Positive Reinforcement in Practice

By focusing on positive training tools, vets can help horses see health interventions as less threatening.
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By focusing on positive training tools such as food treats and wither scratches, veterinarians can encourage horses to see health interventions as less threatening. And that, in turn, creates an environment that’s not only safer for handlers and horses but also conducive to more efficient, more thorough care. | Getty Images

How veterinarians can use positive reinforcement for safer, lower-stress health procedures and handling

Equine veterinarians are at risk of serious injury from the gnashing teeth, swinging heads, and flying limbs of stressed-out patients. Historically, practitioners, their assistants, and other handlers have used restraint methods—ropes, chain lead shanks, hobbles, and twitches, to name a few—and have sometimes resorted to shouting as they themselves got more stressed and feared their safety.

But there’s a far better approach, says Camie Heleski, PhD, senior lecturer at the University of Kentucky, in Lexington. By focusing on positive training tools such as food treats and wither scratches, veterinarians can encourage horses to see health interventions as less threatening. And that, in turn, creates an environment that’s not only safer for handlers and horses but also conducive to more efficient, more thorough care.

“I find myself saying, ‘Why have we not done this for decades?’ ” Heleski says.

With proper training, veterinarians can even get horses to cooperate calmly through positive reinforcement in record time, says Sue McDonnell, PhD, head of the Havemeyer Equine Behavior Lab at the University of Pennsylvania’s New Bolton Center, in Kennett Square.

“If you know the concept, this works so well and so fast compared to what naysayers think,” she says.

To better understand how positive reinforcement works and how to apply it, we’ve gone to the world’s experts to show why positive reinforcement outshines management with more traditional restraint techniques and how it’s a win-win situation for horses and humans alike.

Good for the Vet, Good for the Horse

Forcing horses to hold still for veterinary care is a lot of work, especially when you’re talking about 1,100-pound animals armed with teeth and hooves. But these animals also have relatively high cognitive ability—and by harnessing that, veterinarians are choosing the smarter, safer, more welfare-friendly route, says Gemma Pearson, BVMS, Cert. AVP (EM), MScR, CCAB, PhD, MRCVS, director of equine behavior at The Horse Trust and lecturer at The University of Edinburgh’s Royal (Dick) School of Veterinary Studies, in Scotland.

“I think where we often go wrong is when we try to restrain horses, to stop them from doing what we don’t want them to do,” Pearson says. “I try to look at it the other way around. I train them to do something that I want them to do.”

Using positive reinforcement to teach horses to hold their heads still, for example, or keep their feet on the ground can “change horses’ perception of veterinary care,” she says. It’s akin to giving prizes to children at the end of a dental visit, she says.

Meanwhile, positive reinforcement helps keep horses from acting out in ­dangerous—but totally natural—ways. “We need to recognize that these are normal stress responses for these species,” she says. “So by using positive reinforcement, we can actually prevent that horse from becoming stressed.”

That said, there are certain situations in which veterinarians should reach for restraint devices—as we’ll discuss. But our sources say such cases should remain the exception.

“Don’t get me wrong,” says Heleski. “I’m not 100% against chains or twitches in veterinary care. But that shouldn’t be our go-to.”

Positive Associations: Food and Scratching

Positive reinforcement is the scientific term for rewarding specific behavior by adding (hence positive versus negative) something horses enjoy. That’s generally either food or a scratch, especially on the withers—an act that’s been proven to reduce horses’ heart rates by up to 10%.

By contrast, negative reinforcement is the term for rewarding behavior by removing something horses would rather avoid, such as pressure. Despite how it might sound, negative reinforcement is not punishment or the addition of a negative experience, our sources say. It just means, for example, the veterinarian or handler releases his or her pull on the halter when the horse takes a step forward.

While both positive and negative reinforcement can be welfare-friendly training tools, positive reinforcement might have a stronger effect, says Heleski. Her team’s study results have suggested horses trained with positive reinforcement remember lessons longer—perhaps because of the moderated good-feeling dopamine spikes in the brain they get from food and scratches.

