Animal Health Foundation Blog

More Pet Insurance Policies Are Being Sold. But Are They Worth the Cost?

January 7th, 2019 by Animal Health Foundation
FROM THE NEW YORK TIMES, JANUARY 4, 2019

YOUR MONEY ADVISER

The New York Times

By Ann Carrns Jan. 4, 2019

Americans are increasingly treating their pets as members of the family, feeding them gourmet food, paying for day care and throwing them birthday parties. Family sleepwear sets sold on PajamaGram.com even include matching jammies for the dog.

So it’s not surprising that an increasing number of “pet parents,” as they are known in the pet care industry, are seeking sophisticated medical treatments for their animals.

Enter pet health insurance, marketed as a way to help defray rising veterinary expenses and avoid “economic euthanasia” — the necessity of putting a pet down because the owner can’t afford treatment. More than two million pets in the United States and Canada (most of them in the United States) were insured at the end of 2017, up about 17 percent from the year before, according to the North American Pet Health Insurance Association.

But consumer advocates say that pet owners should make sure they understand how the policies work before buying them.

More than two-thirds of households in the United States own a pet, according to the American Pet Products Association. Americans spent about $70 billion on pets in 2017, including purchases of animals, food, veterinary care, medicines and other services.

“People are much more inclined to think of their animals like children, and treat them accordingly,” said James Serpell, a professor of ethics and animal welfare at the University of Pennsylvania’s School of Veterinary Medicine.

J. Robert Hunter, director of insurance with the Consumer Federation of America, said pet owners should bring a healthy skepticism when shopping for pet insurance. Purchase of the product is “often motivated by a combination of love and fear,” he said. “So the buyer may be particularly vulnerable.”

Details vary by insurer and policy, but premiums for pet insurance typically depend on factors like the cost of veterinary care where you live and the age and breed of the pet. The average annual premium for “accident and illness” coverage was $516 per pet in 2017, while the average claim paid was $278, according to the pet health insurance association.

Jeff Blyskal, a senior writer with Consumers’ Checkbook, a nonprofit group that rates services in major urban markets, said pet owners should compare policies with a critical eye. When years of payments are taken into account, he said, buying insurance could end up being more expensive for some pet owners than going without it, if their animal doesn’t require much care.

Pet policies typically don’t cover pre-existing conditions, Mr. Blyskal said, so premiums are generally lower when your pet is young and healthy. Even if you start early, though, you may end up paying more over time, he said, because some policies raise premiums as pets get older. This can increase costs substantially, he said, and cause owners to drop their policies as the animals get older — just when they are more likely to need the coverage. Industrywide, the average pet policy is maintained for three years or less, according to an insurer regulatory filing in 2016 in Washington State.

The expenses tied to pet health coverage usually include not only a regular premium but also other out-of-pocket costs, like a deductible — an amount that you must pay before insurance begins paying. Insurance may cover less than 100 percent of costs after the deductible, so you’ll still have to pay for part of the treatment. Some policies may cap payments, so ask if there’s a limit.

Rob Jackson, chief executive of Healthy Paws Pet Insurance, said insurance could protect against budget-busting events costing thousands of dollars. (Healthy Paws said a pet’s age affects premiums at initial enrollment, and also as the pet ages.) The Healthy Paws website cites examples like Fridgey the Bengal cat, who had a $4,600 hip replacement, and Lupa the German shepherd, who needed $52,000 in treatment for tetanus exposure.

One way to pay lower premiums, and possibly get broader coverage, is to buy pet insurance through your employer. Eleven percent of employers in the United States offer pet health insurance benefits, according to a 2018 survey by the Society for Human Resource Management, up from 6 percent in 2014. Typically, companies offer pet insurance as a “voluntary” benefit. It’s uncommon for employers to contribute to the cost of premiums, as they do with human health insurance. But insurers may give employees a break on premiums, or offer better coverage, because their marketing costs are lower.

Employees at Ollie, a specialty dog food company, receive a 15 percent discount on premiums from the insurer Healthy Paws, said Gabby Slome, a co-founder of Ollie. (Ollie also offers workers benefits like “pawternity” leave when they take a new dog home.)

