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Zumie05
2nd April 2011, 02:44 AM
Soooooooo Coco has something wrong with her liver. They think she has a shunt and need to do an ultrasound. Sad thing is insurance wont cover, that is now a pre existing condition. Oh how I wish I waited a week longer to make her appointment.

Are there ANY plans out there that help cover costs to pre existing things? I think I may cancel my plan now to try to find something else, I don't know what to do.

Anyways, she has to get an ultrasound, if there is 1 kind of thing they do surgery, if there is another, they treat her with meds because surgery is too dangerous. If there is nothing found in the ultrasound, then we begin to look for other illnesses.

Apparantly metabolic issues cause Coco's reactions, and now that I think about it, every episode she has happens during or after she has eaten, and this also explains why she has been such a picky eater.

During the ultrasound they will also be able to find her bladder and take a sterile sample that way. 2 birds with one stone.

Blondiemonster
2nd April 2011, 03:11 AM
Aw. Im sorry for you and sweet little coco. Unfortunately. As far as I know pre-existing conditions are never covered. Let us know what they come up with.

lovecavaliers
2nd April 2011, 04:51 AM
I am so sorry to hear the bad news. Unfortunately as Blondie's mom said, insurances don't cover anything pre-existing. I hope all goes well with the ultra sound and keep us posted.
:lotsaluv:

Zumie05
2nd April 2011, 07:15 AM
Reading more about liver shunts is really explaining a lot. Symptoms are poor weight gain - she has always been on the smaller side, anorexic behavior - I always thought she was just stubborn and picky, and seizures - which is what the neurologist said her growling episodes were.

Here is what a liver shunt is, aka PSS - ProtoSystematic Shunts. As a puppy in utero, the blood is filtered by the mother's liver, and the puppy's blood gets there through an extra blood vessel that bypasses the puppy's own liver. About 3 days after birth, this vessel closes on its own and the puppy's livers cleanse the blood on their own. PSS happens when that vessel does not close, so toxins get to the brain and can cause seizures.

I hope that she has the type of shunt that is outside the liver, because there is one kind where the blood vessel is actually traveling through the liver, which you can't really operate easily on.

I've read there is an 85% success rate with surgery on an outside the liver shunt, where the blood vessel is closed off over a period of about 6 days. After that the dog is a completely normal dog.

Another thing I was reading is this is hereditary. Coco's health contract states I get a 50% refund if something hereditary shows up at age 1 or younger, so this will help finance her treatment since my insurance went askew.

I just cannot decide whether or not to cancel the insurance :huh:

Feeling a bit better now. Today has been a tough one.

Reptigirl
2nd April 2011, 07:38 AM
I'm so sorry to hear. I know nothing of liver shunts but I sure hope it is something that can be easily treated!

As far as keeping the insurance.... I am really bias but I would keep it. You never know what other conditions could come up!

I have heard of a company Pet Assure. They are not insurance. But a discount program.

There site says "Pet Assure is the low-cost, better alternative to veterinary pet insurance. We give you the same low price regardless of your pet's age and we accept any pet - you can even enroll pets with pre-existing conditions. And unlike pet insurance, Pet Assure has no exclusions, no deductibles and no claim forms to fill out and mail - the veterinary practice staff will give you your savings right at the time of service, even on routine petcare."

http://www.petassure.com/

I looked into it but there are not any clinics that accept it around me. Might be worth looking into....

Rubysmum
2nd April 2011, 11:09 AM
hi,im sorry your news . i read a lot about liver shunts when i got ruby ,shes very small , was very difficult to feed and was sick a lot in the first year. i asked the vet about it and he said its a rare condition and she would be in a much worse condition if it was that. thankfully shes grown sturdier now and appears in good health . hope your coco is ok , dont know about insurance i havent got it for ruby ,she got everything wrong with her even before i looked into it !!!! the best of luck to you x

Jasper and Holly
2nd April 2011, 12:46 PM
Hey, I have heard of this before, I know a couple and their Cav had Liver shunts too. I'm sure she has recovered and is doing well. We have changed computers recently so I will have to go find the email she sent me about what happened. It may take a while to find it if I can, but I think she went to a naturopath vet? I think that would be covered by insurance?

