The All-Important Equine Prepurchase Exam

What to expect when a veterinarian performs a prepurchase exam on a prospective equine partner.
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Veterinarian examining horse
Watching a horse move in hand and under saddle and performing joint flexion tests are paramount to assessing soundness and competitive potential. | Taylor Pence Photography

Prepurchase exam steps, ethics, and best practices

You’re in the market for a new horse and find one across state lines that checks all the boxes; he’s the right age, within your budget, and you love what you see in the seller’s videos. Why spend time and money performing a prepurchase exam (PPE) on this unicorn? In this hot market, you want to snatch him up right now!

“I think of prepurchase exams as an information-gathering mission for the prospective buyer prior to making the decision of purchasing a horse,” says Rachel Roemer, DVM, owner of Great Bay Equine, in Portsmouth, New Hampshire. “I perform them to look for any indication of existing issues that may limit performance in the future for whatever desired job.”

You might think, so what if the horse has a little hitch in his giddyup or less-than-stellar teeth, right? Wrong.

Always remember: Buying the horse is the least expensive part of ownership. “Often, horses are large investments, and it’s a financial commitment to take care of horses in the long run,” says Roemer. “So I get as much info as I can to let them know of any potential issues that they may deal with in the future. Even if a horse is not being sold for much or given away, the potential costs of dealing with underlying chronic medical or lameness issues can be really significant and, in many cases, can exceed the purchase price of the horse. Prepurchase exams help ensure you are not taking on a horse that cannot do what you want it to do and may (cause you to) incur high financial and emotional expenses.”

Here are considerations to make and what to expect when a veterinarian performs a PPE on a prospective equine partner.

Scheduling an Exam

Avoid potential conflicts of interest when choosing a veterinarian to perform your prepurchase exam.

“Any existing relationship between the seller and the veterinarian is a potential conflict of interest,” says Roemer. “I usually have my staff make sure whatever horse we’re looking at has not been a patient of ours previously.”

At a prepurchase exam the buyer is the veterinarian’s client. The buyer is paying the bill, and they own the report and any images within it. As a practicing veterinarian, I also try to refrain from doing prepurchase exams when the seller is my client.

“There can certainly be pressure on the vet from a good client to ‘pass’ the horse to a seller,” says Roemer.

When looking for a veterinarian to perform a PPE, your regular vet is typically a good choice if the horse is local. If the horse is not local, he or she might recommend a practitioner or clinic where the horse is located. Further, if you need help interpreting the prepurchase exam findings, your veterinarian can help steer you in the right direction, because they understand your needs and situation.

The Pass/Fail Myth

It is a (false) understanding in the equine community that the veterinarian performing the prepurchase exam “passes” or “fails” the horse they’re examining. For me, this is truly the most frustrating aspect of performing a prepurchase exam.

“Passing a horse for one buyer is not passing for another,” says Roemer. “It depends on what the horse is to be doing and what the buyer is willing to tolerate as far as preexisting or potential issues. The high-level jumping prospect will have a different threshold than the backyard pony for a child. The needs, and priorities, of buyers vary wildly.”

As a veterinarian, it should not be my concern whether the purchase goes through. My job is to give the buyer as much information about the horse prior to purchase so he or she can make an educated decision.

Buyer Considerations

A buyer who doesn’t know what they want in a horse can be a recipe for disaster. “Whenever I start a prepurchase exam, before I even lay hands on a horse, I make sure to have an upfront and honest conversation with the potential buyer,” says Zach Loppnow, DVM, an equine veterinarian at Iowa State University’s Lloyd Veterinary Medical Center, in Ames. “I want to make sure that they tell me exactly what they are wanting from the horse in terms of future use, as well as what they are looking for from the examination.”

Every client has different levels of disposable income, experience maintaining or treating conditions, and levels of risk they’re willing to take when buying a horse. “It is not my job to make decisions regarding those factors for a client,” he adds. “That is up to them, even when they ask, ‘What would you do?’ In the end, it’s up to the client to decide whether what I report is significant enough to them to buy or not buy the horse, and if it will fit what they are intending to do.”

Look at the Whole Horse

Clients often view prepurchase exams as simple soundness evaluations. “The lameness and musculoskeletal evaluation is obviously a large part of this examination, and often the main focus of a buyer, but it is by no means the only portion that matters,” says Loppnow. “When it comes to prepurchase exams, I am going through a horse from nose to tail. This includes evaluating parts of the respiratory system, gastrointestinal system, neurologic system, eyes, ears, skin, muscles, joints, etc. The list can be quite long.”