“We had a strong belief that pets are a part of one’s family,” she said.

Scott Liles, president and chief pet insurance officer with Nationwide, said half of Fortune 500 companies offer their employees pet insurance from his company. Nationwide’s employer-based plans now underwrite by species — canines vs. felines — but not by age or breed, Mr. Liles said. That means, he said, you won’t pay a higher premium if your pet is older, or if its breed is prone to certain illnesses, unlike policies sold in the open market.

Here are some questions and answers about pet health insurance:

Do some animals cost more to insure than others?

Cats are generally less expensive to insure than dogs. The average accident and illness premium in 2017 was about $45 a month for dogs and $28 a month for cats, according to the pet health insurance association. Because some purebred animals are prone to certain health problems, some insurers may charge higher premiums for them.

What if I can’t afford pet insurance?

Local animal shelters may offer basic services, like rabies vaccinations or spaying and neutering operations, at a discounted rate. The Humane Society of the United States lists groups that can help owners who can’t afford medical care for their pets.

Another option is to put money away each month — perhaps the amount of the premium you would pay — into a dedicated savings account so you will have some funds available for pet care if you need it.

What if I’m unhappy with my pet insurance policy?

Insurance products are generally regulated by state governments, so you may want to contact your state insurance commissioner about your concern. The National Association of Insurance Commissioners offers information about pet insurance and links to regulatorsin each state.

Correction: 

An earlier version of this article, using information supplied by Healthy Paws Pet Insurance, misstated how a pet’s age affects premiums for the company’s policies. The pet’s age affects the premium at the time of enrollment and as the pet gets older, not just at enrollment.

Hospice Care For Dogs

January 5th, 2019 by Animal Health Foundation

From iheartdogs.org

Animal Health Foundation Board Member, Dr. Alice Villalobos, is quoted in this article!

Hospice Care For Dogs: Is It The Right Choice For You & Your Pooch?

Hospice care for dogs is a relatively new concept. Sadly, the word hospice often carries a negative stigma. It reminds us of lonely, sterile rooms and the fear of impending death. In reality, hospice care can be a wonderful gift for terminally ill people and pets. Rather than focusing on invasive medical procedures, hospice provides physical and emotional comfort to end-of-life patients and their families.

hospice care for dogs

What is hospice care for dogs?

Hospice care is based on the philosophy that people and pets deserve to die with dignity. When a dog is suffering from a serious illness and a cure is not possible, hospice care provides a temporary alternative to euthanasia. The goal is to make their remaining days comfortable with pain medications, dietary strategies and human interaction.

Dr. Alice Villalobos is a world-renowned veterinary oncologist. She coined the term “pawspice,” which she describes as supportive care in evaluating and managing quality of life in the time leading up to a pet’s death.

“In-home ‘pawspice’ care is a wonderful next step,” Dr. Villalobos says. “It should be introduced as an interval between the thought and the final act of euthanasia, if the owner really feels that their pet still has a quality of life.”

Hospice care for dogs also allows families to come to terms with the impending loss of a beloved friend. In keeping a terminal pet comfortable, the human family members have time to come to terms with the situation. Hospice allows them to plan special moments with their dog, take family photos, and seek emotional and spiritual support.

Bloating in Dogs Treatable with Gastropexy

January 5th, 2019 by Animal Health Foundation

Courtesy of the Whole Dog Journal

If you have a bloat-prone breed, consider a gastropexy, a surgical procedure that can prevent stomach torsion.

[Updated December 26, 2018]

It was a beautiful fall day, and I was at a dog show. In the ring was a gorgeous veteran Greyhound – strutting his stuff in one of those peacock moments that transport gray-faced show dogs back to their youthful selves, with nothing but time and promise before them. A short time later, I heard a commotion from the parking area, and then the awful news: The handsome old dog was bloating.

Thankfully, this was a group of highly experienced dog people, and the dog’s handler immediately ran to her van to procure the bloat kit that she always traveled with. As several people helped hold the dog, she inserted a tube down his esophagus to help expel the trapped gas that was causing his ribs to expand like barrel hoops, taped the tube in place, and sped off to the nearest emergency vet. I heard through the grapevine later that the dog had, mercifully, survived.

old great dane

There’s good reason why veterinarians call bloat “the mother of all emergencies.” It can come on suddenly and, if left untreated for only a handful of hours, can spell a death sentence for a dog.

