exclusively on practitioner experience, given that hypomobility of vertebral joints was not evaluated by means other than palpation. The presenting complaint could subconsciously bias clinical findings, and, as the author acknowledges, there is no conclusive link between hypomobility and urinary incontinence. 

The article is noteworthy, however, in hypothesizing a mechanism by which soft-tissue or articular manipulation could provide relief of clinical signs, even if the data are insufficient to change recommendations. It is similarly commendable that the author collected the data from his private practice, and I hope more articles are forthcoming.—Justin Shmalberg, DVM, DACVN, DACVSMR, CVA, CVCH, CVFT, University of Florida

References

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