Pre-Purchase

VET CHECK

Supplied by Equine Veterinarians Australia (EVA) Dr Barry Smyth BVSc FACVSc DACVS and Jane Barry (EVA, Executive Officer)

Understanding what's involved in a pre-purchase examination or 'vet-check' and the kind of information it can provide makes the whole process a much more satisfying one from a buyer's point of view.

Hoofbeats thanks Murdoch University Veterinary Hospital for making their facility available for photographs for this article.

Hoofbeats and Equine Veterinarians Australia Affiliation

Veterinary care is an important aspect of health management for horse owners and riders, so Hoofbeats is pleased to announce an affiliation with Equine Veterinarians Australia (EVA) that will aim to present articles addressing a range of issues relevant to horses. The EVA is the professional association representing the interests of more than 850 equine veterinarians across Australia and this wealth of experience will be made available to readers in our easy-to-read article format.
The first article prepared under this affiliation addresses the Pre- Purchase Examination, a service to which an increasing number of horse owners are turning.

To many, a pre-purchase examination or ‘vet check’ seems to have an air of mystery and even ‘dread’ surrounding it, with the prospect of a horse ‘failing’ understandably being a worrying one for both the buyer and the seller. Yet, with everyone concerned in the negotiations for the sale of a horse having a clear understanding of what’s involved and the steps that should be taken to ensure the best information possible is obtained, the pre-purchase vet check needn’t be a stressful experience.

While there seems to be plenty of stories floating around the horse world that relate to pre-purchase examinations, as with any situation where more than one party is involved, there is often another side to the story. In some instances, there may have been misunderstandings about the conclusions a vet could realistically be expected to come up with during the timeframe in which most pre-purchase examinations are conducted, and from the range of tests that were requested.

Myths and Misconceptions
A common misconception many potential buyers have about pre-purchase examinations (PPE’s) is that they are a definitive ‘yes or no’ way of finding out whether or not they should buy a particular horse. This is not actually the case, as the assessments carried out by a vet are really just one part of a whole range of factors that need to be thought about and looked at before a final decision can be made regarding purchase. What a PPE should do, however, is provide information about a horse’s health and well-being that can then be considered along with all the other factors the buyer has managed to find out in the process of their contact with the seller and from their own observations. The onus is then on the buyer to make their own informed decision on the sale, not on the vet to recommend one way or the other.

Another important point to note is that a veterinarian shouldn’t be expected to give an opinion on the value of a horse, as this is a completely separate issue to be decided between the buyer and the seller. After considering the information in a pre-purchase examination report and weighing up all the other factors involved, the buyer must then make up their own mind as to whether they are willing to pay the asking price, offer a lower one or not continue with the sale.

When conducting a pre-purchase examination, a veterinarian is, in effect, working on behalf of the buyer - as they are the one who is paying for the assessment to be done. This means that the written report on the findings of the examination should only be provided to the person who has requested and paid for a PPE to take place, and legally, it should not be passed on to or discussed with any other person - including the seller. It is then up to the buyer as to how they choose to use the information.

It is usually considered to be more appropriate if the vet selected to carry out the PPE for a buyer is not the same one who treats the horse in question or others belonging to the seller. This doesn’t mean to say that the seller’s usual vet can’t do the examination on behalf of the buyer, as sometimes this situation can’t be avoided, but any potential conflict of interest must be declared to the purchaser before the PPE takes place.

One aspect of the pre-purchase examination process that can prove to be disappointing for many buyers is the realisation that the report provided by the veterinarian at the end of the testing regime is not actually a warranty on the suitability of a horse for a particular purpose, nor is it any form of prediction about the horse’s future health or performance longevity. Nowhere will it state conclusively that, for example, “yes, this horse will make a perfect Three Day Eventer” or “no, there is no way this horse will stand up to doing high level dressage”. In reality, it is simply a record of the types of testing and observations that took place on a given day and what the results were.

Horses For Courses
The question of whether a vet is able to comment on the suitability of a horse for a particular discipline is a complicated one as, technically, the answer is no. It is ultimately the responsibility of the buyer to gather enough relevant information about the horse’s capabilities, to be aware of the physical and behavioural demands of the equestrian sport or activity in which they plan to use the horse and then to decide if there is a good enough match between the two to justify the purchase going ahead.

It is crucial, however, that the vet carrying out the PPE is aware of what purpose the buyer intends to use the horse for before the examination takes place. That way, he or she can explain the range of testing they feel may suit these circumstances and will yield the most useful information to assist the buyer in their decision-making process. For example, in the case of someone who is seeking a top level eventer or showjumper, the range of testing suggested is likely to be more comprehensive than if the horse is to be used by a novice rider for Pony Club. (See boxed section entitled The Five Stages of PPE’s for an explanation of the different levels of assessments).

