What will your veterinarian evaluate during one of these evaluations? At the 2018 American Association of Equine Practitioners Convention, held Dec. 1-5 in San Francisco, California, Melissa Welker, DVM, of John R. Steele & Associates, in Vernon, New York, reviewed what’s involved in her prepurchase exams for upper-level sport horses.
“The equine prepurchase exam has evolved a great deal in recent years,” she said. “As technology advances, so does the level of complication these exams often entail. The value of sport horses has increased dramatically in the last decade, creating a new sense of pressures on the buyer, seller, and veterinary practitioner asked to perform the a prepurchase exam.”
As such, she encouraged veterinarians to find a routine that works for them and stick to it.
“The implementation of a thorough system, in conjunction with clear client communication, will help ensure the buyer’s interests are well-represented and that the veterinary practitioner has provided as much information as possible to help them make the best decision,” she said.
Before the Exam
Before a practitioner even sets foot in a barn, Welker said there are several steps they should take to prepare:
- Know the buyer—Professional horsemen and amateurs sometimes seek different types of horses, and some riders are looking for long-term partners while others hope to sell in the future. So, understanding what the buyer wants is key. For example, a rider looking to gain miles at the upper levels with an experienced mount will be looking at a different type of horse than the professional aiming to bring a young horse up the levels before selling him. Some osteoarthritis or issues requiring maintenance would be expected to surface during a prepurchase on the former horse while the same findings on the latter might raise red flags.
- Identify the horse’s potential job—Upper-level dressage and jumping, for instance, have very different physical requirements. Understanding where the horse is headed can help veterinarians better evaluate their suitability for the job.
- Check the horse’s show record—Have the buyer research the horse’s performance record. Does the horse’s current show level seem age-appropriate? Has he shown consistently, or are there gaps in his record? If the horse got off to a late start or had lengthy breaks from competition, can the seller explain why? Welker said evaluating these factors in conjunction with the clinical exam can help veterinarians gain more information about the horse in question.
The Physical Exam
Veterinarians should be prepared to document everything they find during prepurchase exams for upper-level sport horses—good, bad, or indifferent. Make notes during the process, then complete a thorough report for the buyer after the exam.
Welker said she likes to look at the horse in his stall at the start of the exam to get a sense of his temperament, evaluate his posture, and watch for any stereotypies, such as cribbing or weaving. This is also a good time to check the horse’s passport (if he has one) and scan for a microchip.
Next, she begins the physical exam, which includes:
- Taking the horse’s temperature;
- Listening to the heart, lungs, trachea, and gastrointestinal tract;
- Palpating the head and jugular groove;
- Touching the ears and poll to check for earplugs that could be masking behavioral issues; and
- Looking at the teeth to identify potential medical conditions and be sure the horse’s dentition matches his age.
Welker also recommended conducting an eye exam in the darkest location possible.
“Be quick to add a specialist if you see something abnormal,” she said, as eye issues can progress rapidly and cause significant issues for sport horses.
She encouraged practitioners to take a step back and look at the horse’s conformation, paying close attention to the body’s overall balance, the length of the back, any angular limb deformities, and hoof conformation and size.
“Conformation faults will catch up with them eventually,” she said, “even it they haven’t been a problem thus far.”
Surgical scars can also provide information about the horse’s past, so Welker recommended taking time to check for them. Common scar locations include the throatlatch (from respiratory surgery), pasterns and hind cannons (from orthopedic surgery), and the abdomen (from colic surgery).
“Have a statement in your exam report about scars but be sure to note whether the horse is clipped,” Welker said. “We can miss scars on unclipped horses.”
Next up: the musculoskeletal exam, starting with palpating the horse’s entire body.
“Start at the head, work across the neck and back, and then down each limb,” Welker said.
She said to check synovial (joints) and soft-tissue structures for swellings, noting whether they appear to be acute or chronic; these findings could impact the ultrasound portion of the exam, she said. Perform passive flexions (where the veterinarian flexes a joint to see if it has normal range of motion) during this portion of the exam.
Welker also takes a close look at the horse’s hooves. Note whether shoes are fairly normal or more sophisticated, if a horse appears to be shod to help treat a particular condition, whether he’s wearing the shoes a certain way (i.e., more wear on the inside or outside of the hoof), and if he appears to be due to be shod. She also uses hoof testers to check for sensitivity on the sole and heel of all four hooves.
