Chapter 114Prepurchase Examination of the Performance Horse
The purchase or prepurchase examination is a much discussed and sometimes feared subject for equine practitioners. Careless conduct and poor documentation can leave veterinarians wishing they had not agreed to perform the examination, whereas forethought and good planning can lead to a rewarding experience for the practitioner and the client. In the United States the examination is referred to as the purchase examination, because in many cases the deal already has been completed, whereas in Europe the examination usually is referred to as the prepurchase examination, because generally the purchaser has agreed to buy the horse subject to a satisfactory veterinary examination. In some countries (e.g., Holland), where many horses are sold through professional dealers, a horse may be purchased by the dealer and then examined by a veterinarian on behalf of the dealer before resale within a few days. In Europe young competition horses may be sold at auction and are subjected to a prepurchase examination before the sale. The terms of sale usually permit a purchaser to have an additional independent examination performed within a predetermined time after the sale.
When requested to evaluate a horse for purchase, the veterinarian should keep several goals in mind. First, the examination should be an objective assessment of the horse’s physical condition. Second, the examination should be a fact-finding mission to aid the purchaser in his or her decision to make a purchase. This may involve the veterinarian in making some predictions based on experience and probability, but care must be taken to be factual and objective. Last, the examination can serve as a formal introduction to a horse for which the practitioner may provide long-term care. Such relationships may affect the veterinarian’s decision-making process relative to a client’s needs.
It is helpful to have knowledge of the disciplines for which the horse has been and is to be used. Various equine sports place differing demands on the horse, and the clinician should be aware of sometimes subtle, yet important, differences. Some physical characteristics or conditions may be acceptable for certain levels of performance but not acceptable for others. For example, a previous strain of a superficial digital flexor tendon (SDFT) may be an acceptable risk for a show hunter but may carry a high risk for an event horse. Veterinarians should avoid performing prepurchase examinations on horses that will be involved in disciplines with which they are not familiar.
The veterinarian needs to discuss the goals of the examination and horse ownership with the prospective purchaser. Understanding the client, the trainer, and what is expected of the horse will help the veterinarian in assessing the horse’s potential suitability. Passing or failing the horse is not the veterinarian’s job, but it is his or her role to advise on how existing conditions may affect the future use of the horse. It is therefore self-evident that prepurchase examinations should not be performed by recent graduates, who may be fully competent in performing clinical examinations but generally do not have the experience of how to interpret the findings of the examinations and are not in a position to evaluate risk. The prospective purchaser requires advice about the risks of proceeding with the purchase. Prior knowledge of clients, their expectations of the horse, and their attitude toward risk make offering such advice easier, compared with clients about whom clinicians know little.
A veterinarian must be open-minded and should consider himself or herself to be a facilitator for the sales contract: the vendor wishes to sell the horse, the purchaser may have searched for a long time to find a suitable horse, and the veterinarian’s role is to enable the transaction to take place if such is reasonable. Nonetheless, the veterinarian must be streetwise and recognize that a minority of unscrupulous vendors may try to misrepresent a horse. Caveat emptor. Veterinarians also should be aware that prospective purchasers often are keen to buy horses and in their enthusiasm may wish to overlook any problems that are identified during the examination. A veterinarian who believes that the risks of buying a horse are too high is responsible for trying to dissuade the purchaser from proceeding further. If the purchaser ignores the advice, it is essential that the veterinarian documents adequately his or her observations and advice. Purchasers can have remarkably selective memories when things start to go wrong.
The scope of the examination can range from a comprehensive clinical examination of the horse, using basic powers of observation, to a complex investigation using advanced techniques such as radiography, ultrasonography, endoscopy, thermography, scintigraphy, and magnetic resonance imaging (MRI). The wishes of the buyer are important in determining the extent and depth of the examination, which also must be dictated to some extent by the value of the horse and its future athletic expectations. Some consideration to cost should be given, but not at the cost of the quality of the examination. The veterinarian should allow some latitude for deciding what is needed to answer questions posed by the clinical examination.
A veterinarian enters a business arrangement with a purchaser when he or she agrees to perform a prepurchase examination. It is imperative for the veterinarian to understand the buyer’s intentions for the horse and the expectations of the proposed examination. The terms, details, and costs of the examination should be discussed at the time of the initial request. The extent and depth of the examination and its limitations should be emphasized. This is straightforward when the veterinarian is dealing directly with the purchaser, assuming that the purchaser has knowledge of horses. The terms of agreement become more difficult when a veterinarian is speaking to an agent for the potential owner or to the prospective rider of the horse, when the actual purchaser has no knowledge of horses. Such persons may have expectations of the horse as if it were a mechanical object like a car.
If the horse is to be purchased for resale, this should be noted. The purchaser should be warned that the clinician’s interpretation of the findings may not be identical to that of another veterinary surgeon. The examining veterinarian may regard the horse as a reasonable risk for purchase, but this is not a guarantee that others have the same opinion. All observations should be well documented so that comparisons can be made should questions arise at a subsequent resale examination. Such notes may well help save a sale in the future and save face for the initial veterinarian.
It is important to establish if the horse will be insured for loss of use for a specific athletic activity or for veterinary fees. The purchaser should be advised that the examining veterinarian may consider the horse a reasonable risk for purchase but that does not necessarily equate with the horse being a normal insurance risk. The veterinarian may consider that a small, well-rounded osseous opacity on the dorsal aspect of the distal interphalangeal joint is unlikely to be of clinical significance, but for an insurance company to place an exclusion on problems related to the joint would not be unreasonable. The veterinarian should advise the purchaser that if such problems arise, the purchaser should communicate with the insurance company before completing the purchase transaction.
