Seeking opinion about this prepurchase exam... added a bit more info in post #12

[My.COTH.Alter]

Staying vague and using an alter.

I’m selling a horse. Horse did not pass the flexion portion of a prepurchase exam. Vet was surprised because of the rest of the exam, which had been quite successful. He recommended a retest in a week.

So my questions are…

1. What do you think of flexion tests and what they show in a horse that has never been lame? Horse is relatively young, has never had an injury, no hard use.

2. What – if anything – would you feel comfortable/ethical doing to or for the horse in the time between the test and the retest? And if you did something, would you tell the potential buyer? Or would you ask the potential buyer first?

3. If you were the potential buyer, what would you want to see in the retest? Improvement? Complete soundness after the repeated flexion? Something else?

[Beckham03]

Following as I have only had one experience with this. Friend was doing PPE (was on video) of a young horse from a well known farm. Lovely horse and not cheap. No known injuries. I don’t remember which leg it was, but during the flex ions the horse hopped off like it had a broken leg. The stopped the PPE. My friend walked but the farm told her they fixed the horse and it was later sold.

I am assuming this buyer has a deposit on your horse? I would be inclined to continue with the horses normal routine.

[S1969]

Define “did not pass” the flexion portion. What were the flexions? E.g. 1/5 isn’t really a “fail” but something to be noted. 4/5 is nearly 3 legged lame… so…somewhere in between?

My mare was a 1/5 and a 1.5/5 or something like that on the hind flexions. My vet did not consider that a “fail” for the horse in question (low cost, not in work, etc.)

[Bogie]

Are you comfortable with how the PPE vet performed the flexion tests? Some vets flex to the point where almost all horses look lame. If you are concerned, maybe you should have your own vet out?

[IronwoodFarm]

The buyer decides if he/she wants a retest. If I did anything different to the horse in the intervening time before the retest, I would disclose it to the buyer. Ethically that is the right thing to do.

And if the young horse came up with a bad flexion again, then I would try to figure out why. I had that happen to me with a young horse. He was starting to get arthritis as it turned out. His price dropped drastically and I found him a home where the arthritis was understood and managed.

I know there are others here who will post that their horse can’t pass a flexion, has always been sound, and has performed well. It certainly isn’t the end of the world to me, it’s going to be the buyer’s call. Some really care about the flexion, some don’t. Some will buy for a reduced price based on the flexion.

[js]

[QUOTE=Bogie;8062186]
Are you comfortable with how the PPE vet performed the flexion tests? Some vets flex to the point where almost all horses look lame. If you are concerned, maybe you should have your own vet out?[/QUOTE]

I had an equine vet (also a dressage rider in her spare time) tell me that flexion test were not reliable, she said a lot of horses would show lameness even though there was nothing wrong with them. I personally don’t have much confidence in them, I’d rather go with x-rays, a good overall health check and a good reliable history on the horse.

[exvet]

It has been years since I’ve had this happen to me personally as the buyer. However, I was interested in a horse, had looked at several (flying to go look at many of them) that I passed on and found myself actually considering a horse very close to me. I had seen him shown over the years as well as in training with a local trainer. I was as surprised as the owner when he flexed positive during the prepurchase exam in one hind leg. I really liked the horse and had xrays done. They were not conclusive. Based on the OVERALL results I declined the horse. The owner however, did rest the horse and xrays re-taken at a facility with a better unit. She called me about a month to 6 weeks later and told me what she did and what her vet stated/found. I went back out to look at the horse and he was sound. He flexed sound and the xrays didn’t show anything different than before in my opinion. I knew based on what I had seen and assessed that I was taking on a horse that would likely develop DJD in the hocks at a later date. The horse was 8 and had been campaigned. I decided to go ahead and purchase the horse. He was competing at training/first level at the time of purchase. I ended up training him up to third and earning my bronze on him. He was later given to my daughter for her to learn the ropes. There was no difference in purchase price between the initial or follow-up PPE. I simply really liked the horse, couldn’t find another one that came close to meeting my needs and am a veterinarian myself (as was my at the time husband) in addition to the two other veterinarians (pre-purchase vet and seller’s vet) who dealt with this horse. None of us had a crystal ball and I definitely was making a well-informed decision which I never regretted. Luckily I have not found myself in a similar position as the seller; but, I would likely have handled it similarly.

