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Restraint and Handling

Textbook Assignment: Please read Chapter 7 from Clinical Textbook for Veterinary Technicians by Bassert and McCurnin pp. 139-174

Topics:
Restraint and handling of dogs
Restraint and handling of
  cats
Restraint and handling of cattle
Restraint and handling of sheep and goats
Restraint and handling of horses
Restraint and handling of hogs

Objectives:
1)  List the four types of restrain routinely used on animals
2)  List the three questions that should be asked before restraint procedures begin.
3)  Differentiate delayed and immediate stress reactions in animals.
4)  List physical, physiological, and psychological results of stress in animals.
5)  Describe devices used to assist in restraint in dogs and cats.
6)  Describe methods of restraint for procedures and venipuncture in dogs and cats.

Introduction:

"Some degree of restraint is involved in everything a veterinarian does with an animal, and experienced practitioners have studied this just as any other branch of practice"
from Restraint of Animals by Leahy

Although restraint is sometimes considered a menial task, only physical labor, it requires skill, knowledge and strength. Restraint often is the responsibility of the technician.

The goal of all restraint should be to get the procedure done safely with the least amount of stress to the patient. The technician is often responsible for the veterinarian's or other technician's safety.

The importance of the person restraining the patient can not be over emphasized!

Four types of restraint are routinely used on animals:
1)  Non-contact: voice, eye contact, gesture
2)  Manual or physical: using body or devices
3)  Chemical: using tranquilizers or anesthetics
4)  Combination methods: using two or more of the previous methods

Before restraint procedures begin three questions should be asked:
1)  Which technique available is the best for the patient and procedure?
2)  Who is best qualified to do the restraint (without injury to the patient or the handler)?
3)  Where is the best location to restrain the patient?

Clinical scenario. What would you do?
You are to get a blood sample from FiFi, the cowardly yappy teacup poodle. As your assistant attempts to restrain 4 pounds of screaming frantic super dog, she is bitten and spurts blood all over Fifi's white fur.  You grab FiFi by the . . . and ...

For some animals the sights, sounds and smells of the animal hospital can elicit extreme fear responses!
Stress is perceived differently by individual animals. A well socialized dog may not perceive handling as stressful, in fact it might have a calming effect . A patient that has had only pleasant experiences at a veterinary hospital may not be stressed while undergoing treatment.
Stressors include:
restraint
confinement
medical treatment
Stress can be an immediate reaction or delayed reaction. The physiological results from stress are different in these cases, but all can be deadly.

stresshorsejpg.GIF (20541 bytes) To enlarge pictures click on them.
Flowchart showing the hormones involved and possible effects of stress in animals.

For most patients restraint is stressful, to some degree. The effects of restraint can be grouped into four areas:
1)  Physical: including such things as bruising, hypoxia (due to excessive pressure on thorax or trachea), hyperthermia (due to over increased temperature while struggling), and even fractures.
2)  Physiological : including increased heart rate, respiration, temperature and blood pressure.
3)  Changes related laboratory values: 
Leukocytosis, increased numbers of white blood cells, is common in the dog, cat, horse and human. 
Leukopenia, decreased numbers of white blood cells, is common in the cow, mice and rabbit. Increased blood glucose is especially prevalent in cats).
Decreased clotting time and decreases in certain enzyme secretions, (amylase) are seen in some species. 
Changes in the complete blood count (CBC) have been shown to occur within minutes or hours of a stressful situation.
4)  Psychological: An enduring fear of the veterinary hospital and medical treatment or aggressive/defensive behavior.
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                                    Restraint of Dogs 

          
The body language of the canine:
It is important to understand some basic body language of the dog before attempting restraint procedures.  The dogs primary weapon are large teeth and strong jaws.

Aggressive dogs often use direct eye contact and may stare at a human as if to say "I'm number one here, I'm alpha, don't mess with me! " 
Other warnings of aggression include:
piloerection
growling
standing stiff legged
tail flagging.

What does piloerection and stiff legged body stance do for the dog?

Many dogs are fear biters. They may appear submissive at first, but will quickly and quietly bite if their comfort zone is invaded. These animals can be extremely dangerous and hard to "read".

dogincage.jpg (29697 bytes)                 pitbull.jpg (27138 bytes)  To enlarge a photo just click on it.

Which of these two dogs do you think will be the most dangerous to handle?   Why?
Describe the behavior of fearful dog that might bite.

List breeds that you have noticed behavior patterns that could be dangerous during medical procedures.