Once the examination has been completed and the results written up, it is important both that the vet explains the contents of the report and the significance of their findings to the buyer and that they, in turn, have the opportunity to ask questions. Again, although the vet won’t be able to say “this horse definitely is or isn’t the one for you”, they should be able to explain what the results actually mean and any physical problems that they’ve identified in the context of what the buyer intends to use the horse for. For example, if the PPE has detected a splint and this has been recorded in the written report, a buyer who intends to use the horse for sports involving jumping should be able to discuss with the vet how the splint might impact on this career.

If an abnormality of any kind is identified - and, let’s face it, the likelihood of any horse being ‘perfect’ is slim - the issue for the buyer now becomes whether they are willing to accept that deficit but, more importantly, if it can be managed to a degree that means they can still use the horse for the original purpose they had in mind. Still using the case where a splint has been found as an example, it would be relevant for the buyer to ask questions of the vet to clarify things like if the splint is an old or new one; if splints that occur in the place where this horse has one generally cause any soundness problems; if there are any precautions or management strategies that should be followed to reduce the chance of problems arising from the splint; whether there any conformation issues that might be related to the appearance of this splint or predispose the horse developing others and so on.

Delving Deeper
When the buyer’s concern is more about whether a health or structural problem is likely to ‘stand up’ to a given level or intensity of competition or use, and there has been a worrying physical factor identified, the advice a vet is able to give in this regard is unfortunately quite limited. For example, in relation to our horse with the splint and given that it does have a related conformation fault, the vet who performed the PPE can really only draw from what they’ve observed with other similar cases and from their knowledge of research findings to make a general comment. This might be something like “Many horses I’ve seen with this same type of splint haven’t had problems jumping at a low level but, when they have gone up to a higher level, there have been some that have developed soundness issues” or “there isn’t any evidence that splints of this kind will lead to lameness in the future but, of course, that depends a lot on how the horse is managed”.

Although this lack of a ‘straight answer’ on the part of the vet can be frustrating for the buyer at times, it must be remembered that, in the vast majority of cases, the vet will only have had the opportunity to observe and examine a horse undergoing a PPE for about an hour, so to expect them to ‘crystal ball gaze’ and make predictions about what might happen in the future is a little unrealistic! A vet may suggest, however, if the buyer needs more information to consider before they make a final decision on the purchase, that there are a couple of other options open to them - these being further and more intensive PPE testing and/or arranging a trial period in order to ‘road test’ the horse more thoroughly on the type of activities they wish to pursue.

A vet who has carried out a PPE may also recommend that, given the knowledge the buyer now has of any health problems that exist, it would be a good idea to ask some more specific questions of the seller about issues such as (in the case of the splint, for instance) when the splint appeared, if it has ever caused the horse to be lame, if it came about as the result of an accident, whether it has been treated in any way in the past and so on. The buyer has to rely on the honesty of the seller in discussing these types of issues because it must be kept in mind that a vet - whether this be the one who carried out the PPE and/or the seller’s usual practitioner - can’t disclose this type of information. It might seem a little unfair but, even if the vet doing the PPE knows that the horse has a history of problems with, say, a splint, it’s not their place to make a comment like “I remember treating this splint a few years ago but now it seems fine.” Their responsibility is only to identify the presence of a health issue, leaving it up to the buyer to pursue the horse’s history with the seller if they so choose.

Non-Identification
There will always be situations where the ‘potential buyer’ has a PPE done, decides to go ahead with the purchase of the horse because there were no particular concerns identified from the range of tests carried out then is devastated when, at some time in their ownership, a health problem arises that they feel should have been ‘picked up’ by the vet in question. Or perhaps, despite going to the extra expense and effort of having more extensive investigations carried out such as x-rays and scans, at some time after the purchase has been made, the horse becomes unsound. So what avenues of inquiry or possible recourse are open to horse owners in these circumstances?

Firstly, before rushing off to confront a vet or to make that furious or tearful phone call, there are a number of issues to consider. One point to ponder in the context of the whole scenario is the level of assessment that actually took place in the PPE and, given this, if the vet could reasonably have been expected to be able to detect, at the time, what has now become a problem. A good example of this is the purchaser who says “the vet should have told me that this horse has arthritis” but, realistically, it’s very hard to make a diagnosis of this kind without using additional, expensive procedures that can examine the internal structures - such as an x-ray or ultrasound. Basically, if something can be seen, heard or felt during a routine PPE, it should be noted but, otherwise, it’s a bit like saying that a doctor should be able to tell that someone has cancer just by looking at them and taking a few basic measurements!

