Equine Pre-Purchase Exam Radiographs: Workflow, Sharing, and Why Image Management Matters

Equine pre-purchase radiographs may need to move quickly between veterinarians, prospective buyers, specialists, and insurers. A well-designed PACS can make that process easier while preserving the original images, associated reports, permissions, and long-term clinical record.

The AAEP Guidelines for Reporting Purchase Examinations emphasize that the veterinarian remains responsible for determining the extent and depth of the examination. The buyer, meanwhile, is responsible for deciding whether the horse is suitable for the intended use.

Key facts

• There is no universal set of radiographs required for every horse. The scope of the examination should be tailored to the transaction and the individual horse.
• The AAEP recommends retaining radiographs in an archiving system for at least three years. The report and relevant supporting documents should be retained for no less than the applicable statute-of-limitations period. AAEP guidance
• The AAEP states that legal precedent generally treats radiographs as the property of the veterinarian who produced them, while interpreted information belongs to the client. Local law and contractual terms may differ.
• Some insurers may request pre-purchase examination results or recent imaging, but requirements vary by company, policy, horse value, and jurisdiction.
• Keystone Omni supports DICOM and non-DICOM image management, browser access, consultation workflows, local storage, and off-site archival.
• Keystone Equine Repository is designed for auctions and organized horse sales. It is not required for every private pre-purchase examination.

Who may need access to the images?

The people involved will vary from one transaction to another. Access should reflect the clinical relationship, the party that commissioned the examination, any applicable authorization, and local legal requirements.

The examining veterinarian

The veterinarian conducting the examination acquires or arranges the radiographs, evaluates the available findings, and documents the procedures performed.

The AAEP says the veterinarian should retain a detailed description of the procedures and findings, identify recommended tests that were declined, and include reports relevant to the examination in the medical record.

The prospective buyer

The purchase examination is generally performed to help the prospective buyer assess the horse in relation to the intended use. The veterinarian reports the findings and their possible significance, but does not make the final business decision about suitability.

Release rights should be handled carefully. AAEP guidance says radiographs should be released at the request of the owner or the owner’s agent. Its ethics addendum also states that diagnostics paid for by an unsuccessful prospective buyer should not be made available to a future buyer without that original buyer’s authorization. AAEP ethics guidance

Practices should establish who commissioned the examination, who may receive the report and images, and which authorizations are required before the work begins.

Another veterinarian or specialist

The prospective buyer may ask another veterinarian or a board-certified radiologist to review the study, particularly where findings are subtle, disputed, or outside the examining veterinarian’s usual area of interpretation.

The consultant should receive the complete study with appropriate identification, dates, projections, and relevant clinical history. Sending only screenshots or selected JPEG files may remove useful metadata and limit the recipient’s ability to manipulate and compare the images.

Keystone Community is designed to centralize image consultation and report return without requiring the practice to manage separate email threads and manual file transfers.

The insurance provider

Some insurers request a recent veterinary examination, pre-purchase report, or imaging history before offering certain types or levels of coverage. These requirements are not universal.

For example, an official Hartford animal-mortality application for horses states that pre-purchase examination results may be requested. Under the conditions listed in that form, a pre-purchase examination no older than 30 days may be accepted in place of a separate veterinary certificate. This is one insurer’s form and should not be treated as an industry-wide rule.

What can go wrong during the sharing process?

The problem is not always that the study cannot be shared. It is that sharing may require several disconnected steps.

1. Export the study from the acquisition software.
2. Package the DICOM files.
3. Upload them to another portal or transfer service.
4. Send the report and clinical history separately.
5. Provide credentials, instructions, or compatible viewing software.
6. Confirm that every projection and supporting file arrived.

Each manual handoff creates another opportunity for the wrong study to be selected, individual projections to be omitted, reports to become separated from the images, or recipients to review compressed exports instead of the original DICOM files.

A PACS should reduce those risks by keeping the images, patient information, reports, supporting files, and access controls connected.

For a broader look at this workflow, see Why Sharing a DICOM Study Shouldn’t Take More Steps Than Sending an Email.

Why pre-purchase imaging requires careful recordkeeping

A purchase examination documents the horse’s condition and the veterinarian’s findings at a particular point in time. It is not a guarantee of future health, soundness, or performance.

The AAEP says the veterinarian should report abnormal or undesirable findings and give a qualified opinion about their possible significance. The buyer then makes the business judgment about suitability using the report alongside other relevant factors.

Reliable records may later be needed to:

• Confirm which projections were obtained
• Review the findings reported at the time
• Compare future examinations
• Support a referral or consultation
• Respond to an authorized insurance request
• Address questions arising after the sale

An off-site copy can protect the record if local hardware is damaged or lost. Storage alone, however, does not establish compliance with every legal or professional obligation. Image identification, clinical documentation, permissions, retention policies, and the original report remain important.

