Friday, April 16, 2010

4/16/2010 Prepurchase Exam II

Vet tip of the Day: What to Expect in Your Prepurchase Exam 
Key Words: Lameness, Conformation, Physical Examination, Suitability

Before I begin, let me apologize for the gap in my blog entries.  Spring is here and as much as I enjoy writing, my clinical practice takes first priority and it has been consuming my energy lately.  Also, in all honesty, I've been focusing on my young jumper in preparation for his first horse show of the season, and putting him ahead of writing time as well over the past week.

Back to the prepurchase exam.  What should you expect to see happen when a veterinarian is evaluating a horse for you?  First, a complete physical examination from head to toe, including an eye exam with ophthalmascope, careful ausculatation of heart, lungs and gastrointestinal tract with a stethoscope, a brief oral exam and careful palpation of the entire horse will  take place. We are mentally running through a check list of body systems as we perform this initial examination.  Before diving into the musculoskeletal portion of the examination we are checking skin, lymph nodes, circulation, heart and lungs, intestinal tract.  We get a sense of the horse's systemic well-being based on heart rate, respiratory rate, rectal temperature, body condition, and oral mucous membrane color and moisture.  Having completed the overall systemic exam, the musculoskeletal portion of the exam begins.

The veterinarian will look at the horse carefully from front, back and each side before beginning the hands on exam.The horse will be examined for conformational defects, musculoskeletal symmetry, body condition and mobility of large muscle groups such as the neck and back.  Each limb will be carefully palpated and manipulated and hoof testers applied to the feet.  As we feel each limb, there are specific anatomic structures being evaluated systematically by palpation and visual assessment.  Each joint is assessed for fluid filling and mobility.  Tendons and ligaments are palpated for painful responses and palpable swellings or irregularities.    After a thorough examination of the horse at rest, he will be observed in motion.

The gait evaluation portion of the examination will vary depending on the intended use of the horse, the horse's age and training, and the facility where the exam takes place.  For performance horses, even lower level athletes, minimum evaluation includes observation on a longe line at walk, trot and canter on at least two surfaces: once in deeper footing and once on hard ground.  In some cases the horse will be observed under saddle as well.  After evaluating the horse on the longe line it will be observed in hand at a walk and trot in a straight line.  Various full limb flexion tests will be performed to see whether these stress tests produce any alteration in the horse's gait.

Flexion tests are theoretically intended to reveal subtle discomfort in joints or soft tissue structures (tendons & ligaments) that may not cause overt lameness at the time of the examination.  When a horse trots off lame after a flexion test, it may indicate the need for further diagnostic evaluation such as radiographs (x-ray) or ultrasound.  The interpretation of flexion tests is controversial.  There is considerable debate among veterinarians concerning the significance of flexion tests.  The problem is the wide variation from horse to horse in the response to flexion and variations of technique in performing flexion tests between veterinarians.  This is one of the many areas where an experienced trainer, and a veterinarian you know and trust, can be of great assistance in helping you interpret the findings of a prepurchase examination.

I put a lot of effort into trying to make explanations of my findings clear yet thorough when speaking to a prospective buyer during a prepurchase exam.  However, I'll be honest with you,  it is challenging to condense years of knowledge and experience of the anatomy, pathophysiology, and demands of a performance horse's life into simple formulas that adequately explain the implications of every abnormality revealed during a prepurchase examination.  And that is what we are trying to do, both for the benefit of the buyer and the horse.  Therefore, it is important that you ask questions until you feel comfortable in your understanding of the significance of the veterinarian's findings with respect to YOUR needs for THIS particular horse.  Finally, you must understand that as veterinarians, we are asked to look at a horse once, over the course of 45 minutes to a couple of hours, and determine whether it is going to stay sound and healthy for years to come.  Obviously this isn't possible, but remember from the last blog post, you are most likely to have a positive outcome if the horse you are looking at has a complete history and is in full work at a performance level close to its intended use for you.

In tomorrow's blog (and I PROMISE to write an entry tomorrow) we will discuss ancillary tests, such as x-rays, ultrasound, and blood work which may be part of your pre-purchase examination.  Until then, enjoy the sunshine and warmer weather!

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I believe that education is the key to evolution.
I believe that animals are the key to compassion.
I believe the learning never stops.


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