Horse Handling Techniques for Safer Nerve Blocks - EquiManagement on Audio

0:00All the articles you have come to love in Equamanagement Magazine are now available on the Equamanagement on Audio podcast. Each article is released as its own separate episode to make them quick and easy to listen to. Just search Equamanagement on Audio on your favorite podcast player to listen to all the latest articles. Horse handling techniques for safer nerve blocks. How to use positive approaches and minimally aversive methods when performing nerve blocks to benefit both horse and veterinarian. Nerve blocks are one of the most dangerous procedures for equine veterinarians to perform. Putting them at significantly increased risk of fracture, concussion, head injury and hospitalization. To make nerve blocks safer to perform, the first step is to make the horse feel safer in that scenario. Dr. Gemma Pearson, Director of Equine Behavior at the Horse Trust and lecturer in Equine Behavioral Medicine at the University of Edinburgh's Royal Dick School of Veterinary Studies.

1:07Provided learning theory-based recommendations during a presentation at the 2025 British Equine Veterinary Association Congress. We should remember that when horses react in a dangerous manner, this is a normal response to an acute stressor for the species. They are just trying to keep themselves safe as they lack the capacity to understand our intentions, she explained. The use and misuse of restraint. The advice we often hear to reduce risk around horses is to ensure the animal is appropriately restrained. But what is appropriate restraint? There is a Goldilocks level of restraint that makes it as safe as possible for you, whereby you have control of the horse without increasing its level of arousal, said Pearson. Too little restraint, and the horse might move away from the block or kick or trample the veterinarian. Too much restraint, and the horse might become scared, uncomfortable and dangerous.

2:07Restraint is inherently aversive to horses, she added. So when we put too much restraint on them, it can actually be more aversive than the nerve blocking scenario. While restraint is an important part of staying safe, Pearson advised putting more emphasis on keeping the horse's level of arousal low than on physical restraint. Lowering the boiling point. Equine behaviors that can cause veterinarians injury are normal responses to acute stressors. We need to look at the horse in front of us and their level of arousal, said Pearson. When it gets to a boiling point is when things are going to start to go wrong. That's going to look different for different individual horses. Some horses' behavioral responses to stressors are proactive, fidget, flight, fight, while others are reactive, freeze. I think the freeze response is one that's often get injured by, because the horse is standing still, and they don't realize its temperature is increasing until it explodes, she added.

3:12To lower the horses arousal level, you can use learning theory and minimally invasive approaches, including gentle techniques, accurate needle size and placement, a comfortable position for the horse and the least amount of restraint that's still effective, a skin bleb of local anesthesia, a topical cream to reduce skin sensation for more sensitive horses. For challenging horses, Pearson recommended taking the time to perform classical counter-conditioning. This is where we teach the horse to associate someone touching their leg with a positive outcome, usually food, rather than the discomfort that might be associated with a needle. Then, when we do insert the needle, the horse is thinking about the food and is in a positive mood state, so finds it less aversive. To further reduce the horse's stress response, try to minimize noise and distractions in the exam room. The next level of learning theory is operant conditioning, such as clicker training, but it requires more skill to get the timing just right and might take a day or two to retrain the horse, said Pearson.

4:23Pharmacological help. You might consider administering drugs when the horse's arousal level is beyond the threshold before you even begin. You don't have time. To make a situation safer and less stressful, options to lower that level of arousal include asapromazine, chrasidone, and alpha-2 agonists like xylazine. Pearson reminded veterinarians that asapromazine has a negative effect on how the horse feels, depressed, while chrasidone has a positive impact, content, relaxed. Final considerations. Each horse is an individual, and you must think about many factors when assessing a horse's likelihood of reacting to a nerve block and to what degree. Non-horse factors Pearson listed include type of block, such as four limb versus hind limb, which is typically more aversive, or Palmer digital versus deep branch lateral planter block.

5:25The veterinarian's technical experience. The vets impact on horse arousal, as some individuals are more calming or aversive than others. The vets confidence in their ability to perform an accurate nerve block. The handler. Horse factors include age as young horses often have higher arousal, athleticism and increased sensitivity, stress, chronic pain, which can cause the horse to be more sensitive, poor training or can't stand still. The suspected number of blocks you'll be performing. At the end of the day said Pearson, we need to focus on helping the horse feel safe if we want to keep ourselves safe.