Symptoms of bloat, which is incredibly painful for the dog, include pacing and restlessness; a distended abdomen; turning to look at or bite at the flank area; rapid, shallow breathing; retching without actually vomiting up any food, and excessive drooling.

Bloat is a two-part disorder, telegraphed by its formal name: gastric dilatation and volvulus. The first part, gastric dilatation, refers to an expansion of the stomach due to the presence of gas and/or food. The second part, volvulus, is the fatal blow: The distended stomach begins to twist, cutting off the blood supply and causing its tissue to die off. As if that wasn’t trouble enough, the enlarged stomach may press on the blood vessels that transport blood back to the heart, slowing circulation, creating cardiac arrhythmia, and sending the dog into shock.

Once the stomach has torsioned, emergency surgery is required to restore it to its normal position, and to evaluate whether so much tissue has died off that the dog has any hope of surviving.

This was precisely the scenario that the quick-thinking Greyhound handler had sought to avoid: By inserting the bloat tube down the esophagus and into the stomach, she not only created an avenue of escape for the trapped stomach gases, but also ensured that the stomach could not twist while the tube was inserted. As you can imagine, this is not something that most dogs entertain willingly, and, indeed, on the ride to the veterinarian, the dog struggled and the tube was dislodged. Still, it bought enough time for his survival.

Many owners, however, don’t have the inclination or the fortitude to stick a tube down their dog’s throat, even if he is bloating. And for those who have breeds that are at a higher risk for bloat, the constant stress of worrying “Will she bloat?” after each meal is enough to prompt them to consider gastropexy, a preventive surgical procedure where the stomach is sutured to the body wall. While gastropexy won’t prevent a dog from dilating, it does greatly reduce the likelihood that the stomach will flip – which is the life-threatening “volvulus” part of gastric dilatation and volvulus.

Dog Bloat Risk Factors

Owners who are determined to prevent bloat nonetheless want to understand its causes before submitting their dogs to an elective surgery like gastropexy. The problem is, veterinary science is still unclear about precisely what triggers an episode, and instead can only offer a long and varied list of risk factors.

The mother of all bloat studies was done two decades ago by Dr. Lawrence T. Glickman and his colleagues at the Purdue University Research Group, and is still being discussed and quoted today. The 1996 study and its follow-up research found that many food-management practices that were initially believed to help reduce the risk of bloat – like feeding from a raised food bowl, moistening dry food before serving, and restricting water access before and after meals – actually increased the odds of a dog bloating.

Other risk factors include eating only one meal a day; having a close family member with a history of bloat; having a nervous or aggressive temperament; eating quickly; being thin or underweight; eating a dry-food diet with animal fat listed in the first four ingredients, and/or eating a moistened dog food, particularly with citric acid as a preservative.

Not surprisingly, certain breeds were found to be at high risk for bloat, particularly large or giant breeds. Topping the list were Great Danes, followed by St. Bernards and Weimaraners. The study found that breeds with deep and narrow chests – like the Greyhound that started this story – are also at higher risk for bloating, as are males and older dogs.

Also according to the Purdue study, the risk of bloat was more than twice as high in dogs seven to 10 years old compared to dogs two to four years old, and more than three times as high in dogs age 10 and older.

Reducing the Risk of Bloat

While not a guarantee that your dog will avoid experiencing an episode of bloat, these steps can help lower the risk.

1. Feed several smaller meals per day.

Feeding a large, once-a-day meal can extend the stomach and stretch the hepatogastric ligament, which keeps the stomach positioned in the abdominal cavity. Dogs that have bloated have been found to have longer ligaments, perhaps due to overstretching.

2. Slow down fast eaters.

Some theories suggest that air gulping can trigger bloat. To keep your dog from gobbling down his meals, invest in a slow-feeder bowl, which has compartments or grooves to require dogs to pace themselves; there are several brands available. For a low-tech version, try placing a large rock in the middle of your dog’s food bowl, which will force him to eat around it. (Of course, make sure the rock is large enough so it can’t be swallowed.)

