I was wondering what is for you a hard pass when you go and buy a New horse in a vet check. I dealed with a lot of soundness issues in the last 35 years but some of them are more difficult to manage than others. To me it would be a horse with navicular disease. I had a couple of horses with it and AT the end i could never have them sound.
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I think itās usually based on personal bad experiences, like you mentioned of your navicular deal breaker.
A vet recently dismissed my concerns about cervical spine abnormalities found in a PPE as a ātrendyā thing to worry about, but Iāve known the heartbreak of those shapes becoming a neuro problem when the horse ages and arthritic changes come into the equation. If Iāve been devastated by an issue before, it is much harder to intentionally sign up for another round of that same problem.
In one PPE, the horse seemed pain free on the day of the exam despite ugly radiographs. I planned to sell the horse in the future. The population of people who would buy a horse with those images would be very, very small. If I had my own property with a spare field for retirement, my risk tolerance would have been different.
I always get a couple consults on PPE images. Three vets can have three different takes. If at least two out of three say āthis would be riskyā, it scares me off.
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Blind. Everything else is negotiable. Resale or personal use. Resale must have very good PPE. Type of job. Willingness to finesse the program to manage the horse. Budget vs wants. When you have a small budget you canāt afford to be too picky. Nobody has a crystal ball to see if you get 6 months or 6 years before those ugly navicular X-rays catch up to you. Or if the kissing spine horse is one of the ones that cannot tolerate work or one of the ones that manages fine. Take the PPE information, add your own experiences and roll the dice.
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Hocks and neck.
That said, Iāve bought days old foals the last couple of times, and didnāt PPE.
A PPE would probably have revealed the hock issue.
For me itās intended use.
My horses have always been Lifers.
Granted, the total #, over nearly 40yrs owning, is a mere 7.
But aside from my first, Iāve either done a P(ost)PE or skipped the exam altogether.
Based on what my plans were for the horse.
#1 was to be my Show Hunter, so PPE was a given. Exam turned up no more than vetās opinion that horse could be a B contender at best.
He was wrong, 2yrs later local Very BNT offered me 10X his purchase price 
I had him for 20yrs & in all that time just 1 bad subsolar abcess in his early 20s.
If I had plans for a rigorous career campaigning a potential horse, then PPE would need to show nothing career-ending looming in the near future.
For a Pleasure horse, more would be tolerated.
Caveat that ongoing expensive treatments would
have been a dealbreaker even when I was working (salary mid-5s) & now Iām retired, just not possible.
But, as someone upthread said:
No Crystal Balls for horses 
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History of laminitis. Neck/spine. And very thin soles because after 10 years of dealing with that particular issue on a pony that canāt be shod Iām kinda weary of it.
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My deal breakers are good feet and vision issues. I donāt ever want to deal with complicated shoeing issues ever again and I had a terrible experience with a lovely horse with a vision issue.
However, I didnāt PPE either of my current horses. One came with an extensive vet history, so I knew exactly what I was getting, the other I purchased as a green broke 3 yo from a breeder and program I knew well, and I knew that the vet thought she was a very nice horse.
But that was for my personal use. I can retire something to pasture easily and at low cost, and my intended use for these horses isnāt terribly demanding - pleasure riding, hunter pacing and foxhunting.
Previously in my life, if I bought a horse for resale, any finding that show up on a subsequent vetting or would impact resale was a no go. That included any arthritic changes not typical for age/current use, any prior surgeries.
If I was consulting on a purchase for a client, Iād accept moderate arthritis for a horse that was a good match otherwise if the client was okay with the eventual expense of injections or Previcoxx. Same for shoeing issues - if the horse needed special shoes (NOT glue ons) but otherwise held shoes well, and the buyer understood the expense, Iād be okay with that. Whether or not navicular changes were a deal breaker depended on the horseās confo and whether they were sound doing the intended job at the moment.
Old, cold, low bow? Probably okay for anything but an upper level eventer or a first flight hunting horse. High bow or new bow, pass.
Anything neuro? Suspicion of KS, previous history of EPM, any neuro symptoms? Hard pass.
