Purchase Exams Table Topic

Purchase examinations are a big bone of contention in many equine sale situations--not so much over the necessity of them, but over what exactly needs to be evaluated and how to interpret the results. Rick Mitchell, DVM, of Fairfield Equine Associates in Newtown, Conn.; and Harry Werner, VMD, who practices in North Granby, Conn., moderated a lunchtime Table Topic on this subject on Dec. 8.

Werner said, “The purchase examination is a successful combination of art and science, and science is the easy part.” This certainly is true with respect to interpreting radiographic findings as well as interpreting and relaying information to the prospective buyer. Mitchell presented X rays of several horses he had examined, discussed their histories, and asked the attendees what they saw and how they would describe any significant findings to clients. The variation in the answers, although they of course had a great deal in common, illustrated the variation in veterinarians’ experience that can cause different interpretations of examination findings.

This variation also stimulated further discussion on what other imaging methods or angles might be recommended to further clarify ambiguous findings. “Especially with purchase exam radiography, you want to avoid one-stop shopping,” said Werner. “Clients might try to cut down on the number of (X ray) views to save money, but don’t rely on only one view of an area for diagnosis. Shoot what you’re after, and if that takes more views, then take them.”

If it isn’t possible to take more views, then it was advised that the veterinarian should note in the report what additional views he would like to add and describe findings as those based on what they could tell with limited information.

Mitchell added, “Let the exam guide you--what you see on the physical exam guides what (radiographic) views you will take.”

The AAEP has published guidelines for reporting the purchase examination.

What’s Said After the Exam

The recurring theme was that veterinarians have to clearly explain to the buyer (and owner in most cases) what they see during the examination, and interpret those findings in the context of what type of horse it is and what his job is. They should not, however, recommend that the person buy or not buy the horse based on the physical examination--the potential buyer needs to have all of the information he/she can get on the horse’s physical condition, behavior, training, etc., and make his/her own decision.

“At the end of the day, the people I work for don’t just want to know that a horse has distal tarsitis,” said Werner. “They deserve as much ‘what does this mean to me?’ explanation as I can reasonably provide.

One attendee asked others what they did in cases where they were to relay the purchase exam results to a trainer or barn manager rather than the prospective buyer. “I don’t mind talking to the trainer first,” said Mitchell, “but I want to talk to the buyer. I fax the report to the buyer first, let them evaluate it, then call them to discuss it.”
Werner recommended that veterinarians pre-empt communication hazards with clear understanding of the goals of the exam before it is done. “The buyer has to speak with the veterinarian before the exam, so you know what they want,” he said.

One attendee discussed his practice’s requirement for a full history on each horse before they will even begin an examination. “We’re often asked to make all these decisions based on a 20-minute examination, or maybe a two-hour exam,” he said.

Werner agreed that a full history is essential to the success of the examination. Without a history, it’s impossible to interpret whether a finding is the normal result of use and has been tolerated well during work, or if it’s a problem that exists with no apparent cause in an idle and might worsen with work, for example.

Shoes Off

Mitchell started off the discussion by recommending removal of shoes for X rays, saying, “I think you can evaluate a lot of the horse’s foot with the shoe on, but not all of it. At the end of the purchase exam, if the client didn’t let you take the shoes off, note that on the report.” He added that the American College of Veterinary Radiology recommends removing shoes for this purpose.

Several X rays were used to illustrate the value of removing shoes, and this turned to a discussion of the various problems seen on the X rays and their frequency. Many points were made concerning the rate and implications of certain problems in various breeds and disciplines. Radiographic technique for evaluating different problems and areas was also discussed, resulting in quite a bit of food for thought for veterinarians who conduct purchase examinations.

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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