You have found a horse that suits your needs and you’re interested in moving forward with the purchase.
You dream of galloping across the cross country field, completing a 4th level dressage test, cruising around a 3ft hunter course, or riding at home for pleasure.
Whatever your goals, buying a horse is a large investment and it’s important to make sure this potential new partner can stand up to your needs.
To ensure you are making an educated decision, you should contact a veterinarian and book a pre-purchase examination (PPE). Pre-purchase exams shed light on current or potential health and soundness issues. 
The goal of a PPE is not to tell you whether you should buy this horse or not. Instead, the pre-purchase exam aims to provide you with as much information as possible so that you are aware of the needs of any prospective horses.
If you are considering moving forward with a PPE, you have likely met the horse and ridden them at least once. You’ve decided their temperament, current level of training, and rideability are desirable.
Before you book a pre-purchase examination, it is a good idea to ask yourself the following;
- What do I want to use the horse for?
- How long would I like the horse to perform at this level?
- What issues am I willing to live with?
- What are my absolute deal-breakers?
- What is my budget for the PPE?
- What – if any – additional diagnostics am I willing to pay for?
Responsibilities of Buyers and Sellers
As the buyer, you have several key roles to play in a pre-purchase exam, starting with the decision to move forward with a PPE and determining what exam components you would like included.
Most veterinarians will offer a standard PPE with optional add-ons to provide further diagnostics. It is your choice whether to include those add-ons. 
The seller also has a very important role during the PPE process. The seller must work with you to book a time and place for the exam, and most sellers will handle the horse for the exam.
In good faith, the seller is should disclose any current or past issues to the vet.
Selecting a Veterinarian
The next step is to find a qualified veterinarian and book an exam. Depending on location and availability, your current veterinarian may be able to travel to the seller’s facility to conduct the PPE.
If you do not have a current veterinarian or your vet is too far away to travel to the seller’s facility, you will need to find a vet to complete the exam.
Use a vet that does not provide routine care for the seller to protect yourself from possible bias.  Your current vet may have suggestions for reputable clinics in the seller’s area. You can also call around and talk to vets in the area or ask for recommendations from other horse owners.
When choosing a vet for the PPE, consider these key questions:
- Will the new vet talk to your current vet about the PPE findings?
- Does this vet have experience with the type of horse and discipline you would like to use this horse for?
- Does the vet have access to a portable digital x-ray machine?
- What does this vet usually include in their PPEs and what is their cost?
- What is the cost of any additional diagnostics?
Conducting a PPE
Once you have found an experienced veterinarian whom you trust, discuss with them what you plan to use this horse for and what your disqualifying considerations are.
For example, a disqualifying trait for a potential Grand Prix jumper may not be a deal-breaker for a low-level hunter.
A dialogue with your veterinarian about your intended use of the horse will allow them to provide appropriate guidance on what to accept versus what not to. You can also discuss potential issues with your coach or trainer to get their feedback on disqualifying issues.
If the seller is highly experienced in conducting a PPE and is comfortable handling the horse, you may not be required to attend the exam. However, if the seller is inexperienced or uncomfortable handling a horse for a PPE they may require you to be there.
There are several benefits to attending the PPE, such as getting more time to interact with your prospective horse and observing their temperament while under veterinary examination. If you are present for the exam, you can also stop the exam at any time, potentially saving you money for unnecessary diagnostic tests.
Standard Pre-Purchase Exam Checklist
Most veterinarians will recommend a standard PPE for pleasure and mid-level competition horses. A standard exam will investigate most aspects of lameness that could indicate the horse is not well-suited for the intended use.
If the veterinarian finds an issue considered a deal-breaker at any time, the seller can terminate the exam.
The exact components of the examination may differ depending on the vet, but all PPE should include the following:
- Medical and performance history
- Written identification
- Physical Exam
- Movement evaluation
- Flexion tests
- Diagnostic imaging
1. Medical and Performance History
The first stage of any PPE is discussing the horse’s medical and performance history with your goals in mind. Your vet will ask the following questions to discern any red flags that may affect the horse’s future performance or health: 
- Has the horse had any major medical issues requiring intervention?
- Has the horse had any lameness concerns, either past or present?
- What medications and supplements are the horse on and why?
- What is the horse’s current feed program?
- What is the horse’s current deworming and vaccination schedule?
- Does the horse have any stereotypic behaviours, such as cribbing or weaving?
Your vet may also contact the horse’s current vet to obtain past medical records. There is sometimes an additional fee for obtaining these records, but it is well worth it to have a complete medical history.
Some horse owners may not entertain a horse with a suspensory ligament strain in their past or a horse that is prescribed a full dosage of omeprazole every day. Other owners may be fine with those issues.