GraciesMom
2nd April 2011, 02:48 PM
I hope that they can fix your baby so that all is well. I feel your pain as Gracie's colitis is a pre-existing condition and not covered no matter what the cause of it is.....we have spent a lot of $$$ on that problem. You will not get any insurance that will cover pre-existing. Unless you have another reason to cancel I would not. Because another pricey problem could crop up. You and Coco are in my prayers.

waldor
2nd April 2011, 03:21 PM
Poor Coco! I am sending her doggie hugs. She is so cute and so brave; I hope everything will work out well for both of you.

lovecavaliers
2nd April 2011, 03:37 PM
Hi Coco's Mom, I will be keeping my fingers crossed that the shunt is outside the liver, as you wrote that should be the easier surgery:xfngr:
I am glad that you will be getting 50% of the cost back from the breeder. Smart of you to remember to look into your contract as you deal with all this.
As for your pet insurance, is the only reason they are not covering it due to the discovery of the shunt being within the waiting period? Also does it cover congenital diseases? If so I would keep it since SM and MVD are so prevelant in this breed and very costly.
@reptigirl, thanks so much for sharing that info on petassure, worth looking into for those who dont have insurance and/or available funds for tx.

Pat
2nd April 2011, 04:27 PM
I am very familiar with PSS - and it is portosystemic not protosystemic for those that want to google. Coco's neurological symptoms could be attributed to that.

I had a shih tzu with a PSS that was diagnosed when she was about a year old. She had successful surgery and lived to be 15 years old. (She is my girl that died because of acute pulmonary arterial hypertension after she threw a clot to the lungs.) She had some other complications around the time she was diagnosed and she also had to have a kidney removed - yet she was very healthy from years 2 to 15 until a few weeks before she died.

First of all, PSS is CONGENITAL, not hereditary. Congenital is a birth defect - something that is fully present at birth. Hereditary health problem is a condition that develops after birth (and often in mid or later life) because of the inherited genes that a dog or person has. Hereditary disease is like MVD - a dog has the "bad genes" when he is born but does not have the disease.

For a congenital birth defect, a good breeder should give a FULL refund especially when there is an expensive surgery that can 100% FIX the defect. Most PSS can be completely fixed - surgery is very successful and doesn't have the complications of, for instance, FMD surgery which has varying levels of success.

Get a written statement from the vet if this is diagnosed and ask your breeder for a full refund. If your breeder is a member of a national Cavalier breed club, you'll have a better chance of taking action if you are ignored. You seem to be on good terms with your breeder, so I feel pretty sure that you should get a full refund. This is a very "black and white" situation - no shades of grey such as you would find with hereditary conditions.

PSS is not common in Cavaliers. It is a problem in shih tzu, so there is a hereditary basis for this birth defect.

Pat

P.S. I was going to suggest earlier that they could do an ultrasound guided cystocentesis which is often done if there is trouble palpating the bladder.

Zumie05
2nd April 2011, 06:52 PM
hi,im sorry your news . i read a lot about liver shunts when i got ruby ,shes very small , was very difficult to feed and was sick a lot in the first year. i asked the vet about it and he said its a rare condition and she would be in a much worse condition if it was that. thankfully shes grown sturdier now and appears in good health . hope your coco is ok , dont know about insurance i havent got it for ruby ,she got everything wrong with her even before i looked into it !!!! the best of luck to you x

The strange thing is that Coco is not very sick! She is active, and otherwise happy. The only problems we have had are 1) crystals and uti - vet said this is probably related to liver shunt 2) her random barking/growling episodes. But she has a shiny coat, clear eyes, and is very spunky.

I just feel we are so un lucky :(

Zumie05
2nd April 2011, 06:55 PM
First of all, PSS is CONGENITAL, not hereditary. Congenital is a birth defect - something that is fully present at birth. Hereditary health problem is a condition that develops after birth (and often in mid or later life) because of the inherited genes that a dog or person has. Hereditary disease is like MVD - a dog has the "bad genes" when he is born but does not have the disease.

For a congenital birth defect, a good breeder should give a FULL refund especially when there is an expensive surgery that can 100% FIX the defect. Most PSS can be completely fixed - surgery is very successful and doesn't have the complications of, for instance, FMD surgery which has varying levels of success.

Get a written statement from the vet if this is diagnosed and ask your breeder for a full refund. If your breeder is a member of a national Cavalier breed club, you'll have a better chance of taking action if you are ignored. You seem to be on good terms with your breeder, so I feel pretty sure that you should get a full refund. This is a very "black and white" situation - no shades of grey such as you would find with hereditary conditions.


