I want to start today by thanking our clients- I have been intensely gratified by the interest in chiropractic care for your animals and the enthusiastic response that Dr Surasky and I have received now that we are certified practitioners.
This leads to an interesting challenge- who am I exactly? Chiropractic theory and practice has given me a new way to assess and treat patients, and it has also improved my skills as a lameness and performance veterinarian. The challenge now lies in deciding how to proceed with an integrated approach on a case-by-case basis.
Sometimes the decision is made for me when a person who already has a regular veterinarian contacts me purely for chiropractic care and nothing else. Although this is often related to an ongoing lameness or performance issue, my role is very clear. I perform my exam, followed by appropriate adjustments, but it is not ethical for me to “take over” the case or indeed the entire client based on that interaction. I am both humbled and grateful when another veterinarian refers a horse to me for chiropractic, and I would not jeopardize my professional reputation by becoming a “pirate”. “But”, you may ask yourself, “what if you see something that is critically important to the overall case?” This is where openness and communication is key. I should be able to speak to the regular veterinarian about my observations and how they may contribute to the overall diagnosis and management of the horse. This is in the best interest of the patient, yet it preserves the relationship between client, the vet they have known and used for years, and me in the role of chiropractor.
Other situations are more complex. We see a lot of lameness and poor performance problems in our caseload, and while some are fairly straightforward, others are the result of multiple subtle issues that finally culminate in an observable problem. Once we get past the easily identifiable head-nods and concrete diagnosis through blocking, we are left with these complicated and challenging cases. Chiropractic has given me additional keys for unlocking this puzzle, but I have to decide where to integrate it into my diagnostic and treatment strategy. Is a series of adjustments alone going to be enough to resolve the problem? Do we have to start with more aggressive interventions? Ultimately I have to devise a program as unique as the individual I am treating.
This is when I manage to squish both hats onto my head. As a veterinarian-chiropractor, I palpate all over the horse’s body and limbs, observe it move under various conditions and challenges, and decide what areas to focus on. As a veterinarian I perform the diagnostic tests and imaging, various therapies ranging from joint injections and PRP/IRAP to shockwave, mesotherapy, and more, and finally set up the ongoing medication and management protocols. As a chiropractor, I perform the adjustments and suggest stretches and exercise programs that will develop the proper musculature and functionality. Finally, I put both hats on again and try to identify how those multiple separate issues have contributed to today’s problem. Whether we start with chiropractic alone, or more aggressive treatments followed up by series of adjustments all depends on the nature of the problem, the circumstances of that particular individual, timing of competitions, and preferences of the owner/trainer. There is often more than one way to effectively address the issue, the key is to create a plan and stick to it, with regular reassessments to make sure we are staying on the right track.
While integrating all I have learned in my chiropractic training into my longstanding experience in equine veterinary medicine can be difficult, it is a challenge that I welcome wholeheartedly. It means that I have more resources to draw upon when trying to do my best for our equine companions.
Melissa McKee DVM