[quietann]

Yes, flexions can make a horse look lame even if it’s not. I might ask for a different vet to do them if you’re doing another PPE, and if they stay positive, X-ray the affected joints.

For a “possibly lame” horse having another PPE in a week, maybe just rest it but not stall rest or anything like that, turn it out, etc. just don’t ride it.

Finally, look at the conformation of the affected leg and the other legs. I do say this with experience… My mare flexed +1 or +1.5 on her left hind, which sounds like nothing, but that combined with poor conformation in the right front, and some of the mare’s history, led to a lot of frustration and a lot of vet bills, and a surgery with a long rehab. That “diagonal axis” thing should have been a red flag, but I was quite inexperienced at the time.

[toady123]

[QUOTE=js;8062273]
I had an equine vet (also a dressage rider in her spare time) tell me that flexion test were not reliable, she said a lot of horses would show lameness even though there was nothing wrong with them. I personally don’t have much confidence in them, I’d rather go with x-rays, a good overall health check and a good reliable history on the horse.[/QUOTE]

I agree with this. How lame was the horse? Is horse conformed in a way that would predispose them to injury? Is horse older with lots of miles, young and pushed to advance early, receiving maintenance or being advertised as lameness free? There are so many variables to consider. If in question, x-ray.

[FindersKeepers]

Flexions are quite subjective, as different vets perform them differently, and if done a day after a horse pulls something playing in the pasture or slipping coming out of their stall, they may flex positive from soft-tissue inflammation that could be absolutely nothing, they just need 72 hours to cool.

Purchaser decides if they want a re-test, though most vets would just suggest radiographs if a horse flexes positive to determine the cause, rather than wait and just flex again.

If I were on the selling side, and purchaser has already decided to have vet back out to re-flex, I’d likely do nothing. Literally. I’d let the horse chill. Normal turnout routine, maybe some a light hack or two, and that’s it. So if it IS soft tissue, it has a chance to relax before the horse is seen again. I would disclose this to the purchaser. I would absolutely not give any medications, etc unless the purchaser has already decided to pass and the recheck is for your own sanity.

If the horse flexed 1 or 1.5, I’d not stress about it. If horse flexed 3 or 4, I’d likely work it up, and not wait a week.

If I were the buyer and decided to re-flex. I’d want to see complete soundness next visit out. If horse was still positive, or only slightly improved, and I loved the horse, I’d do radiographs to decide if this was a case of horse being a bit of a wuss over mild DJD changes, or if there is a joint nightmare in a young horse that I would not want to take on. If I wasn’t crazy about the horse, and he still didn’t flex 100%, I’d walk.

[horsepoor]

A young horse with no hard use should have fairly decent flexions, IMO. Saying the horse didn’t pass the flexion portion doesn’t tell me if there was just one joint that had an issue, or all of them, or what degree (big difference, as someone above said, between trotting off 1/5 vs. 4/5 lame!). If the buyer didn’t go ahead and do x-rays, that makes me wonder if it was more than one of the flexions that came up bad so they didn’t want to chase a bunch of stuff. If just one particular place reacted (like say, a hock flexed a little more than everything else - like a 2/5 where everything else was nothing or <1/5), as a buyer, I probably would x-ray then make a decision based on the whole exam. This case here, if there were several flexions that were questionable, I can see where they want to come back.

I would think that having the vet come back, as a seller, I’d be wanting to see improvement from the first exam. And I would expect the seller to tell me if they do anything at all in between those exams. That is the ethical thing to do, and I’m sure the vet will ask. Won’t surprise me if they draw blood as well so they can test if suddenly the horse flexes beautifully.

I have seen young horses that are difficult to evaluate because they aren’t used to being handled and flexed, so it may be that is what is going on here too. There really isn’t enough information in the OP to say.