3. If you feed kibble, add some variety.

Dogs that are fed canned food or table scraps have a lower incidence of bloat. If you feed kibble, try to avoid food with smaller-sized pieces, and opt for brands that have larger-sized pieces. While some raw feeders maintain that feeding a raw diet prevents bloat, there are no studies to support this, and raw-fed dogs are not immune to bloating.

4. Don’t go for lean and mean.

Studies show that thinner dogs are at greater risk for bloat; in fatter dogs, the extra fat takes up space in the abdomen and doesn’t give the stomach much room to move. While no one is advocating that you make your dog obese, keeping a bloat-prone dog on the slightly chunkier side might have some merit.

5. Reduce your dog’s stress.

Easier said than done, of course. But if at all possible, opt for a house sitter instead of taking your dog to a kennel. If you have multiple dogs, feed your bloat-prone dog separately, to avoid the stress (and resultant gulping) from worrying that his meal might be snagged by a housemate.

6. Don’t eat and run.

Veterinary experts recommend that you avoid giving your dog hard exercise one hour before and two hours after he eats. Many give the green light to walking, however, as it does not jostle the full stomach and in fact can help stimulate digestion.

Assembling a Bloat Kit

Because bloat strikes when you least expect it – often at night, when most veterinary practices are closed, and the nearest emergency vet might be a distance away – a bloat kit can be a literal lifesaver.

Some dog-care sites sell pre-assembled bloat kits. (One option is available from A Better Way Pet Care.) Most include clear vinyl tubing (the kind sold by aquarium stores); a wooden mouth block, to keep the mouth open while the tube is being inserted (a piece of PVC pipe can work in a pinch), and water-soluble lubricant.

Ask your vet to show you how to measure the tubing so that it is the correct length, how to insert it, and how to tell if you are passing the tube down the trachea rather than the esophagus.

Remember that a gastric tube is not a treatment for bloat; it is a first-aid measure. If you are unsure of how to use the kit, or if you are alone and don’t have someone to transport you while you work on the dog, make getting to the vet your first priority.

dog bloat emergency kit

Deciding on Surgery

If your dog bloats and her stomach has torsioned, surgery is the only recourse if you want her to survive. And if you get to the vet in time, the odds are with you: In a retrospective study of 166 cases between 1992 and 2003, researchers found that short-term mortality resulting from bloat surgery was a relatively low 16.2 percent.

Risk factors for a fatal outcome included having clinical signs more than six hours before surgery (i.e., the longer you wait, the worse your dog’s prognosis), hypotension during any time of the hospitalization, peritonitis, sepsis, and administration of blood or plasma transfusions. Dogs whose tissue damage was so advanced that they required part of their stomach or their spleen removed (partial gastrectomy or spleenectomy, respectively) also had worse prognoses.

But the decisions regarding a gastropexy – essentially, “tacking” the stomach so it cannot torsion – are not as clear-cut. If your dog has never bloated, you’ll need to weigh the risk factors: Is your dog’s breed prone to bloat? (Great Danes, for example, have a whopping 42.4 percent chance of bloating in their lifetime.) Do you know of any siblings, parents, or other close relatives who have bloated? Is your dog nervous, aggressive, or a super-fast eater?

And, most important, has your dog bloated before? Studies indicate that such dogs have a recurrence rate of more than 70 percent, and mortality rates of 80 percent.

Types of Tacks

There are several kinds of gastropexy surgery. Securing the bottom of the stomach to the right side of the body so it cannot rotate during an episode of bloat is the common goal of each type of surgery, but slightly different methods are used to accomplish this. There are no studies that compare the efficacy of the various types of gastropexy, but the general consensus is that there is not a huge difference between them. Most veterinarians will choose one over the others based on their own preference and amount of experience.

Incisional gastropexy is a straightforward procedure in which the bottom of the stomach (the antrum) is sutured to the body wall. It relies on only a few sutures until an adhesion forms.