Dogs respond to dominance much better than cats, due to their alpha orientation in a pack. They are used to having another "pack member" over them in the pecking order.
Depending on the situation a firm manner might get the best results, but there is the risk that firmness might be interpreted as a challenge to a very dominant dog. This could incite an attack. The decision to use this technique must be made very wisely.

Certain techniques can be used successfully to approach most dogs including:
Modulating the voice (a high pitched voice maybe less threatening to some dogs)
Avoiding eye contact
Non threatening body posture (standing sideways or crouching down)

These techniques might enable the handler to put a leash or muzzle on the patient.
There are certainly wide variations in behavior between breeds and even individuals within a certain breed. But, don't prejudge a patient due to breed, .
Remember that if a patient has a traumatic experience at your hospital it has probably "learned" some negative behavior and will be more difficult to handle the next visit. Within reason try to make the hospital visit pleasant for everyone, including the patient.

Procedures
Removing dogs from cage: Several techniques are discussed below, this will also be a "chat" topic.
Many small frightened dogs can be secured by carefully looping a leash over their head and pulling them to the front of the cage. Often these dogs will relax when petted or carefully picked up. Leather gloves can be used to protect the hands.
For larger or more aggressive dogs a snare (also called a rabies stick) may be needed to move the dog. The snare is a loop, on the end of a pole,  which can be tightened around the neck to control the dog.  If this device is not used properly the dog can be strangled or the neck seriously damaged. This should be used as the last means of controlling a dog. It will also make the dog fearful or aggressive of those who used the rabies pole.

rabiesstick.jpg (65404 bytes)
rabies stick

Plastic squeeze barriers (shields with a hand hold) can be used to push an aggressive small or medium sized dog to the back of the cage, then a loop can be placed over the head. Some commercial barriers have holes for giving injections through the barrier.
In the past a leash was sometimes left on the patient in the cage, for easy access to the dog.
What is the danger of this?

Lifting and carrying dogs:
A small dog can be carried by holding it between the arms, being sure to support the back. This should be done with the dog muzzled, unless the dog is very trustworthy.
A large or medium sized dog should be lifted carefully (from a squatting position) to prevent back injury. If the handler is able to carry the dog it can be done is a manner described above. If the dog is heavy a rolling cart or stretcher should be used.


carrydogbadjpg.jpg (84432 bytes)                        
dogcarry.jpg (56678 bytes)

Is this the proper way to carry (most) dogs?  Why or why not?

 

Restraint for basic procedures:
Restraint for physical examination. Depending on the type of examination the dog can be standing, sitting, or lying. If the patient is standing or sitting and is gentle and calm, one arm can be placed under or over the neck to control the head, while the other arm goes around the thorax to control body.
restrexank9.jpg (53325 bytes)

Lateral lying:
Some patients may need more restraint and can be laid on their side with all four legs and their head controlled. Again this is fairly severe restraint and care should be taken not to injure the patient and yet keep those handling the patient safe.

Restraint for venipuncture:
Jugular vein.  The dog is usually in the sitting position. The restrainer elevates head with one hand wrapped around muzzle and the nose directed upward.  The front legs may also need to be controlled.  The person taking blood in this case will hold off the jugular vein with one hand and draw the blood with the other hand.

Cephalic:  The patient is positioned in standing, sitting or lying position (depending what the technician prefers).  The head is restrained pointing away from venipuncture site.  The restrainer uses either the thumb or forefinger to grasp the front leg at (or slightly below) the elbow and "roll" the cephalic vein lateral.  Firm steady pressure is placed on the leg and vein to "hold off" and fill it with blood.


cephalinj.jpg (69639 bytes)                            

Saphenous vein: The vein is located on the lateral hind leg above the hock joint, this vein collapses easier than others  and is used as a last resort usually.  The patient may be standing or lying on it's side for the venipuncture.  The vein is held off at or slightly below the stifle joint  by wrapping one hand around the leg and applying pressure, the other hand and arm are used to restrain the patient. The person taking the blood steadies the lower leg and does the venipuncture with their other hand.



Muzzles: 
Although clients usually do not want their pet muzzled it is (as we know) sometimes necessary for everyone's safety.  Some dogs become submissive after muzzled when they realize that it is useless to fight, unfortunately some do not.
Various types are sold commercially and muzzles can be "homemade" in emergencies.
dogmuzzeljpg.jpg (83745 bytes)

Home made muzzles can be made with  gauze or rope. How are these applied?

Muzzles are made of:
Leather
Wire (basket with leather straps)
Nylon (cone with plastic or velcro closures)

What are the pros and cons of each of these types of muzzles?

 


catstress4.jpg (38186 bytes)*
A patient that is not used to physical restraint will be stimulated in many ways as it is restrained!

