the PPE post

The pre-purchase exam: What, why, and how I've used medical history (or lack thereof) in horse buying decisions.  

Let's start with the basics. Most horse sellers will allow you to hold the horse for a specified time period (maybe 5 days to a week) with a nonrefundable deposit (often 10% of purchase price) in order for you to arrange a medical exam to inform your purchase decision. 

The standard PPE package offered by most vets in my area includes a physical exam - TPR, vitals, listening to the heart and lungs, evaluation of the horse's presenting physical condition, etc - plus flexion + jog tests to assess overall soundness.

Depending on findings from this preliminary assessment, you may decide to either proceed with the sale, walk away, or pursue additional diagnostic tests such as taking radiographs (at cost) of particular joints or areas of interest -- either bc those are areas you specifically care about, or based on findings from the flex tests. You might also draw blood for testing any time over the next 30 days -- for example if the horse's demeanor or soundness changes dramatically and you suspect he may have been drugged.

isabel, c. 2014

I purchased Charlie, my first ever horse, in 2016 for $2,500, and did a PPE plus hock rads plus blood drawn, for a total cost of $615. Notably, the vet who did Charlie's PPE was local to me (vs local to the adoption facility), and would continue on as the horse's primary care provider. 

So her recommendations, based on both the PPE and my goals, were directly intertwined with expectations around developing a care plan going forward with Charlie. For example, we determined that he would continue to need hock maintenance based on PPE results, but was otherwise cleared for eventing!

she was always a good patient, and generally quite sound!

Buying Charlie felt like an incredible leap of faith, and I was pretty insecure about the whole thing. Everything about it was new and scary - the level of financial commitment, the uncertainty around whether this un-restarted (and huge) racehorse would be a good fit, moving to a new-to-me boarding barn.... 

Getting the pre-purchase exam done by a vet I trusted helped reassure me about my decisions, gave me confidence about having done my due diligence, and also proved to be Step 1 in building out Charlie's care team --- the group of professionals I'd need to rely on to keep everything on track.

bali, c. 2015

Flashback to a year prior, and we see a similar story play out with a different ending. Longtime readers might remember Bali, a sweet OTTB on the verge of flunking out of the lesson program at the farm where Isabel lived. I started schooling him on the side, and basically fell in love.

Alas, he had some physical characteristics that.... Gave me pause about committing when it became clear his time was up at the lesson program. But, just to be sure, we did a lameness eval + rads -- essentially amounting to a targeted version of a PPE. In this situation, I already kinda knew what we'd find... But maybe just needed to be told in no uncertain terms. Needed to know that actually, it was kinder to him to let him go to a non-sport home. 

gosh i loved him, but he was not destined for soundness

So, flash forward to nearly present time. Before I bought Mondeuse, if you'd asked me about doing a PPE, my advice would have been "absolutely." "Cheap insurance." "Peace of mind." "Set a good baseline, eliminate some uncertainty."

"Why would you not?"

Aaaand then I started horse shopping, found Doozy, evaluated the circumstances, talked through the pro / con arguments with a few friends.... And completed the purchase without a vet exam.

charlie, c. 2016

To answer the "Why not?" question above... Basically it boiled down to the pure economics of this particular sale. Doozy's sale price was $1,500. Meanwhile, the adoption facility is out of range for both my normal vet practice and the few others I've used over the years. 

There are certainly excellent practices local to the Fair Hill area, many of which came highly recommended, and many of which offer a wide array of PPE services for non-regular clients. Ahem, to the eyepopping tune of $650 for just the physical examination and flexions. Not even including any x-rays you might want.

we entered our maintenance relationship with eyes wide open

So let's break down that math a bit, yes? Charlie cost $2,500, and got a PPE valued at $615 (including rads). So I basically paid another 25% of his purchase price to assess that he didn't have any major red flags that would preclude him from long term soundness. 

