Talking through the five stages of a Vetting: Expert Advice from Hook Norton Veterinary Group

Recently, we had the pleasure of attending one of the client education evenings hosted by Hook Norton Veterinary Group, offering valuable guidance for anyone considering buying a new horse and navigating the vetting process.

We’re grateful to Sam Cutts, MRCVS, for sharing her expertise and practical insights. In this blog, she talks through the five stages of a vetting so you know exactly what to expect.

Stage One: Examination at Rest

This is the preliminary exam - a thorough check at rest including eyes, heart, lungs, and conformation..

What will the vet typically do?

•Feel over every inch of the horse’s body

•Check for a reaction to direct downward pressure on the dorsal spinous processes (back)

•Pick up each leg and palpate joints and tendons

•Assess the frog and sole of each foot and use hoof testers

•Feel for wolf teeth and check horse’s correspond with the age in the passport

•Listen to heart and lungs with a stethoscope

•Examine external and internal appearance of eyes with an opthalmoscope

•General assessment of horse’s behaviour during the examination

So the kit that we need for that is the microchip scanner, stethoscope, hoof testers, an ophthalmoscope, but, most importantly, we need our hands and our eyes - this is our chance to have a look and  feel of every part of the horse.

This is also an opportunity for a general assessment of the horse's behaviour. If it's trying to kick me every time I've tried to do anything, and it's for a 16 year old buying as a first horse, then that's really going to be part of my conversation with the purchaser!

So what can commonly be found at this stage?

Sarcoids on the skin. Depending on their position, I would assess them very differently. For example if they're near the eye or where the tack goes, that's going to be a much more significant issue. 
Now, if the horse you're buying is 15 and you’re buying it as a schoolmaster for a couple of years that might well be ok.If the horse you're buying is four or five and you want to have it for 20 years, get your crystal ball out as to and whether or not those are going to cause a problem! And obviously, if you're buying a horse for future resale, then it doesn't matter whether you feel it's fine and you can manage it, you're also trying to guess whether somebody in the future is going to think it's fine or not!

Feet. I would say one of the biggest reasons that I end up looking at the horse and saying it might not be suitable for purchase is looking at the external appearance of the horse's feet. The saying no foot no horse is absolutely true. It doesn't matter how lovely it is or how beautifully it moves if the feet aren’t good enough for the horse to have a realistic chance of staying sound in the future.

Eyes.  With eyes, the vet is trying to look at what's happened in the past and predict what's going to happen in the future. We're looking for things like signs of previous Uveitis (moon blindness) as this is a recurrent condition, Squamous cell carcinoma (SCC)
of the third eyelid, melanomas and cataracts.

Generally, I would say cataracts cause all sorts of excitements and problems at vettings and very rarely otherwise! We can have hours of debate about whether to buy the horse due to cataracts - even though generally, they're established and unlikely to progress. When they might cause problems if you think that they're immature and they're going to develop further, or if you think they're associated with uveitis. So if I see a cataract, I'm always look looking for subtle changes, because a cataract associated with uveitis is potentially a significant risk going forward (due to recurrence of the uveitis), whereas a stable mature cataract, I'm generally not very excited by.

Stage Two: Examination in hand at walk and trot

We start with and walk and trot in a straight line. 


Hopefully the horse is basically sound, so then I'm really looking at how the horse walks and trots. Does it move in a straight line, head and neck in front of front legs, front legs in front of back feet? Is it walking with its front feet turned out? 
Has it got front feet turned in, or back feet?

When you come to trot, is the horse trotting in a straight line, or is it swinging back legs out as it trots. Horse that abduct their hind legs can have a higher risk of stifle issues. With horses that are plaiting behind, you're questioning, that they have any hock pain. 
That doesn't mean that every horse that abducts their legs has stifle issues, but you are always just putting things together and thinking 'I'm just going to pay particular attention to this and make sure that it isn't a problem’.

Flexion tests.

We hold the horses leg up for between 30 to 60 seconds and then ask it to trot off. We accept there may be one or two steps that are a little bit uneven, but then it should trot straight off after that.

Every vet will do it slightly differently, but the main thing is that each vet does it consistently every time they see a horse - so they know what is normal for a horse after they have flexed it.

From a flexion test, we're trying to pick up sub-clinical issues that might become a problem in the near future if you go ahead with purchase.

And obviously, interpretation of affection tests will change, depending on what the horse is and what you're buying for in the future. 
If you're buying a five year old, because you want to go and try and qualify for 4* in the future, then I'm going to be very intolerant of a positive response to flexion. If you're buying that horse again in the future, now it's 15 and it's been to that four star, I'm not going to be surprised at all if it's slightly positive to flexion, but we're going to be having discussion about how are you going to manage this horse when you've purchased it.

Short circling at walk.

What we're particularly interested in here is what it's doing with the outside leg, because if it's swinging it out as we go around, that can be a sign of Wobbler Syndrome.

Backing the horse up.

We're obviously looking for it to move off in nice diagonal pairs, but what we're particularly checking for is Shivers. If it's an obvious shiverer, then you'll likely have already discussed it beforehand, but you quite often will pick up subtle shivers during Stage 2.

Lunging on the hard (and sometimes soft)

Lunging on the hard is specifically part of standard vetting practice, and we are looking to assess the level of soundness. It's a brilliant way of picking up sub-clinical foot pain, and it's giving you that little bit more information for a horse that isn't lame in ridden work yet, but that might be about to go lame.