                           Restraint of Cats 

Cats are considered by some more difficult to handle and treat than dogs.
Very few cats have no reaction to manipulation. It may vary from mild displeasure, to depression, to rage and often changes from one to another quickly!
Most cats do not react well to pain or heavy handed restraint methods. Some people who are excellent at handling dogs are awful with cats.

Interpretation of the body language of cats is important in predicting what they will probably do when being taken from the cage or restrained.

Cats in a defensive position usually crouch, exposing the side of their body, their eyes are dilated, the tail may be lashing, and the hair maybe standing "on end" i.e. piloerection. Often they do not want to look directly at a person and will hiss or growl.

Cats that are very aggressive (on the offensive) usually display piloerection, dilated eyes, tail lashing, hissing and are in a upright frontal stance. They may be at the front of the cage facing a person and maintaining eye contact.

catincage1.jpg (45141 bytes)                   catincage2.jpg (30803 bytes)
Which of these two cats would you rather restrain?  Why?

Cats injure people with their teeth and front and rear claws

Often the first step in handling and treating a cat is removal from a cage or carrier.  Leather or protective gloves can be used to grasp and hold the cat,  probably by the scruff, (to be covered later).
A towel can then be thrown over the cat and it can then be quickly transferred to a cat bag or wrapped tightly in the towel.


burrito2jpg.jpg (63824 bytes)                       catbag.jpg (81122 bytes)

cat towel wrap                                cat bag

A small snare (similar to the dog snare or rabies stick) can be used to loop over the head and lift the cat from the cage where it could be placed in a cat bag or stretched.

Some clinics have large metal tongs, which look like fireplace tongs, that are placed around the cat's neck, the tongs do not press on the trachea  The cat can then be lifted from the cage. This is similar to the snare but doesn't tighten around the neck and cause hypoxia.

Injectable tranquilizers have been sprayed into the open, hissing mouth of a difficult cat. This might have a somewhat calming effect depending upon how much of the drug is absorbed.

Preferred method to carry and control a gentle cat.
The left hand and arm are used to cradle the body, control the hindquarters and press the cat into to the body of the restrainer. The right hand can be used to scruff or just rested on the neck to reassure the cat.


carrycatrightjpg.jpg (72535 bytes)              
splitfingerrest.jpg (18710 bytes)   
The split finger hold to control the front legs is very effective.   
The front legs are positioned between the thumb, index finger and middle finger.

A similar hold can be used "in reverse", cat's head is tucked beneath the right arm and is pointing backward. The hindquarters are controlled with the left hand. This method can be used if the cat's vision is to be blocked.


catreversecarry.jpg (58735 bytes)

Restraint for examination
Many cats react  better to loose gentle restraint, at least up until the more painful procedures have to be carried out. Some experienced very cat oriented technicians can even draw blood without assistance!


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Gentle restrain

Remember you are stronger than a cat, although sometimes it doesn't seem like it!
It is the technician's responsibility to not injure the cat during restraint or allow the cat to injure the veterinarian. This takes experience and skill.

"Scruffing" refers to holding a cat by the loose skin at the back of the neck. This is the way mother cats carry their kittens. Young kittens actually relax when carried in their mother's mouth. Some adult cats may also become limp when held like this, i.e. the "scruff response", but they are too heavy to be carried in this manner.


catscruff.jpg (53898 bytes)

The scruff and stretch technique is used to give injections to difficult cats. The cats can be suspended in mid air or laid on a flat surface. If the cat's back is pressed against the restrainers outstretched arm the patient is less likely to move or struggle as much.


stretchscruff.jpg (37578 bytes)

The scruff, stretch and press technique is similar to above, except pressure is applied downward on scruff to force cat flat on table thus overpowering the animal.


catlatrecum.jpg (75071 bytes)
Lateral recumbency restrain with legs held.

In situations where only one person is available to do both restraint and administer an intramuscular injection on a difficult patient the following method has been used. One hand is used to elevate the patient by the scruff and hold one of the hind leg (with the same hand).  The restrainer gives the injection with the free hand in the hind leg that is not being held.  This method of restrain for intramuscular injection should only be used on young supple cats.  This technique requires a large hand, strength and co-ordination!

Restraint devices used for cats:
The cat bag is an old devise that is still useful for physical restrain of hard to handle felines. The cat is placed in a tight fitting bag with the head sticking out of an opening. Some newer bags have zippered openings for front or hind legs, the legs can be taken out and used for venipuncture. The bags come in various models, sizes, and materials and are commercially available.


catbag.jpg (81122 bytes)

The towel wrap, also called the "kitty burrito,"  is a method used to wrap the cat's body in a large towel and create restraint similar to the cat bag. The cat's head is left out and depending on the technique the front legs can be pulled out for venipuncture.

burrito1.jpg (82803 bytes)


A method that can be used when working alone on a difficult patient  is to "hobble" the cat so it can not move it's legs. The legs are taped together (the front to front and hind to hind) and the cat laid on it's side. The legs can also be taped to the table to prevent movement of the body. A muzzle can be placed on the head and then the treatment administered. 
Obviously this is very stressful for the animal and should only be used by someone working alone and as a last resort.
Cat are more difficult to muzzle because of their short flat faces, as compared to dogs. Muzzles made for cats are available.

Restraint for venipuncture:
The jugular vein maybe the vein of choice depending on future medical procedures or the condition of other veins. It is the largest peripheral vein. 
The cat is usually positioned over the edge of the table, a towel can be placed under the cat for comfort. The restrainer is positioned behind and to the side of the patient. The front legs are held together (split finger position) and pulled downward with one hand. The head is held and positioned with the other hand. The position of the head is very important so that the jugular vein is adequately exposed. The hand is wrapped around the head to keep the mouth closed and the nose is pointed upward. 
The jugular venipuncture can also be performed with the cat in dorsal recumbency (lying on it's back) in this case the cat is usually restrained in a bag or towel.

Feline cephalic venipuncture is very similar to that of the dog. The cat is placed in ventral recumbency (it can be in a bag or towel if needed). A front leg is extended and the vein rolled outward and pressure applied to hold it off. The head is controlled with the other hand and back legs controlled by the restrainer's body.
How should the leg be prepared before venipuncture?

The femoral vein is located on the inside of the hind leg. It is quite easily palpated and  superficial to the artery. This vein is easily collapsed and easily double punctured.  It is used for intravenous injection and small volume blood collection.

catfem1.jpg (202160 bytes)

The cat is placed in lateral recumbency (usually in the stretch or scruff and stretch positions). Blood is taken from the down leg (on the table). The "up leg" and tail are held out of the way. The heel of the hand holding the "up" leg is placed in the groin area to occlude the femoral vein (pressure is applied at the femoral triangle proximal to venipuncture site). The restrainer holds the scruff and holds off the vein, the venipuncture "down" leg is held by the person taking the blood.
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                   Restraint of livestock and horses

lazysteer.jpg (22624 bytes)
If only all bovine patients were this relaxed!

Objectives
1)  Explain why dairy cattle are easier to handle than beef cattle
2)  Explain how cattle, sheep and goats injure people
3)  Describe how cattle can be moved in a group and as individuals
4)  Describe a squeeze chute and head catch and how they are used
5)  Describe how nose tongs are used
6)  Describe how to "set up" a sheep
7)  List restraint method differences between sheep and goats, and between horses and cattle

Restraint of ruminants
Cattle:
Cattle are generally are not aggressive. Cattle have been domesticated thousands of years and are still economically the most important animal in the world. Although cattle are about the same size as horses very different restrain techniques are used on them routinely.
Why?

Dairy cattle are bred to be more tractable they are handled from birth and milked twice daily. Beef cattle are usually free to roam on pasture and are handled less often and primarily for medical treatment. This makes handling these two classes of cattle different.

cowstocks.jpg (21581 bytes)
Method of light restrain for grooming used on a dairy cow.

Cattle can cause injury in several ways including:
Horns (only certain breeds have horns and most calves are dehorned shortly after birth to prevent injury to other cattle and humans.)
Kicking with the hind legs. Cows kick to the side, unlike horses that usually kick straight back.
Trampling people when "spooked" or frightened and squeezing or stepping on people. (Squeezing may be a passive/aggressive means of defense for some cattle).
(
Even the tail switch can be painful when lashed across your face!)

What signs do cattle display before aggression and panic?

Moving cattle
movingcows.jpg (124623 bytes)

How would you move these cattle from the far end of the pen to the end of a chute?

Beef cattle are usually worked in pens (corrals), chutes and head gates. In the open it usually requires help from horses or A.T.V.s to move and treat cattle. Cattle are driven from behind then moved down chutes individually and finally into stocks with head gates or squeeze chutes for treatment.

When standing directly behind a cow that won't move there are several things that can be attempted.  The tail twist is usually effective and is simply grasping the tail at the base and twisting it. The cow rarely kicks and usually moves forward!


tailtwist.jpg (30842 bytes)


Swatting cattle with sticks or flat plastic paddles will often get them moving. (The plastic paddle is being used more because it doesn't damage the carcass and is more humane).

