The occurrence of a twitch suggests the existence of advanced veterinary practice involving specialized tools in combination with complex physiological knowledge (the concentration of nerves in the upper lip). Advanced veterinary practice can be expected in cavalry stables of the Roman army for instance, since we know that these units employed professional veterinarii (Adams 1995, 51-65; Dixon & Southern 1992, 220-233; Davies 1989, 212-214). However, for agrarian communities like Tiel-Passewaaij, this advanced practice is less self-evident. It was already established that horse breeding was an important part of the local economy of Tiel-Passewaaij on the basis of the zoological remains (Groot 2008, 77-91), but the find of a twitch provides us with complementary evidence about the care for animals.
Apart from procedures involving castration mentioned above, specific information on procedures and instruments concerning the care for and treatment of horses is scarce. Written sources like the Mulomedicina, Columella and Pelagonius dwell on diseases, injuries, grooming and feeding in general terms mostly. The treatments mentioned are general in nature and only rarely provide details on the instruments used (Dixon & Southern 1992, 202-233; Hyland 1990, 49-60, 122-129; Adams 1995, passim).
To conclude: in sharp contrast to the enormous importance of equines in the Roman world, the practices surrounding the treatment of horses are hardly ever traceable archaeologically. The identification of a twitch is a welcome addition to our knowledge of practices around horse care. Given the fact that twitches are found in cities (Pompeii; Franchi dell'Orto & Varone 1992), military camps and villa's (Kolling 1973) as well as non-villa rural settlements (Tiel-Passewaaij), it can be inferred that civilian, military and agricultural communities made use of the twitch to sedate horses while treating them.