Equine Fear Score

By Susi Cienciala DVM

In the small animal veterinary world low-stress handling techniques have become mainstream in most hospitals thanks to the work of Dr. Sophia Yin, who was the pioneer of low-stress handling in the veterinary world. Now we need to adopt this same attitude in the equine veterinary world. Veterinarians are busy people and usually under time constraints. It is easy for a simple and painless procedure to become a stressful event for equines, which may or may not escalate into a potentially dangerous situation for everyone involved due to the size and strength of a fearful horse.

It is not uncommon for small animal veterinarians to have owners administer mild sedatives or anxiolytic medications to the patients prior to coming into the vet hospital. The staff are also trained to use low-stress handling methods and to give food rewards to encourage patients to be relaxed while at the hospital. This is not only a positive experience for the animals and their owners but also for the staff of the veterinary hospital. The number of injuries to staff from fearful animals is reduced significantly.

Most horses allow routine procedures such as vaccinating, deworming and physical exams without difficulty. There are a few, however, either through prior history or personality that can be a potential problem. Properly dealing with these individuals is critical to everyone's safety including the horse. Through the understanding of learning theory and a handful of simple techniques, most of these horses can be convinced to allow veterinary procedures to occur without fear or stress.

Veterinarians need to be able to read the horse's behavioural signs and quickly assess the horse's level of fear. They may even have to come back another day or leave the owners with oral sedation that can be given prior to a subsequent visit. It can be difficult to tell an owner that the procedure should not be performed as planned, but most owners are happy to have their horse’s welfare preserved. Owners can also be shown how to use some desensitization training (injections) or habituation (i.e. clippers and picking up hooves) if they are willing to put in the time required.

There are distinctive changes in a horse’s behaviour as it goes from a relaxed state to a state of extreme fear. I have developed the Equine Fear Assessment Scale to categorize the signs of escalating fear on a score from 1 to 5. The scale provides information on how to avoid escalating fear responses, make an ongoing risk assessment, and offers clear guidelines about how to proceed when a horse does become fearful. If the horse scores a 1 or 2, then procedures may be performed. If the horse scores 3 or higher, then steps need to be taken to modify behaviour before continuing with the intervention. Hopefully, this offers a significant improvement over the “get ‘er done” strategy.

SCORE 1: relaxed body language

Standing still and resting one leg, head in natural outline, eyes normal, ears quiet, tail flat, eating readily (either treats or hay) and focused on food, responds promptly to handler.

SCORE 2: mildly alert body language

Standing still, not resting a leg, head in natural outline most of the time but occasionally looking around, eyes normal, ears relaxed but moving slightly front to back, tail flat, eating treats readily but cautiously, responds to handler.

SCORE 3: moderately alert body language

Taking small steps forward or sideways, head lifted slightly, eyes normal, ears moving front to back, eating treats cautiously and looking around while chewing slowly or just holding food in mouth, tail slightly raised, delayed response to handler.

SCORE 4: alert body language

Feet moving slowly but regularly (standing still briefly but then moves), head held up, eyes wide open, ears moving front to back quickly, respirations elevated, tail raised, not taking food, minimal response to handler, passing manure.

SCORE 5: extremely alert body language eyes, body stance, willingness to eat and how the horse is responding with the handler.

Feet moving quickly in all directions and horse needs continual restraint, sometimes dragging handler in an attempt to flee, head is very high, eyes wide open with whites showing, ears moving in all directions quickly, nostrils flared, tight muzzle, raised tail and may even give a high pitched snort, no interest in food at all, may kick out in frustration, obvious to handler, passing manure.

Sometimes fear states can change during a procedure, and veterinarians need to be willing to stop until the animals’ fear or stress responses have subsided. In small animal practice this has now become routine. For example, formerly, dogs who were reluctant to have their nails trimmed were simply held forcibly until the nail clipping was completed. Now small animal veterinarians routinely stop at the first sign of struggle, use food as a distractor, sedate the animal, or stop altogether and have the client train the dog at home to slowly accept the procedure. Clients generally appreciate a doctor that is concerned for their animal and the dog’s welfare is preserved. You wouldn’t pin your child down to trim their toenails would you?

2. Move the horse to an area where it is comfortable. This may be away from the vet clinic and next to a paddock or it may be just a quiet space nearby.

3. Bring another horse out to be with the one being worked on.

4. Work in hand for a minute or two to distract and re-focus the horse (overshadowing).

5. Use chemical sedation.

6. Remove the horse from the environment and try again another day or at another location. Send the owner home with an oral sedation product to be given prior to veterinarian arriving.

1. Ensure the handler is experienced (some owners are not necessarily proficient handlers). Veterinary technicians need to understand learning theory. The handler needs to continually monitor the ears,

When the horse is at a score of 5

1. Inform the owner that the procedure cannot be done safely at this time and even trying to give an IV sedation could be dangerous for the veterinarian.

2. Remove horse from the environment as safely as possible.

3. Give owner an oral sedative product to take home to give the horse prior to the next visit, or come up with a plan as to how to complete the procedure in a safer environment.

Using the fear score can be helpful for everyone in the horse industry from vets to farriers and beyond. It helps create a common language to describe the fear behaviour of our beloved equines.

Check out the podcast on Spotify: “Horse Behaviour for Veterinarians”