Most veterinarians have a standard prepurchase exam they conduct however each exam needs to be tailored and interpreted for the specific animal, its future rider, and its anticipated use. Exam results revealed on a 20-year-old "pasture potato" who will be used for an occasional trail ride would have a significantly different interpretation if found on an 8 year old hunter who is actively campaigned. In the same context, a horse intended solely for breeding requires a substantially different exam than a child's first horse.

Although purchase exams are conducted differently by every veterinarian they are basically comprehensive physical exams with an emphasis on the musculoskeletal system or reproductive tract (breeding animal). Most of the problems encountered following exams prior to purchase seem to originate from poor communication. Unrealistic expectations of the exam by the buyer can be brought into the process but poor communication between veterinarian and buyer can worsen the situation. Buyer, seller, and veterinarian can contribute to poor communication. Other problems arising from purchase exams have to do with attorneys and the concern of litigation and will be discussed later in the article.

To get the most out of a purchase exam it is critical you understand the veterinarian's exam procedures. A thorough understanding of these procedures can give you a reasonable expectation of what can and cannot be revealed by the exam. Ask your vet to discuss the exam procedures as well as the reasons for them and their interpretation. Before the appointment, review the expenses entailed in the exam especially if you anticipate more in depth procedures such as blood tests or x-rays. If at all possible be present during the exam because you can observe the tests and discuss their results as they are revealed. If you have any questions about the exam there won't be a better time than during the exam to ask them. Although the seller should be present to handle the horse and answer questions about the horse's previous use and medical history, discuss the veterinarian's findings in private. Inform the veterinarian of your plans and expectations of the horse, be it performance, breeding, or pleasure. Even though there is a wide range of what may be included in a purchase exam some procedures are hallmarks of many exams and are discussed below.

A thorough medical history including the schedule of vaccination, dental care, and de-worming should be reviewed and any veterinary records on the horse should be requested. All current or previous treatments of any kind should be discussed and I have the seller sign a form confirming the medical history. I ask for permission to examine all veterinary records and have the seller sign a form granting me access to these records. Temperature, pulse and respiration are taken. An ophthalmic exam is performed, preferably in a dark stall so the pupils dilate and inspection of the eye's interior is possible. The horse's hearing and vision is evaluated and the heart & lung examined with a stethoscope. Dental and neurological exams are performed. A careful exam of the skin is in order to find any signs of dermatological problems. Blood may be collected for any tests such as equine infectious anemia, complete blood counts (CBC), and drug screens. Because equine infectious anemia is not treatable but easily diagnosed by a Coggins test it is recommended, especially in light of some small recent outbreaks in the West. Observation of the horse's disposition and manner may prevent a disappointing or tragic mismatch of inexperienced rider and inexperienced horse.

The musculoskeletal portion of the exam is often the longest part (unless one is looking solely for a breeding prospect). This segment involves evaluating the horse's conformation and its gait. Understanding the contribution of conformation to lameness is very important but must be carefully evaluated with the horse's future use in mind. For example, steep pasterns and excessively small flat feet would be interpreted quite differently in a cutting horse or dressage athlete in contrast to the horse who will be used for an occasional trail ride.

Careful observation and examination of the feet is critical; with particular attention given to their length, angle and any asymmetry between hooves as well as their general condition (dry, cracked, horizontal ridges). The way the foot grows can provide meaningful clues as to a horse's long-term soundness both historically and in the future. Thorough palpation and manipulation of the limbs is helpful to detect pain, heat, swelling as well as range of motion. Most veterinarians examine feet both with visual inspection and hoof testers. Flexion tests of the limbs are usually done and their interpretation seems to be a sticking point on many exams. Following flexion, many horses will be "off" for 10-25 feet and this can be perfectly normal. Lameness of greater distances is not a favorable finding and requires an experienced equine veterinarian to interpret. Contrary to claims I have occasionally heard it is not possible to cause lameness from a properly applied flexion test. An integral part of the purchase exam involves observing the horse at the walk and trot both in a straight line and during lunging. A hard flat surface or gravel is preferred to the soft flooring of an arena so as to accentuate any possible discomfort or gait deficit and in itself will not cause any lameness. Trotting the horse for 15 minutes allows the opportunity to look for gait deficits, early fatigue, stumbling, interference, and cardiovascular recovery following exercise. These in turn may help to reveal the general fitness, subtle lameness, or possible heart problems.

