Classic Equine - Pre-Purchase Exam
Horse: 	Sex: 		Age:		Breed:		
Owner: 		Date:	
Findings:
Temparature:		Pulse:		Respirations:		Mucus Membrane:		CRT:	
Vaccine History:
Vaccines Administered/Date Given: 
Deworming:
Last Deworming Date/Brand, Drug: 
EIA (Coggins) Test:
Last Performed Date/Results: 
Ophthalmic Exam:
Drainage: 
Optic Nerve (menace response): 	
Pulpillary Light Reflex (PLR): 
Cornea, Anterior Chamber, Lens, Retina: 
Intraocular Pressure: Not evaluated
Shirmer Tear Test: Not Performed
Notes: 
Respiratory Exam:
Thoracic Auscultation: 
Left: 
Right: 
Trachea: 
Heave Line: 
Nostril Flaring: 
Nasal Drainage: 
Notes: 

Cardiovasuclar Exam:
Clearly Audible Rhythm: 
Murmurs: 
Pulse Deficit:  
Notes: 
Integumentary System:
Scars:	
Lesions: 
Shedding Currently: 	
Signs of Colic Surgery: 
Jugular Fill: 
Notes: 
Gastrointestinal Evaluation:
Estimated Ideal Weight: 
Endocrine/Metabolic Concerns: 
Dental Exam: 
Abdominal Auscultation (all 4 quadrants): 
Evidence of Sand in Colon (via auscultation): 
Fecal Consistency: 
Appetite: 
Current Diet: 
Reproductive Exam:
Female		Male		Castrated Male
Two Testicles:	
Sheath Clean: 		
Rectal Palpation and Ultrasound Exam Done: 	
Male Reproductive Evaluation Done: 
Female Reproductive Evaluation Done: 
Uterus and 2 Ovaries Present:
Uterine Abnormalities:
Ovarian Abnormalities:
Cervix Palpates Normally:
Vulvar Confirmation:	
Musculoskeletal System
Palpation of Extremities: 
Joint Effusion: 
	Location if present: 
Abnormal Painful Response Elicited When Torsion Applied to Fetlocks and Carpi: 
Abnormal Painful Response Elicited When Torsion Applied to Shoulder Extended:
Palpation of Cervical Vertebrae: 
Thoracic, Lumbar, Sacral, Vertebral Palpation: 
Poll Flexion: 
Tail Tone: 
Notes: 
Hooves:
Hoof Testers response: 
Fusobacterious Necrophorum (thrush): 
Stratum Internum (white lamina): 
Hoof Length: 
Hoof Cracks: 	
Trimmed	Shod Front	Shod All Around
Notes:
Lameness Evaluation:
Straight Line Walk, lameness observed: 
Straight Line Trot, lameness observed: 
Lunge Line Walk, lameness observed: 
Lunge Line Trot, lameness observed: 
Lunge Line Canter/Lope, lameness observed: 	
Notes:

Joint Flexion Exam:
Left Front Fetlock and Hoof: 
Left Front Knee: 
Right Front Fetlock and Hoof: 
Right Front Knee: 
Left Hind Fetlock and Hoof: 
Left Hind Hock and Stifle: 
Right Hind Fetlock and Hoof: 
Right Hind Hock and Stifle: 	
Notes:

Radiographs Offered: Yes (Accepted	)
	Abnormal Radiograph Findings:

Evaluation of Symmetry and Gait Under Saddle:

Neurologic Exam (shortened): 
Cranial Nerves:
Circles: 
Tail Pull: 
Ground Poles: 
Backing: 
Blindfold: 

Hematology (blood work) Requested: Yes	No

Notes:

I have evaluated the above listed horse at the above listed date and find the findings to be true. This is an evaluation of the health and soundness/lameness of the horse present at this time. This is not a guarantee of future soundness or health nor should it be used to predict future soundness or health of the horse.
Kirk W. Johnson, DVM						Date: