Re-examining the Pre-Purchase Exam
You're in the market for a new horse. A few good prospects are on your list, and you want to narrow down your choices. Because health and soundness are important, veterinary and chiropractic pre-purchase exams are important. Depending on the type of work your horse will be performing, a thorough and complete health examination will be invaluable if you want to be sure you are getting a sound horse.
What is chiropractic?
Chiropractic care is a supplemental method of care with a holistic approach to the health and performance of the horse. The equine chiropractic practitioner evaluates the health and proper biomechanical function of the spine through locating and correcting vertebral problems.
Chiropractic believes that the horse has its own inborn ability to heal. Many things can interfere with this ability such as drugs, toxins and other environmental factors, injuries, pain, and misalignment of the spine. Known as a subluxation, this misalignment of the vertebrae can be corrected through proper chiropractic manipulations or adjustments, thus removing that interfering factor and restoring the ability to self-heal.
A subluxation is disharmony between two vertebrae resulting in reduced flexibility and impaired mechanical function. The vertebrae may be dislocated, stuck, or unable to move properly, putting pressure on the nerves. This hinders cerebrospinal fluid flow and blood flow to neural tissues, disturbing normal nerve function. Disruptions of nerve function can affect many other areas of the body, causing decreased performance, gait problems, lameness, and behavioral problems. Pain may or may not be evident. The absence of pain does not necessarily indicate that the spine is in proper alignment because not all nerve fibers carry messages of pain; they also carry messages of function. This means that there can be impaired performance long before there is obvious pain.
The chiropractor's extensive knowledge of the individual vertebrae and how they work together allows him or her to locate problems through palpation and by observing the horse in motion. He or she identifies the subluxations and performs an adjustment, or manipulation, of the affected vertebrae to return the bones to their proper positions, thus restoring proper mechanical function.
Chiropractic is an important part of the horse's total health care plan. Though chiropractic care is not a replacement for traditional veterinary care, it does serve as a biomechanically based, complementary and supplemental method of care. Not only is it valuable in treating problems; it is valuable in diagnosing them as well. It is not just for maintenance and therapy. Chiropractic can identify sources of locomotor and biomechanical problems, gait abnormalities and other problems in the horse. Because chiropractic deals with the relationship between the nervous system and the spinal column, the potential benefits of chiropractic care are endless.
What's in a pre-purchase examination?
A typical, routine veterinary pre-purchase exam (PPE) consists primarily of checking the heart, wind, eyes, mouth, teeth, limbs, and hooves and may involve x-rays, blood tests, and fecal exams, depending on how thoroughly you want your prospect examined. A horse who will be expected to carry you on weekend trail rides will probably need a less rigorous exam than a horse who will be eventing or racing. But one of the shortcomings of a routine veterinary exam is that unless the veterinarian is also skilled in chiropractic, potential problems may go unnoticed.
According to Steve Dill, DVM in Barboursville, Virginia, the routine PPE does not generally involve any in-depth examination of the spine. Including a chiropractic examination in the PPE is quite valuable in that it may reveal some conditions that might otherwise be overlooked.
"A chiropractor looks at how the spine flexes and moves," says Dr. Dill. "Static palpation examines the spine as it lies, and motion palpation examines the motion or movement of the bones. It's essential to look at how the spine flexes and moves in order to recognize potential problems," Dr. Dill explains. "A horse may be sore in certain areas without any obvious cause, yet a chiropractic exam may reveal this cause. In some cases the cause of an unexplained lameness is a malpositioning, or a subluxation, of the spine," he says. Subluxations can often be corrected with chiropractic care, so a potential prospect may still qualify with the assumption that chiropractic treatments will correct the problem. Many problems that are undiagnosed, misdiagnosed or deemed untreatable by more traditional means may respond to chiropractic care. However, some cases may involve changes in the bones, fusion or scar tissue. In this case, chiropractic care could still improve function but the horse may never be the same structurally as a normal horse.
Dr. Edy Rooke, Nevada, says, " A veterinary pre-purchase exam should be more than adequate to determine soundness and suitability of an animal, but there are chiropractic issues that would not be addressed by most vets. Veterinarians typically look at metabolic processes and lameness issues primarily, as well as conformation. Chiropractors look at subtle 'sticky' joints that may cause other problems in adjoining areas over time. A chiropractor also looks for obvious subluxation patterns and determines if they are acute or chronic. Old, chronic subluxations can cause other structural problems down the line. Some conformation types are predisposed to subluxation," she explains. "A chiropractic consult would be very useful if a problem would be found by the veterinarian during the initial exam."
From a DC's perspective
Dennis O'Brien, DC, in LaCenter, Washington, explains why a chiropractic exam is necessary. "A chiropractic assessment provides a different perspective. It can detect lameness or unsoundness higher up than the knees and the hocks such as in the shoulder, hip, spine, or TMJ [temporomandibular joint, where the jaw hinges to the skull]. Most veterinarians are not trained in chiropractic or the assessment of joint biomechanics. These can give big clues as to how a horse is moving, potential performance problems and athletic limitations," he says.
A chiropractic exam is necessary for the detection of joint subluxations. Dr. O'Brien explains, "A subluxation is the abnormal biomechanics of two contiguous joint surfaces causing local muscle spasm, swelling, heat, and decreased nerve function in nerves crossing the joint. For example, normal biomechanics of the lumbar spine allow rotation and lateral flexion at lumbar vertebral segments. A subluxation at one or more vertebral levels will typically cause decreased stride length, hollowed back, and inability to change leads effectively." He continues, "Normal biomechanics of the thoracic spine allow for flexion and extension of vertebral segments. A subluxation in this region may cause difficulty in rounding the back to develop a proper frame. Subluxations can also occur in the extremities giving rise to gait problems such as short stride length and inability to change leads."
What's in a chiropractic exam?
Dr. O'Brien describes his procedure. "I evaluate the horse overall by checking his conformation: Is this a long back or short back? I look at the neck length and configuration. Are the feet symmetrical - equal toe length? What's the heel angle? Wear patterns on feet give clues as to how the horse is traveling. I look at the pastern length, shoulder angle, angulation of the canon bone. I also consider the weight of the horse. I do a postural evaluation and look for symmetry - is there a high or low shoulder, high or low hip, any asymmetrical muscling?"
He continues, "Next, I perform static palpation with even pressure to analyze osseous segments and their processes - does the horse flinch with pressure over joints? I feel for swelling, heat, bumps, abrasions, especially on legs as there may be brushing or interfering, indicating how the horse is traveling.
"Next I perform motion palpation, the part of the physical examination that is specific and often exclusive to chiropractic - I check each vertebral joint for mobility, and for a normal or abnormal range of motion." Based on the biomechanics of the spine, locomotion problems can be predicted.
Dr. O'Brien then watches the horse move. "I look for symmetry. Walking in a straight line, does the horse rope-walk behind? Is stride length even? Does one shoulder drop on a lunge line?"
He adds, "I also encourage consulting with other professionals. Many vets are skilled in veterinary medicine yet have little or no experience in riding, shoeing, saddle fitting, training, or chiropractic. That's why it's a good idea sometimes to consult with these other experts, especially when considering the serious sport horse. For example, a vet may rule out lameness, but have no clue as to the athletic potential of a given horse for a particular job; so it would be wise to consult with a trainer. Also consult with a good farrier." Farriers can identify and correct unbalanced and improperly shod or trimmed hooves and often give a more realistic view of how this particular horse's feet are affecting his performance. A proper foundation and sound base is essential to have a sound horse; the base affects the whole horse, so there must be proper support of the skeletal structure.
Among the many things to look for that may indicate back problems and subluxations are:
- Uneven strides, short strides, toe dragging, stumbling, forging
- Unusual wearing down of the shoe or hoof
- Not level, has abnormal posture while standing, uneven hips, 'hunter's bump'
- Unusual behavior patterns such as biting or threatening in a previously gentle animal, unusual sensitivity to touch, bucking, rearing, grinding teeth, showing discomfort when being saddled or mounted, wringing tail or pinning ears
- Poor performance, picks up the wrong lead, refuses to jump or has trouble jumping, has trouble collecting, using hindquarters, and performing lateral movements, has difficulty trotting up or down hills and backing, has extended head or neck, hollows the back, works below capacity
The value of a chiropractic pre-purchase examination should not be underestimated. Though one can never be absolutely sure that a horse will remain sound for any given length of time, one can get a better idea of a predisposition to problems through a chiropractic exam. Subtle imbalances can compound into major problems. Also, A seemingly impossible problem may be correctable through chiropractic. The chiropractor can establish whether or not a particular problem is there to stay or can be helped with therapy. It is not easy to determine, however, how long it will take or how many adjustments are needed for a problem to be overcome. How much follow-up will be needed to regain full motility and soundness depends on the individual horse's capacity to heal, the follow-up care provided and the management practices of the farm.
Natural Horse Magazine thanks Dr. Steve Dill, Dr. Edy Rooke and Dr. Dennis O'Brien for their valuable assistance in preparing this article.