The electric prod, which delivers a strong shock, is still used in some places. Many farmers and ranchers have found that using more humane methods of handling cattle is actually more profitable. Cattle that are not over stressed gain more weight and bring more money at market time.

calfhalter.jpg (16120 bytes)
               positioningcow.jpg (32930 bytes)
Beef calf haltered.                  A safe position at the point of the shoulder

Since cattle are usually not trained to the halter or to stand still for medical procedures they have to be placed in stocks,  milking stanchions or squeeze chute. 
The squeeze chute is a series of panels with levers which control the width of the chute and position of body.
The head catch or head gate is a device located at the front end of the stock or squeeze chute. It can be closed around the neck of the cow and the head can be positioned for blood samples or other procedures.

Nose tongs are a restraint device used to control the head of cattle.  The tong is closed on the nasal septum which is a sensitive area in the cow and the head can be controlled and moved by placing pressure here.

headgate.jpg (99259 bytes)

Angus cow in squeeze chute and head catch  with nose tongs.
   
Scan33.jpg (74391 bytes)  Nose tongs

Casting is an old technique still used on occasion to force a cow to lie down without anesthesia. By placing ropes around the body at sensitive areas along spinal column, then tightening the rope and applying force to those points the cow can be forced down, there are different techniques used for casting.

Most procedures can be done using the previous restrain methods. 
Cattle can also be anesthetized, tranquilized and local or epidural anesthetics administered. 
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                                 Restraint of goats and sheep

These small ruminants are not as dangerous as cattle, but they can certainly hurt a person especially the males. Like cattle they are herd animals and will try to stay with the flock and become distraught when separated from the group.
They are also moved in groups and worked in chutes and sometimes restrained small stocks.

Goats are more gregarious and intelligent than sheep and are often kept as pets. Goats can be trained to do tricks, to lead and to pull carts. Well socialized goats can be haltered or led with a collar and handled almost like a small animal.
Although it seems natural to hold and lead goats (or sheep) by the horns they don't  like it and will usually shake their heads and fight this technique of leading or restraint.

Goats and sheep can injure people with their:
Sharp horns
Heads (by butting)
Hind legs (kicking). 
Because adults usually weigh less than 200 pounds they can not do as much damage by kicking as cows, but there have been serious injuries due to males charging and ramming with their heads and horns.
Why don't we worry about ruminants biting when restrained?

Types of restraint for simple procedures include:

Small stocks to immobilize the body and small head catches.
sheepstocks.jpg (18539 bytes)

Halter or Halter and staff. A staff is long strong pole with a small hook on the end. The hook is attached to the halter on the animal's head and the animal can then be controlled at a distance.

Collars are used on goats
goatcollar.jpg (15291 bytes)

Manual, using arms (same as for foal)

Setting up sheep

sitsheep.jpg (99676 bytes)
A Sheep "set up" for hoof trimming

Sheep (not goats) can be placed on their rumps and leaned against the restrainers legs or almost anything solid. Their front feet are held and it is then possible to perform various procedures on them. For some reason they usually will sit in this position and not struggle. It is sometimes difficult to "throw" a large sheep in the sitting position (see description in book).
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                                                 Equine Restraint

Most people either respect or fear horses. Those who are experienced with horses respect their strength and quickness, those who have not handled horses are usually intimidated by their size. Thankfully, most horses are not aggressive or mean, but unless they are well trained and socialized they can be dangerous due to their instinct to escape danger and pain. Their first reaction when frightened is to run or "spook".  If they can not escape a fearful situation they may use front and back hooves or teeth to protect themselves.

While restraining and handling horses the following things should be considered.
1)  The disposition and training of the horse, remember even a gentle good natured horse can injure a handler simply by charging forward or sideways or rearing out of fear. Some horse trainers insist that more people are injured by "gentle" horses that do unexpected things, than by mean or inexperienced horses.
2)  The location of the personnel that will be assisting or performing medical testing or procedures, the horse can be dangerous at both the front end (by striking outward with one or both front legs) and rear end.
3)  The procedure to be performed, how painful or frightening is the procedure? Will physical restraint be adequate or will tranquilization be needed?

Understanding the body language of the horse is obviously very important to safely and effectively handling the horse. Although this is not a course in animal behavior the basics should be known by anyone restraining horses for veterinary purposes. Horses that are alert or fearful hold their heads high, the eyes are often wide and rimmed in white (sclera). If the horse is frightened or focused on something in front of them the ears are pointed forward. If the horse is mad or aggressive the ears will be "pinned" back. Like other domestic animals horses facial expressions change with emotion, but those expressions are subtle and somewhat individualized. Horses often warn of their intention to kick, by lifting a hind leg, or by swinging their head or hind quarters towards the person.

