Purchase Exam at Auction (AAEP 2005)

Like many areas of horse care, veterinary inspection of horses for sale often raises questions as well as answers. Whether the issue at hand is how to properly take radiographs or interpret them, or the significance of endoscopic upper airway examinations, these questions are often asked within the veterinary profession as well as without. The Purchase Exams at Auction Forum on Dec. 2 at the American Association of Equine Practitioners Convention in Seattle, Wash., provided an opportunity for members to discuss these topics.

Co-moderator Roger Murphy, DVM, of Lexington, Ky., opened the session by noting that an instructional DVD on proper radiograph positioning for auction repositories is in the works and will hopefully be completed in December 2006. Jeffrey Berk, VMD, of Ocala Equine Hospital in Ocala, Fla., will be handling that process, and the DVD will be available free of charge to any AAEP member who would like one. Interested parties should contact the AAEP office at 859/233-0147 to request a copy once they are completed.

"We just want to take out the guesswork so we're all comfortable with what we're trying to see on these radiographs," Murphy said.

Upper Airway Endoscopy

Regarding endoscopic upper airway examinations, co-moderator Scott Pierce, DVM, MRCVS, of Rood and Riddle Equine Hospital in Lexington, Ky., commented, "At public auctions, when we put video endoscopes in there (the repository), we kind of messed that up because there was no set of standards like with radiographs, such as the number of minutes you keep the scope in the airway, whether you use the right or left nostril, etc. It's also failed because a lot of exams were substandard and didn't provide enough information. It only decreased the number of endoscopies I did by about 25%; I still went back and examined many myself."

He stressed that having endoscopic upper airway exam videos in the repository is not meant to replace an actual physical exam of horse, just decrease frequency of exams.

He also noted that a questionnaire at last year's convention found that of those respondents, having video in the repository would only decrease scope exam numbers by abut 30-40%, if that.

One attendee commented that while consignors used to hate these exams, they are now very welcoming of it because it's opportunity for them to assess action on the horse (how many people are seriously looking at the horse).

"We need to form a task force to give recommendations for video endoscopy," said Murphy. "As a working sales vet, I need to be able to talk to a client and say a 2b is an accepted grade for the airways (possible grades from normal to most abnormal are 1, 2a, 2b, 3a, 3b, and 4).

However, that's not as easy as it sounds; a hot topic of discussion involved the variability between practitioners when it comes to grading upper airways. One attendee said, "It's awful to have all the experts with different answers--if we can't all agree (on the grade a particular upper airway should receive), how do the rest of us know what the heck we're doing? Are we using too fine a measurement? We're crucifying people over these factors, but we don't know what we're doing to the degree we should, and we're affecting too many people's incomes. People need confidence that we know what we're doing. I don't think we're doing our clients justice. The horse is what he is, and we should have the ability to determine what that is, and we can't."

Another practitioner said, "The systematic problem is that it's a subjective exam. We all grade differently, and we would often even grade the same horse differently on different examinations."

Yet another attendee said, "None of our opinions are worth anything unless they compare to the numbers (which need to be studied in the future). If they really are just as good a risk (2b upper airways) as 2a on the numbers, I think it's unethical for any vet to say any different."

Another veterinarian commented, "Right now nothing published says a 2b does anything other than be functional. The only literature right now says a 2b is OK, so we need to quit worrying about trying to sell horses (a horse graded 2b is often harder to sell). And if it's a 3, it's a 3. Period. You've got to call it like it is."

"We need to come up with a better way--we need to come together and get everyone on the same black and white page," said Murphy.

High-Speed Upper Airway Evaluation

Pierce also noted that several horses with supposedly bad upper airways looked much better when scoped working on a high-speed treadmill. "But a treadmill exam is certainly not meant to replace a resting exam," he said. This touched off a discussion of whether treadmill scoping would be better than a resting exam because scoping during exercise more closely reflects the intended use of the prospect.

"I'm not convinced that a resting endoscopic exam is good way to evaluate a racehorse's airway," said one attendee. "It's just what we have and what we do."

"I'd rather see a high-speed treadmill scoping of every horse out there, to see if it will work when running," commented another practitioner. "I'm not looking for a yearling that can stand in a stall. I want to see if the horse will train for the guy."

One attendee commented that often a horse that has been scoped many times that day might appear worse when scoped again. "I've started asking how many times horse has been shown," he said.

The Perfect Horse?

While all attendees agreed that there is no such thing as a perfect horse, they also agreed that what is good enough for racehorse buyers might not be good enough for pinhookers (people who buy horses with the intent to resell them), although some said that shouldn't be the case. "We need to get rid of the atrocity that a horse is OK to race, but not to pinhook," stated one.

Another commented, "The problem is with neophytes in the business who want the perfect horse." Pierce said that one study found upper airways frequently improved in young horses as they matured, so perhaps marginal upper airways in weanlings aren't such a bad thing.

Pierce noted, "With a yearling, there are a million things to go wrong. High suspensories, chips, etc. I think scoping for pinhooking 2-year-olds is an investment exam, not a functional one. There are hundreds of issues; one they don't want is the airway."

"Pinhookers don't want horses in the barn at the end of year, so they will be more critical," said another. "That's just the way it is."
"That's on us to correct," replied another. "We're the ones who told someone at some point that a normal upper airway was abnormal, and it's on us to fix it."

"There is a problem with the difference between buyers, sellers, and pinhookers, but if you can educate buyers that a 2b upper airway is OK, then the problem goes away for the pinhooker," said another.

One attendee noted that there is a perception by the public that veterinarians turn down a lot of horses for airway problems. "We don't, I probably only turn down four or five out of 100," he noted. "I'm fairly lenient on upper airways and we're not having problems."

Future Directions

One attendee commented that with videoendoscopy, practitioners could measure symmetry and come up with exact measurements for upper airway grades. Another commented that there were more things that could be looked at, such as pharyngeal size.

Murphy summed up the forum thusly: "The difficulty is to take all of our individual knowledge to develop standards to teach the next generation what to do."

About the Author

Christy M. West

Christy West has a BS in Equine Science from the University of Kentucky, and an MS in Agricultural Journalism from the University of Wisconsin-Madison.

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