Research from the Royal Veterinary College (RVC) has found that lameness ranks as the most common adverse 
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finding in pre-purchase examinations (PPEs) conducted on horses in the UK.
The aim of the prepurchase examination is to carry out a thorough clinical examination of the horse on behalf of the potential purchaser to identify any cliiinical issues that might make the horse unsuitable for its intended purpose, whether that be elite competitions, breeding, or leisure riding.
In the United Kingdom, PPEs generally consist of either a two stage (two stage vetting [2SV], i.e., general physical examination at rest and basic trot in-hand) or a five stage-examination (five stage vetting [5SV], i.e., general physical exam at rest and after exercise, lameness evaluation including strenuous exercise with re-evaluation after a period of recovery).
In the United Kingdom, The standard PPE consists of five stages, (five stage vetting [5SV],ie general physical examination at rest; walk and trot in hand; strenuous exercise; rest and a second trot up)
Sometimes it may not be possible to complete all five stages or the purchaser may request a limited examination, in which case the examination can be limited to the first two stages (two stage vetting, 2SV).
PPEs yield recommendations based on the veterinary surgeon's assessment at the time of examination. As such, PPEs are largely subjective and often the subject of impassioned debate.
Despite their widespread use in equine practice, PPEs have been the subject of limited research.
The research team from the Royal Veterinary College (RVC), comprising Dr. David Bolt, Senior Lecturer in Equine Surgery; Dr. Jason Tupper, Head of the RVC Equine Practice; and Annabel Shelton, a graduate of RVC's BVetMed program in 2023, scrutinised 133 PPE certificates belonging to a mixed, non-racing horse population sourced from three primary equine practices.
The analysis encompassed an evaluation of the examination format (e.g., 2SV or 5SV), use of diagnostic imaging modalities (e.g., radiographs), purchase price, animal characteristics, intended use of the horse, PPE outcomes, and any prejudicial findings uncovered during the examination.
They found that a 5SV was performed on 68.5% of horses compared to 34.1% which underwent a 2SV.
Of the 133 horses examined, 57.1% had prejudicial findings, the most common of which was lameness. Other prejudicial findings included diagnostic imaging findings (14.5%); respiratory system findings (6.6%); skin conditions (5.3%); and cardiac abnormalities (3.9%).
Unsurprisingly, horses with a higher purchase price were more likely to undergo the full 5SV, and undergo pre-purchase radiography. They were also more likely to have prejudicial findings identified.
Dr Tupper said: “A pre-purchase examination can discover a number of issues before buying a horse. This study reveals lameness to be the commonest issue. Few horses are perfect when it comes to temperament and health. The vetting process determines the issues and the vet can then help the purchaser weigh up their significance and decide if they can compromise and accept the issues or not. Further studies can now focus on the cost/benefit of radiology as part of the vetting procedure and the potential use of gait analysis.”
The researchers hope that their work will stimulate future investigations into the merits of 5-stage (5SV) and 2-stage (2SV) PPE formats, as well as the diagnostic techniques employed. This will, in turn, help to better inform prospective horse buyers when considering their purchase.
For more details, see:
Prejudicial findings regarding suitability for intended purpose during pre-purchase examinations in a mixed horse population—A retrospective observational study in the United Kingdom.
Shelton AV, Tupper J, Bolt DM.
Equine Vet J. 2024.
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