Just as the first step in restraining a small animal is usually taking them from the cage the first step with horses is getting them out of their territory, the stall.
The halter and lead rope are the basic tools used for handling of trained equines all over the world.
Approaching and haltering:
Most well trained horses will allow haltering once a hand is on their neck or shoulder.
The safest area to approach is at the shoulder, on the left (many horses are handled from the left and become accustom to it.)  Always speak softly to the horse and move slow and steady. Horses can recognize people who are fearful.
Remember horses have panoramic vision and see things almost directly behind them, which can cause them to spook or jump into a person.
The horse's nose is placed through the halter and a strap is secured behind the ears
(see diagram in book). It is safest to lead the horse by walking at the point of the left shoulder, don't wrap the lead rope around your hand!

How should you approach a horse that has turned its rump towards you? How far back can a horse kick?

Control points on the horse: 
The horse has many sensitive areas on the body and head which can be used to control or distract the horse, these areas include:
Lips and gums
Bars of the mouth (on the gums inside the mouth)
Bridge of the nose
Chin
Ears
Skin over neck and shoulders
Poll (on head behind the ears)

Obviously these are the areas where the bridle and other tack comes in contact with the body and is used to control and direct the horse while being ridden and driven.

Tying the horse:
A horse can become injured if not properly tied. The lead rope has to be tied long enough to allow some movement of the head, yet short enough so the horse doesn't get a leg over the rope. There also has to be a secure non slipping knot used that can be quickly released if the horse gets tangled and panicked.
Some horses have learned to pull back very hard on the halter and lead rope to break it and then get loose. These horses need special training and equipment to over come this serious and dangerous problem.

Restraint devices and methods used to control the head

The horse has many sensitive areas on the head but if these pressure points are over used the horse can become head shy and difficult to handle.

The Twitch

patchytwitch1.jpg (112608 bytes)   chain twitch                          patchyhumanetw.jpg (142333 bytes) Humane twitch       
humane twitchpg.jpg (64368 bytes) Humane twitch

The twitch utilizes the sensitive upper lip to control difficult horses or restrain horses for painful procedures. Twitches are applied to the lip then, depending on the type of twitch, it is either squeezed to apply varying amounts of pressure (humane twitch) or twisted to apply increasing amounts of pressure (loop twitch). 
The type of twitch that loops over the nose uses either a rope or chain as the loop, this device can put tremendous pressure on the lip as the restrainer turns the handle to increase leverage. 
The other method, using the humane twitch or a self retaining twitch, can be set at a certain tension by clamping down on the ends and then securing the rope at the end of the twitch and clipping it to the halter. A person can use this type of twitch, attach it to the halter and work on the horse alone. The other twitch requires someone to restrain the horse and apply pressure as needed.  It is not possible to apply as much pressure to the horse using the humane twitch.

What are endorphins? Why are endorphins mentioned when discussing twitching horses?

The chain lead
The chain portion of the lead shank can be placed either: 
Over the nose
Under the nose (at the chin)
Inside the mouth (over the tongue)
Between the upper gum area and the upper lip
 
If the chain is applied hard enough the skin can be broken and severe injury inflicted on the horse. A chain placed on the upper gum line inside the mouth is considered by many the most sensitive area and the most severe restraint method. It should only be used by experience handlers

The ear twist
The ear can be grasped and bent to distract the horse, the "cowboy way". This method is not recommended due to the possibility of cartilage damage and causing the horse to become head shy.

The skin fold
Another old method used to distract a horse is to grasp a fold of skin on the shoulder region and squeeze it tightly. This requires lots of strength, since horses do not have loose skin like small animals.

Hobbles
Unlike the previous methods, hobbles physically restrict movement.
There are several types of hobbles principle is to inhibit the horse's ability to escape by restricting it's leg movement.
A front leg hobble, which holds a single front leg in flexion, can be applied quickly and can be used on some horses for simple procedures. The hobble makes it hard for the horse to escape and often the horse will quite down and become docile and submit to treatment. 
Other hobbles involve the hind legs, such as breeding hobbles which restrain both hind legs of the mare during breeding and prevent kicking. 
Another type of hobble attaches to a single hind foot and suspends the leg so the horse can not kick.

Stocks
Horses can be held in strong stocks if they are calm (or tranquilized) and acclimated to them. This is a safe way (for a person) to treat a horse with less risk of injury.

The cradle
The cradle is similar to the Elizabethan collar used in small animals. It is a device used to keep the horse from disrupting a bandage or wound on the legs or body. (See photo in book).