And again, like everything else, you make your interpretation depending on what the horse is and what you're buying it to do in the future. 
If you've got a horse, that you're buying for resale in the future, you're going to have a very limited tolerance to problems on the lunge on the hard, as that is likely to make future resale diffcultWhereas if somebody is buying a perfect first pony for their child, I'm going to be not mind too much at all if it's not perfectly sound on the hard, if it's got the perfect temperament and it's going to give them everything they need in the future. 
So it's always vetting for the purpose for which the horse is being purchased.

Stage Three: Examination Under Saddle

This is the strenuous exercise part: assessing the horse under saddle to check wind, heart recovery, and ridden soundness.

At the beginning, I'm going to watch the horse being tacked up, I want to see that so I can check the horse is looking comfortable while it's being tacked up.

I'm then going to have the horse out, see it walk a little figure of eight around me. Pick up trot, trot a big circle, trot a small circle around me, as small as it's capable to do. Same the other way in trot, same in canter - a big circle, and then a small circle around me.

And then after that, it will very much depend on what the horse is capable of doing.

If I'm vetting a Grand Prix Dressage Horse, I want to see it do all the movements from a Grand Prix test. I'm not judging it like a Grand Prix judge would. But what I want to see is how is that horse using its body? 
Is it equal if it does a left and right trot half pass? Is it struggling to cross over one way? But actually finds it quite easy the other way? 
Is it slightly late in a left-right change? In piaffe is it actually not picking one hind leg up quite the same as the other?

And particularly because a lot of these horses I then go on and look after as their vet. So you're trying to build a picture of what's the likelyweaknesses of this horse.Then we can think about how we're going to best manage it and look after it in the future.

Once you've done all of that, then I see them open up and gallop. I need the heart rate to come up, so we're going to be here for a little while. You're also listening to the horse's wind. Expiratory noses are usually of no concern, it's inspiratory noises that indicate there's some effect on the airway.

Now again, if you're wanting to buy a horse to happy hack, I don't really mind if it makes that sort of noise, but if you want to buy a horse to be a racehorse or to event at a high level I'm going to be much more concerned and we're probably going to recommend that we scope that horse. 


Effect of the rider. There are an awful lot of lamenesses that don't show up until you have a rider on board, but equally well, a good rider can hide quite a lot. It's your job as a vet to spot what they're doing and say, can you just give it a longer rein please? Or can I just see it on that turn again?

Stage Four: Examination At Rest

Here I'm assessing the recovery of the horse. We want to see it loose in the stable, see if it's showing any vices - box walking, crib biting, weaving.

We're also giving that horse a chance to stiffen up. Because actually some horses will look fine when you first see them, but when you see them again after the ridden stage, then they start to look a bit stiff and sore. 


Stage Five: Second In Hand Examination at Walk and Trot

This is the final trot up, and it's just trying to make sure, 'is this horse still sound now it's been ridden?'

If I had a question mark over any of the flexion tests earlier on, or the lunging on the hard, then I'll repeat them again at this stage. 


It's all about making sure that you're as confident as possible, you're giving the right advice to your client, rather than just following the list as it says on a clipboard.

We will take a blood sample at the end of the fifth stage that is stored for six months in an independent laboratory and can be run if needed. It's not a health sample, it's purely to be run essentially if you if the horse develops a lameness and you think 'was it on Bute when it was vetted or might it have had medication and joint injection just before the vetting?'

Then at the end of the fifth stage, I would have a discussion with the purchaser and say this is everything that we've found, this is everything we've talked about - and do any of them prejudice the horse for the job for which you want it to do?

So there is no pass or fail aspect of a vetting, but people often take this 'do or do not' as a pass or fail which we need to move away from. In Europe they say 'this horse is a low/medium/high risk , which seems to be a much better way of doing things.

The vetting form also reminds you that if you're planning to have the horse insured, that you should check that your insurance company is happy to cover the horse before you decide to go ahead with a purchase. And that also you need to get your own warranty if you would like to regarding vices or previous problems or surgery.

But an important reminder, no horse is perfect. 
There are always going to be findings to discuss. There's nothing more frustrating than when I've finished a pre-purchase examination on a lovely horse. I've said to the client that there are just a few things we need to discuss, and they decide to walk away from a horse that would have been brilliant for them because there's something wrong with it. I've yet to meet the perfect horse!

Additional tests

Radiographs

The majority of vettings I do will be followed with a series of radiographs. Make sure you check with your desired insurer whether they've got any specific requirements. If you're likely to sell the horse in the future, we'd highly recommended to take some as a baseline at purchase and then you know what you're getting yourself into for the future.

Equally if there are any existing radiographs of the horse available, send them to us before the vetting so we can have a look at them and check that everything looks in order before we start.

Ultrasonography

This is usually for competition horses who are expected to have a degree of ‘wear and tear’. We usually focus onsuperficial and deep flexor tendons in front and your proximal suspensory ligaments behind.

Upper airway endoscopy

This would be recommended if we had picked up at the vetting that the horse made an inspiratory noise.

Bloods

Sometimes purchasers want a health profile run on the bloods in house just for peace of mind going forward.

What isn't included?

• Pregnancy check

• Detailed dental examination

• Official height measurement

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To find out more about Hook Norton Equine Vets, visit -

https://www.hooknortonvets.co.uk/departments/equinevets/