Thanks for all of this info, very helpful. I will discuss with my breeder. Luckily we are on very good terms, so I think we can have a good and honest discussion about this. She is a member of the CKSC

Jasper and Holly
3rd April 2011, 10:40 PM
The strange thing is that Coco is not very sick! She is active, and otherwise happy. The only problems we have had are 1) crystals and uti - vet said this is probably related to liver shunt 2) her random barking/growling episodes. But she has a shiny coat, clear eyes, and is very spunky.

I just feel we are so un lucky :(

I Am SO sorry to hear that Coco is sick. She is such a sweet dog. I hope she gets well soon and you get to the bottom of whatever is causing her to be like she is.
The people I knew who had a dog with Liver Shunts was really sick, unlike Coco who appears to be well, this little dog did recover without surgery. They went to a natropth. I cannot find the email I had about this dog. Sorry.
Sorry to hear your insurance will not cover Coco. I don't really know what to suggest as an alternative. I really feel for you right now.

mommytoClaire
3rd April 2011, 11:59 PM
I am so sorry to hear about this news. And twice as sorry that your insurance won't cover anything.

I'm just hoping and praying for the best outcome for Coco.

I'd keep the insurance, because as others have said, even without it covering this, there are so many other things that the future may or may not bring.

Hugs to you both,

Cindy and Claire

whittakeramy
4th April 2011, 03:55 PM
Oh my, i am so sorry to hear about coco, i cant say i know about her problem but to me it sounds so serious, i hope it is the easier of the 2 to fix. Im my opinion i wouldnt cancel the insurance either just incase she takes a tumble or something at least then you dont have to worry about the cost of that on top of this. I hope she gets better soon you are both in my thoughts. xxx

Karlin
5th April 2011, 06:21 PM
You can have mild cases of liver shunt that can be managed on diet. But also, Coco is still pretty young and you may only be seeing its earliest effects. If it is causing the kind of neurological problems you are seeing, I would already consider that to be a fairly significant health impact that is surely quite disturbing for her to experience? Over time, if she has a compromised liver, you would probably start to see further health effects. Are they absolutely sure they are seeing liver shunt?

The other possibility is that if she hasn't had a neurological exam and an MRI, then it wouldn't be clear whether the kind of behavior you saw is linked to another problem, such as epilepsy or SM or hydrocephalus, regardless of whether she has liver shunt or not. So those may remain considerations depending on how well she does if you shift her diet.

Pat, I have found references that state that this type of liver shunt is actually considered to be likely to be a hereditary condition in many breeds. Perhaps it is not considered a hereditary problem in Cavaliers, however, though I have heard of a few cases.

This is from the University of Tennessee vet school website:


Are shunts hereditary?
A disease is likely to be hereditary if it occurs more commonly in one breed than others; if it occurs in a family of dogs; or if it or a closely related disease is proven hereditary in other breeds or species. Liver shunts are considered hereditary in Irish wolfhounds, Cocker spaniels, Maltese, and Yorkshire terriers, and are probably hereditary in several other breeds. The affected dog should be castrated or spayed and, because the mode of inheritance is not known, it is best to avoid breeding the parents.



link: http://www.vet.utk.edu/clinical/sacs/shunt/faq.php

Pat
6th April 2011, 12:47 AM
Yes, I should have elaborated more - in shih tzu and other breeds, the defect is congenital AND hereditary. Dogs with PSS should not be bred and serious consideration should be given as to whether to again breed the parents who produced the dog with PSS. I haven't seen evidence that this is a hereditary problem in Cavaliers, though as I've just heard of a small handful over many years. My main intent was to point out to Alisha that if Coco indeed has a PSS, this is a problem that was present at birth - just as if Coco had been born with three legs or with five legs - and that a birth defect should receive a full refund to go toward the surgical repair.

Was the ultrasound done yet and did it confirm PSS?

The first symptoms that my shih tzu exhibited were seizures and other neurological symptoms when she was close to one year old - that led to the tests that confirmed PSS. As I mentioned, surgery for her was successful, and she lived to be 15. If it is confirmed that Coco has PSS that can be surgically repaired, I would do the surgery asap and wouldn't mess around trying to see if diet helps.


Pat

Zumie05
6th April 2011, 12:58 AM
Yes, I should have elaborated more - in shih tzu and other breeds, the defect is congenital AND hereditary. Dogs with PSS should not be bred and serious consideration should be given as to whether to again breed the parents who produced the dog with PSS. I haven't seen evidence that this is a hereditary problem in Cavaliers, though as I've just heard of a small handful over many years. My main intent was to point out to Alison that if Coco indeed has a PSS, this is a problem that was present at birth - just as if Coco had been born with three legs or with five legs - and that a birth defect should receive a full refund to go toward the surgical repair.

