05/25/2025
Great overview of a PPE!
PrePurchase Exam of the Horse
Brian S. Burks, DVM, DABVP
Board-Certified in Equine Practice
The purpose of a PPE is to evaluate the horse’s health, soundness, and overall suitability so you can make an informed buying decision—not to give a horse a “pass” or “fail” grade. It is not uncommon to hear about a horse that comes up lame or ill within a few days or weeks.
The veterinarian’s role in the PPE is a critical part of the buyer’s investment, helping the buyer to evaluate a horse before a commitment to purchase is made. Expectations for the horse are an integral part of the PPE. Horses are living creatures that change with time and use; consequently the evaluation is an assessment at a specific point in time. None-the-less, it is important to examine the animal for what is present now and what may occur in the future as a result of the PPE findings.
To help your veterinarian get the clearest picture possible, come prepared with the following:
• Any available medical or vaccination records from the seller
• A copy of the bill of sale or purchase agreement (if applicable)
• Tack and equipment if an under-saddle evaluation is needed
• A list of your goals for the horse (e.g., intended discipline, short/long-term plans)
• A notepad or mobile device to take notes during the evaluation
Veterinarians evaluate the medical aspects of the horse- general health and soundness. Other examinations can be performed, dependent upon the intended use of the horse, such as racing or breeding. We do not ‘pass’ or ‘fail’ the horse during the evaluation, but rather make the buyer aware of any abnormality that may be present and affect the intended use. It is best if both the buyer and seller are present during the purchase examination.
A pre-purchase examination should include the following:
• Share your expectations and both short- and long-term plans (e.g., showing, breeding, trail riding).
• Ask your veterinarian to outline recommended procedures and explain why each one matters.
• Discuss and agree upon the cost of the exam and any optional diagnostics.
• Be present during the examination, along with the seller or their agent.
• Review the findings privately with your veterinarian.
• Don’t hesitate to ask questions or request clarification on any results.
A typical PPE begins with a comprehensive physical exam, which includes:
• Vital signs and overall body condition
• Eyes, teeth, heart, and lungs
• Skin, limbs, joints, and hooves
The teeth are evaluated for age, dental points, malocclusions, hooks, waves, and missing teeth. Horses with dental abnormalities may require increased dental work. A horse with recently floated teeth and a clean preputial sheath suggests a horse with good care.
The horse’s vision and critical structures of the eye are assessed.
The cardiopulmonary systems are ausculted for abnormalities such as murmurs and arrhythmias. The lungs may have abnormal sounds, there may be mild nostril flaring, or there may be an increased respiratory rate.
The skin is evaluated for lumps and bumps that may be benign or may represent tumors such as squamous cell carcinoma or melanoma. Summer sores may be present in some cases.
The cranial and peripheral nervous systems are evaluated for abnormalities. Hearing, neck flexibility, and various reflexes are tested. It is important to rule out neurologic disease as diagnosis and treatment can be quite involved and expensive.
The horse’s conformation is evaluated. Muscles, ligaments, tendons, and joints are all palpated, assessing for pain, heat, stiffness, or decreased range of motion. Secondary/compensatory problems, such as a sore back, may be detected and may provide clues to the type of primary problem that exists. Hoof health is also evaluated. The foot should have a robust frog that contacts the ground and is free of disease. It should not be growing forward or underrun.
Next, the veterinarian will observe the horse in motion—walking, trotting, and possibly performing under saddle—to detect subtle signs of lameness or gait irregularities. Hoof health, shoeing, and limb conformation are also evaluated, as they directly impact performance and long-term soundness.
Different types of horses have different physical demands, and the exam should reflect that.
• Performance Horses: If you are purchasing for high-impact sports (jumping, dressage, racing, endurance), your veterinarian may recommend more extensive lameness evaluations, radiographs of high-stress joints, or advanced imaging to assess joint, tendon, and ligament health.
• Breeding Horses: Buyers interested in breeding prospects should prioritize reproductive soundness and genetic health. This may involve reproductive evaluations, ultrasound, and screening for heritable conditions.
• Pleasure or Companion Horses: These horses may not require as many diagnostic tests, but a general wellness check is essential. Your veterinarian will focus on mobility, dental health, hoof condition, and temperament to ensure the horse is suitable for a lower-intensity lifestyle.
Based on the horse’s intended use or findings during the initial exam, additional diagnostics may be recommended, including:
• Radiographs (X-rays): Evaluate bone structure and detect reasons for lameness or joint issues.
• Ultrasound: Visualize soft tissue structures, such as tendons and ligaments. It is also used for a breeding soundness examination.
• Drug testing and blood work: Assess overall health or screen for medications that may mask underlying issues.
• Endoscopy: Evaluate airways or gastric health (e.g., signs of ulcers).
• Bone scan (nuclear scintigraphy): Detect bone abnormalities not visible on X-ray.
• MRI: Provide detailed imaging of both bone and soft tissue, particularly in complex or subtle cases.
Radiographic examination of the feet and hocks is quite common. Other areas may be radiographed depending upon the intended use, examination findings, or insurance requirements. Radiographs are interpreted in conjunction with the soundness examination. Unremarkable radiographs do not confirm the lack of pain and inflammation, just as some radiographic abnormalities do not confirm the presence of inflammation.
At the conclusion of the examination, go through the findings with your veterinarian and ask any questions you may have.
Fox Run Equine Center
www.foxrunequine.com
(724) 727-3481