Don't get kicked: Physical restraint methods for horses

Working around ill or injured horses is not easy, even for the seasoned, savvy practitioner. When in pain, even a normally calm horse with a gentle demeanor may be antsy and fractious when approached for treatment. It only takes a moment for a horse to become extremely tense and strike out. Being kicked or bitten is not a minor concern. A 1,200-pound animal can inflict serious injury.

Proper restraint: Employing the best techniques for handling a horse will ease the horse's anxiety as well as yours. (KATHRIN ZIEGLER/GETTY IMAGES)

"When horses are hurt, injured or diseased, they may be more nervous anyway, but then a strange person—a practitioner—approaches them, and that may make them even more tense," says Jennifer Williams, PhD, president of Bluebonnet Equine Humane Society in College Station, Texas. "I've seen a couple of veterinarians get hurt because they haven't paid attention to a horse's behavior. They obviously focus on their work and forgot to watch the whole horse. I think veterinarians need to take time to observe what's going on with a particular horse and what works and what doesn't."

This article concentrates on physical restraint methods for handling and treating horses. Look for an upcoming article on chemical restraint methods.

Keep a close eye

The handler, be it a veterinary technician, owner or groomer, can assist you in keeping a close eye on a horse's behavior. "What the veterinarian has to do is instruct owners and handlers how to recognize fear and aggression, especially before a hoof has landed on their body," says Katherine Houpt, VMD, PhD, Dipl. ACVB, Cornell University's College of Veterinary Medicine.

"Sometimes veterinarians are working with horses in good confinement settings," Williams says, "but other times they may be working with loose horses in a pasture and would need to have eyes around their head to observe every aspect of the horse they're working on and the other horses in the pasture."

Williams recommends that while you are concentrating on a particular procedure, someone else should keep his or her eyes on the horse to warn you when the horse is getting upset. The owner may be an especially good choice since he or she should be savvy about the horse's behavior. "The owner may realize well before the veterinarian does that the horse is getting nervous, unhappy or frustrated. The veterinarian can ask the owner to let him or her know how the horse is behaving," Williams says.

"The handler should be restraining the horse near the head, not several feet down the rope, with a proper fitting halter, lead rope and tack that is safe," says Jeannine Berger, DVM, Dipl. ACVB, University of California-Davis' School of Veterinary Medicine.

The handler should stand at the horse's head at a 45-degree angle on the same side of the horse as you are on. This person should maintain eye contact with the horse and position him or herself to bend the horse's neck toward you and stop the horse from moving forward or make it step back if necessary. If you are working at the hind end, it is especially important for the handler to watch the horse at all times. He or she can observe a change in breathing patterns or notice other subtle signs of distress and communicate that to you.

It is best for you to be close to the horse, keeping contact with it at all times. "The practitioner, when approaching the horse, should start out at the shoulder," Berger says. She suggests starting at the shoulder and neck, even if you need to go to the hind end. Keep your hands on the horse, running them backward and talking to the horse, as you walk toward the area to be examined. If you need to change sides, make sure the handler does as well. "If you're up close against the horse, then your risk of getting kicked is fairly small," Berger says. "The closer you are with a hand on the horse, the better, even if you need to step back and look at the hips or symmetry."

Most horses, though used to being handled, react to sudden movements. So stay close by, let the horse know you are moving from one side to the other with close touch and gentle talking and keep your hand on the horse to let it know your position, realizing there is a small blind side to the rear. "I always make sure I rub my hand over the other side first, leave it there, and then move from one side to the other," says Berger. "If you want to move, and if it's a nervous horse, then step away at that hip, at a 90-degree angle and walk a wide half circle around the horse—the length of the leg and then some—and then you're within a safe distance of not being kicked. As you go from one side to the other, it's good to go up to the shoulder and work your way back, keeping your hands on the horse as you move to the rear. If you have an antsy horse, make sure you're at that safe spot at the shoulder when you start out."

As far as positioning the horse, you need to be careful to not get trapped between the horse and a solid object. "Always move your horse around, especially if you're in a stall, so the horse is close to the wall and you have the majority of space within the stall to maneuver," Berger says. The horse should not be blocking the doorway so if anything happens, you're able to quickly step out of the stall to safety, if necessary.

Horse cues

Each horse is different, but some basic behavior observations should be monitored. "Look at the horse—they usually give you a clue as to how they're feeling," Houpt says. Kicking is primarily defensive. "A fearful horse is more likely to kick you than an offensively aggressive horse. If they're in pain, they're more likely to be fearful."