Another issue is whether the intended use of the horse was made clear to the vet before the PPE took place and/or if anything has changed in that regard since the purchase. For example, if the PPE was designed and carried out on the understanding that a young child would be using the horse for very low level Pony Club activities then, six months later it ends up being used by an older or more experienced person in the family for a sport such as eventing, it would be very difficult to prove that the vet was remiss in not identifying any unsoundness that might arise from the new circumstances.

What can be explored further, however, is a case where the buyer of a horse feels that a vet may not have taken ‘reasonable care’ in carrying out a PPE examination and in the preparation of their report and, because of this, they have been disadvantaged in some way by going ahead with a sale. An example of this might be if an X-ray taken as part of a PPE clearly shows an abnormality of some kind but this is not noted in the report. On the other hand, legally, a veterinarian can’t be held liable for not identifying certain deficits - the reason being that even with the greatest skill and exhaustive testing, some conditions are extremely difficult to diagnose.

If the buyer is to have any grounds of accusing a vet of not conducting a thorough pre-purchase examination, it really is essential that they were present when the testing took place and therefore have some concrete evidence to back up any claims of areas they feel weren’t fully investigated. For example, if the range of testing agreed on/paid for was equivalent to the whole Stage 1-5 process of a PPE and something obvious is not assessed at all and should have been - like, for example, the eyes - the buyer would have every right to consider making a complaint if, immediately afterwards, it becomes apparent that the horse is actually blind in one eye and has been for some time.

Any concerns about the PPE should be first discussed with the veterinarian who conducted the examination but, if a satisfactory explanation can’t be obtained, and if there is any doubt about the professional conduct of the veterinarian, then the relevant State or Territory Veterinary Surgeons Board (VSB) should be advised. The VSB is restricted by its governing legislation in what it can do to address the concerns of the purchaser but another source of re-dress is the relevant State Consumer Affairs body (in Victoria, for example, this is the Victorian Civil and Administration Tribunal (VCAT) - similar bodies exist in all states). Equine Veterinarians Australia can also refer misconduct by one of its members to an ethics committee of the Australian Veterinary Association Ltd, but this can happen only after all other legal hearings have been completed.

Head vs Heart
It is also a reality, that while perfection is understandably a state many of us strive for, when it comes to horses, most will have physical or health shortcomings of some kind - however slight. There is also a certain element of risk in anything we do and in the choices we make so, at times, it is sad to see some situations where a horse that would have ideally suited a buyer in most ways is passed over because of a deficit that could well have been managed very successfully in the context of what the person intended to use it for.

On the other hand, there’s also times when, if buyers are honest with themselves, perhaps despite some issues of concern being identified during a PPE, the decision to go ahead with a sale is made with the ‘heart’ rather than ‘head’. That’s not to say this is a bad thing, as there are many examples of horses that ‘fail’ a vet check but still prove to be ‘the right one’ in the long term.
Given all the issues surrounding the sale of a horse, the differing roles of the parties involved and the fact that we live in an imperfect world, then perhaps the best way to approach and consider the results of a pre-purchase examination is with a balance between ‘head’ and ‘heart’. Although obviously easier said than done, being able to consider a potential purchase from both points of view may well be the way to make the search for the ‘perfect horse’ a whole lot more rewarding.

The Five Stages of Pre-Purchase Examinations
Veterinarians who are members of Equine Veterinarians Australia (EVA) conduct PPE’s that consist of up to five stages, although the vast majority of testing involves only the first two. The range of testing to be carried out and the cost of this need to be decided by the potential buyer and the vet before the examination takes place. Most PPE’s will take about an hour to complete, although extensive ones (Stages 3-5) might take half a day or longer, depending on the circumstances. As there is such a wide variation in charges across the country it is difficult to provide an estimate of possible charges as this depends on what the purchaser wants, and should be discussed up-front with the veterinarian.

Stage 1: Preliminary Clinical Examination (All horses)
During this stage, a complete description of the horse is taken by the vet, including its reported age, colour, breed, sex, distinctive markings, scars or other obvious injuries. Any brands are recorded, along with a unique microchip number if the horse has one.

Starting at the head, the vet should carry out their initial examination by working back over the body and down the limbs of the left (near) side then follow the same procedure on the right (off) side. The teeth should be examined for abnormalities, the correctness of the bite checked, and the age of the horse estimated. The horse’s resting heart rate needs to be measured and heart sounds listened to. Respiratory health should be assessed. A measurement of rectal temperature should be made and intestinal sounds in the abdomen checked. Both eyes should be examined with a torch and an ophthalmoscope. The vet should inspect all body openings, such as the mouth, ears, nostrils, sheath or vulva and rectum, and record any abnormal discharges.