For this reason, starting out young horses with positive reinforcement during veterinary procedures or using this method to improve the horse-vet relationship in mature horses can create a lasting positive association with veterinarians, Pearson says.

McDonnell agrees. “Well-timed positive reinforcement is a game-changer for keeping horses positively interested in veterinary staff and procedures,” she says.

By contrast, restraining horses forcefully is neither positive nor negative reinforcement; it’s simply forced control, says Pearson.

And punishing horses—for example, by raising a hand or yelling at them—only increases everyone’s stress levels, adds Heleski. Such “rough-and-tumble” veterinary management techniques are gradually becoming part of the past, she says.

Rewarding Appropriate Behavior

Effective use of positive reinforcement involves recognizing which specific behavior veterinarians want to see in their equine patients and then rewarding that behavior immediately, says Pearson.

That good timing can even undo the “accidental training” veterinarians might have done with their patients in the past. “A lot of these horses won’t even let the vet into the stall with them, because they’ve learned that the only way to prevent things from happening to them—even if it’s just in the moment—is to be aggressive toward people,” she says.

Pearson says she breaks down her goals into small steps. For a jugular vein puncture, for example, she trains the horse to stand still while the veterinarian approaches, then puts her hand on the shoulder, then the neck, then the vein, then while the vet puts the syringe on the neck, then the vein, etc. For each of these steps, she gives positive reinforcement within a second of the wanted behavior.

In difficult cases—for example, with horses that react aggressively—she starts with negative reinforcement. Her favorite negative reinforcement in such cases? The simple removal of herself. “As soon as the horse starts to relax, I step away, or the hand goes away, and I simultaneously say, ‘Yes!’ and (provide) some feed,” she says. “And that can make a massive difference, because all of a sudden the horse thinks you’re much more predictable and controllable, so she feels much calmer. And then you can get closer to the horse and, ultimately, do what you need to do with her.”

Positive reinforcement when retraining horses with a long history of problems with veterinarians is a sure success, says McDonnell. “It always helps,” she says.

Counterconditioning With Food, Scratches, and Lollipops

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RELATED CONTENT | Incorporating Equine Learning Principles Into Veterinary Practice

Similar to positive reinforcement, counterconditioning is a useful tool that helps horses create positive associations with veterinary care, our sources say. In this case, though, the animals receive the treat at the same time as something they might not want, such as an ultrasound exam.

“With positive reinforcement, you’re marking specific behavior and rewarding it, whereas with counterconditioning you’re changing the horse’s perception or emotional state,” Pearson says. “It’s independent of how the horse actually behaves. But because the horse’s emotional state changes, the horse’s behavior changes.”

A good example is reproductive exams, she says. For initial exams, mares might be better off with an antispasmodic drug, or even sedation, so they don’t associate exams with pain. “But before we do that, we’ll try just giving them a bucket of feed while we do the exam,” she says. “And it’s amazing how many of them—if you’re just slow and gentle—will settle on that. Over time, they start to associate the vet with a bucket of feed, so they’re just nice and calm and relaxed.”

Counterconditioning is also useful with diagnostic imaging and nerve blocking, she adds. “Let’s say we’re going to X ray the horse’s hock,” she says. “As soon as the X ray plate goes toward the horse’s hock, we start to trickle-feed them. Then we take the plate away, and the feed stops. Then you bring it toward the hock again, and the feed starts again. By the third time the horse is usually like, ‘Right, here comes the feed,’ and they settle and you can get the equipment around them.”

For ultrasound, Pearson says she often gives horses a molasses lick—“like a lollipop for horses.” The horses focus on and enjoy the “lollipop” while she conducts the exam.

Heleski, meanwhile, ensures her horses enjoy treats during veterinary procedures and even as she’s managing health issues around the barn. “Let’s say I’m soaking a foot with an abscess,” she says. “Why not let my horse eat alfalfa hay out of his hay bag? I’ve just made everybody’s life so much easier.”

Pearson agrees. “It just makes it a more positive experience for the horse and makes everyone’s job nice and easy,” she says.

