Flexions have identified a mild/moderate suspensory injury in one horse I was vetting that was otherwise quite sound trotting in a straight line and hard ground, and also led us to find a bone cyst in the hock of another horse I was vetting who was also looked pretty darned good for a horse of his age/career.
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Yep same. Found some weirdness with flexions on one that looked quite good for the level I wanted - he never got sound.
That said, my main vet back home was notorious for flexing “hard” - he could make anything at least a 1/5 cause he was heavy handed. BUT he also told us that a slight flex off wasn’t a dealbreaker automatically, it was just info. Especially if the horse flexed evenly.
There’s a difference between rejecting a horse due to flexions that are just a tiny bit off, and not doing flexions at all. I’m still one to take X-rays for personal horses, because I know what I don’t want to deal with again.
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Interesting that he only discussed forelimb flexions.
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Yes I was also wondering about that when the article first came out
I messaged him and asked for you.
If I get a reply I’ll let you know. (I can call him later if he doesn’t see the message but he’s on the west coast)
Em
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As far as the OP’s original question, I’m on the fence. People’s experience will color their perspective on whether rads of the neck are valuable in a young horse. Having a few horses with advanced cervical arthritis, I can tell you it is no picnic. You will spend a lot of time examining your conscience and doubting yourself. And in the end, you will likely have to put down the horse sooner than you’d like as you watch them decline and become neurologic - sometimes overnight. Those who have been through it never want to go through it again, for good reason.
I have a horse with ugly neck rads. If I had been aware of them before purchase, I would have passed. Which means I’d have missed out on the nicest horse I’ve had the privilege to own. His ugly rads are not symptom free. He requires maintenance and neck injections to remain comfortable.
On the other side of the coin if you are looking for blemish free neck rads, you are going to kiss a lot of frogs before you find your prince. I have not seen many clean neck rads on PPE. YMMV.
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Before I dismiss this as ridiculous, could you explain what you mean by “lame almost every day”?
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I read it as: just that little bit of wonkiness that makes you go hmmmm “lame”, not 3 legged or clearly trying to blow an abscess “lame”. Babies in growth spurts move in some really ugly ways. And I’m guilty of staring at my horses until they’re all lame anyways 
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I’m not @RAyers so I can’t speak to exactly what he meant, but these days it seems like any mild asymmetry in a horse’s movement is interpreted as “lameness” or “pain” and I’m not sure that’s actually helping horses be any sounder than they were in decades past.
Obviously horse’s aren’t people and they can’t say to you “nothing hurts, I feel fine,” but most humans that aren’t in pain will still have some degree of asymmetry in their movements and strength. I’m not talking about people who have aches and pains but can function okay with a little ibuprofen … I mean people who feel totally fine. Few of us are completely ambidextrous.
I’m not sure why it’s automatically assumed that horses are different … that having a preference for one lead over the other, or some asymmetry in the way of going is always caused by pain.
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Boy, you all may not be me but you sure as hell know what I’m thinking!
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Ok so let me preface this that I should never forget the wicked sense of humor of vets. 🤦
I did message back and forth with Dr. Ramey. I asked why he didn’t mention hind flexions in the article I linked?
His answer: “I didn’t do the study on hind flexions 
”
More back and forth. What I can say here is that his opinions on hind flexions parallels that of front flexions. But as he correctly pointed out, he didn’t do a study on them.
Emily
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I didn’t do neck rads on a PPE in January. 48 x-rays that look great but none of the neck. Horse came up LF lame last week, I thought it was foot sore or potentially a splint. He doesn’t block to the foot of leg. X-ray the neck and there are arthritic changes C3-C7. In a five year old pony.
We are headed to a bone scan next week to make sure there is nothing else that lights up but the future is not looking terribly positive. I don’t usually do a prepuchase with x-rays at all, but really loved this little horse so wanted to cover my bases because I could see myself getting super attached. Neck x-rays weren’t ‘standard’ and not warranted by breed (Connemara), size, or time under saddle (less then 60 days). So, feeling pretty bummed over here.
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Chiming in from dressage land to say that over in the dressage forum, there is a thread going about a 6 y/o stallion who walks differently on contact than he does on a free rein. Shocker (not). And there have been insinuations that the horse is unsound, and maybe even neurological. 
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In fairness an enormous number of dressage people have had custom bred youngsters come up incurably neurological in the last 10-15 years and it’s getting worse. A friend has a very nice, very well bred, very expensive 5yo that stopped cantering under saddle in January and is currently at a major clinic while they debate if he just has neck/rib/sternum malformation and can be pasture sound or also has EDM and should be PTS today.
