Providing evidence-based and behaviour-friendly equine visits - Veterinary Practice
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Providing evidence-based and behaviour-friendly equine visits

Equine visits can prove challenging from numerous behavioural perspectives; therefore, maximising safety, welfare and compliance are key to a successful visit and to the pattern of future visits

Equine visits can prove challenging from numerous behavioural perspectives including client, horse and vet safety, as well as the additional challenges brought about by COVID-19 restrictions and social distancing considerations (BEVA, 2020).

Maximising safety, welfare and compliance are key to a successful visit and to the pattern of future visits. The interplay between safety, welfare and compliance is heavily linked to the behaviour of the horse during a veterinary visit and in order to maximise these three aspects it is key that the horse under treatment is as cooperative as possible (Nellist, 2021).

Over the last two decades, zoos have increasingly been engaging in cooperative behaviour training (CBT), utilising positive reinforcement techniques to train animals to cooperate with handlers and vets for both prophylactic and reactive treatments (Graham et al., 2011; Hosey et al., 2013). This successful implementation ensures a low-stress environment which enhances both safety and welfare and provides the animal with some agency in regard to the veterinary intervention (IAABC, n.d.). Successful training also facilitates easier treatment and as such heightens compliance (Loftus, 2012).

There are a multitude of positive reinforcement training techniques available to prepare an animal for veterinary intervention and the technique selection will be dependent on the current status of the animal’s behavioural response, the required outcome and the timescales involved in the process. All positive training techniques are based upon accepted learning theory (Starling et al., 2016) and the LIMA principles of “least intrusive, minimally aversive” in order to successfully train a behaviour or modify emotional, and thus behavioural, responses to stimuli (IAABC, n.d.).

We can consider three main steps to maximise low-stress positive equine visits.

Patient and environment preparation

Teach the owners how to prepare their horse at least six weeks before a veterinary visit is due, if possible.

Preparing the horse for the procedures should be undertaken well ahead of the date of the proposed event in order that the horse can be gradually habituated and/or trained for the process (Landsberg and Horwitz, 2004). This not only raises the owners’ awareness of how their horse may feel, but also what is expected of their horse during a procedure and how to understand their horse in order to set them up to succeed.

Preparing a safe, horse-friendly environment – friends, food and freedom to move are pivotal to low-stress procedures.

Allowing the horse to spend time in the examination area with positive consequences, such as relaxing time with conspecifics (companions), eating food (or having a wither scratch if valuable to that individual horse) and having the ability to move away from perceived threats, can begin to build positive associations and lower novelty responses (Loftus, 2014). Providing enrichment in the area can help to facilitate the development of positive associations (Haines, n.d.).

Habituating the animal to the examination/treatment area, equipment and any restraint required.

FIGURE (1) Body language signals in horses. Know when to stop, when to be cautious or when you are safe to proceed (Draaisma, 2017)

Getting the horse used to the environment where the examination/procedure will take place can significantly lower stress responses that may otherwise occur due to the potential perceived danger of novelty. Pairing the introduction of new equipment items (for example, if the owner can purchase a child’s toy stethoscope and some empty syringes to practise with, or practise bringing a table closer if the horse is going to be scanned) with positive consequences such as a tasty treat can also help to reduce the number of potential triggers when it comes to the actual procedure/examination. Likewise, gradually introducing and practising holding the horse in the manner required for examination/the procedure can help the horse to gradually become accustomed to the pressure without becoming fearful of it (Draaisma, 2017; Figure 1). Providing small, high-value food rewards during handling and while being restrained and then moving to the next step of rewarding immediately following calmness during restraint can help to develop a positive (or at least less negative) emotional response to it (Bloomsmith, 2014).

Preparing the animal for procedures, examination and close-contact handling through classical and operant conditioning (Figure 2).

Often the use of a stationary or moving target can be very beneficial for the process to provide the horse with a focal point for attention or touch which will be highly rewarded, and these training aspects are often intertwined with clicker training (Loftus, 2020).

FIGURE (2A) Preparing a horse for veterinary procedures using food as a positive reinforcer, including asking the horse to approach
FIGURE (2B) Preparing for blood sampling (raising the jugular vein) – the horse is watching something in the distance but has chosen to remain working with the handler in a relaxed manner
FIGURE (2C) And preparing for an intramuscular injection (pinching the skin on the neck). This horse remains relaxed and in a positive emotional state with low arousal; notice the lowered head, the softened eye and, aside from eating, the relaxed muzzle and nostrils. Recognising these behavioural signs, you could proceed with the veterinary handling

Desensitisation and counter-conditioning of an animal to any previously learned negative associations with veterinary procedures.