A pre-purchase study is a dated clinical record, not a prediction of everything the horse will do in the future.

How long should equine pre-purchase radiographs be retained?

The AAEP recommends retaining radiographs in an archiving system for at least three years. It separately advises retaining the purchase-examination report and relevant documents for no less than the statute-of-limitations period that applies where the service was performed.

Those are different retention considerations. State, provincial, national, licensing-board, insurer, and contractual requirements may be longer. Practices should use a written retention policy based on the longest applicable requirement and obtain local legal advice where necessary.

Asteris states in its current FAQ that data is retained on its servers for seven years for most Keystone customers and that longer retention can be arranged. That is a Keystone service term, not the AAEP’s universal professional standard.

Who owns the radiographs?

This question should be handled carefully because legal rules can vary.

The AAEP’s current guidance says legal precedent generally treats radiographs as the property of the veterinarian who produced them, while the interpreted information belongs to the client. It also recommends releasing radiographs when requested by the owner or the owner’s authorized agent.

Practices should explain their ownership, release, authorization, copying, and fee policies before the examination, particularly when the prospective buyer, seller, trainer, agent, and examining veterinarian are in different locations or jurisdictions.

What should a PACS support?

A PACS used for equine pre-purchase imaging should support more than basic file storage.

Complete studies

The system should preserve the complete study, patient identification, dates, projections, modality information, and original diagnostic data.

DICOM and non-DICOM content

Radiography commonly produces DICOM images, while some ultrasound equipment, photographs, video, reports, and supplementary files may use other formats.

Asteris states that Keystone can receive standard DICOM modalities and package certain non-DICOM device data into a DICOM-compliant structure. It also supports attaching PDFs, documents, and video clips to a study. Learn more in What Is DICOM? A Veterinary Team’s Guide.

Controlled sharing

Outside recipients should receive only the studies and information they are authorized to view.

Browser access can make review easier, but practices should confirm whether a recipient needs an account, whether the original DICOM files can be downloaded, how long access remains active, and whether access can be revoked.

Asteris’s public materials support browser access and remote DICOM download through its online tools. They should not be interpreted as guaranteeing that every external recipient can perform a complete diagnostic review anonymously through one browser link.

Consultation and report return

The system should make it possible to send the study with the relevant clinical history and return the completed report to the correct patient record.

Keystone Community allows users to request consultations and receive reports without requiring an extended service contract or membership. Asteris does not itself provide the interpretation, but works with radiologists, specialists, and integrated consultation providers.

Local and off-site availability

For practices acquiring images where connectivity is unreliable, local storage can allow imaging workflows to continue without waiting for every file to upload.

Asteris describes Keystone as a hybrid PACS in which local infrastructure receives and stores images while the same data synchronizes with its cloud environment. Local access can continue during an internet interruption, while off-site synchronization and remote sharing require connectivity.

This reduces dependence on a continuous connection. It does not make the system immune to local hardware, power, network, internet, or cloud-service failures.

Data-integrity and recovery controls

Asteris states that Keystone uses encryption, hashing, patented lossless compression, and data-recovery mechanisms. Its public FAQ also states that diagnostic data is not altered for storage-space optimization and can be restored if local data is lost or damaged.

These features support data integrity and recovery. They should not automatically be described as establishing a legally sufficient chain of custody, which depends on broader documentation, system controls, and jurisdiction-specific requirements.

Where Keystone Equine Repository fits

Keystone Equine Repository should be distinguished from a general practice PACS.

Asteris describes Equine Repository as a platform for auction and sales organizations handling high volumes of radiographs, reports, and supporting files. Repository administrators can define required submissions, organize files, change the status of lots, and consolidate multiple studies and supplementary files into one hip or lot submission.

That makes it particularly relevant to public auctions and structured sales repositories.

For a private pre-purchase examination outside an auction environment, the more relevant Keystone functions may be:

• Multi-modality image management
• Browser and remote access
• DICOM file transfer
• Consultation workflows
• Report and document attachment
• Local and off-site archiving

The repository product is valuable when the transaction involves a formal sales repository, but it is not automatically required for every equine purchase examination.

For more context on structured sales workflows, read Veterinary Imaging for Horse Sales: A Practical Guide.

Frequently asked questions

Final takeaway

Equine pre-purchase imaging is not always a four-party workflow, and a formal sales repository is not required for every examination.

What every practice does need is a reliable way to retain the original study, document the examination, control access, send complete images for authorized review, and retrieve the record when it is needed later.

Keystone can accurately be described as supporting multiple modalities, DICOM and non-DICOM content, browser access, consultation workflows, local and off-site storage, and structured auction-repository submissions. Asteris also states that most customer data is retained for seven years.

Those capabilities are strong enough without claiming that every examination involves the same parties, that every recipient receives anonymous full-resolution browser access, or that a seven-year service term eliminates future liability disputes.

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