Sometimes additional tests such as x-rays, ultrasound, endoscope, nerve blocks, or blood tests are requested or recommended. Interpretation of any of these tests is very dependent on the results of the initial exam. If upon examination a suspicious finding is revealed, additional tests may clarify these results. Obviously the cost of the horse will play a determining factor as to how comprehensive the exam is. Serial x-rays of a horse showing no symptoms can be of value. Two noteworthy examples follow 1) when examining a horse of high financial value any additional information to the exam is cost effective. 2) Another example exists when you are trying to sell a horse and the buyer has x-rays taken. Many potential problems seen on x-rays are insignificant if it can be proven that they have been present for some time without any consequence. X-rays taken years ago by your vet when you purchased the horse may show that an irregularity observed by the Buyer's vet have not changed and are inconsequential. One of the basic tenets of x-rays is that they help in the interpretation of exam findings but cannot replace the exam. Many variations of so-called problems seen on x-rays are routinely found in the normal horse. If a subtle lameness or suspicious area is detected on exam x-rays may help determine if the problem is significant or not. The sale of many sound horses by ethical sellers have fallen through because of inappropriate use and interpretation of x-rays and additional tests.

The conclusions of the prepurchase have changed through the years. Today many veterinarians follow the recommendation of the American Association of Equine Practitioners (AAEP) and do not "pass" or "fail" a horse. These findings were ripe for misunderstanding and greatly misconstrued the meaning and possibilities of an exam prior to purchase. Veterinarians cannot read the future. The only result a thorough exam can provide is information of the horse at the time of the exam. Competent interpretation of the exam findings can alert the buyer for potential problems. The accuracy of the exam is dependent on the extent of the exam, the experience of the veterinarian, and the type of underlying problem. Any problem subtle or not should be discussed with a best or worst case scenario as an integral part of this discussion.

A mention was made above about attorneys, lawsuits and their effect on prepurchase exams. Every veterinarian realizes the possibility of making an error or missing an existing problem during an exam or its interpretation. Veterinarians are also acutely aware of the potential for a misunderstanding following a purchase exam. These misunderstandings have lead to lawsuits not only from the buyer but from the seller as well! The AAEP regularly sends us reports of how prepurchase exams went wrong. This concern is not taken lightly by any vet and some refuse to conduct exams prior to purchase. Others I am told seem to discourage every sale in the attempt to protect themselves. This is unfortunate because it not only hinders the equine industry but also lessens the benefit of purchase exams. Effective clear communication coupled with a thorough exam are the best remedies to these problems. Most horse owners are reasonable and if given a clear idea of what to expect from an exam are satisfied with their results.

The topic of lameness discovered during purchase exams deserves some discussion. Most veterinarians refrain from advising buyers about the actual purchase of a horse and instead give advice on the exam findings and their interpretation. The only exception often made to this rule is not to buy a lame horse. If a horse is discovered to be lame during a purchase exam one prudent option involves reexamination in the near future. If the problem is a minor bruise or sprain a short rest period will eliminate any confusion. If the lameness is due to a more serious problem a complete lameness exam may be pursued but remember it may result in additional expense to you on someone else's horse. A thorough lameness exam takes a significant amount of time, expense, and often nerve and or joint blocks (requiring seller permission). As many of you know, some of lameness can be simple others complex, while some incurable. Some serious lameness' can be managed with proper shoeing and medication but the best therapeutic options sometimes require lots of fine tuning. The consequences of this, and whether a horse is serviceable or not, is dramatically different if it occurs on a horse you already own versus one you just bought.

In conclusion, although a purchase exam may not give you a direct answer to the question "should I buy this horse?" it can provide you with an educated opinion based on the exam results and experience of the examiner. This opinion will ultimately help you make an informed decision regarding the purchase of a particular horse and help you avoid an expensive unsuitable purchase.