Dental issues, ophthalmic problems, or respiratory concerns can be significant findings at a prepurchase. Furthermore, owners can request specific diagnostics. For example, a broodmare prospect might also receive a breeding soundness exam, or a Thoroughbred coming off the track might get a gastroscopy to evaluate for gastric ulceration. Another common practice is pulling blood for drug testing to ensure the horse was not medicated prior to the examination.

“Ultimately though, that’s what a prepurchase exam is: looking for something that could be a problem for this horse and its expected job down the road,” Loppnow says.

Assessing the Athlete

The meat of the prepurchase is, indeed, the soundness evaluation. Mark Baus, DVM, is a founding partner of Grand Prix Equine, a sports medicine practice in Bridgewater, Connecticut, and prepurchases make up a large portion of his practice. He says most of his vettings are for high-end sport horses, where the horse’s competitive potential is the first thing on the buyer’s mind.

“My responsibility at the time of a prepurchase exam is to discuss physical findings only,” says Baus. “Athletic ability, to me, is outside of that wheelhouse.

“How you best predict future competitive ability, in my currency, is pain,” he adds. “When I’m looking at a horse, my job is purely to be assessing sources of pain.”

Baus does this by watching the horse move in hand and under saddle and performing joint flexion tests. These simple techniques are paramount to assessing a horse’s soundness, he says.

“I always tell clients the best (and soundest) horses have the least amount of pain,” he says. “Competitive ability is directly tied to soundness. And the soundest horses I’ve ever vetted were seven-figure horses. I truly believe that horses are priced relative to athletic ability, and athletic ability is tied directly to ­soundness.”

The significance of PPE findings can vary depending on the intended use for the horse. “In the hunter world, a horse with mild hock changes will probably not have any clinical lameness, so I would probably not warn the client of any potential limitations to their ability,” says Baus. “As the changes progress and the clinical signs are more apparent, I do feel the need to say that this horse may be restricted in certain circumstances.”

The prospect’s workload is another important factor to consider. It’s all too common to come across young horses that seem to have incredible athletic potential, even though they aren’t yet in work. The purchase proceeds, but once workload increases the horse develops a lameness. This is the unfortunate reality of prepurchasing a horse that is not in regular exercise, as some clinical findings only manifest once work begins.

While veterinarians and buyers should consider all prepurchase exam findings, again, not all findings are equal. “I address two factors with every finding: Is this going to change with time or with use?” says Baus. “I think it is important to help clients understand that some findings are going to change no matter what you do with the horse, and some will change more with what you do with them. Some findings will change more rapidly with what you do with a horse. If you rested a navicular horse for X period of time, they’ll likely be sound for a while. If you do too much with them, they’re going to be crippled.”

Radiographs and ultrasound are great diagnostic tools that can tell us a lot about a horse. While it would be wonderful to image every horse getting a prepurchase, this is not financially feasible for many prospective buyers.

Some buyers always request radiographs of the hocks or front feet or back. While this can be good practice, I recommend financially conscious buyers let the exam guide the imaging. “My imaging definitely highlights areas of clinical findings and concerns, based on flexion responses, joint effusion (fluid swelling), palpation, and hoof tester responses,” says Baus. Ultrasound comes into play as well. “I probably scan about a third of the horses that I vet,” he says.

An important development in the veterinary community is the use of board-certified radiologists to help assess PPE findings. “I am now recommending to all of my clients buying that we send out the radiographs to a radiologist for their opinion,” says Baus. “First of all, it is humbling, because I’ve been looking at horses for 40-odd years and drinking my own Kool-Aid, writing down whatever description I want, and these guys are coming up with very professional, very detailed reports, frankly seeing things I didn’t see. Furthermore, they’re describing things better than I would describe them.”

Take-Home Message

Hunting for the perfect horse is exciting but can also be frustrating. My piece of advice for any prospective buyer: Decide what you want, know your deal breakers, and don’t fall in love with an ad. Look for a horse that fits your budget, lifestyle, and goals. Take everything the seller says at face value. Ask your regular vet to perform the prepurchase exam. If they can’t, chances are they have a colleague in the area they can recommend.

Lastly, know that there’s nothing worse for vets than performing a postpurchase exam on a horse that didn’t receive a PPE and delivering the news that a new equine companion has terrible navicular changes or severe kissing spines (ask me how I know).

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Written by:

Chris White, DVM, was raised in central Maine and competed in barrel racing his entire childhood. He received his Doctor of Veterinary Medicine from the Atlantic Veterinary College, in Prince Edward Island, Canada. His interests include performance horse medicine, ophthalmology, and dental care. He has practiced in Upstate New York, New England, and Atlantic Canada.

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