Belt-loop gastropexy involves weaving a stomach flap through the abdominal wall. Though a relatively quick procedure, it requires more skill than an incisional gastropexy.

In a circumcostal gastropexy, a flap from the stomach is wrapped around the last rib on the right side and then secured to the stomach wall. Proponents of this approach note that the rib is a stronger and more secure anchor for the stomach. This type of gastropexy requires more time and skill to perform; risks include potential rib fracture and pneumothorax, in which air leaks into the space between the lung and chest wall.

Gastropexy is now being performed with minimally invasive approaches such as laparoscopy and endoscopy, which shorten surgery and anesthesia times, as well as the time needed for recovery. Though both use remote cameras to visualize the surgery area, the laparoscopic-assisted approach requires an extra incision through the navel, which allows the surgeon to directly visualize the position of the stomach and make any modifications necessary.

A 1996 study of eight male dogs compared those that had laparoscopic gastropexy with those that had belt-loop gastropexy, and concluded that the laparoscopic approach should be considered as a minimally invasive alternative to traditional open-surgery gastropexy.

Complications from gastropexy are relatively minor, especially for young, healthy dogs who are undergoing the surgery electively, before any incidence of bloat. As always, be sure that your dog has a complete pre-surgical work-up to ensure there are no chronic or underlying conditions that might compromise her ability to successful recover from surgery. And again, while gastropexy isn’t foolproof, Dr. Glickman has been quoted as saying that the risk of bloat and torsion after the procedure is less than five percent – not bad odds at all.

If you do elect to have a gastropexy performed on your dog, many veterinarians do the procedure at the same time as spaying or neutering. That way, the dog doesn’t have to go under anesthesia again, or, in the case of conventional surgery, be “opened up” another time.

In the end, the question of whether or not to have a gastropexy done is arguably tougher for those whose dogs who are not at very high risk: The owner of a Great Dane has a greater incentive for getting a gastropexy than, say, the owner of a Shih Tzu, whose bloat rates are not as comparably high.

A 2003 study that looked at the benefits of prophylactic gastropexy for at-risk dogs used a financial metric to assess the benefits of surgery: Working under the assumption that elective gastropexy surgeries cost about $400 and emergency bloat surgeries cost at least $1,500 – or as much as four times that – the study concluded that the procedure was cost effective when the lifetime risk of bloat with torsion was greater than or equal to 34 percent.

As with any complex decision, assess your dog’s risk factors, as well as your individual circumstances, and then make the choice that seems right for the both of you.

Denise Flaim raises 12-year-old triplets and Rhodesian Ridgebacks, on Long Island, NY.

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Pets, Asbestos Exposure, and Mesothelioma

December 5th, 2018 by Animal Health Foundation

From www.mesothelioma.net

For more information and to sign up to receive resources by mail, go to:

https://mesothelioma.net/pets-asbestos-exposure-mesothelioma/

Pets, like their human caretakers, are susceptible to becoming ill from asbestos exposure. Dogs, cats, and other animals can develop mesothelioma and other asbestos-related illnesses, with devastating consequences. As with humans, mesothelioma in pets is an aggressive and deadly type of cancer. The treatment options are even more limited and the hope of survival minimal.

Pets may become exposed to asbestos in many of the same ways people are. Older homes with worn and exposed asbestos insulation, for instance, can send fibers into the air that humans and animals alike may inhale. If the owner works around asbestos and brings fibers home on clothing, this too can lead to exposure in pets. Mesothelioma in pets is rare, but it is possible. It is important to minimize exposure risks for people and animals in the household.
mesothelioma in pets

Asbestos Exposure Causes Mesothelioma in Pets

Evidence that points to asbestos as a cause of mesothelioma in humans is already overwhelming. Research into pets with mesothelioma is much more limited, but it does exist. One study, for instance, examined the tissues of dogs that died from mesothelioma. Researchers saw pleural, peritoneal, and pericardial mesothelioma in the population of dogs studied and even some that had cancerous tissues in more than one part of the mesothelium. Most of the dogs in the study were found to have asbestos in the affected tissues, providing a link between the cancer and exposure to asbestos. Dogs in a control group had far fewer fibers.

