Northern Lakes Equine Practice is proud to offer integrative veterinary medicine as part of our service list. Dr. Laurel Meininger is an equine Certified Veterinary Medical Manipulation Practitioner (CVMMP) and received her training at the Integrative Veterinary Medical Institute in Reddick, FL. The program is exclusively offered to veterinarians with a strong focus on equine anatomy and neurology.
Veterinary Medical Manipulation (VMM) is very similar to chiropractic, though the term “chiropractic” is reserved for individuals receiving human training as a doctor of chiropractic. VMM focuses on identifying and relieving restrictions (areas of reduced range of motion through the spine or joints of the limbs) to restore normal range of motion and function. When used appropriately, VMM can help to maintain a patient’s comfort, soundness, and muscle tone to ensure all areas of the equine musculoskeletal system are in sync and reduce the likelihood of overstrain injury to the horse.
When your horse is evaluated for VMM, Dr. Meininger will begin with an initial assessment, which will likely be a more comprehensive evaluation than follow-up examinations. Dr. Meininger will obtain a thorough history of your horse including your horse’s use, history of lameness/performance issues, issues under saddle or in hand, medication history, and any pertinent treatment history. Common complaints that would indicate a medical manipulation is needed include the following: changes in behavior/attitude, shortness/stiffness of stride, muscle asymmetry/atrophy, change in bit contact, sticking the tongue out while riding, bucking under saddle, back pain, resistance to collect during ridden work, and dragging toes. Once a history is obtained, Dr. Meininger will perform a thorough static and dynamic examination of your horse, which will combine both conventional and integrative medicine. She will look closely for any asymmetry in muscle development, foot conformation, and stance, palpate for any evidence of pain, and watch your horse in motion to assess for any gait abnormalities or lameness issues. If any lameness is suspected or identified, flexion tests may be performed to further evaluate these findings.
Following this assessment, Dr. Meininger will begin to identify any restrictions of the musculoskeletal system through “motion palpation,” a way of evaluating the range of motion through the spine and joints of the limbs. The most common areas for restrictions are the poll, lower neck, back, pelvis, and sacrum. She will then correct these restrictions using a combination of high velocity-low amplitude (HVLA) thrusts in the plane of the joint and long-lever techniques (done for some limb restrictions) to restore normal range of motion of a specific joint.
VMM may not be recommended in every case. In horses with severe osteoarthritis or a history of neurologic issues/trauma/severe pain, Dr. Meininger may recommend additional diagnostics (radiographs, ultrasound, or occasionally higher imaging) before completing a medical manipulation. This is because these clinical signs may be further exacerbated if a medical manipulation is performed, and our primary goal is always the safety and comfort of your horse. Additionally, if a lameness is identified on the initial evaluation, a conventional lameness evaluation and treatment may be recommended to complement the medical manipulation examination. Additional treatments may include systemic joint health products (NSAIDs, Adequan, Legend), joint injections, mesotherapy, laser therapy, or shockwave therapy.
Upon completion of the VMM session, Dr. Meininger will make recommendations regarding follow-up appointments, additional treatments (if indicated) and homework for the client to help extend the benefits of the manipulation session and encourage proper stance, posture, and muscle development of the patient.
If you have additional questions regarding VMM and whether it’s right for your horse, or to schedule an evaluation, please call our office at 847.388.9141 Extension 3. You do not need to be a routine client of Northern Lakes Equine Practice to utilize our integrative medicine services—we maintain strong working relationships with the area’s equine practitioners to work on a referral basis. If you have your horse in routine care with another veterinarian, we will happily communicate our findings to your routine provider to ensure continuity of care.