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The pre-purchase examination

Continuing his "ask the experts" series, Kieran asks two equine vets about the ins and outs, and potential pitfalls, of the pre-purchase exam

16 April 2018, at 4:55pm

Although the pre-purchase veterinary examination (PPE) of a horse follows a well-established protocol, issues can arise which rely very much on the experience and approach of the examining clinician. Here we ask Mark Lucey and Rod Fisher to give their opinions on common situations that can occur at vettings.

Mark Lucey recently retired as a partner in Bourton Vale Equine Clinic, Gloucestershire. He has officiated at Olympic Games as an eventing Team Vet, and was Team Vet for the British Young Riders eventing team for 15 years.
Mark Lucey recently retired as a partner in Bourton Vale Equine Clinic, Gloucestershire. He has officiated at Olympic Games as an eventing Team Vet, and was Team Vet for the British Young Riders eventing team for 15 years.
Rod Fisher recently retired as a director of Abbey Equine Vets in Abergavenny, but remains a consultant. He was Team Vet for the British Endurance Team from 1989 to 2001 and has been Team Vet to the British Para-Equestrian Dressage Team since 2002.
Rod Fisher recently retired as a director of Abbey Equine Vets in Abergavenny, but remains a consultant. He was Team Vet for the British Endurance Team from 1989 to 2001 and has been Team Vet to the British Para-Equestrian Dressage Team since 2002.

What information, if any, do you send to the purchaser in advance of the vetting?

ML It depends on the experience of the purchaser. If there is any doubt, the receptionist explains the procedure, and we have a PPE protocol description available to email. If there are still any queries, the PPE vet speaks to the purchaser to explain the procedure.

RF The five-stage vetting procedure is generally described in a telephone call when the PPE is arranged. Where a two-stage PPE is required, a standard form is sent to the prospective purchaser outlining what is involved and the limitations of that examination. A copy must be signed by the potential purchaser recognising these limitations before the examination can go ahead.

Do you routinely ask the purchase price of the horse? Does the PPE fee vary depending on the price, and what formula do you use for this?

ML I did vary the fee depending on the purchase price, banded according to the price (up to £10k, £10k to-£50k, over £50K). The charge was roughly 25% more as the price went up a band.

RF I do not routinely ask the purchase price of the horse. The question being answered is, “Is the horse suitable for the purpose for which it is intended?” It should be a standard examination for a standard fee; the purchase price is irrelevant. Sometimes I will enquire after the examination, but this is merely for my own interest and to keep abreast of current market prices.

How common are microchip irregularities at PPEs? What irregularities do you see?

ML They are rare. I only remember one, where the chip and passport differed. The wrong passport had accompanied the horse from Holland. I occasionally get two or even three chips in one horse. Only very rarely does a chip not scan if you are using a good reader and are patient. Remember that French vets usually chip horses just behind the poll.

RF Microchip irregularities occur from time to time. Sometimes they involve an incorrect digit when compared with the passport. These are clearly clerical errors and in these cases, an accurately completed written description and diagram in the passport is very helpful. Occasionally, more than one microchip is found. The microchip is extremely valuable in establishing the correct identity of the horse, especially where the horse has been through a dealer’s yard.

Do you consider lungeing on a firm surface to be an essential part of the two-stage PPE, if the horse is used to being lunged?

ML Yes.

RF Lungeing on a firm surface is probably the most valuable part of any PPE.

A prospective purchaser of a 10-year-old showjumper requests a two-stage PPE. Do you or your office staff usually try to persuade the purchaser to ‘upgrade’ to a five-stage vetting?

ML No.

RF My staff would try to persuade the prospective purchaser to have a five-stage examination on the grounds that:

1. To fully evaluate the cardiac and respiratory systems (particularly the upper airway), the horse will be required to undergo strenuous exercise;

2. A full orthopaedic examination involves seeing the horse at faster paces (preferably ridden). Some orthopaedic conditions do not become apparent until the horse has been worked hard and then rested for a short period, allowing them to ‘stiffen up’.

You are asked to vet a fit eventer. Only a sand school is available for stage three of the examination. Would you accept that? What is your actual procedure for stage three in this circumstance?

ML Yes. Nearly all my PPEs were done in all-weather ménages. I make sure the horse is worked sufficiently on both reins to make it ‘blow’ sufficiently to hear any abnormal respiratory noises. Ménages are good because the horse is always fairly close to the examiner and it is easier to hear abnormalities. You may have to be patient if the horse is very fit, but all horses can be worked hard enough in a ménage.

RF Provided the sand school is large enough to allow the horse to be galloped, this is acceptable. The horse needs to be worked until it is blowing hard (which in a fit eventer may take some time) and sweating. The procedure is to allow the horse to warm up adequately so that it is observed at walk and trot, then cantered until it shows signs of becoming tired. Finally, a short period of gallop is incorporated close to the observer and preferably upwind when passing, before the horse is warmed down.

At stages two and five, a hindlimb flexion test in a six-year-old show horse produced a positive result in one hindlimb only. The purchaser asks you to x-ray the limb to check ‘it’s nothing serious’. What is your response?