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Just out of curiosity, why are glue-ons a hard ānoā for you? Theyāve made life so much easier for me/my horse.
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Yes, for me navicular would bƩ a hard pass because had 2 horses and both did not Cope with more than very light riding and i felt i could not do much omfor them ti make them confortable.
The only āstop the vetting, hard passā that Iāve had is when the horse was advertised as 8 years old from a high volume sales barn. The barn staff, not knowing the specifics of the horse, gave its coggins to the vet for name/age/etc. Coggins said horse was 18. 
.
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I always have them scan for microchip first, if it doesnāt match, move on. Has happened to me more than once.
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This was a LL domestic bred event horse 5 or so years ago, so no chip to scan. Would have been a good thought though!
The expense. I donāt know what they cost in your area, but theyāre crazy pricey in mine.
Glue-ons short term to get a horse past growing out an abscess or a hoof wall issue? Sure! Horse needs to be in glue-ons in front permanently? Add $5K - $10K to the budget and look for a horse with better feet.
ETA: Back in my hunter days, something that didnāt measure was also a hard pass. Made a couple of purchases contingent on the pony being able to get a permanent card; and ā¦they didnāt. Seller thought the buyer would fall in love with the pony andā¦Not measure it as part of the PPE? Bribe a steward to get it a card? Show the hony until it was challenged?
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Some of the things on my hard pass list are found before a PPE.
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Cribbing
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Hoof issues: Mismatched feet/hi-low syndrome, NPA, inability to go barefoot or thin soles.
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Any hint of metabolic issues or propensity for it. Iāve been down that road and donāt want to ever experience that again.
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Findings on X-rays in neck and back are hard pass.
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Colic surgery or frequent history of colics.
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I have used glue-ons, and in a humid climate, they can be very difficult, was my experience.
On the rare dry days the glue-ons were great. I could rasp the foot and set the glue-ons myself.
But unfortunately, where I live, sometimes the glue just could not set properly and they didnāt stay on long.
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I would say muscle issues (pssm 1 and pssm 2). Iāve had 2 paints with pssm. One was on lease and seemed depressed or lethargic under saddle. I couldnāt figure out why I could not put weight on her. Went outside one evening and she was tying up out in the field. Staggering, abdominal muscles all tucked up, and looked like she was going to go down at any minute.
Then one of my horses went on to become symptomatic for type 2 pssm and has to be limited to 30 min of exercise or less. She is a very fun horse. Eager to jump and go out on trailsā¦ but it is not so fun when they go down on a trail ride 5 minutes away from getting back to your horse trailer.
I could do a muscle biopsy and more diagnostic testing but no supplement or diet change has helped her exercise intolerance. Consistent exercise helps. Just not enough.
Recurrent uveitis is another deal breaker. I had the sweetest horse with it but he decided he was done with treatment and refused eye drops and medications. I gave him to someone as a pasture pet with the understanding that he requires euthanasia when his vision eventually fails. He was a young horse and otherwise in good health. I really debated on euthanasia but my heart couldnāt do it. He gets to be a pasture pet on her farm until the end.
I donāt want a horse that requires shoes. Boots yes, but shoes, no.
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Colic surgery or history of frequent colic episodes.
Blindness (unless it was born that way or happened as a foal and the horse is well adapted)
Frequent choke episode history ( I know most of the time itās minor but I dealt with it for a long time with my boy Hook and it scared the hell outta me every time. 0/10, do not reccommend)
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Yes. They are at least twice as expensive as regular.
All of the above are good points.
Right now, in my life, anything short of perfection is a deal breaker. The past ~20 years, itās been one thing after another, with multiple horses, and since Iām a āone at a timeā owner, that makes life very difficult.
To be fair tho, āintended useā is probably the best descriptor of what would pass/fail for me. I need decent feet/legs, a good back. I can deal with general maintenance (such as hock injections), but not in a 4 y/o. Things like that.
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I vƩ been the same thƩ last 8 years, i sometimes ask myself where are thƩ sound horses? Are there still any???
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