Every dressage rider knows of 10 stories like this. if you read German you can go on the forums and read one story after another there too. Lots of broken hearts and broken wallets. The issue is clearly more prevalent in some lines that have a certain kind of movement and physical type. People are paranoid and seeing unsoundness and neuro symptoms everywhere. It’s part of what is driving the popularity of what were formerly considered off-breeds like PREs and DHHs
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Good point, and I know the feeling, having had one that developed neurological issues, partly from EPM but also from an old undiscovered SI injury that turned out to be a herniated disc. And it was very probably the disc injury that caused much of his NQR episodes up until the time he contracted EPM.
My point about the horse on the dressage forum is that he had a lovely, lovely walk on free rein (Carl Hester apparently said the horse “walked for a 10”). But in the short snippet of video showing him walking into contact, the cadence was a bit off. It seemed obvious to me that the horse was tight, whether from soreness (he is a young breeding stallion) or because he was just being a bit mentally cheeky about using his topline and walking through his body into contact. It just seemed - odd - that some folks would immediately assume the horse was unsound or neurological.
I freely admit that I am not a trainer, nor a judge, nor even an advanced rider, but I was involved in the breeding and dressage worlds for a good while and have seen many a young horse with a very good natural walk not be able to maintain that ooey-gooey, rhythmic quality when first asked to “collect” the walk a bit. There is usually some resistance - perhaps hesitation is a better term - as the horse tries to figure out what he/she is being asked to do. And that can certainly be exacerbated in a young breeding stallion who may be a bit tight or sore from jumping the phantom or in any horse that has a “WTF?” moment when his walk is being “confined.”
But to get back to the question asked by the OP - yes, knowing what we now know about the prevalence of cervical issues in sport horses, I would absolutely do neck rads - and spinal rads - on a PPE.
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Because that’s how a lot of them start: big lanky movement but a little too loose-goosey looking and the more they are collected up the more uncoordinated it gets. Hand waved off as tension or immaturity at first and three or four years later you are holding an empty halter and an empty wallet. I saw that post and the way that horses moves is something I would actively avoid at this point due to the risk. He’s probably fine since he had to jump at the inspections and most of the bad ones can’t jump properly. But like I said we are all more than a little gun shy.
Back to the question though I mostly x-ray necks mostly to look for injuries caused by horses puling back (stop tying horses to telephone poles to teach them to “give to pressure” ffs) or arthritis from being ridden too short or an injury etc. I wouldn’t buy one with a severe malformation but a mild one I might be OK with on an older horse.
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Agree - and it is why the German inspectors and Y/H trainers I was around always cautioned about how easy it is to “ruin” a good walk through taking up too much contact, too soon. Also, for a while, walks were deteriorating in the top breeding stallions as inspectors and breeders focused on the trot and the canter. Then the pendulum swung the other way and stallions with very big elastic walks were getting rewarded at the licensings. And when breeders started using those stallions a lot, the walks got bigger in the foal crops (speaking in generalities here). Now some walks are so big and fluid that inspectors and Y/H trainers and judges are cautioning against huge walks because they are so darned hard to collect without affecting the quality. IOW, the pendulum is starting to swing the other way again - so instead of the top stallions having "10’ walks, they may have a 7, 8, or 9.
At any rate, if a horse has clean rads on PPE but becomes more uncoordinated some years down the road, it tends to be more because of injuries suffered AFTER the purchase, or because of training issues or some other affliction such as EPM, etc.
So (to use a very shopworn term) at the end of the day - do all the rads you can think of during a PPE. Then you at least know what you are starting with and if the horse deteriorates down the road, you don’t make yourself crazy wondering if there was a undetected skeletal issue at the time you purchased him.
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This is what happened to my 5 year old as well. Lame in right front for no reason. Arthritic changes C5-C6.
Jingles for you.
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FWIW - a good friend has a horse that would light up like a Christmas tree if you did a bone scan. She’s conformationally very downhill - she was bred to be an AQHA hunter. She has some ugly cankles, she’s a little sickle hocked, had a cyst on her stifle, has KS, and cervical arthritis. She rocks around 2*L like it’s nobodies business and the only time she’s ever been lame is when she caught a nail schooling cross county from jump decorations.
I’ve never met an UL horse that would actually pass a PPE.
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