Which. Ya know. He's a high mileage horse with a lot of wear and tear on his body. Soundness continues to be an issue for him. But he's also had a number of accidents and injuries -- the splint surgery, various hoof punctures over the years, getting caught up in fences.... stepping on a god forsaken piece of gravel and having the bottom of his foot fall off... Ya know. All sorts of external factors that the PPE can never rule out.

And what we did learn on the PPE, we already understood from his history. The PPE just gave us a more well-defined lens --- but we probably would have done his hocks anyway, right?

were less aware of what the hoof situation would be tho

As for the math on Doozy, a $650 PPE that didn't even include x-rays for a $1,500 purchase price seemed to fly in the face of rational thought. 

A trusted friend played devil's advocate and peppered me with questions -- Didn't I want rads to make sure nothing significant happened from Doozy's fence accident? And, Given all of Charlie's hoof issues, didn't I want pics of Doozy's hooves too? Friends who've been thru other circles of lameness hell added, I'll never buy another TB without checking for kissing spines!

My answer? The horse currently appears sound. Quite sound, actually. Taking pictures of 3-4 different areas might find something that may or may not be significant, but that has no manifest physical presentation in the horse. It might be "nice to know" about those areas, but at what cost vs what impact on my decision? In this case, adding rads to the PPE could easily amount to $1,000+ in exam fees -- for what is, by all appearances, a sound and cheap horse.

mondeuse, c. 2023

None of those questions were compelling enough for me to spend $1,000 on a PPE that would only provide raw information about the wisdom of spending $1,500.... I'd rather buy the horse outright, and divert that PPE cash away from diagnostics and toward treatments -- like ulcergard, body work, training, etc. 

Because again, in this case, it really did come down to purchase price. The calculus changes entirely based on this sole factor. I referenced the "cheap insurance" analogy earlier, but what does that mean when the purchase price itself is already cheap? 

It's been said you should "only insure what you can't afford to replace." Is $1,500 insignificant? Absolutely not. But it's equivalent to 2-3 months of board. Assuming my budget works, that's how long it'd take to replace the cost if things don't work out and Doozy goes back. 

In this case, knowing Doozy can go back to the facility is the insurance, rather than the physical exam and flex tests. A different situation - like with a more expensive horse and no take-back option - could result in a different decision. Spending $1K to evaluate the wisdom of a $15K purchase is a very different equation, right?

gettin started with a bang!

My own personal situation is also a little different now than it was when I bought Charlie. I'm more confident in my horse selection process, more confident that I know what I like. And comfortable knowing it'll be ok if it doesn't work out long-term either. 

I also have an excellent and established tribe now. I know they'll be honest about their assessments of the horse, and I know I'll heed their advice. For example, one friend came with me to look at horses, and others weighed in on the videos. General consensus of the horse was favorable, even knowing she has some areas we'll keep an eye on -- a recent tieback, imperfect leg conformation that will impact hoof wear, and now this cellulitis situation. 

But we knew that without a PPE, just like we could have surmised Charlie would need hock injections without the PPE. And we'll develop any necessary adjustments to her care plan in response to any compelling physical presentations, as needed. 

we never really know anyway, right? but i'm excited to find out :)

So... Basically, when it comes to a PPE, my opinion is that "it depends on the situation." Context matters. Everybody's tolerance for risk and uncertainty will be just as different and personal as your expectations around expenditures and budgets. 

In the three examples above, I used some PPEs to reaffirm my decisions to buy or not buy, and also skipped a PPE after determining it wasn't likely to change my mind. It might be that in each of those situations you would have chosen differently. Like for Bali, maybe you wouldn't have paid for those rads -- but for Doozy, you would have. 

I'm curious what you think here -  whether you've had similar experiences, if you've used a similar thought process? Or maybe your experiences have completely changed your opinions on PPEs relating to buying horses? Or there's some critically important aspect in your decision making that I didn't even address here? For instance, anything related to the very young horse or the seasoned veteran that might change the stakes compared to an un-restarted OTTB?

People are curious, so please share!!