Desensitisation is working with small and controlled gradual exposure to a specific stimulus that an animal is sensitised to already (a trigger), for example, being approached to be injected with a needle. Counter-conditioning is where you teach a behaviour response that is completely incompatible with that horse’s previous behavioural response to the same cue; for example, if a horse has previously responded to a vet approaching them with defensive behaviour (trying to flee the situation but if they’re unable to, striking out), then teaching calm, relaxed behaviour would be a counter-conditioned response, as the two responses could not happen at the same time.

FIGURE (3A) Photo series of the approach of a person, using a positive reinforcer (food) and recognising that this horse is not comfortable with the interaction. This individual horse is quite food motivated; she is keen to approach when asked as she is aware that food is an incentive
FIGURE (3B) She then displays potential emotional conflict (a mixture of emotions consisting of wanting to approach but feeling concerned and therefore also wanting to avoid at the same time) where her ear direction changes, her eye shape changes and her muzzle appears tense (also taking into account that she is possibly still eating treats from the ground); she doesn’t want to get much closer
FIGURE (3C) Horses may prefer to view a potential threat from a different angle (which people often call “shying” where they almost arch around the threatening object to get a better look; they often orientate their head towards the object)
FIGURE (3D) She still accepts the treats but looks uncomfortable; her neck muscles appear tense
FIGURE (3E) As an arm reaches towards her neck, it is very clear that she is fearful and uncomfortable of this interaction; she turns her head away, her weight is shifted away from the person, she orientates her ears towards the potential threat, there is peri-orbital tension, her jaw appears tense and her nostrils are strained.
FIGURE (3F) As an arm reaches towards her neck, it is very clear that she is fearful and uncomfortable of this interaction; she turns her head away, her weight is shifted away from the person, she orientates her ears towards the potential threat, there is peri-orbital tension, her jaw appears tense and her nostrils are strained. Recognising these behavioural signs, you would be advised to stop the veterinary handling and teach the owner how to practise positive veterinary handling with this horse

Safety (emotional and physical)

Safety is paramount in a clinical situation and in order to maximise safety it is essential that both the owner and clinician can recognise signs of anxiety and stress in horses and make proactive decisions regarding how or if to proceed with the process. Figure 1 highlights the escalating body language and behavioural signs in horses who are uncomfortable and/or under stress and identifies when it may be appropriate to halt the process. Figure 4 is the flowchart to follow to promote safety and low-stress handling in every procedure you expect to perform on a horse.

  • Looking for calming signals
  • Looking for displacement behaviours
  • Looking for stress signals
  • Looking for distance-increasing behaviours (Figures 1 and 3)
  • Knowing when to stop and when to proceed (Figures 1, 2, 3 and 4)
FIGURE (4) Flowchart to aid “within-visit decision making” with regard to when to proceed safely with a procedure and when to postpone for behavioural training

When you’re there (the prepped and non-prepped horse)

Consider creating a smooth, pain-free, comfortable interaction from the horse’s perspective as well as yours. This may include ensuring you use fresh needles before piercing the skin, using food as a distraction if they are underprepared or prepared and considering pre-event medication (this is usually in oral form) as an anxiolytic for the owners to give before your scheduled visit, to help set the patient up to succeed. Our patients learn from every interaction they have with us, so if we can strive for our patients to have a perceived positive experience, then the next time they are likely to be in a calmer and more positive emotional state. Overall, this increases safety as well as facilitates compliance for procedures in the future.

Take-home messages

The main aim of this article is to encourage the practitioner to consider whether the procedure is an emergency that is essential to complete before the horse is fully prepared for it, or whether the patient would benefit from postponement and some prophylactic training or remedial behaviour modification to prepare for the procedure. Utilising the information within this article and considering (a) processes to follow with a prepared horse (Figure 4), (b) processes to follow for an unprepared horse (if procedure completion is not essential, see Figures 1 and 4) and (c) processes to follow for an unprepared horse (if procedure completion is essential; see Figures 2,
and 4) can aid the equine practitioner in providing and developing a positive and safe veterinary experience for all involved, and increasing cooperation and compliance for the future.

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