Handling foals
Many foals have not been halter trained and during medical procedures may have to be wrestled down by several people. Foals main defense is to run, jump and kick. Small foals may be held with an arm in front of their chest and the other arm behind the rump or holding on to the tail. Some mares may become aggressive if their foal is in distress.

What kind of procedures and restraint would be done (and used) on a typical equine farm call?

Restraint of horses has improved greatly over the last 25 years. Many safe and effective anesthetics and tranquilizers for equines can now be administered in the field. 
This has enabled even smaller people (women) to restrain horses and perform medical procedures.
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                                    Restraint of Swine


Objectives
1)  List ways that hogs can injure humans
2)  List reasons that hogs are extremely difficult to restrain
3)  Describe how hogs can be moved from one place to another

Most technicians will not restrain hogs raised for slaughter,  but with the popularity of pot bellied pigs as pets, small hogs might be encountered in practice. Although pot bellies are often kept as house pets they still retain the same characteristics as their larger "cousins". Techniques used on pet pigs obviously have to be different than those used in agriculture. We will briefly discuss both methods of handling swine.

Characteristics of swine which make them difficult to restrain include:
Strength and body conformation. Hogs are low to the ground and have short legs which are difficult to hold. 
Hogs usually struggle and vocalize (they have loud shrill squeals) when handled for medical treatment.
Hogs can and will bite.
Hogs are the most intelligent of the farm animals and often seem to think through situations, instead of being driven through passageways they will stop to look where they are going.

Sows (females) are strongly bonded to their young and can become aggressive and dangerous when the piglets are traumatized. It is best to remove piglets from the sight and hearing range of the sow when performing medical procedures on them.

Catching and handling hogs and piglets

On the farm piglets can be captured and held by one or both legs. For fairly quick procedures (i.e. castrations) small piglets can be held off the ground by both hind legs with their backs lying against the restrainers legs. Other methods of restraint are sometimes used including a metal V-trough, in which the piglet lies on it's back with the feet tied.

Larger animals can be confined by squeezing them into corners by holding them against large solid wooden or metal panels, small stocks (similar to cattle stocks) are sometimes used.

Hogs can be moved by being tapped with wooden canes. Since hogs are not halter trained (some pot bellied pigs are leash trained) the only way to lead them is by the snout snare. The snare is similar to a heavy duty rabies stick which is placed over the upper jaw behind the incisors (front teeth).

These restraint procedures are not appropriate for pet pigs. Some technicians have reported success with placing a plastic bucket over the head of the pig to force it to back up, it is then steered down hallways and "backed" into exam rooms.
Pigs can be muzzled to prevent biting, but they usually squeal.

Piglets are restrained for the following common procedures:
1)  Injections of vitamins and vaccinations
2)  Clipping the needle teeth, the very sharp deciduous (milk teeth) incisors which can puncture the sow's udder.
3)  Castration
4)  Ear notching for identification

Venipunture and injections

Blood is routinely drawn from the: 
marginal ear vein (auricular)
jugular vein
anterior vena cava (at the thoracic inlet)
Because of the conformation of hogs it is nearly impossible to use the leg veins in adults. Another venipuncture site used in pigs is the lateral canthus of the eye. A small amount of blood can be obtained from the blood filled sinus below the third eyelid. 

Intramuscular injections are usually given in the muscles at the side of the neck. Other sites can be used but may cause damage to tissue (meat).


Textbook Assignment: Please read Chapter 1 from Clinical Textbook for Veterinary Technicians by Bassert and McCurnin and e-mail the answers to tcockburn@nvcc.edu
Please cut and paste these questions into a word document then answer them in word.

VET 105 Lesson 2
Restraint

1. What is the most important reason for restraint of veterinary patients?

2. What is meant by the statement "horses have sluggish accommodation"?
Why is this important in handling horses?

3. Why is it more dangerous to be kicked by a horse or cow standing 6 ft. away from their body than right next to them?

4. List 2 ways a chain (in conjunction with the halter) can be used to control a horse?

5. If you are restraining a horse for a veterinarian and they are working on the right side of the horse which side should you be on? Why?

6. What is the Frick speculum used for?

7. What is meant by "casting a cow"?

8. What is the primary reason for placing a cow in a hydraulic tilt table?

9. What 2 behaviors (of dogs and most species) are motivated by fear?

10. What type (breed example) of dog is difficult to muzzle and often determined biters?

11. What is the main reason for tranquilizing/sedating animal patients?

12. Do cats generally resist being placed in boxes, wrapped in towels etc.?

13. What method can be tried when bathing a cat?

14. After casting a cow it is safer for it to remain in sternal recumbency- why?

15. Horses are used to being handled on the "near" side, what does that mean?

16. What type of swine are particularly aggressive?

17. What is ethology?

18. Why might ear plugs be needed when handling pigs?

19. How should a female dog with puppies that has come to your clinic for tail trims (puppies less than a week old) by restrained?

