Case series report: Systematic rehabilitation of specific health care procedure aversions in 5 ponies

Five Shetland-type ponies (3 geldings and 2 mares), ranging in age from 2 to 3 years, were presented for behavior evaluation and rehabilitation of specific health care aversions. Their history included the use as subjects in an equine surgery course for veterinary students, during which each pony had developed specific aversion to 1 or more handling and health care procedures for which they had been compliant before use in the course. Initial assessment consisted of exposing each pony to the same battery of handling and health care procedures to which they had reached compliance before use in the course. These included (1) approach of a handler; (2) haltering; (3) oral examination; (4) simulated application of eye medications; (5) ear manipulation; (6) auscultation (cardiac, thoracic, and gastrointestinal); (7) inguinal palpation; (8) rectal thermometer insertion; (9) limb lifting with hoof picking; (10) intramuscular needle stick; (11) jugular (intravenous) needle stick; (12) simulated clipping of the jugular groove, face, and ears; and (13) oral dosing. Each pony was scored for each procedure using an informal subjective 10-point numerical rating scale, and specific avoidance responses were noted. The general behavior modification approach was positive reinforcement-based systematic desensitization and counterconditioning done in a series of once-daily sessions over a period of 2 weeks. Daily sessions averaged 13.9 minutes of contact time. Criterion for successful rehabilitation was defined as scoring 9.5-10 for each procedure, with no more than 2 procedures scoring 9.5. Maintenance was assessed and reinforced for 3 additional daily sessions, followed by a final assessment session with a second, highly experienced clinician. Rehabilitation of these 5 ponies with a total of 31 mild-to-significant aversions proceeded efficiently. Four of the 5 ponies reached criterion by the eighth daily session; the remaining pony by the ninth session. The total contact time to reach criterion ranged among ponies from 107 to 123 minutes, with a mean of 115 (standard deviation 6.65) minutes. All maintained criterion levels of compliance for the subsequent 3 daily reinforcement sessions, and all scored at or above criterion on the final assessment by the second clinician as well as on follow-up assessments at 2-week intervals for 6-10 weeks until rehomed.