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Pre-purchase examinations (PPEs) are frequently performed to evaluate the health and soundness of horses before being purchased or leased. A veterinarian does the exam, which can range from a simple physical examination to an exam that includes various evaluations and diagnostic tests. The PPE is arranged by the potential horse buyer with the consent of the horse seller and can help identify problems the horse has and help guide the buyer's decision to purchase the horse. The buyer needs to recognize that the exam does not provide a "guarantee" for the horse; it is only an evaluation of that horse on the day of the exam and does not--and cannot--provide a prediction of that horse's future health or soundness. Our upcoming series will dive into what to expect from the various parts of the PPE.

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The scope of a pre-purchase examination should be decided in a conversation with your veterinarian before the exam. Communicating your needs and intentions as a buyer is one of the most important parts of the exam and increases the chances of you getting the information that will help you decide on the purchase. Often, the exam scope depends on the current and/or intended use of the horse being considered for purchase. For example, the exam on a filly or mare intended for use as a broodmare would involve procedures quite different than for a horse intended to be used as a western performance or English sport horse. Once you and your veterinarian have agreed on the specifics of your wants and needs from the PPE, arrangements can be made with the seller to schedule the exam.

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The pre-purchase exam (PPE) often begins with your veterinarian asking questions about the horse's use and medical history. The horse's history provides valuable information that your vet will use to focus the exam and help answer questions about the horse's overall health and soundness. The PPE aims to identify any health problems the horse has on the day of the examination, including problems that the horse was born with (e.g., some heart murmurs) and issues that have developed since birth (e.g., scarring on the cornea on the eye because of an ulcer).

Some things that your vet may cover during the general exam include using an ophthalmoscope to evaluate the horse's eyes, a stethoscope to listen to the heart and lungs, and thoroughly reviewing the horse to feel and look for anything considered abnormal.

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A healthy respiratory tract is essential for a horse's performance and well-being. During a pre-purchase exam (PPE), the upper and lower respiratory tracts are thoroughly checked using the following methods.

Upper Respiratory Tract:

• Scoping - An endoscope examines the nostrils and throat to detect structural issues and breathing problems. The procedure is typically done while the horse is at rest, but newer dynamic endoscopes can be used while the horse exercises.

Lower Respiratory Tract:

• Stethoscope - Your veterinarian will listen to the lungs for normal airflow and abnormal sounds.
• Rebreathing bag - A large plastic bag is placed over the horse's nostrils to make them take deeper breaths, which can be used to detect abnormal sounds like coughing.

Stay tuned for our next post in the series, which will cover what to expect for the cardiovascular portion of the PPE.

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Horses have big hearts in both a literal and a figurative sense. Horses typically don't have heart problems as often as people or dogs, but evaluating the heart during a pre-purchase examination (PPE) is still important. During a PPE, your vet will listen to the horse's heart to determine if the heart is beating at a normal rate with a normal rhythm and to listen for any abnormal sounds like a heart murmur. It's also common to inspect the horse's jugular veins because, in rare instances, repeated intravenous injections can cause problems with clots or infections of these veins. Veterinarians have additional, more elaborate ways to evaluate the heart, including diagnostic ultrasound and electrocardiograms (ECG). Still, just as with the respiratory tract, these tools are not routinely used when doing a PPE.

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There are not as many horses being evaluated for purchase as breeding animals as horses for athletic purposes. The pre-purchase examination (PPE) for breeding is often much more specialized, concentrating on the horse, whether a mare or a stallion, having the normal anatomy and function of the reproductive tract.

Examining mares includes visually inspecting the external portions of the reproductive tract, including the mammary gland, and palpating and/or using ultrasound to view the internal reproductive organs. Samples may be obtained from the uterus to culture for any bacterial infections or to examine the uterus's lining to see if it can maintain a pregnancy.

For stallions, a similar type of examination may be done to evaluate the external reproductive organs, and a semen sample may be taken to assess the number, shape, and motility of the sperm cells. These exams determine the likelihood that the horse, whether a mare or stallion, can produce foals.

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The most common reason for performing a pre-purchase exam (PPE) is to evaluate the horse's soundness. Lameness is the number one cause for loss of use in horses, so this is often the potential buyer's biggest concern and reason for having the horse evaluated.

Here's what you can expect during the lameness portion of the exam:

1. Initial check - The veterinarian will examine the legs for heat, swelling, or pain.
2. Movement - The horse will be observed in straight lines and circles at a walk and trot.
3. Flexion Test- Specific joints are flexed, and after, the horse is jogged for the veterinarian to spot any lameness.
4. Ridden Exam- Many vets like to observe the horse under saddle to spot subtle issues.

If no significant problems are discovered when evaluating the horse's gaits, the next step in the exam is often diagnostic imaging of the horse's legs. The most common imaging includes taking radiographs (X-rays) to evaluate the bones and joints and ultrasound to evaluate the soft tissues (tendons and ligaments). Whether you want to have X-rays and/or ultrasound performed as part of the PPE should be discussed with your veterinarian when you schedule the exam.