20. What is the difference in a catís reaction (compared to a dog) when it escapes in the clinic?

 

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Answers to italized questions from above.

Clinical scenario. What would you do?  Do not throw the dog!!   Get hold of your emotions and remember someone loves FiFi and she is frightened.  Why not put back her in the cage and tend to the bite wound.  After everyone has settled down Fifi can be handled more gently and muzzled for the venipuncture.

What does piloerection and stiff legged body stance do for the dog? 
Makes the dog appear larger and may "scare" the opponent.

Which of these two dogs do you think will be the most dangerous to handle?   Why?   
This is kind of a "trick" question, since you can not do a complete evaluation.  Are either of them growling?  Is there piloerection?  I would be cautious around both, but the Pit Bull's expression and head position (lower) I find more threatening. Some dogs lower their heads because (in theory) they have a better chance of grasping the jugular area of their victim's neck.

Describe the behavior of a fearful dog that might bite.  
Fearful dogs often crouch and "slink",  avert their eyes and hold their tails between their legs.   Fear biters may send "mixed" signals (of both submission and aggression) , including growling, some eye contact and piloerection.

List breeds that you have noticed behavior patterns that could be dangerous during medical procedures. 
 
Again this is kind of a trick question, I don't like to point to any particular breed as always aggressive or always docile, it is very individual.   Certainly some dogs bred for protection/aggressiveness and some of the "Northern" breeds with curly tails have the reputation for aggressive behavior.  But I've seen some mean goldens & Beagles.

What is the danger of this?
Is this the proper way to carry (most) dogs?  Why or why not?  
The arm positions are alright, but the dog could bite the handler in the face easily.

Home made muzzles can be made with  gauze or rope. How are these applied? 
Generally a loop is placed around the muzzle and tied on the top, then looped again and secured below the muzzle, then the ends are brought behind the ears and tied.

What are the pros and cons of each of these types of muzzles?  
Leather maybe comfortable but can not be disinfected well.  The cage muzzle is difficult to apply and may injure the handler or patient.  Nylon muzzles can be disinfected and come in various sizes to fit most animals.

Which of these two cats would you rather restrain?  Why?  
About the only difference I see in these cats is the one on the right has dilated pupils, which is part of the fight and flight response.  It may be more upset than the posture (lying down) indicates.

How should the leg be prepared before venipuncture?  
At the very least it should be disinfected with alcohol or chlorohexidine before the puncture, if a catheter is placed the leg should be shaved and disinfected/scrubbed more extensively.

What signs do cattle display before aggression or panic?  
They may snort, become tense with their heads up and whites of the eyes showing.  Some may paw before charging.

How would you move these ten head of cattle from the far end of the pen to the stock at the end of the chute?  
Cattle have a "flight zone" and "balance point". The flight zone is the distance at which they will move away when approached. The balance point is that position (often at the point of the shoulder) that the animal will stand still if the handler stands still or move away from the person when approached. It is used for controlled movement of individual animals.   
Cattle usually will not enter an unknown area (i.e. chute ) if there is possible danger lurking i.e. noise or people. 
The method to use is to slowly move towards the cattle from the back and slightly to the side and to urge them (voice, or hand motion if needed) to move forward as a group along the fence and into the chute. Usually they will stop before entering the chute and the first in line will decide whether to go on. If the rest of the herd can be gently urged forward they will crowd the first one down the chute then the others will follow. 
If there is sudden movement by the handler they will probably run in all directions but not into the chute.  If there are people at the far end of the chute they will not enter it.

Why don't we worry about ruminants biting when restrained?  
They don't have upper teeth.

How should you approach a horse that has turned its rump towards you? How far back can horse kick? 
With great care!  Some horses will show fear (and still kick) others may be aggressive.  It is always best to move slowly and talk calmly to horses, take your time.  
Some horses will turn to face you if they become less scared and can then be haltered.  
A food treat may entice a horse to come forward.  
Some horses are playing a "game", they have learned that by turning their back on a person they are left alone.  But if you don't know the horse this can be a dangerous game.  It maybe best to let someone with experience with the particular horse catch it.

What are endorphins?
Chemicals produced in the brain during certain physiological conditions, including intense exercise (the so called "runners high").  These chemicals induce a feeling of euphoria.

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