Looking at a horse's hindquarters will tell you a lot because if the horse tucks its tail, it is probably frightened, which makes it more likely to kick. "But there is also the horse that is lashing its tail, displaying offensive aggression, and that horse may kick too," Houpt cautions. "If you're lucky, they'll make a kick threat. They may pick up their foot, but they won't aim at you."

"If you look carefully, their heads will tell you what they're doing," she says. If their nostrils get small and constricted, that is a sign that they are becoming more aggressive.

Pinning ears is an obvious sign of aggression, but that happens later in the aggression progression. "By then you've missed all the subtle signs, and they may be really frustrated or in a lot of pain and ready to let fly," Williams says.

Looking at their eyes is also important. "Seeing the whites of the eyes is a good sign that the horse is fearful," Houpt says.

"When it comes to the whites of their eyes, some breeds tend to naturally show more white," Williams says. If the owner is assisting you, he or she will know what is normal for that animal.

So what does an overly tense horse look like? "Besides the more obvious signs of ear pinning and cocking of a hoof, there are the more subtle signs. Some veterinarians don't realize that a horse might be cocking a hoof because they're resting, or that particular leg is sore," Williams says. "The practitioner has to look for overall body tension, so that he or she realizes that the cocked hoof indicates that he's not just resting anymore, but thinking about whether to kick you. Look at the mouth and eyes. Tension around the mouth tells you that they're getting frustrated and hurting and are nearing the end of their rope as far as what they're going to tolerate."

Williams worked with a neglected horse that was just frustrated with people. "I noticed that his lips and face were just tight. Later in the day, he nipped at someone who was trying to handle him. He was gritting his teeth, and his mouth was clamped shut. He just looked frustrated. When I approached him earlier, I backed off realizing he needed a little space. Later in the day, another person didn't back off, and the horse bit him. He just clamped his lips together and showed a very tense look in his face," Williams says.

"One of the things that seems to be very obvious to a behaviorist but not necessarily to even the best or most experienced equine clinician is that most often when people get hurt, the horse is afraid," says Sue McDonnell, PhD, University of Pennsylvania's School of Veterinary Medicine. "Fear in horses goes unrecognized because the signs are subtle. Horses are an open-plains, grazing species, and they have evolved to hide their fear, signs of pain and discomfort in response to predators. If they displayed conspicuous behavioral signs of pain and fear, they would not only draw attention to themselves but to the whole herd."

Clinicians and handlers who get hurt often say that it just came out of nowhere. "That's the way horse behavior is designed," McDonnell says. "Most people don't see the subtle signs of fear as such but as misbehavior, so the tendency is to just increase the aggression, the restraint and all the things that push the horse over the edge, instead of relaxing, trying to be more soothing and reducing the amount of pressure on the fearful horse."

The need for more education

"I really would like to see more veterinarians know more about basic horse behavior," Williams says. "Although equine veterinarians surely know their medicine, they often don't receive a good background in basic equine behavior."

At the New Bolton Center at the University of Pennsylvania, a basic equine behavior and handling lab is now part of the third- and fourth-year veterinary students' first clinical rotation with horses. The two-hour lab reviews basic horse behavior and handling, with time for hands-on work with experienced horsemen and animal-care staff to coach them and give tips about the treatments that are the most challenging for new clinicians. It's important to remember, some of the students are completely new to handling horses, while others grew up in the horse industry and have worked with horses for years. The experienced students come from various backgrounds in horse-handling style and technique.

"I don't have any data, but it would be my opinion that the safest approach is nonconfrontational," says McDonnell. "We often find that the students who become the best horse handlers and the least likely to be injured are people who didn't grow up in the horse industry." McDonnell thinks this is the case because they are often more amenable to embracing positive behavior modification and employ proper horse-handling techniques. The handlers who think they are really good with physical restraint techniques are often the ones that seem to be getting hurt and the ones who become the most frustrated with horse behavior.

"I've tried to pay attention to the manner and techniques of those who seem to work especially efficiently with horses and to those who seem to have the most trouble, whether they are farriers, veterinarians, dentists, trainers or owners," McDonnell says. "By far, the folks with the most respectful, nonconfrontational style seem to be the ones who avoid injuries, doing the same types of procedures with similar potential risks.

"I've been at continuing education lectures around the world where the discussion seems to dwell on physical restraint, much of which only increases the pressure on the horse," says McDonnell. "In my opinion, these discussions reach a level of physical restraint that only increases, rather than decreases, the likelihood that the horse is going to explode. Anything we put on the horse for restraint in reality is only going to slightly mute the explosion if it happens. If they really reach the blow stage on a twitch or on a gum chain, they can easily hurt us and or themselves when they explode out of it."

