Page 1205 - Adams and Stashak's Lameness in Horses, 7th Edition

Miscellaneous Musculoskeletal Conditions 1171

that, if in this situation, there must be full disclosure to should include the availability of all involved parties and
all parties that this relationship exists and that the seller competent help to perform the exam, scheduling conflicts
VetBooks.ir conflicts of interest and written agreements from all par­ weather conditions. If any of these conditions risk the
of the examining veterinarian, location of the exam, and
give full disclosure of all medical records and history. All
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quality and completeness of the examination, the veteri­
ties should be documented. The veterinarian should not
act as the prospective buyer’s agent and should not hold narian should consider postponing the examination.
any responsibility for the prospective buyer’s decision to Documentation of any less than satisfactory conditions
complete or reject the transaction. 25 should be included in the final PPE report. Additionally,
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The agent for the buyer or trainer may be separate the PPE can require considerable time to perform prop­
individuals or one in the same. It is important to estab­ erly, and if not scheduled appropriately, the veterinarian
lish their role and legal powers prior to initiating the can find himself/herself rushed and distracted from the
PPE. The agent or trainer will play a role in evaluating task at hand. There are advantages to performing the PPE
the suitability of the horse for their particular client and in the horse’s home environment, but there cannot be dis­
the horse’s intended purpose. Werner recently published tractions that will not allow for an accurate assessment of
his approach to the PPE and outlined service maps that the horse. Space and footing is also very important espe­
he established to help guide the examination and define cially when examining a performance horse. Working the
the roles of all the individuals’ involved in a successful horse on multiple level footings and having adequate
PPE. The reader is referred to this manuscript for fur­ space to exercise the horse on the lunge and under saddle
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ther details on the PPE. are often imperative. 24
Step Two: Review and Define PPE
Prior to initiating the PPE, the veterinarian should
STRUCTURE OF THE PREPURCHASE take the time to acknowledge all parties that are present
EXAMINATION and review the Step 1 information. Any questions or
requests that the prospective buyer(s) might have per­
The PPE should be broken down into different steps taining to the examination should be answered at that
to make the examination progress more efficient and time. The veterinarian should confirm the prospective
reduce the potential for deletions or inaccuracies in the buyer’s expectations of the PPE and make it clear that
examination. although the PPE is a very complete and comprehensive
Step One: Pre‐examination examination, it may not identify all potential abnormal­
This step should be performed prior to the PPE ities. 11,21 It should be made clear that the PPE is a short‐
appointment. A request should be made to obtain previ­ term contract lasting the day of the examination and not
ous medical records and all pertinent history (perfor­ a warranty. 13,16 The ability of the veterinarian to predict
mance career, current level of work, etc.) either from the the future soundness and suitability of the horse is
seller or through permission from the seller, from impossible. Recommendations for imaging or testing
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the seller’s primary veterinarian. 24,26 It is also during this based on pre‐exam information, signalment, intended
step that all potential conflicts of interest be acknowl­ purpose of the horse, and requests made by the prospec­
edged, discussed, accepted, and documented. At this tive buyer can also be discussed at this stage. Additional
stage, if there is any refusal of information from the specialty testing (i.e. reproductive ultrasound, upper air­
seller, or the veterinarian perceives any significant rea­ way endoscopy, advanced imaging, etc.) should also be
son to doubt the seller’s integrity, the veterinarian should outlined, and the indications for performing and costs
document any conflicts and refuse to perform the exam­ associated with each test should be discussed. If a test is
ination due to a conflict of interest. 23,26 If the veterinar­ recommended or requested but not available at the
ian has prior knowledge of the horse including any examining practice, potential referral and its expense
existing problems, they should insist that the seller gives should be discussed.
permission to reveal all information to the prospective Step Three: Prepurchase Examination
buyer. If permission is not granted, the veterinarian The PPE can be designed and carried out in various
should graciously refuse the examination. 2 formats. A detailed description of the complete PPE will
Developing a PPE package of information that can be not be discussed, as this will vary greatly from case to
sent to the prospective buyer and seller prior to the PPE case. Within any equine practice, a PPE may vary
can save time on the day of the PPE and help to identify depending on the type of equine population, economics,
any potential conflicts prior to initiating the PPE. and the needs of a particular client base. Regardless of
Prospective buyer and seller information should include the horse’s value and the wants and needs of the client,
all contact information (buyer, seller, agent, trainer), it is important that the quality of the exam, communica­
horse identification (name, breed, sex, age, markings, tion, and reporting of findings be held to the utmost
tattoos, freeze brands, and height), conformation of standard of care. The veterinarian should develop a sys­
availability on the day of the PPE, and the appropriate tematic approach to perform each and every PPE using
prospective buyer/seller consent and waiver forms. 15,26 that system to help avoid overlooking portions of the
A detailed description of the PPE format can also be exam. 11,21,24 It is common practice to use a dedicated
included. Once the information has been collected, the worksheet that is designed specifically for the PPE and
veterinarian can review the information in preparation can be tailored to the veterinarian’s methods. The work­
for the appointment, and any conflicts can be resolved sheet should include patient identification (age, breed,
at this time. sex, color, markings, tattoos, and brands), checkboxes
Scheduling of the appointment time and location and comment areas referring to general body condition,
should also be carefully considered. Points of consideration conformation, inspection of all body systems, soundness