Was the ultrasound done yet and did it confirm PSS?

The first symptoms that my shih tzu exhibited were seizures and other neurological symptoms when she was close to one year old - that led to the tests that confirmed PSS. As I mentioned, surgery for her was successful, and she lived to be 15. If it is confirmed that Coco has PSS that can be surgically repaired, I would do the surgery asap and wouldn't mess around trying to see if diet helps.


Pat

Ultrasound is scheduled for tomorrow. I am afraid to ask the breeder for a full refund, but here is an email I got from her the other day:


"
Hi Alisha, Thank you for keeping us informed. We will stand behind our contract which state that
1) The puppy is also guaranteed for one year from the above date to be free of any genetic problems which might prevent him/her from being a happy family pet. If such problems should arise Vendor will upon receipt of a veterinarianís certificate to that effect refund 50% of the purchase price or replace the puppy as soon as possible. Note: This guarantee does not apply to Mitral Valve Disease, or Syringomyelia, the genetic inheritance of which is presently unknown.


So what has to be determined is if it is a genetic problem. We would like to talk to your doctor by phone this week Tues- Thurs and we will call him/her when it is convenient for your doctor. We also would like a second opinion and have our doctor read the tests and talk to us about it. When will you be having the ultra sound if you haven't had one already? We feel badly that this is happening and we are glad you stuck with this and are looking for a solution."


I gave my vet the ok to release medical records to them and to their own vet. So far I am please she is concerned and is continuing to keep in contact with me. It is just that nothing in our contract states that a full refund would ever be given.



Along with the contract I was give information about the CKCSC Usa Code of ethics and in there I am having a hard time finding any information stating a full refund should be given for a birth defect :\

Reptigirl
6th April 2011, 01:18 AM
Note: This guarantee does not apply to Mitral Valve Disease, or Syringomyelia, the genetic inheritance of which is presently unknown.

Just woke up from a nap so I HOPE I am reading this wrong.... The breeder DOESN'T guarantee against SM or MVD? or am I just reading this wrong and there is a different part of the guarantee that covers that?:confused:

Sorry to go off topic and I hope things go well tomorrow. :xfngr:

Pat
6th April 2011, 01:43 AM
Well I'm sorry to read that response.

I'm saying that this is the RIGHT thing to do, and this is what my ethical breeder friends would do and have done (that would be Liz S. and Anne R. and Pat W. and similar breeders) in a situation of a congenital defect. You aren't going to find this legislated in codes of ethics (although you could certainly make an appeal if you so desired and you could make a very good case to receive a full refund).

If Coco had been born with five legs - the breeder could not have sold her but would likely have placed her for free with someone that would commit to surgery to remove a leg (I'm obviously just using this as an illustration!). Or the breeder would have the surgery done to remove leg #5 and would then place her in a pet home for free or reduced price. She would not be sold as a "premium" pet. She might have been culled at birth.

The only difference is that PSS isn't "visible" at birth. It requires an ultrasound to see it. Routine ultrasounds aren't done just for the heck of it; they are done when symptoms lead a vet to do this test to rule problems in or out. Your breeder has every right to have her vet consult with your vet and get copies of tests, etc. That is a very reasonable request. But if PSS is diagnosed on ultrasound, this is a black and white situation; no grey about it. Coco would have been born with this, so, looking at this in terms of a "product," she is a "defective product." (Obviously I don't look at dogs as "products" I'm just using this for illustration. And I have adopted plenty of "defective dogs" and had them treated at my own expense and I've loved them dearly and as much as any "normal" dog.) PSS didn't happen because you were neglectful or did something wrong; it was present (but unknown) when you made the purchase.

Basically, your "guarantee" isn't worth crap, but this is actually quite typical. The exception for MVD and SM pretty much seals the deal that your guarantee is crap. It's highly unlikely anyway that these conditions would be diagnosed before one year of age, but then the exclusion eliminates these problems at ANY age. So what IS covered in your guarantee - just a fifth leg? Also your breeder clearly doesn't know the meaning of a "congenital" problem.

Pat

Jasper and Holly
6th April 2011, 01:43 AM
Good luck with Coco hope all goes well for you both.