“What is a prepurchase examination and why should I have one done?”

Jennifer L. Wright, DVM

My aged horse passed away last year, and it took me a bit of time until I was ready to start looking for a new horse.  After a few months of horse shopping, though, it would appear that I have found the horse of my dreams—the spitting younger image of my old friend!  I was ready to sign on the dotted line, but my friend suggested that I have a prepurchase examination done before getting too excited.  It has been ages since I’ve bought a horse, and I am not familiar with prepurchase examinations.

A: First of all, congratulations on finding the horse of your dreams!  But your friend is wise…before you sign the check and load him onto your trailer, you should equip yourself with the information that you need to make an informed decision whether or not to purchase him.  Despite how the horse is marketed, most sale transactions are considered caveat emptor (“buyer beware”), meaning that the purchaser assumes all the responsibility to make sure that the horse is actually healthy and sound (there are no returns or refunds)!  Contrary to popular belief, prepurchase exams (sometimes simply called “vet checks”) are not “pass” or “fail” examinations.  Rather, they are comprehensive risk assessments designed to identify existing and/or potential health issues that may affect your decision to purchase the horse.  In other words, this examination can help to ensure that you are making a smart, informed decision before the sale is final.

Prepurchase examinations are not “one size fits all,” and can be largely customized to accommodate each purchaser’s desire for information and budget.  In general, every prepurchase examination should at the very least include a thorough evaluation of the horse’s health history (ideally, the seller has provided full disclosure of all known medical records), a comprehensive physical examination (including auscultation of the heart and lungs, ophthalmic examination, oral examination to confirm reported age, and palpation of every square inch of the horse’s body), and assessment of soundness (including evaluation with hoof testers, palpation of the soft tissues and joints of the limbs, determination of joint range of motion, flexion tests and evaluation under saddle (riding horses) or in harness (driving horses)).  Naturally, the horse’s behavior will be noted during the examination, although the veterinarian’s primary goal is to focus on health issues.  Ancillary diagnostics that may be “added on” to the prepurchase examination include radiographs, ultrasound, endoscopy, bloodwork, and less commonly nuclear scintigraphy (bone scan) and MRI.

Flexion tests

Flexion tests

Every prepurchase examination is different, and you should work closely with your veterinarian to determine the best plan for your needs.  Each phase of the prepurchase examination may include multiple steps, and what is included in your prepurchase examination will depend on your expectation of the depth of information you desire to gain.  Is it your intent to identify every tiny flaw in the horse, or are you concerned only with major issues?  The harder you look, the more you will find…colic surgery scars, dysfunctional jugular veins, retinal detachments, heart murmurs, bone chips, strained tendons, indications that the horse has been “nerved”…the list is infinite.  There is no such thing as a perfect horse, and a diligent veterinarian will find flaws in every horse presented to them.  The purpose of the prepurchase examination is to help the purchaser determine what abnormalities are acceptable and unacceptable.

The elements included within each prepurchase examination may be chosen depending on several variables, such as the horse’s intended discipline or use, previous performance history, age and/or purchase price.  By far, the most common ancillary diagnostic included in prepurchase examinations are screening radiographs, but there are infinite combinations of views that may be obtained.  For instance, it would be important to include views of the hind fetlocks in the set of screening radiographs of a high level dressage horse that is going to be expected to work hard off its hindquarters in a very collected frame.  On the other hand, hind fetlock views would be less important in a horse working at speed, such as a barrel horse…in that case, the screening radiographs should include front feet and hocks.  A full panel of radiographs may be chosen for a young horse being purchased as a sale prospect, so that the purchaser may represent the horse as a lesser or known risk to future purchasers.  Some purchasers simply desire to acquire “baseline radiographs” to keep with the horse’s medical records should they proceed with the purchase.  The radiographs obtained during a prepurchase examination are not necessarily expected to be “clean,” as horses that have had a working career often carry a certain amount of joint pathology.  The goal is to determine if the abnormal changes observed on the radiographs are what would normally be expected for that horse’s age, breed and use.  In horse sport speak, the veterinarian is identifying any suspected future maintenance needs that the horse may have in order to continue soundly in work.

Hock radiographs

Hock radiographs

Ultrasound imaging of the horse’s soft tissues may be indicated if the horse has a history of soft tissue injury or presents with signs of either a previous or active soft tissue injury.  Upper airway endoscopy is warranted if the horse is suspected of making a respiratory noise during work (to identify a “roarer” or other performance limiting medical issue).  The most common bloodwork performed as part of a prepurchase examination is a Coggins test (if the horse does not already have a current test) and/or drug screening (most commonly for pain killers and/or sedatives).  Blood for drug screening may be collected and stored for up to 1 year.  Nuclear scintigraphy (bone scan) is less commonly performed as part of a prepurchase examination as it is expensive and such a test is typically performed on a horse with suspected soundness issues.  MRI is also less commonly performed for the same reasons as nuclear scintigraphy, and also because the superior “non-sway” images require general anesthesia.

To a certain extent, the purchase price of the horse may dictate the amount of ancillary diagnostics that a purchaser requests…or it may not.  Consider the following example:  A purchaser presents an 8 year old gelding to the veterinarian for a prepurchase examination.  The purchaser intends to use the gelding for pleasure trail riding and possibly low level jumping, but is not sure of the gelding’s actual performance potential as he has been in sporadic work at best under saddle.  The purchaser initially balks at the added expense of screening radiographs of the gelding’s front feet and hocks.  The veterinarian explains that the gelding has not been in consistent work, and therefore has not proven his ability to stay sound in work (this horse is a greater risk than a horse that is currently performing soundly in the job for which he is being purchased).  Screening radiographs may be within normal limits, or they may identify an underlying condition that will likely require veterinary treatment.  Suddenly, the $1000 horse becomes more expensive.  At that point, it is up to the purchaser to decide if this is acceptable or not.  Maybe the purchase price was a “steal,” and the thought of additional funds funneling toward veterinary treatment is not a deterrent.  On the other hand, the purchaser may not want to have to deal with that particular veterinary issue.  If the purchaser declines to purchase, the horse returns to the seller and the purchaser avoided the risk.  If the purchaser still desires to purchase the horse, they have gained valuable information and are making an informed and educated decision.

So, what about the prepurchase examinations during which the horse is found to be unsound or lame?  Depending on the situation, the purchaser may declare a full stop and walk away from the horse.  If the purchaser still really wants the horse, the prepurchase examination may be placed on hold.  At that point the prepurchase examination has transitioned to a lameness examination.  There are no hard and fast rules in this case, but ideally it is the onus of the seller to present the horse to their veterinarian for diagnostics and treatment.  If the horse is successfully treated and deemed to be sound by the owner’s veterinarian, it may be presented again for prepurchase examination WITH THE FULL DISCLOSURE OF ALL MEDICAL RECORDS, INCLUDING ALL DIAGNOSTICS AND TREATMENTS PERFORMED.

As you can see, the prepurchase examination is a dynamic situation and no two are the same.  It is a “snap-shot in time” of the health and soundness of a horse, and it cannot guarantee the future performance prowess or longevity of a horse.  It can, however, identify immediate risk factors and uncover medical or soundness issues that a purchaser may not be willing to live with.  A prepurchase examination may prevent you from purchasing a horse that you cannot use, and that is definitely effort and money well spent!