Pre-purchase Exams

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Information about Pre-purchase Exams
Health & Medicine

Published on February 20, 2014

Author: dvmfun



Overview of considerations for a pre-purchase exam in the horse. Audience: equine-orientated equine students

Pre-Purchase Exams for the Horse Dane Tatarniuk, DVM Equine Surgery & Sports Medicine University of Minnesota Equine Center

What? • What is a pre-purchase exam? • House inspection prior to purchase • Mechanic check on a car prior to purchase • Also called ‘soundness exams’, ‘vettings’

Why? • Why perform a pre-purchase exam? • Horses are rarely purchased just to be ‘pets’ • Most often, athletic use or reproductive function desired by buyer • Rarely, deals are ‘money back’ guarantees by seller • Information for buyer to negotiate with seller on the price of the horse • Goal: • Determine if there are any limitations in health or soundness that preclude the horse from performing its anticipated purpose at present time • Gain knowledge of any early disease, previous injuries or preexisting abnormalities that may limit the use of the horse in the future

Why? • The exam does not involve an assessment or guarantee of the trainability or behaviour of the horse • Evaluation for a horse to be ‘serviceable’ for a discipline • No evaluation of a horses ‘suitability’ for a discipline

“The veterinarian’s job is neither to pass or fail an animal.” “Rather, it is to provide the buyer with information regarding any existing medical problems and to discuss those problems with you so that you can make an informed purchase decision.” “Your veterinarian can advise you about the horse’s current physical condition, but he or she cannot predict the future. The decision to buy is the buyers alone to make.” AAEP Client Handout “Don’t Skip the Purchase Exam”

Who? • Parties involved: • Buyer / Buyer’s Agent • Pays for the examination • Determines which veterinarian will perform the exam • Seller / Seller’s Agent • Current owner or agent of the horse involved • Should provide an honest medical history of the horse, including any previous diagnostic imaging exams performed prior • Gives permission for veterinarian to perform examination and procedures on the animal • Can deny certain procedures to be performed • Veterinarian • Needs to provide disclaimer to buyer if there is a conflict of interest • Ie, if veterinarian has previously worked on the horse up for sale or has relationship with the seller • Additional members present • Ie, technicians, vet students • Document as they are witnesses to the examination

Where? • Can be performed in a clinic or on-farm • Provide yourself with a generous amount of time to perform the exam • ie, most exams take at least 1-2 hours to perform • Important to document any environmental influences that could interfere with assessment of horse • ie, uneven surface for trotting, no hard ground, poor lighting, distractions or background noise

Buyer’s Questionnaire • Before the exam • Establish the cost of the pre-purchase exam with the buyer • Questions to consider asking the buyer • How much do you know about the horse? • Have you had the chance to ride/work the horse? • What is your intended use for the horse? • Short term goals (ie, riding) • Long term goals (ie, breeding) • As the veterinarian, you do not need to know / get involved in the asking price of the horse • Whether it is a $500 or $500,000 value, treat the exam the same.

Seller’s Questionnaire • Opportunity for seller to fully disclose history of the horse • Questions: • • • • Level of current work / discipline? How long has seller owned the horse? Vaccines / Deworming / Coggins? Previous medical history? • Ie, respiratory infections, colics, etc. • Previous surgeries? • Ie, colic, arthroscopy, upper airway surgery, etc. • Previous lameness? • Ie, joint injections, supplements, etc. • Previous or current medication? • Stereotypies? • Cribbing, weaving, head tossing, biting, kicking, etc.

Examination • Be thorough • Examine any and every aspect of the horse • This should be the most complete exam you will perform in veterinary medicine • Document everything, even if you are unsure of the clinical significance

Basics of the Exam • • • • Confirm breed of horse Document any tattoos or brands present Document the markings and color of the horse Attain weight • Either weight scale or weight tape • Attain height • Important in some disciplines for entering specific classes • Temperature, heart rate, respiratory rate • Document scars, skin lesions or growths • ie, Grey horse = melanomas • Sarcoids

Oral Exam • Variable depending on practitioner • At a minimum • Check the incisor teeth to ensure the reported age roughly matches the teeth • Open the mouth (unsedated), grab the tongue and evaluate for sharp points of enamel on the molars, wolf teeth, etc. • Further examination • Sedate the horse (with permission, and after lameness evaluation) • Open the mouth with a speculum, and fully evaluate all arcades with dental mirror and probes • Any significant concerns • Recommend dental radiographs

Ophthalmological Exam • At minimum, • Evaluate both eyelids, the third eyelid, sclera, for any abnormal masses or pigmentation • Check direct/indirect pupillary light response • Check menace response • With ophthalmoscope, evaluate the cornea, anterior chamber, iris, pupil, lens • Further examination, • Dilate the eye and examine the optic nerve, retina • Tonometry of the globe

Auditory Exam • Evaluate the inner aspect of the ears for any aural plaques or abnormal skin growths • Produce noise to determine horse can properly hear

Respiratory Exam • At a minimum, • Evaluate both nares for normal airflow, any nare pathology, mucopurulent discharge or odor • Percussion of the sinuses, evaluate facial bones for any asymmetrical swelling • Palpate the larynx, muscular process • ‘Slap test’ for arytenoid abduction • Look for ‘tie-back/tie-forward’ scars • Palpate guttural pouches for swelling, fluid fill • Palpate submandibular lymph nodes for enlargement • Auscultate trachea & all areas of both sides of the lungs • Further examination, • Rebreathing exam with bag • Upper airway endoscopy exam

