What is everyone doing on PPEs these days?

[sassy]

Just as the title states. Beyond the basic exam and rads of the front feet is there anything else that you’re doing? I know there is the option to x-ray as much as I want but I’m not inclined to take images of every single joint on a relatively inexpensive horse.

I’m expecting people to suggest neck and back rads with kissing spine and neuro issues becoming more dx’ed. I’m planning to do a basic neuro exam as part of the PPE and go from there.

Horse is a 5 year old OTTB that raced 25 times and retired sound to my knowledge.

So, not a 100k horse I’m expecting to campaign at 3’6 But then again - they all cost the same amount to fix!

[fivestrideline]

If your PPE vet can do it, the C6-7 X-ray, even if you don’t do the rest of the spine. TBs have a higher likelihood of a deformation there that can cause a lot of issues, often once the horse hits double digits in age, it seems.

I’m following out of curiosity, though I expect my next one will be a youngster which is a whole different ballgame.

[zany1]

Seconding this. C6-C7 can cause so many issues

[dmveventer]

What are you hoping to do with the horse? And how flexible are those goals if it turns out the horse can’t hold up to them? How painful would it be to retire him early if you need to?

I x-rayed pretty much everything when I bought my OTTB. He’d been out of work for a while when I bought him and I have high hopes for moving him up the levels so I wanted as much information as possible, and I really didn’t think it was that expensive in the grand scheme of things. Plus I think having the baseline images is helpful, I’ve already used mine with my vet (who didn’t do the PPE).

You have to weigh your budget and your risk calculus, but I personally wouldn’t consider the horse’s price in deciding what to do on the PPE - care and vet bills cost the same no matter how expensive the horse is.

[Trekkie]

If you think you are ever going to want to resell the horse the more radiography the better–that way you will not be caught surprised when a potential buyer finds something they think is a dealbreaker and you lose valuable time and money invested. If it is a horse you can afford to keep forever then I would be inclined to do less extensive radiography evaluation.

[anonevent]

I like a thorough PPE. It will serve as a baseline, if nothing else. Basic physical examination to check body condition, respiration, heart rate (look for murmurs etc), eyes, teeth. Lameness evaluation w/flexion and look for any tell tale neuro signs. If that all looks good, I’d x-ray as much of the spine as is visible. Feet (ask specifically about sole depth) and legs. Ultrasounds of the suspensories is common for purchases at the track. I had it for the hindlimbs. CBC/chem & have the practice hold some blood for potential drug testing.

I had a PPE where the neurological exam was positive and cervical spinal compression was revealed in the x-rays, unfortunately. So, I’m nervous about that stuff.

[Renn_aissance]

I like images of hocks and any joint that flexes positive. If nothing else it will give me a baseline for when the horse is 15.

I mention this because you know my vet- she says she will not do PPE x-rays of neck and back in most cases because she does not feel that they offer sufficient value in predicting the horse’s long term soundness. Your vet may well have a different opinion. Basic neuro exam, absolutely.

[Hunter11]

Another vote for a thorough PPE, including neck and back rads. The little bit of extra money spent could save you thousands later on, as well as significant heartbreak. This isn’t to say anything that cropped up would definitely dismiss the horse - there’s always something as I’m sure you kn ow - but at least you KNOW and have a baseline if something were to happen down the road.

I do: basic physical exam, bloodwork for drug test, neuro exam, and flexions to determine if I want to x-ray any limbs. I always x-ray feet, neck, and back. If anything funky comes up, don’t be afraid to pay a small fee to send to a larger University clinic (if you do your exam locally) for a second opinion. I did this for my current horse who didn’t have perfect neck x-rays and they gave me solid information for moving forward.

I will admit that I have had some terrible luck in the past with a neurological horse which was incredibly heartbreaking, so I know that I am much more nervous about PPEs than others.

[Amy3996]

Another vote for hocks, anything that flexes questionably, and basic neuro exam at minimum. Also, if you’re going to do rads of the front feet, just bite the bullet and do the hinds while you’re at it. Best case scenario, it establishes a baseline and gives your farrier some more info. Worst case, it identifies pathology or NPA to give you time to decide whether to walk or manage it before it snowballs.

Learned this the hard way - could have saved myself a lot of money and angst and my horse a lot of discomfort.

[Irene2022]

I would add an EPM test to your bloodwork if it’s not already a standard for your vet’s PPE. I’ve seen EPM presented in different ways regardless of the physical neuro exam, so it’s best to know from the beginning if it’s either a dealbreaker for you or to know what you’ll be getting into with treatment. Plus it’s a relatively inexpensive test.

[Arzny]

@Irene2022

I would add an EPM test to your bloodwork if it’s not already a standard for your vet’s PPE. I’ve seen EPM presented in different ways regardless of the physical neuro exam, so it’s best to know from the beginning if it’s either a dealbreaker for you or to know what you’ll be getting into with treatment. Plus it’s a relatively inexpensive test.

Anything exposed to EPM, even if they are not affected, will show on an EPM blood test. You’re going to be vetting a lot of horses if you need a negative test.

[Irene2022]

Still helpful to know as a baseline, just like x-rays

[Amy3996]

@Irene2022

I would add an EPM test to your bloodwork if it’s not already a standard for your vet’s PPE. I’ve seen EPM presented in different ways regardless of the physical neuro exam, so it’s best to know from the beginning if it’s either a dealbreaker for you or to know what you’ll be getting into with treatment. Plus it’s a relatively inexpensive test.

I lost my heart horse to EPM in 2020. When I was shopping for my current horse, this was something I discussed at length with multiple vets. Peterson & Smith in Ocala ended up doing the PPE on my current horse. The vet’s recommendation aligned with what I had heard from many other vets - a blood test for EPM is indicative only of exposure and holds little value absent clinical symptoms. Titer value ≠ likelihood of developing clinical EPM.

[Trekkie]

Looks like 80% of all horses will serum test positive so not really that helpful to know.
Clinical signs are more important.

https://thehorse.com/1121657/treating-epm-in-horses-comparing-serumcsf-titer-treatment-trial-costs/

[Irene2022]

Goodness, strong opinions on a $60 blood test. I have found it helpful to pair with clinical findings and for peace of mind given the variety of presentations it can have. It helped me eliminate one neuro issue on a horse who didn’t perform amazing on his functional neuro exam (turns out he’s just a compliant gelding). I know people who put their horses on the treatment plan regardless just in case because it’s so prevalent.
Negative? Great. Positive? Just one more helpful thing to know and potentially prepare for.

[Amy3996]

Genuine question - where are you getting an EPM titer for $60?

I’m in a relatively low cost of living area and a Lyme titer (not snap test) can’t be had for less than $100. An EPM test is $200.

[TheJenners]

@Renn_aissance

any joint that flexes positive

This is my go-to, plus any bumps n such. I just failed PPA because we shot an old splint to see how it healed and found a completely new and unknown one that hadn’t even palpated when the vet did his exam, sometimes adding that is helpful.

[Irene2022]

Midwest! My vet grouped together a couple of tests on billing so not sure exactly how much mine was but UC Davis has some of their prices listed. The cost is per sample and then there are all the shipping-related expenses too, so I should have been more accurate in saying $60/sample (but looks like prices are higher now than when I got my original quote for it) vs total tests + shipping + etc.

Equine Protozoal Myeloencephalitis (EPM)

[Tha_Ridge]

You’re very lucky to have found sellers who will hold horses for you while waiting for bloodwork to come back. I certainly won’t.

[Irene2022]

We also run the bloodwork through drug tests as well. Heard too many horror stories of lame or wild horses being drugged to get through a trial.