Proper use of the twitch

One of the common misunderstandings that perpetuates in the horse industry has to do with the use of the twitch. "I would guess that there are fewer than 5 percent of experienced horse handlers, including equine veterinarians, who know how to most effectively use a nose twitch," McDonnell says.

A twitch, just like sedation with a pharmacologic agent, takes time to work—and just like chemical sedation, it wears off. It takes about three to five minutes for the endorphins that are released to reach effective levels, and in the meantime, the twitch is just one more annoyance for the horse. It can distract the patient slightly, but it is really just adding more discomfort. If you wait the three to five minutes, you get the endorphin release. That lasts about 10 to 15 minutes. After that, the available endorphins are depleted, and the levels typically plummet below baseline, which is worse than nothing. Not only does the horse have the pain of the procedure that is in progress, but it also has less natural analgesia to cope with it. In the same context, you would not give xylazine, pull out the needle and immediately begin a procedure. You would wait until the desired effect is observed, and, similarly, if it started to wear off before the procedure was complete, you would stop the procedure to administer more.

"Horses hate the twitch because the handler waits until they are losing endorphin effects to remove it," McDonnell says. "The horse's last memory of the twitch experience is the increasing discomfort associated with the handler, the veterinarian and the procedure. As a horse starts to develop an aversion to the twitch, a common approach is to then wait until the last minute to apply the twitch, rush the procedure and then quickly take it off. As a result, the twitch has all the negative aspects of discomfort and none of the positive effects of endorphin release. People tend to conclude that horses hate the twitch itself when, in fact, it is the improper technique that is the problem."

Quick tips for equine physical restraint

"I put twitches on horses regularly," McDonnell says. "If you abide by the simple rules of applying it respectfully—where you then wait until it has observable sedating effects, the horse gets that glassy eye and droopy lip—and then taking it off before the effect wears off so that the patient is left with that high feeling associated with the twitch, horses almost never build an aversion to it. And to rehabilitate a horse from twitch aversion, that's exactly all you have to do a few times. Put it on in a calm and respectful manner, wait for it to be effective before adding any discomfort of a procedure and then take it off while the horse is still in that high state.

"A lot of horsemen who think they know where they're coming from using the twitch, respond, 'Whoa, I never realized it should be used that way,'" McDonnell says. "Even in veterinary hospital settings, you will occasionally hear handlers advised to wait until the very last minute to put the twitch on, and they put it on very abruptly, in a hurry, and leave it on until the horse can no longer stand it."

Treatment treats

"The use of a small food reward is an extraordinarily simple method for gaining cooperation of horses with veterinary procedures," McDonnell says. "At the New Bolton Center, we've gone to what we call treatment treats, which are individually wrapped to meet the needs of our biosecurity risks." The treats are available in handy dispensers in the patient barns and treatment areas so they can be given regularly. Certain patients that have frequent treatments get their own bag of treat packets attached to their stall door to encourage everyone to offer a treat before and after each treatment.

"I find the program to be a good teaching tool in the hospital, illustrating the principles of behavior modification," says McDonnell. "For example, it demonstrates the principle of less is more because small treats given frequently to mark good behavior are much better than giving the mother lode every time you go in. If the patient has a big mouthful of grain and then does an undesirable behavior, it tends to chew out of frustration and ends up rewarding itself for the undesirable behavior."

The behavior modification rule is a small treat given quickly so that you can mark the positive behavior. If the patient comes to the door willingly, you treat them. If you are performing a procedure and the patient is a little bit wiggly, every time it relaxes you give it a little treat, being careful to mark the relaxation and not the wiggle.

"This has helped instill a more positive-reinforcement-based patient handling program and a more informed understanding of behavior modification for animals in general," McDonnell says. "How nice to walk through the hospital barns and hear the crinkling of the treat wrappers and the handlers calmly and confidently saying 'good' as a secondary verbal reinforcer as they deliver a treat instead of hearing a yank on the chain shank or any of the other negative things that handlers tend to resort to when they get frustrated with a patient that is struggling with a procedure."

"This sort of thing can be done by the veterinarian making a barn call," Houpt says. "It doesn't have to be much. A small slice of carrot will be enough so that the horse won't fear you—not quite as much anyway. A major study was done in which they trained yearlings to stand, where half of them got a handful of sweet feed afterward and the other half did not. A year later, those that had received the treats would still approach people more quickly, and they retained the training better. Positive things can have a long-lasting impact."

Ed Kane, PhD, is a researcher and consultant in animal nutrition. He is an author and editor on nutrition, physiology and veterinary medicine with a background in horses, pets and livestock. He is based in Seattle.