Learning Good Positive ­Reinforcement Skills

There’s more to good positive reinforcement training than just having a bag of treats available, our sources say. Timing is very important in both negative and positive reinforcement, so the improper use of treats could lead to rewarding the wrong behaviors—and making things worse.

“Willy nilly treats can result in wiggly patients asking and nudging for reinforcement,” McDonnell says. “It isn’t rocket science, but it is a science and a skill to watch for and (to learn to) mark the behavior you want with the ­reinforcement.”

While good timing is important, the biggest mistakes veterinarians make is in aiming for steps that are too big and not taking horses’ level of arousal—or alertness in the moment—into consideration, says Pearson. “If you take the example of a needle-shy horse, your ultimate goal is for the horse to stand calmly while you raise the vein and insert the needle into the jugular and, then, either give the drug or remove a blood sample,” she says. “So there are lots of different components to that. A lot of people start off trying to raise the vein, but I start off by just putting my hand on the horse’s withers. The horse is often already way beyond his threshold there. The more tiny steps you can find in between, again, the faster your training will go.”

McDonnell keeps treat pouches on each stall door and makes sure the center’s team, including vet techs and assistants, understand procedures related to positive reinforcement. Veterinarians wishing to learn these skills can follow her short course on equine behavior modification at New Bolton Center, she says. They can also find downloadable papers on the Havemeyer Equine Behavior Research Lab’s official website.

She recommends veterinary personnel learn discernment in their management of equine patients. “Focus on what you want, and not on any mistakes the horse makes as he learns,” she says.

“The hardest part for people wanting to use all positive reinforcement is giving up the need to react to anything undesirable, and remaining quiet and just delivering the primary and conditioned positive reinforcement to mark the behavior, or the increment in behavior, that you want,” McDonnell says. “Just don’t forget that undesirable things may happen as the horse is learning what you want—in other words, what’s getting the reinforcement.”

The Right Treat Matters

It’s easy to think of apples and carrots when talking about positive ­reinforcement—but in many cases such a high-value reward can be counterproductive, says Pearson.

“Every time you use those, you get these spikes in dopamine in the brain,” she says. “And for some horses their arousal level gets too high, and then they get frustrated quite easily.”

Sport horses and those fed concentrates can usually be trained with their regular feed, she says. But those at pasture are often better off with a ration balancer or chaff or chopped hay.

Some veterinarians prefer scratching over food, says McDonnell. “Scratching at the withers in the pattern of mutual grooming is often as effective as food,” she says. “And it’s less likely to lead to the mistake of accidentally reinforcing ­wiggliness.”

Changing Everything in a Matter of Minutes

“Patience and time are what people often preach, which gives the impression of taking forever,” McDonnell says. “But really when your skills are good, it is scary how fast horses learn to do all sorts of things for positive reinforcement.”

“You can retrain 90% of needle-shy horses within 30 seconds to a minute,” Pearson adds.

For others, it might take five to 10 minutes, she says. “But those are often the ones that people were spending 20 minutes or half an hour trying to get into the right position (with restraint). So, yeah, for the vast majority of horses, incorporating positive reinforcement is actually faster than the usual methods. And the more you do things, the faster you get at them.”

That’s true even for the “old dogs learning new tricks” with a heavy weight of emotional baggage from past veterinary experience, adds Heleski. “You can absolutely retrain those horses,” she says. “But depending on the level of bad stuff they’ve experienced, it might take longer.”

Take-Home Message

Practitioners take risks when working with equine patients that get frightened or stressed or have had negative experiences with veterinary interventions. Bringing positive reinforcement into the clinic can change a horse’s attitude, behavior, and association with the people who provide procedures and treatments that help ensure his good health.


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Passionate about horses and science from the time she was riding her first Shetland Pony in Texas, Christa Lesté-Lasserre writes about scientific research that contributes to a better understanding of all equids. After undergrad studies in science, journalism, and literature, she received a master’s degree in creative writing. Now based in France, she aims to present the most fascinating aspect of equine science: the story it creates. Follow Lesté-Lasserre on Twitter @christalestelas.

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