Front Matter

Chapter 22 The Role of Acupuncture and Manipulative Therapy in Canine Rehabilitation 557

Case Study 22.2 Sporting dog with thoracolumbar heat, left thoracic limb short stride, and paraspinal

muscle sensitivity

Signalment: 9-y.o. M/N English Cocker Spaniel.

Active in upland hunting, barn hunt, dock jumping,

and family pet.

History: Several-day history of mild palpable heat

over the thoracolumbar spine. No lameness noted.

Patient normally runs and works at least 30 minutes

daily.

Examination: BCS 4.5/9. Posture square at down, sit,

stand. No appreciable weight shift. Active spinal

ROM (cookie stretches) good in all directions (exten-

sion, flexion, lateral bend, coupled rotation). Gait

fluid and even on clinical evaluation, but when

viewed in slow motion video, at the trot, slight short

stride of the left thoracic limb noted. No pain on pal-

pation of the limbs. Slight muscular sensitivity and

fasciculation elicited upon palpation of paraspinal

muscles in the area of T13–L2. Slight tenderness at

stretch of left iliopsoas muscle. Slight resistance to

full extension of left thoracic limb. No restriction of

PROM of coxofemoral joints. No instability palpated

in shoulder or stifle joints.

Muscle girth symmetrical (using a Gulick girthom-

eter) at proximal and mid-femur measurements, and

at mid-tibia, and distal humerus measurements.

VSMT (veterinary spinal manipulative therapy)

exam: Tenderness at T13–L2. Restricted motion at left

temporomandibular joint (TMJ). The following restric-

tions/hypomobilities were found on motion palpa-

tion: ADR (atlas dorsal right), C6BL (6th cervical

vertebral body left), T13PL (13th thoracic vertebrae

posterior (dorsal) left), L4PL (4th lumbar vertebrae

posterior (dorsal) left), left T9 rib dorsal.

Assessment: Several areas of hypomobility or restric-

tions in the caudal thoracic and cranial lumbar spine.

Left 9th rib restricted dorsally—discomfort associ-

ated with this rib restriction could affect thoracic

limb extension as upon extension the dorsal–caudal

angle of the scapula normally glides caudal–ventral

along the dorsal arches of the adjacent ribs. Patient

may resist full extension of the thoracic limb to pre-

vent this scapular motion. In addition, the brachial

plexus originates from the last three cervical and first

two thoracic nerves, so any vertebral restrictions in

this area could alter nerve activity, potentially lead-

ing to increased nociception, decreased mobility,

and diminished activity. Because of the slight dis-

comfort elicited by the iliopsoas stretch test, iliopsoas

muscle strain cannot be ruled out. The sensitivity to

palpation at T13–L2 correlates to iliopsoas origin

(last thoracic and first 4–5 lumbar vertebrae).

Restriction of L4 correlates with emergence of one

nerve root of the femoral nerve, which innervates the

iliopsoas muscle.

(Continued)

The angulation of the articular facets of the
quadruped thoracic vertebrae caudal to the
anticlinal vertebrae is such that the motion of
the thoracic spine caudal to the anticlinal verte-
brae and of the lumbar vertebrae is primarily
dorsoventral flexion and extension.

Pelvis and sacrum

The canine sacrum is composed of three fused
sacral vertebrae. The angle of the canine L7–S1
articular facets is approximately 45 degrees
from each of the sagittal, transverse, and coro-
nal axes. The angle of the canine sacroiliac artic-
ulation varies among dogs and is a topic of
research through the American Kennel Club
Canine Health Foundation (AKC-CHF) and
North Carolina State University, the goal of

which is to determine variations within and

among breeds and the relationship of the canine

sacroiliac joint angle to the lumbosacral, pelvic,

and stifle joint angles.

Extremities

In addition to palpation and evaluation of ver-

tebral motion segments, the manipulative ther-

apist evaluates the motion quality of the motion

segments of the extremities, performing appro-

priate motion palpation to challenge the mobil-

ity of each motion segment in the direction of

normal mobility. If hypomobility or restriction

of normal motion is detected, the manipulative

therapist determines whether to perform a

manual adjustment to help restore function

and/or modulate pain.