Cardiovascular Exam • At a minimum, • Fully auscultate the heart, from both sides of the thorax, to evaluate for any valve murmurs • Auscultate heart for normal rhythm, normal rate • ie, atrial fibrillation, 2nd degree AV block • If 2nd degree AV block, exercise horse & see if block disappears • Evaluate peripheral artery for pulse quality • Facial artery on ventral aspect of mandible • Evaluate both jugular veins for normal fill, patency • Further evaluation • ECG • Cardiac ultrasound exam

Abdominal Exam • At a minimum, • • • • • Palpate ventral midline to feel for previous colic surgery scar Auscultate all four quadrants for normal gastrointestinal motility Auscultate ventral abdomen for sand in large colon Palpate flank for previous standing surgery incisional scars Palpate for ventral midline, umbilical, abdominal, inguinal hernias • Further examination, • Rectal examination • Get permission! • Collect feces, add water, and float for sand • Abdominal ultrasound exam • Ie, SI/LI wall thickness, motility • Abdominal radiographs • Ie, enterolith

Urogenital Exam • At a minimum, • Examine external genitalia for any abnormalities • In mares, evaluate perineal/vulvar conformation • Check for Caslick stitch • If a stud, palpate for two descended testicles into scrotum • Further examination, • Sedate studs & geldings to drop penis, evaluate for any masses or growths • Ie, squamous cell carcinoma • Perform vaginal exam via vaginal speculum • Uterine ultrasound, cytology, culture, biopsy • Stallion collection, semen motility & morphology

Laboratory Tests • Not all tests are routinely done, but any test available can be offered to buyer based on the individual horse examined • Most common, • Complete Blood Count • PCV/TP, RBC, WBC, Platelet, Fibrinogen • Chemistry • Muscle, Kidney, Liver, Electrolytes, Protein • Urine Analysis • More specific, • Drug Testing • Submit serum to a drug testing lab for surveillance of common equine drugs • Ie, NSAIDs, sedatives, steroids, etc. • Genetic Testing • HYPP, HERDA, Glycogen Branching Enzyme Deficiency, Cerebellar Abiotrophy, PSSM, etc.

Conformation • Stand the horse square and document any conformational abnormalities • ie, varus/valgus joints, cow hocked, sickle hocked, bench knees, pigeon toes, toed out, etc. • Document with pictures always beneficial • Correlate conformational abnormality to any potential predisposition injury (due to abnormal loading) • Evaluate foot conformation in all four feet • Shod, unshod? • Toe length, heel length, club foot, hoof wall defects, etc. • Apply hoof testers to all four feet

Musculoskeletal - Passive • Systematic palpation of the neck, back and pelvis • For the neck, use treats to evaluate the range of motion in all directions • For the back, palpate the musculature and dorsal spinous processes for reaction • For the pelvis, evaluate the tuber coxae, ischii, sacrum for symmetry • Systematic palpation of the four limbs • Proximal (top) to distal (bottom) • Palpate each joint for effusion • Palpate each tendon/ligament for thickening, swelling, pain to palpation • Palpate each joint for normal range of motion

Musculoskeletal - Active • Walk, trot, canter horse • In straight line and on lunge line (if possible) • On soft surface and hard surface • If abnormal gait is noted, first step is to evaluate whether horse appears lame or neurological • If appearing neurological (ataxic), perform basic neurological examination • If confirmed, likely a deal-breaker • Identify the limbs of lameness, and assign appropriate grades of lameness • AAEP scale, grade 1 – 5 • Perform flexion tests • Distal limb, carpus, stifle, upper hindlimb

Radiographs • Based on passive and active musculoskeletal exam, assign areas of concern & therefore recommended radiographs • Based on budget, some buyers decline radiographs • Other buyers elect to radiograph every joint • Depending on the breed/age, certain joints are commonly recommended to radiograph for surveillance • Thoroughbreds • Fetlocks, Carpus • Young horses • Hocks, Stifles (OCD) • Quarter Horses • Hocks, Navicular bones

Ancillary Exams • Drug Testing • Upper Airway Endoscopy • Evaluate standing or dynamic endoscopy to look for performance limiting upper-airway abnormalities • Gastroscope • Reproductive Exam • Uterine ultrasound, cytology, culture, biopsy • Stallion collection, semen motility & morphology • Cardiology • Cardiac ultrasound, consult DACVIM specialist • Ophthalmology • Any concerns, consult DACVO specialist

Putting it all together… • Go over the findings with the buyer • Best to talk about the findings without the seller present • You do not need to disclose your findings to the seller, unless your buyer provides permission • Remember, you work for the buyer! • Remember, If there is a litigation suit that results later on, the pre-purchase report is your defense • Complete, thorough, detailed, etc.

Putting it all together… • Report: • Make the report organized • State the location, time, all in attendance of the exam • Digital advantage • Take pictures of any external abnormalities • Attach radiographs / endoscopy exam / ultrasound exam pictures • Can even consider video of the movement exam, attached to report • Include every aspect of the exam that you performed (list what is normal, in addition to abnormalities) • State the ancillary exams that were offered but declined by buyer • State that the findings were discussed with the potential buyer • Include a disclaimer statement


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