The client should be informed clearly that the results presented are good for the day of examination, but predictions about future soundness and suitability are impossible. The limitations of analysis of blood for drugs must be detailed, bearing in mind the difficulties of detection of many drugs administered by the intraarticular route. The client should be warned that several days may elapse before the results of blood tests are known and that the purchase transaction should not be completed until the results are known. The veterinarian should discuss with the client how the findings will be transmitted and what kind of report will be issued.
Any potential conflicts of interest for the veterinarian must be disclosed to the buyer. Previous dealings with the vendor, although the vendor may not be a current client, could be perceived as a conflict of interest. In the horse world today, not to have such conflicts arise is difficult, but such conflicts should be acknowledged, and the buyer should be given the option of having someone else perform the examination.
The vendor must understand clearly what facilities are required for the examination and should be advised that the horse should be stabled before the examination and not worked earlier in the day. If the vendor is unable to be present at the examination, the veterinarian should establish the answers to a number of important questions in advance:
Fig. 114-1 British Equine Veterinary Association prepurchase examination worksheet. D, Dorsal; Di, distal; L, lateral; LF, left forelimb; LH, left hindlimb; M, medial; O, oblique; P, proximal; Pa, palmar; Pl, plantar; RF, right forelimb; RH, right hindlimb; URT, upper respiratory tract.
(Courtesy British Equine Veterinary Association.)
When the examination actually is performed, ideally all involved parties or their agents should be present. This provides an environment in which the veterinarian can ask pertinent questions of the buyer and seller regarding the horse’s history and future use and can assure the buyer that a complete examination has been performed. Problems that arise during the examination can be discussed with the purchaser.
The veterinarian should not compromise the standard of the examination because of physical conditions. If modifying the procedure of the usual examination technique is necessary, such should be noted in the subsequent report, and the purchaser should be advised accordingly. The limitations of the conclusions drawn from the examination should be documented. If an uncooperative vendor or agent makes conducting the usual examination difficult, the veterinarian may choose not to continue the examination to protect the interests of the buyer and personal interests.
A client may request the veterinarian to examine a valuable competition horse that is a long distance away or possibly in a foreign country. A number of alternative strategies can be applied. It may be prudent to first have the horse undergo radiographic examination and proceed with visiting the horse only if these radiographs are considered acceptable. The veterinarian is of course relying on the honesty of everyone concerned that the radiographic images provided are current images of the horse in question. It is critical that the veterinarian provide clear guidelines of the views required and be prepared not to compromise on quality. Alternatively, the veterinarian can travel and examine the horse and be present for the radiographic assessment. However, this may mean that the clinical examination is compromised by inadequate riding facilities at a veterinary clinic or that substantial time is spent traveling between the site where the horse is examined and the veterinary clinic where ancillary tests are performed. However, clinic facilities may be required anyway for additional examinations such as ultrasonography or endoscopy.
A client may inform the veterinarian of an intended purchase of a horse from a foreign country and that it has been recommended that he or she employ a specific clinician from that country to carry out the prepurchase examination. The client should be warned that the method of carrying out and reporting the examination may differ from what he or she is used to seeing and may have limitations of which he or she is unaware. For example, in some countries in Europe the examination is much more limited and does not encompass assessment of conformation. It is not usual practice to examine the horse being ridden. It is worthwhile developing a group of professional colleagues whose clinical expertise and trustworthiness the veterinarian respects, one of whom can be recommended to the purchaser. The veterinary surgeon performing the examination should be requested to communicate with the client’s own veterinarian and to send radiographs for assessment. Discussion between two colleagues—one who has examined the horse and the other who knows the client—can result in a highly satisfactory outcome.
Various national bodies have established guidelines for the way in which a prepurchase examination should be carried out and reported, to which the veterinarian obviously should adhere. The legal responsibilities for the veterinary surgeon and the vendor may vary in different countries. For example, in Holland the expectations of the veterinary examination performed on behalf of an amateur purchaser are higher than for a professional purchaser. In Denmark, if clinically significant radiological abnormalities that obviously predate the purchase are discovered soon after purchase, the vendor is liable.
The clinical examination should evaluate all organ systems as comprehensively as possible. The examination should be methodical and repeatable. Using a checklist may help. The principal aims of this chapter are to focus on the examination of the musculoskeletal and neurological systems1,2 and to discuss the interpretation of abnormal findings.
The veterinarian should identify the horse, including name, breed, sex, age, markings, tattoos, freeze marks, brands, and height. In Europe a freeze brand L signifies that the horse has previously been a loss of use insurance case. The horse’s identity should be compared with its passport or vaccination certificate.
The horse first should be examined in the stable, with assessment of demeanor, attitude, stance, and conformation and thorough observation and palpation of the head, neck, back, and limbs as described in Chapters 4 to 6. Collection of blood samples may be performed at this stage or when the examination is completed and the veterinarian deems that purchase will probably be recommended. More comprehensive evaluation of the feet, overall conformation, and evaluation of muscle symmetry is best performed outside, where the horse can be viewed better from all angles.
If the horse will be used for show purposes, in which the cosmetic appearance of the horse is important, the veterinarian should draw the purchaser’s attention to all possible abnormalities, such as a prominent base (head) of the fourth metatarsal bone that a lay judge may misconstrue as a curb. If the purchaser has expressed reservations about a swelling such as a splint, the veterinarian should be sure to document its size and possible importance. If the purchaser is concerned about the horse’s hock conformation, recommending radiographic examination of the hocks is worthwhile, even if the veterinarian considers the conformation to be acceptable and the horse appears sound.