Regardless of the owner’s individual preferences, it is the veterinarian’s responsibility to thoroughly examine the horse and make this information available.
2. Written Identification
The next component of a PPE is a written identification to describe the horse’s physical appearance.
The purpose of this identification is to ensure the horse being examined is the horse that is ultimately purchased. Accidents can happen and the best way to avoid a dispute is to have written and documented proof of the horse’s appearance.
Your veterinarian will carry a form with empty diagrams of a horse and areas to write notes on physical appearance. Your vet will take detailed notes about the horse’s appearance, including:
- White markings on the face or legs
- Scars or other markings
- Joint effusions
- Approximate height
3. Physical Exam
Your veterinarian will also complete a thorough physical exam of the horse taking notes on the following: 
- The overall impression of the horse, including any conformation faults
- The current condition of the horse, including a Henneke Body condition score on a scale of 1-9, the attitude of the horse, and the current coat condition
- The current vitals of the horse (respiratory rate, heart rate, appearance of gums, temperature)
- The sounds of the heart, lungs, and gut, paying special attention to the presence of heart murmurs, heartbeat consistency (noting any skipped beats or arrhythmias), and any abnormal sounds in the lungs (i.e. rattling or wheezing)
- Any palpable swelling or blemishes on the legs
- Any painful response on palpation of the back
- Any dental abnormalities and age as apparent by the teeth
- Whether the horse has evidence of prior foaling (if a mare) or whether the horse has been gelded (if a stallion or gelding)
- How the horse is weight-bearing and whether the horse has abnormal weight shifting while standing still
- Any positive neurological signs on a brief neurological evaluation
The initial physical exam can bring to light any significant concerns, such as high-grade heart murmurs. This exam can also indicate any blemishes that may need further investigation with diagnostic imaging. 
4. Movement Evaluation
Next, your veterinarian will want to perform a movement evaluation by watching the horse walk and jog in hand on firm ground, both away from and towards them.
This will allow the veterinarian to observe:
- Asymmetry in the movement of the back or pelvis
- Movement deviations of the limbs, such as paddling or plating
- How the horse’s feet land on the ground
- Obvious lameness or pain
Your vet will also want to see the horse lunge on firm ground in a large circle in both directions. The vet will ask to see the horse move at a walk, trot, and canter. This will highlight: 
- Fluidity in transitions (or lack thereof)
- Gait at fast trot and canter that cannot be seen in hand
- Any shortness of stride
- Any lameness that is more apparent on a circle
- Any respiratory issues that become apparent at higher rates of speed
Lunging on a circle also allows the vet to compare vitals before and after exercise.
5. Flexion Tests
If the veterinarian and buyer would like to continue with the pre-purchase exam, the vet will then perform flexion tests to simulate stress on targeted joints.
Flexion tests involve holding the limb in a flexed position (determined by the joint being examined) for 30 seconds to 2 minutes. This is intended to put the joint under equivalent stress compared to that which is experienced in a performance setting. 
After holding the limb, the horse is immediately trotted in hand away from the vet. The vet looks for any lameness that may be apparent and any movement changes that require further investigation. 
While horse owners often put a lot of weight on the results of flexion tests, these exams are quite subjective. What one vet may consider a positive result could be regarded as negative by another.
Flexion tests are not meant to provide definitive answers as to whether a horse can hold up to performance. These tests provide guidance for further diagnostic imaging and give the buyer additional information about the horse’s joints. 
6. Diagnostic Imaging
Many veterinarias consider x-rays a crucial part of any PPE, but they are always optional. Diagnostic imaging can help your veterinarian detect evidence of bone changes such as arthritis, bone spurs, and laminitis.
Most vets recommend obtaining the following images: 
- The front feet
- The front and hind fetlocks
- The stifles
- The hocks
To get a full picture of the joint, multiple x-rays at different angles must be taken. Each image costs an additional fee. Your vet should help you decide which images are most critical and should suggest obtaining those first.
Diagnostic imaging suggestions will often be made relative to the purchase price of the horse. For example, a horse with a purchase price of $1,500 would not warrant $1,500 of x-rays, but a horse with a purchase price of $60,000 most likely would.
The buyer has the ultimate decision regarding how many images they would like to pay for.
Joint x-rays can provide meaningful insight into the future soundness of the horse. Many joint issues are apparent upon imaging and can make it easier to disqualify a horse that is not well-suited for your intended use.
Pre-Purchase Exam Add-Ons
Depending on the price of the horse and findings of the standard PPE, your veterinarian may suggest further testing such as additional x-rays, a blood panel, ultrasounds, endoscopy, or a ridden examination.
