Prepurchase Exams: Crystal Ball Not Included in Veterinarian's Kit

As much as buyers want veterinarians to perform a prepurchase exam and predict a horse’s future, the equine doctor’s medical kit doesn’t include a crystal ball.

“The client does want us to predict,” Reese Hand, DVM, Dipl. ACVS, told practitioners at the 65th Annual American Association of Equine Practitioners Convention, held Dec. 7-11, 2019, in Denver, Colorado. “They want us to tell them that a horse is going to be sound for so many years and that he’s going to be productive at whatever job he’s going to be asked to do.

“But keep in mind, the prepurchase exam is not a guarantee,” he continued. “You’re looking at this horse at one point in time, and you’re trying to give the buyer as much information as you can—including possible risk factors—so he can make a proper decision. But it’s a window.”

While some veterinarians approach the task with dread, this equine surgeon from Weatherford, Texas, looks at prepurchase exams (also known as “PPEs”) as an opportunity to meet new clients and patients. He suggested the key to success is performing them consistently and confidently, with an understanding of the clients’ goals.

“It’s a home run if you can do the exam the same way every time,” he said.

Hand starts by getting the horse’s complete medical and performance history: illnesses, injuries, lameness issues, current or previous medications, joint injections, surgeries. He wants to know all the disciplines the horse has done in the past, what it is currently doing, and what the buyer hopes to accomplish with the horse in the future.

During the physical exam, he uses a form to help guide him through the process, so he doesn’t skip any essentials. He progresses 360 degrees around the horse: left side first, nostril to tail, top to bottom; then right side, hip to nostril. He checks ears, eyes, nose, throat, lungs, heart, teeth, joints, tendons, ligaments, feet, back, abdomen, and genitalia. Hand examines and palpates, documenting any anomalies at the time of the exam. Details matter. Does the horse have a parrot mouth? He looks at the teeth to find out.

He routinely recommends an endoscopic exam (a “scope” of the upper respiratory tract) and a blood-screen for drugs and diseases. “It doesn’t matter if my brother is the one selling the horse, I’m going to always offer that client a drug screen,” he said.

Hand is equally methodical during the soundness exam, which includes flexion and hoof tests. He says it’s important to perform the flexions the same way each time. “Know what and how you’re interpreting that particular flexion,” he advised.

Hand assesses conformation and does a neurologic evaluation, as well. This practitioner wants to see the horse move at a walk, trot, and lope on three surfaces: asphalt, dirt, and turf. It’s also helpful to see a performance horse under saddle and loose in a round pen, not just in-hand.

Invariably, the veterinarian will identify possible concerns. The more difficult question is whether those imperfections will prevent the horse from doing his job.

“We have all seen those horses that we thought would never have done his job, yet he goes out and he’s the top horse in that competition,” Hand said. “Some horses can deal with imperfections.”

Hand’s initial findings will influence his recommendations for radiographs, ultrasound, MRI, and CT scans, as well as possible referrals to specialists. He might want to look more closely at a single joint or recommend a more extensive imaging package. He’ll perform a reproductive exam on stallions and mares when breeding is a consideration now or in the future.

The information gathered then goes into a clear and timely written report, along with test results, diagnostic images, and notes about the findings. The documents include a complete description of the horse, including his age, sex, weight, color, brands, tattoos, markings, and blemishes and where and when the exam took place.

“Personally, I never pass or fail a horse,” Hand said. “I’m going to tell clients the risk factors and try to help them understand whether or not it’s a smart investment based on those risk factors.”

Once that report has been signed, sealed and delivered, the horse’s future is in the hands of the buyer and seller. No crystal ball. No guarantees.