Prepurchase Examination of Horses

Prepurchase examinations (PPEs) of horses can range from a basic physical and soundness examination to a highly comprehensive examination that includes evaluation under saddle, multiple modalities of diagnostic imaging, laboratory testing, and video documentation.

PPEs are not standardized in the US and vary widely according to the practitioner, price, and discipline of the horse.

In some countries, such as Australia (Equine Veterinarians Australia, Australian Veterinary Association: Vendor and Purchaser Statement – Prepurchase Examination) and the UK (British Equine Veterinary Association: Certificate of Veterinary Examination of a Horse on Behalf of a Prospective Purchaser), the basic PPE is standardized by a national veterinary organization, which issues the examination form that veterinarians must complete.

A comprehensive PPE will identify some abnormal findings in almost every horse; veterinarians should rely on their clinical experience and current veterinary literature to interpret these findings for the buyer.

Equine veterinarians of all levels of expertise are encouraged to use a checklist and ensure consistent, systematic methodology when performing any PPE.

Beyond the minimum examination components, additional procedures might be warranted, depending on concerns of the veterinarian or buyer, or on the value or intended use of the horse.

Ideally, the veterinarian performing the PPE will have no relationship with the seller and no prior knowledge of the horse, but this is not always possible. Any current or past relationship between the veterinarian and the seller should be disclosed to the buyer in the presence of the seller, or in writing.

Before the PPE, the seller should be asked to disclose, in writing, any medical or surgical history of the horse, as well as the dates of recent preventive health and maintenance events, such as shoeing, vaccinations, deworming, and dentistry.

The veterinarian should determine from the buyer who will be the main point of contact on the buyer’s behalf during the examination and whether that representative will be physically present. If not, they should be instructed to be available by phone during the examination, so that they can approve any recommended additional diagnostic testing as the examination progresses.

The intended use, past performance history, and current work level of the horse, as well as the intended rider’s level of expertise (if applicable), should all be discussed before the PPE, because these factors provide context for the veterinarian’s assessment of the horse.

The client must understand the nature of the PPE and its limitations, and that a PPE can never be a guarantee of future soundness. For example, certain disorders, including myopathy and subclinical neurological disease, might not be detectable in a PPE.

At a minimum, the PPE of a horse for sale should include the following:

• Verification of identification and age: Microchip, tattoo, brand, and/or markings might be recorded for verification.

• Thorough physical examination at rest: This examination should include ophthalmoscopic evaluation for cataracts, evidence of uveitis, or evidence of chorioretinitis.

• Examination for soundness:

  At a minimum, this examination should include the walk and trot, on a hard surface and in a straight line viewed from behind, from the front, and from the side. Ideally, evaluation on a circle in both directions on hard and soft ground and evaluation at the canter are also included. Auscultation after exercise is also strongly recommended.

  Flexion tests are considered a standard element of evaluating soundness in a PPE and should be performed unless the patient’s age or temperament precludes them.

In addition, the PPE can include any or all of the following:

• Radiography:

  • For young horses (in racing, cutting, and many sport horse breeds), a full radiographic series of multiple joints is commonly generated. Buyers and their veterinarians can then review images of multiple purchase prospects. Usually the radiographic images include a full series of front feet, all fetlocks, carpi, hocks, and stifles.

  • For pleasure, western, dressage, or sport horses, front feet, fetlocks, hocks, and stifles are commonly radiographed. For racehorses, the carpi are always included.

  • For many racing, dressage, and sport horse prospects, the cervical spine, dorsal spinous processes, and sometimes thoracolumbar spine are also radiographed.

• Neurological evaluation: A preliminary evaluation is made during gait assessment. Any concerns about neurological deficit based on those observations should prompt a comprehensive neurological examination.

• Ultrasonography: Screening for suspensory ligament desmitis or superficial flexor tendinitis might be performed for racing, sport, or dressage horses.

• Upper airway endoscopy: Upper airway endoscopy is commonly performed for some racehorses or sport horses, and whenever a respiratory noise is detected during the examination.

• Laboratory testing:

  • Drug testing for NSAIDs or other analgesic substances can be performed during a PPE. Blood must be drawn at the beginning of the examination, before any sedation for radiography.

  • A CBC and serum biochemical analysis are sometimes requested by owners. Pre- and postexercise muscle enzyme testing, or genetic testing in some cases, can be performed to evaluate for the possibility of myopathy.

  • Infectious disease testing might be necessary for horses destined for export to an international buyer—eg, when the horse originates from a country where equine piroplasmosis is endemic. This process can substantially complicate the purchase process for some buyers.

• Breeding soundness examination: Breeding soundness examinations, apart from confirming normal external genitalia in a horse that could potentially be used for breeding, are not part of the PPE for most horses. (Even the check of external genitalia might not occur routinely, because examination of the penis generally requires sedation, which may or may not be performed in a PPE.) In purchase prospects intended to be used as breeding stock, a full breeding soundness examination includes palpation and ultrasonography of the uterus and ovaries in mares, and semen evaluation in stallions.

Often, the veterinarian performing the PPE for a horse buyer is not the buyer's own veterinarian—particularly when the horse is distant from the buyer’s home. In these cases, the veterinarian performing the PPE will be asked to relay the results of the examination to the buyer’s main veterinarian at home, which might be in a different state or country.

Technological advances help streamline this process. For example, the use of video to share soundness examination footage has become commonplace. However, the task of the buyer’s regular veterinarian is not trivial: they are hired to give a second, trusted opinion on another veterinarian’s findings without seeing the horse in person.

Communicating across time zones and languages can sometimes pose a challenge, as can obtaining large numbers and sizes of digital radiography files. Cataloging the receipt of radiographs, documents, and videos to ensure that all materials intended for review have been received poses a clerical challenge as well.

Ultimately, the buyer must understand that the decision to purchase rests with them. The veterinarian should perform the requested examination, make appropriate recommendations when further testing is warranted, interpret the findings, and generally advise the buyer.

• American Association of Equine Practitioners: Guidelines for Reporting Purchase Examinations

• Equine Veterinarians Australia, Australian Veterinary Association: Vendor and Purchaser Statement – Prepurchase Examination

• British Equine Veterinary Association: Certificate of Veterinary Examination of a Horse on Behalf of a Prospective Purchaser.

• Cowles RR. Ethics: conflict of interest in the purchase exam. AAEP News. 2014.

• Shelton AV, Tupper J, Bolt DM. Prejudicial findings regarding suitability for intended purpose during pre-purchase examinations in a mixed horse population-A retrospective observational study in the United Kingdom. Equine Vet J. 2025;57(1):153-159.

• Also see pet owner content regarding Selecting a Horse.