Each of the feet should be picked up and examined, with all joints in each limb being flexed, extended and rotated to detect any pain or limitation of movement. Hoof testers should be applied around the sole, across the heels and between the frog and heels.

During examination of the legs, the vet should devote quite a lot of attention to feeling (palpating) the flexor tendons (those that run down the back of the legs) and the suspensory ligaments - with any thickening or signs of discomfort recorded. The entire length of the splint bones in all legs should be felt and all joints inspected for abnormal swellings, especially the carpal joints, fetlocks, stifles and hocks. All the limbs should be raised, flexed, extended and rotated.

To complete their examination of the horse while it is standing still, the vet should gently but firmly feel (palpate) along the length of the back from the wither to the rump with an open hand. In doing this, they are assessing muscle tone and looking to see if there is any muscle spasm (tightness), particularly in the lumbar area. Any exaggerated responses a horse may make to the pressure, such as ‘dipping’ or repeatedly flinching away, will be noted.

Stage 2: Examination during walking, trotting, lungeing, turning and backing on hard, level ground (Most horses but may be limitations if unshod, not educated or age-related)
The horse should be walked in a straight line twenty metres away from the veterinarian, turned and walked back then trotted away for thirty or forty metres and trotted back. The vet should then ask the handler to turn the horse one way then the other and to back it for several paces. Finally, a short period of lungeing in a tight circle on firm ground in both directions may reveal lameness that is not evident in a straight line.

Stage 3: Examination during and immediately after strenuous exercise
(Some horses - depends on fitness level and intended use).
The age, condition, education and fitness of the horse should be taken into account during this level of assessment. The horse should be given sufficient exercise to make it breathe rapidly, so any unusual breathing sounds may be heard. The chosen form of exercise should also result in an increase in the heart rate, which can allow any abnormalities to be more easily detected. After exercising and a short period of rest, observations are made to see if any injuries have been revealed by stiffness or lameness being present.

Stage 4: Examination during period after exercise
(Some horses - depends on fitness level and intended use).
The purpose of this stage is for the vet to check on the horse’s rate and degree of recovery after the exercise test done as Stage 3 and to examine for any cardiac or respiratory abnormalities that might have been made more obvious. The horse should be allowed to stand quietly in a stable for at least half an hour after completion of the chosen exercise test, during which time the vet will check its heart beat and observe its breathing. Where any lameness is suspected, it is advisable that a cooling off period of at least one hour is permitted before the final examination with the vet able to make careful observations of the horse’s movements (such as pawing and continual weight shifting) in this time.

Stage 5: Final examination including walking, trotting, lungeing, turning and backing – a repeat of Stage 2 (Some horses - depends on fitness level and intended use).
The horse should be walked and trotted away and back in a straight line, turned to either side, backed and lunged in a tight circle as before to enable the vet to observe its gait and general appearance.

Note: Not all circumstances will allow the level of examination under exercise described in Stages 3-5 so any limitations due to the horse’s age, condition, level of education and fitness should be discussed by the vet with the potential buyer, recorded and included in the report. Also, there may be cases where the potential buyer only wishes to have an examination carried out and an opinion given on a specific area - such as a joint they are concerned about after making their own observations of whether the horse is suited to their needs in all other ways.

Additional Procedures
Depending on findings of the above examinations, further procedures might be requested by the potential buyer or can be recommended by the examining veterinarian. Such additional examinations might include:
- radiography (X-rays) of suspect areas to examine bone or joint problems
- an ultrasound to examine soft tissue areas
- an airway endoscopy to examine airway anatomy and function
- electrocardiography to evaluate electrical activity of the heart muscle
- treadmill exercise tests to help define more precisely the source of abnormal airway noises or gait abnormalities
- drug screens to detect pharmaceuticals and their by-products that might be modifying, for example, the horse’s behaviour or gait.

Supplied by Equine Veterinarians Australia (EVA)
Dr Barry Smyth BVSc FACVSc DACVS, President-elect of EVA, President of the Australian Horse Industry Council and Registered Specialist in Equine Surgery and Jane Barry (EVA, Executive Officer)

About the E.V.A.
Equine Veterinarians Australia (EVA) is the professional body representing veterinarians who have a special interest in horses. Members of this group regularly practice in the area of equine medicine, supplying veterinary services and advice to horses and owners.
For more information Ph (02) 9431 5080, email: administration@eva.org.au or refer to the website www.eva.org.au

Thanks to Murdoch University Veterinary Hospital, Eileen Harmer and Lauren Brown for their help with photographs for this article.