She recommended collecting blood for a complete blood count/chemistry panel and a Coggins test to check for equine infectious anemia. If warranted by a horse’s history or clinical signs, Welker said she might also run Lyme disease, equine protozoal myeloencephalitis (EPM), and metabolic tests. More owners are seeking drug screens as part of prepurchase exams for upper-level sport horses, so Welker offered the following tips:
- Submit samples for drug testing, but hold and freeze at least one tube of blood in case there’s an issue with sample delivery to the lab or processing;
- Not all laboratories test for the same substances, so know in advance what your lab of choice will screen for;
- If any party (i.e., the buyer, seller, trainer, etc.) declines the drug screen, document it in your exam report and note who declined it; and
- Communicate with the buyer what to expect from the results and when they should arrive.
During the physical exam, Welker recommended practitioners speak with the seller, the trainer, and/or whoever is responsible for the horse’s care at his current home.
“Ask them direct questions regarding the history of the horse, and document direct communications to them and record their responses,” she said. “In recent years, it has become routine to ask the sellers to disclose the records of the horse for review by the veterinarian performing the prepurchase exam.”
Such records can include medication administration (at least for the past six months), recent veterinary records, surgical records, and diagnostic imaging reports.
The Dynamic Exam
Once the veterinarian has looked at the horse standing still, it’s time for the dynamic—or moving—part of the exam.
Welker said her in-hand exams include:
- Watching the horse walk and trot in a straight line on firm ground;
- Evaluating the horse walking a figure-eight;
- Conducting coordination tests, such as spinning the horse on a tight circle in both directions (“Do this test yourself,” she said. “You can get a lot of information from it.”);
- Watching the horse back up; and
- Performing dynamic flexion tests on a hard surface; these involve holding a joint in a flexed position for a span of time (usually about 50 seconds) before watching the horse jog off.
Welker said veterinarians generally perform the following flexions:
- Front and hind fetlock;
- Stifle extension;
- Stifle crossover;
- Coffin joint; and
- If there’s evidence of forelimb lameness, upper limb flexions.
She also evaluates the horse on a longe line on hard and soft surfaces, if both are available. She said she evaluates the horse’s body lean, how he uses his body, and his behavior, including if he’s more or less willing to go forward in one direction than the other.
“Next, have the handler tack the horse up,” Welker said. “This is a good opportunity to assess the horse’s temperament and, again, overall comfort when the saddle is being placed.”
She said an under-saddle exam is a very important part of prepurchase exams for upper-level sport horses, as many horses she sees that appear sound in-hand and even on the longe line are significantly lame with a rider. Again, she watches the horse on hard and soft footing if they’re available.
Welker said she has the rider:
- Work the horse in all three gaits—walk, trot, and canter—both with rein contact and on a loose rein;
- Execute flying lead changes;
- Shorten and lengthen the stride at the trot and canter;
- Ride the trot sitting and posting, on both the correct and incorrect diagonals; and
- Gallop the horse, after which she listens to the heart after intense exercise and evaluates how the horse recovers.
Post-exercise, she said, she’ll palpate the neck and back, along with soft-tissue structures, to see if any pain has improved, worsened, or remained the same.
Welker then collects ultrasound and radiographic images, including of the neck and back. Another presentation at the convention covered imaging during prepurchases in-depth.
Finally, Welker gave practitioners pointers on how to best document and report to the client their findings:
- Use a template for consistency;
- Be careful with terminology. “Words such as ‘on this day,’ ‘at the time of this exam,’ and ‘not a guarantee,’ will help remind the buyer that the prepurchase exam is a variable exam that can change quickly,” she said;
- Include a statement documenting when the exam results were discussed with the buyer and trainer or representative; and
- State that the buyer has researched and knows the horse’s show record. “This can entail a significant amount of research and should fall on the potential buyer to put the necessary time into searching for gaps in the horse’s performance record,” she said.
In closing, Welker said, prepurchase exams for upper-level sport horses can be expensive for the buyer, are time-consuming to carry out, and come with a significant liability for the veterinarian.
“The veterinary practitioner plays a key role in the purchase of a horse,” she said. “Taking the time to perform an in-depth clinical exam, researching the history of the horse, and recording findings in a consistent manner will give the buyer the confidence they need to make the right decision for them.”