Incorporating Equine Learning Principles Into Veterinary Practice
Behavioral issues during veterinary procedures are not uncommon. Horses that are frightened, injured, or unfamiliar with a procedure not only take longer to examine but also pose a safety risk to human handlers.

In recent years, researchers have identified a possible link between veterinarians’ limited understanding of learning principles and the high incidence of injury in equine practice. So, to help practitioners reduce fear and problem behaviors and promote positive veterinary care, Robin Foster, PhD, CAAB, CHBC, described behavior modification techniques based on principles of equine learning at the 2017 American Association of Equine Practitioners convention, held Nov. 17-21 in San Antonio, Texas.

The benefits of incorporating learning principles into equine practice are many: It can lower veterinary costs (e.g., less sedation, fewer visits to get the job done), promote positive care, eliminate problem behaviors, improve equine welfare, and reduce risk of human injury. And it all starts with addressing the source of procedural aversions: fear.

“Fear and anxiety are the root cause of behavior problems with veterinary care, including not standing still for examination; barging or pushing; refusing to enter the exam room, stocks, or trailer; bolting or pulling away when led; being head-shy; and biting, kicking, striking, and rearing,” said Foster. “These behaviors are often inadvertently reinforced by the release of pressure (called negative reinforcement) and will be repeated.”
For example, if an anxious horse pulls back during a blood draw and thereby delays the procedure, he’s going to continue that defensive behavior because it’s effective.

The goal of behavior modification in veterinary care, said Foster, is to reduce the horse’s fear and unwanted behavior, as well as improve compliance. To accomplish this she described several techniques veterinarians can use.

Reduce Arousal

We often don’t recognize the signs of an impending problem until a horse “explodes.” Therefore, it’s important to monitor horses’ body language for early signs of fear and anxiety.

“Body language can reveal information about arousal and emotional state before the horse acts,” said Foster. “Watch for facial expressions (including eye wrinkles, ear position, mouth and facial tension, flared nostrils). These are useful because humans are good at recognizing expressions and because handlers can’t always see the horse’s whole body.”

After a veterinarian learns to identify arousal, he or she can take steps to create a more relaxing environment for the patient. Choose a familiar but neutral location (one that has no meaning to the horse, i.e., he doesn’t associates it with negative experiences, such as punishment, or with positive ones, such as mealtime) that’s quiet with few distractions in which to perform procedures, said Foster. With particularly frightened or fractious horses, the vet might break the exam into multiple visits, postpone nonessential procedures, or use sedation. It might also help to recruit a helper horse—a familiar, calm buddy that can mitigate stress through social buffering—to promote relaxation, she added, putting him in a stall or crossties nearby.

Habituation and Systematic Acclimation

“The initial veterinary experience can have a profound and lasting effect on future behavior,” said Foster.
Take a syringe, for instance. Initially it’s a neutral and harmless stimulus. It only gains meaning when it causes pain and discomfort, at which point the horse learns to fear and avoid it. Then that horse might learn to fear and avoid the veterinarian and his or her truck, clinic, or equipment through association with the syringe, as well. In this scenario, prevention through habituation and acclimation is the best medicine, said Foster.

To accomplish this, expose horses to new or mildly aversive objects or situations gradually. Habituation is a neurologic process, she explained, so if you present a stimulus repeatedly, the horse’s response behavior should become weaker.

Foster warned, however, against making a situation too intense for a horse, which can lead to sensitization and heightened fear reactions.

Systematic Desensitization

This technique—the process of overcoming a horse’s learned fear of an otherwise harmless object or situation through gradual, progressive exposure to it—is most commonly used to treat existing fears, said Foster.

“The horse should not experience discomfort or pain,” she said. “Start with a weak, nonthreatening intensity, and increase it gradually. Meanwhile, train the horse a different response (e.g., dropping, not raising, his head during a procedure).”

Counterconditioning

This classical conditioning process involves pairing a feared stimulus with a pleasant one, with the goal of replacing a fear-based problem behavior with a relaxed one.

“For example, a horse with a learned fear of injections may withdraw from the syringe by becoming tense, raising its head, and stepping backward,” said Foster. “During counterconditioning, the syringe would be paired with and predict something pleasant, like a treat placed in a dish on the ground, such that when the syringe is presented, the horse remains calm, drops its head, and takes a step forward for the treat.”

Scratches and massage can also be effective positive distractions. Foster cited one example of a gelding that when scratched on the belly with a stiff brush while having his feet trimmed, immediately stopped fidgeting and pulling his leg away.

A “helper horse” can assist in keeping a patient quiet during treatment. | Photo: Thomasin Levin

Overshadowing

This technique involves leading or stepping the horse back and forth with determination while presenting a feared stimulus. “The movement ‘overshadows’ and prevents the avoidance response,” said Foster. She explained that this can be effective with horses that are fearful during procedures, such as injections or clipping, but does require a skilled handler.

Avoid Flooding

“Flooding refers to exposing the horse to a high intensity of the feared object or situation until the unwanted response disappears,” said Foster. “At the same time, the horse is typically confined or restrained to prevent it from escaping or performing the problem behavior.”

In theory, this technique seems like it should work. Rather, it can be distressing or traumatic to the horse and dangerous for the handler. It can also worsen the problem behavior, especially if the horse breaks free from the restraint, she said.

Reinforce Desired Behaviors

“The most effective way to change behavior is to reinforce the behavior you want and not the unwanted behavior,” said Foster.
She again uses the example of the needle-shy horse: Veterinarians can apply well-timed positive reinforcement in the form of a treat or withers scratch as a reward for standing still when the syringe is in place.

Alternately, if the horse tries to barge forward as the veterinarian approaches with a syringe, he or she should keep the syringe in constant position (if safe to do so), moving with the horse and only taking the syringe away when the horse stops moving.

This example of negative reinforcement “will reinforce the desired behavior of standing still, but not the unwanted behavior of moving away.”

Avoid Punishment

“In practice, fear-based behaviors are often punished with forceful, painful, and confrontational methods, including yanking on a shank or bit; waving a whip or rope; yelling sharply at the horse; and striking the horse,” said Foster.

Punishment, however, does not address the fear at the root of a problem. Instead, she said, it only validates the horse’s fear and adds to the unpleasant experience.

“The repeated use of punishment can also lead to … a worsening of problem behavior, with greater intensity and earlier onset as the horse anticipates not only the veterinary care but also the unpleasant punishment,” said Foster.

Use Minimal Restraint

For low-stress handling, Foster recommends using the least amount of restraint possible. However, restraint often plays an important role in managing horse behavior. Less stressful methods include lip twitches and, for particularly painful procedures, sedation.

“These should only be used if the veterinary procedure can’t be postponed,” she added.

Take-Home Message

Foster said applying these learning principles in practice can improve safety and equine welfare, as well as client satisfaction. Used by the horse owner between veterinary visits and over a horse’s lifetime, they should reduce animals’ fear, anxiety, and behavior problems. They’re also important because “veterinary professionals set an example for owners and the public about how to properly handle animals in a safe and humane manner,” she said.