[My.COTH.Alter]

I have never seen a PPE before and didn’t know what to look for or ask. The vet took the horse’s front leg, pulled it forward pretty dramatically, then curled it all up. I couldn’t tell from either the (a) flex itself or (b) reaction of horse whether it was knee, fetlock or even shoulder/rib. It was repeated three times during the PPE (flex, do something else, flex again, lunge, flex again) and by the last time, he really was bobbing HARD – not three-legged lame because he wasn’t trying not to bear weight on the leg, but clearly very sore. From my position as horse owner, motivated seller and naive observer, I wanted to scream “he’d be fine if you’d just STOP DOING THAT!!!”

Of course I’m not privy to vet’s conversation with potential buyer. To me, the vet said he would be recommending a retest prior to xrays. And that he didn’t think of it as being horribly significant, but more worrisome in that it was not bilateral – other leg did fine. Of course other leg didn’t get flex #2 and #3…

[horsepoor]

Repeating flexions on the same day is not a good idea. Maybe doing one more time, and even then, the vet will typically hold a little less than the first time. Flexions can be cumulative, so a horse that is a little iffy the first time, if you flex it three or four times (which is ridiculous, IMO), will be downright lame by the end. I have only seen this particular scenario when a vet who I despise did a PPE - same vet that didn’t notice my horse had a head injury and proceeded to do a rectal for colic (I was not there, he is my friend’s vet and she had my horse – I’ve pretty much banned him from touching my horses now). Anyway, when this guy did the flexions and didn’t like them, he did them again and again, and the horse went from a 1/5 to a 4/5 and looked horribly lame. My own vet saw the results of the PPE and was appalled that they had been repeated so many times.

Now that I now better, as a seller, I’d never let anyone do the flexions more than twice. Didn’t know that then - I was the seller, and the buyer was freaked out by how the horse looked after the 4th time (I was too!). I offered to do the x-rays since I wanted to know what was going on, and had my vet out. He flexed him ONCE - same results as the first ones the bad vet did - 1/5. Did x-rays that were clean, so buyer had their own vet (not bad vet, but from where they live) review them and bought the horse. But not every seller is going to go ahead and spend $500 on films like I did… depends on the price of the horse (I lost a boatload of money on that one, but he went to a good home and I wanted to make sure he would work for them – no problem since).

[One_Two_Three]

Repeat flexion sounds like a possible reason.

I had my mare go through a lameness eval (for my own piece of mind) where the vet flexed and trotted her off and around in circles. She was fine aside from coming up a bit short in her hind legs, which even the vet admitted was most likely because they were trotting her up and down asphalt and gravel and my mare is barefoot and NOT worked on gravel or asphalt let alone even exposed to it in her day to day. Horse has never been OFF or NQR, she’s just sensitive to hard or rocky surfaces (understandably). There are a LOT of factors in the flex test. I take them with a grain of salt. Clearly if you flex up once and trot off and the horse is debilitated, there may be a deeper issue.

I’d be curious to see how a recheck goes. I’d keep the horse in whatever ‘work’ it’s doing. Don’t want to exacerbate muscles during the PPE because it wasn’t in work all week.

[S1969]

Depending on the value/age/health of the horse, and your own finances, I might have my own vet do a recheck/lameness exam so that you can have that 1st person conversation with the vet and really know what they found. It’s hard to say whether the vet repeated the same flexion or changed to a different joint in the same leg, but because the first one was painful, the others were as well?

While every vet should be able to do a full lameness evaluation, I’d try to get a vet that actually specializes in lameness if you can. It’s very difficult to know (and probably hard to learn/teach if they don’t do it a lot) how hard one vet “flexes” the joint versus another vet - obviously they want to put stress on the joint, but the flexions themselves shouldn’t hurt an otherwise uninjured/uncompromised horse…just expose (if possible) an injury or issue with a joint.

That’s why I said a 1/5 flexion isn’t a “fail” because even in a horse without joint issues it might trot off a bit stiff for a few strides. What you saw sounded like a 2/5 or 3/5 which would be an issue for me as a buyer - if I trusted the vet - and would probably be followed up with xrays.