Stories of animals suffering and dying from mesothelioma are rare, but heartbreaking.  In the United Kingdom there was a case reported of a dog that died from mesothelioma. The devastated owners reported that their dog had sniffed asbestos-containing materials that had been dumped at old building sites in the woods where they regularly walked. After thousands of dollars in vet bills the dog could not be saved.

How Pets May Be Exposed to Asbestos

Although mesothelioma is rare, it is strongly linked to exposure to asbestos so pet owners need to be aware of the asbestos risks and should take steps to minimize any possibility of exposure. One of the most likely ways in which an animal may be exposed is through secondhand contact. If you come home from work with fibers of asbestos on your clothes, your pet is likely to inhale those fibers or even ingest them.

Pets may also be exposed to asbestos that is in the home. Homes built before the 1980s most likely contain asbestos in insulation, HVAC systems, flooring, siding, ceiling materials, and other areas of the house. If that asbestos is disturbed, worn down, or damaged, the fibers can become airborne where they can be inhaled by anyone in the house, including pets.

This risk is especially high during renovation or remodeling projects. This kind of work can disturb previously encapsulated asbestos. The best way to protect animals during home projects is to keep them temporarily out of the home, at someone else’s house or at a kennel or boarding facility. While humans can wear protective gear, animals cannot. Also, dogs may lick things on which asbestos dust has settled.
Like the dog in the United Kingdom that died after being exposed to asbestos on walks, exposure outside of the home is a rare but possible risk for pets, especially dogs. Dogs that go outdoors for walks or spend a lot of time out in the yard may be at risk for exposure from any nearby demolition, construction, or mining.

Symptoms of Mesothelioma in Pets

If your pet has been exposed to asbestos, you may see signs of illness. If you catch these early and have your dog or cat diagnosed and treated, you may be able to extend the life of your beloved pet. There is no way to cure mesothelioma in cats or dogs, but early detection can give you more treatment options and a better chance of giving him or her a better quality of life for as long as is left. Dogs are more likely to develop mesothelioma than cats.

With pleural mesothelioma, a pet may exhibit signs such as labored breathing, rapid breathing, or shortness of breath, and a cough. With peritoneal mesothelioma, an animal may display abdominal discomfort, abdominal swelling, or vomiting. Other symptoms of any type of mesothelioma may include fatigue and lethargy, an enlarged scrotum, and unusual sounds in the abdomen or chest.

Diagnosing and Treating Mesothelioma

If you see any unusual symptoms in your dog or cat, you should take your pet to the vet immediately. If you have any reason to believe your pet may have been exposed to asbestos, inform your veterinarian so that your animal will get a complete diagnosis. As with humans, diagnosing mesothelioma can be tricky. Your vet will begin with a physical exam and likely a blood and urine analysis. From there your vet will probably want to do imaging tests, like an X-ray, to look for tissue abnormalities. The next step would be a biopsy to remove fluid or tissue for examination.

Much of the treatment given to an animal for mesothelioma will be palliative, to keep the pet comfortable. However, there are some cancer treatments that may slow the progression of the disease and give you more time with your pet. In one small study, a specific combination of chemotherapy drugs allowed a dog to go into remission, although other animals in the study did not. Palliative treatments for an animal with mesothelioma include medications for pain and procedures to drain fluid from the abdomen or chest cavity.

Help Your Pet Live with Mesothelioma

A diagnosis of cancer in a pet is devastating news, especially when the prognosis is not favorable. There are things you can do to make sure your pet lives the rest of his or her days in the most comfort possible. Limiting activity is important, especially for a pet with pleural mesothelioma. Taking slower and shorter walks can give your dog a chance for exercise and fresh air without overexertion, for instance.

Your pet should also be given a quiet and comfortable place in the home to rest. Make this area easy to access, but out of the way of noise or disruption so that he or she can rest as needed. Regular visits to the vet are also important so you can be sure that you are doing the best for your animal and providing all the care that is necessary for maximum comfort. When the time is right you may need to make the difficult decision about letting your pet go, but your vet can help you make that choice. The loss of a pet to a disease like mesothelioma is terrible and the only way to prevent it is to keep your pet safe from asbestos.