ML I am never keen to radiograph a horse that has failed a PPE for any reason. The dilemma is when radiographs show no obvious abnormalities. The horse is still clinically wrong and is best left alone. Also, what area do you radiograph, assuming the lameness is coming from a bonerelated lesion and you cannot do a proper work-up?

RF Radiographs will not demonstrate all serious conditions causing lameness and a lack of visible changes on radiographs can lead the potential purchaser into a false sense of security. My advice is that the purchaser’s original tenet is incorrect. If they wish to continue with the potential purchase then the cause of the positive response should be fully evaluated; radiographs will not be sufficient for this.

The purchaser of an unbroken three-year-old requests a five-stage examination. The vendor states it has never been lunged, but the seller is happy to ‘chase it around the school’. How would you proceed?

ML I would have it ‘chased round the school’ and if I can assess cardiovascular function, that is satisfactory, but I would state on the PPE report form that the horse was loose-schooled. If I cannot assess cardiovascular function satisfactorily, I stop the exam and explain to the purchaser that stages three, four and five could not be done satisfactorily.

RF If the horse is ‘chased around the school’, this may provide evidence of a problem, but it must be made clear on the report that this has been done and that the procedure is not an adequate substitute for lungeing. Alternatively, carry out only a two-stage examination.

At stage two of the examination of an eight-year-old hunter, you notice that it is intermittently lame on one forelimb when lunged on a firm surface. The horse was sound in a straight line and the flexion test responses were normal. How would you proceed?

ML I ensure there is no obvious simple cause for lameness, e.g. a low-grade corn. If a cause is found, I could re-examine in a few days when hopefully it has resolved. If no cause is found, I then would ideally speak to the purchaser to discuss. I would not continue the exam beyond stage two unless the purchaser wishes.

RF I would terminate the examination and advise against purchase.

Roughly in what percentage of cases where the PPE blood sample is analysed is evidence of illicit medication found?

ML I only ever had one positive and that was phenylbutazone. I probably requested 100 analyses in my career, so that’s 1% positive. I always ask if the horse has had any recent medication before the PPE and one seller admitted phenylbutazone administration four days before. The horse in question was subjected to a completely new PPE and a blood sample medication analysis seven days later at the seller’s cost.

RF In my experience, evidence of illicit medication is extremely rare. However, sometimes unexpected findings may occur. Omeprazole is an example of a drug being used but not being declared – accidentally or deliberately.

In the event of a serologically-positive blood test for strangles at the PPE, do you attempt to persuade the purchaser to commission a guttural pouch lavage to confirm freedom from infection?

ML I almost never took a strangles blood test. The test brings up too many false positives or inconclusives and then everyone gets in a panic. However, a guttural pouch lavage should clear up any doubt and I would recommend it. Anecdotally, I hear the test is done more often nowadays.

RF I do attempt to persuade the purchaser to have a guttural pouch lavage. However, less than half of potential purchasers agree to this. The majority withdraw completely from the sale.

You are booked to vet a 12-year-old top-class dressage pony. On the day of the vetting you are notified that the child rider is ill and you are asked if the exercise phase could be done by lungeing. What is your response?

ML I really like to see a dressage horse or pony ridden if possible. I would immediately speak to the purchaser and see what they want, and point out the limitations of assessing a dressage animal without seeing it in ridden work. If the purchaser agreed to lungeing only, I would write that on the certificate. It is better to delay until a rider can be found.

RF Although it is preferable that the strenuous exercise be carried out with the pony ridden, lungeing is an acceptable alternative. This must be made clear on the report issued following the examination.

A prospective purchaser asks you if you would vaccinate the horse ‘if it passes’. What is your response?

ML I would give a full verbal report before any vaccination to ensure they are going to proceed with the purchase. After all, it is not their horse until they have completed the purchase after my examination, so what happens if the horse blows a vaccine reaction?

RF A pre-purchase examination is an assessment of risk in purchasing the horse, not a pass/fail scenario. There will almost certainly be issues resulting from the examination which need to be discussed with the purchaser. If there are no issues, there is no reason why the horse may not be vaccinated subject to the agreement of the seller.

The opinion section of the PPE certificate requires a clear declaration that the condition(s) observed do or do not prejudice the horse’s suitability for a defined purpose. This statement allows no qualification. Do you find this a handicap?

ML I add the phrase ‘subject to my proviso/cautions detailed below’ and then add all the worry points. I think the wording is far too restrictive for some horses and really you are there to point out the defects or worries to enable the purchaser to make up their own mind. I also put the words ‘if the purchaser is proposing to obtain insurance cover, I advise that satisfactory cover be obtained before agreeing purchase terms’. I always found the more you write, the better you can explain injuries and abnormalities which may or may not affect the future use, and it gets you out of trouble if something untoward happens after your PPE.

RF I do find this declaration a handicap and sometimes write a caveat that while the condition(s) do not currently prejudice the horse’s suitability, this may not be the case in the future, as discussed in the section on relevant clinical findings.

Kieran O’Brien, MA, MVB, PhD, MRCVS, worked as a clinician and lecturer at the University of Bristol before moving to Penbode Equine Vets in Devon 20 years ago. He is a columnist for Horse and Hound magazine and author of the book Essential Horse Health.

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