Potential buyers may want to obtain additional x-rays outside of what is included in the standard exam. Your veterinarian may also suggest additional images based on findings of the previous exams.
Standard PPEs do not include x-rays of the back, making it difficult to identify a horse with kissing spine. Prospective owners that have previously purchased a horse affected by this issue may decide to pay for full-back x-rays.
Back x-rays may also be recommended by your vet depending on the horse’s posture, behaviour while working, and response to back palpation.
Your vet may suggest additional images of the joints based on the standard joint images obtained. It is not possible to view the entire joint from one angle, so if a veterinarian sees something of concern they may suggest additional views.
Your vet may also suggest additional views based on palpitating the joints during the physical exam and observations during the flexion test.
You are never required to obtain additional images. The vet can only suggest additional imaging based on the previous testing you have consented to.
A comprehensive blood panel can give you an overall impression of the horse’s health, liver and kidney function, as well as any metabolic issues. A full blood panel is not a common component of a PPE, but your veterinarian may suggest this if the overall impression and condition of the horse are poor. 
The most requested blood test during a PPE is a Coggins test, which is required to travel between countries and many equestrian facilities. A Coggins test detects if the horse is a carrier of Equine Infectious Anemia, a potentially deadly viral disease. 
If you are purchasing a high-end performance horse, you may want the vet to run a drug panel. Although rare, some sellers have been found to sedate the horse and administer pain-relieving drugs before the pre-purchase exam to hide potential lameness. 
If your vet finds something of concern on previous examinations or in the history of the horse, they may suggest performing an ultrasound to detect soft-tissue damage.
Ultrasound is recommended for horses with severe swelling in the lower limbs or a past soft-tissue injury so the veterinarian can visualize the extent of tissue damage.
Not all soft tissue injuries are career-ending; some injuries can heal completely with proper care and rehabilitation. Discuss with your vet what career the horse can have and what care is required if a soft-tissue injury is apparent.
Although unusual, some vets perform endoscopy at your request during a pre-purchase exam. An endoscopy can look for any ulcers in the stomach or upper respiratory issues.
The vet will sedate the horse and pass a small camera up the nose and into the stomach or larynx. An endoscope allows the veterinarian to visualize gastric ulcers or issues in the larynx (i.e. laryngeal hemiplegia and inflammation). .
Some vets may suggest an examination under saddle, especially before purchasing a high-performance horse.
Lameness may not be apparent until weight is added to the back of the horse. The veterinarian may ask the current owner or rider to ride the horse at a level they are expected to perform at.
It is up to the veterinarian to identify the presence and severity of any issues. But it is up to you as the buyer to determine what issues you can work with and what issues are disqualifying.
The vet is there to perform the tests and disclose all results to you. They are not there to decide on the purchase but to provide guidance so you can make your own decision.
No horse is perfect. Every pre-purchase exam will uncover issues that you may need to deal with should you decide to move forward with your purchase.
Regardless of your decision, conducting a thorough pre-purchase exam will let you move forward with your purchase as an informed buyer and avoid any surprises the future may hold.
Is Your Horse's Diet Missing Anything?
Identify gaps in your horse's nutrition program to optimize their well-being.
- Burba, D. Pre-purchase Examination. Manual of Clinical Procedures in the Horse. 2017.
- Plewa, D. The Legal Conjunction of horse purchase and veterinary pre-purchase examination. Pferdeheilkunde. 2012.
- Mitchell, R. Imaging Considerations in the Purchase Examination of the Performance Horse. AAEP Proceedings. 2009.
- Buchner, H. et al. Body centre of mass movement in the lame horse. Equine Vet J. 2010.
- Busschers, E. and Van Weeren, P. Use of the Flexion Test of the Distal Forelimb in the Sound Horse: Repeatability and Effect of Age, Gender, Weight, Height and Fetlock Joint Range of Motion. Transboundary and Emerging Diseases. 2001.
- Hauspie, S. et al. The use of different imaging modalities in a pre-purchase examination. Vlaams Diergeneeskundig Tijdschrift. 2011.
- Clabough Sellon, D. Equine Infectious Anemia. Vet Clinics of NA: Equine Prac. 1993.
- Sandoval, C. and True, C. Equine Wellness Care in Ambulatory Practice. Vet Clinics: Equine Prac. 2012.
- Murray, M. et al. Gastric ulcers in horses: a comparison of endoscopic findings in horses with and without clinical signs. Equine Vet J. 1989.
- Koblinger, et al. Endoscopic Assessment of Airway Inflammation in Horses. Journal of Vet Internal Med. 2011.