Are cruciate ruptures traumatic? A new question on claim form

RE: Are cruciate ruptures traumatic? A new question on claim form

Anthony Todd — Tue, 09 Feb 2016 23:33:09 GMT

[quote user="robloxley"]Not us. The principles of certification would guide us that we shouldn't certify something what we don't know, so I think that is often the answer[/quote]

Unless the insurance companies specify that a sample of the ruptured and/or degenerated cruciate ligament be submitted for histological examination to confirm traumatic rupture of a histologically normal ligament before any claim can be met.......

RE: Are cruciate ruptures traumatic? A new question on claim form

Rob Loxley — Tue, 09 Feb 2016 20:01:41 GMT

[quote user="Joyce Whitehead"]i don't Rob, that's what I mean, who is to decide?[/quote]

Not us. The principles of certification would guide us that we shouldn't certify something what we don't know, so I think that is often the answer

RE: Are cruciate ruptures traumatic? A new question on claim form

Anthony Todd — Tue, 09 Feb 2016 15:09:13 GMT

We've been here before and I was of the wholly traumatic view but then this:

Most commonly CrCLD is caused by a combination of many factors, including aging of the ligament (degeneration), obesity, poor physical condition, genetics, conformation (skeletal shape and configuration), and breed. With CrCLD, ligament rupture is a result of subtle, slow degeneration that has been taking place over a few months or even years rather than the result of acute (sudden) trauma to an otherwise healthy ligament (which is very rare). This difference between people and dogs explains two important features of canine CrCLD:

from:

https://www.acvs.org/small-animal/cranial-cruciate-ligament-disease

RE: Are cruciate ruptures traumatic? A new question on claim form

Joyce Whitehead — Tue, 09 Feb 2016 13:53:24 GMT

[quote user="robloxley"]

[quote user="Joyce Whitehead"]My old departed Border Terrier ruptured her first one racing across the beach chasing a ball, very suddenly pulled up lame, so surely that would be classed as traumatic. Then the second one she jumped out of the car and fell awkwardly, so also traumatic? Obviously neither was the result of a car accident or similar, but ruptured suddenly. [/quote]

How do you know the trauma was the primary sole cause of rupture and not rather just the straw that broke the camel's back?

[/quote]

i don't Rob, that's what I mean, who is to decide? She wasn't lame on the affected leg prior to these sudden events, but I can't say if there was cellular degeneration before the actual incidents.

RE: Are cruciate ruptures traumatic? A new question on claim form

Rob Loxley — Tue, 09 Feb 2016 13:39:56 GMT

How do you know the trauma was the primary sole cause of rupture and not rather just the straw that broke the camel's back?

RE: Are cruciate ruptures traumatic? A new question on claim form

Bob Russell — Tue, 09 Feb 2016 13:10:08 GMT

Young dog, sudden turn chasing a ball, yelps and comes back lame. Traumatic seems pretty obvious. Similar to a broken toe or other 'athletes' injury. Considered traumatic for a footballer!

Older dog more likely to be a degenerative element but I suspect still needs a degree of trauma to trigger lameness.

RE: Are cruciate ruptures traumatic? A new question on claim form

Clare Tapsfield-Wright — Mon, 08 Feb 2016 23:44:51 GMT

Certainly traumatic in the border collie failing to clear the five bar gate and getting lower leg trapped but fat rottweiler with poor muscle tone and poor stifle conformation is a rupture waiting to happen.i have always assumed that there is a whole spectrum of causes which could lead to ultimate rupture and it's impossible to ascertain when the ligament is first damaged and if that could have been trauma induced or not. Does knicker elastic snap due to intrinsic weakness , repeated stretching or choosing too small a pair and snapping it and would you know at the crucial moment ? i don't think it usually possible to be completely sure enough after the event to accurately document the cause of a crucial rupture on a claim form. It would have to be based on the client history and conjecture .

RE: Are cruciate ruptures traumatic? A new question on claim form

Aine Seavers — Mon, 08 Feb 2016 23:16:40 GMT

Was there a paper about 5 years ago suggesting it was an immune mediated disease? I will try and find it, that might be why they got the loophole passed. Also papers on inflammation from WAT organ (white adipose tissue) mediators affecting cruciate integrity esp in obese labs, the comment from Diane Shelton than the disease in Newfounds might be a neuromuscular degeneration and hence why poor response to ops compared to others. The effect of oestrogen in the JSAP paper around 2010-12 showing suggesting elevated oestrogen a risk for rupture etc. Plus the review by the ortho guru again in the JSAP in an editorial suggesting not much between all the ops means perhaps the surgical approach may need to be reviewed as part of the package not the sole route. Bilateral cruciate is a hard case but where only one leg, where one can get weight reduction generally and be a neutered animal and use disease modifying meds like carthrophen, then a great quality of life can still be possible for the owner with no money?

RE: Are cruciate ruptures traumatic? A new question on claim form

Joyce Whitehead — Sat, 06 Feb 2016 09:35:40 GMT

I think it would be virtually impossible to say in many cases, other than those that present with a mild chronic lameness, which I guess we couldn't say was traumatic. My old departed Border Terrier ruptured her first one racing across the beach chasing a ball, very suddenly pulled up lame, so surely that would be classed as traumatic. Then the second one she jumped out of the car and fell awkwardly, so also traumatic? Obviously neither was the result of a car accident or similar, but ruptured suddenly.

Who classifies what is "traumatic"?

RE: Are cruciate ruptures traumatic? A new question on claim form

Emily Rainbow — Sat, 06 Feb 2016 08:34:36 GMT

[quote user="Michael Woodhouse"]

[quote user="Emily Rainbow"]

There are already some who do. I had to PTS an 18m rottie with bilateral cruciates because the small print on the insurance policy said they would only contribute up to £350 for cruciate repair.

[/quote]

Bilateral lateral suture? I've done one under the same GA and it did well. Spoke to an ortho specialist who advised not ideal, but it was that or nothing. There are cases written up in the literature.

[/quote]

We offered but client couldn't afford it either. Really sad as she thought she'd done the right thing by insuring him with a life long policy etc but didn't notice the exclusion until too late.

RE: Are cruciate ruptures traumatic? A new question on claim form

Braden Collins — Sat, 06 Feb 2016 00:56:54 GMT

My impression (and I may be wrong), is there is a weakness in the ligament, so the rupture itself is rarely "traumatic" in the sense that normal activity could cause the rupture. The normal history I get is "jumped down off a wall" or chasing a ball - all things the dog would do every day of its life.

That being said, I have certainly seen some which are definately traumatic, so it would be hard to exclude all when looking at accidental cover.

It's such a common problem that it definately needs discussing with clients when talking about what to look for in an insurance policy.

There are definately breeds over-represented for the problem, but excluding them on that sort of basis would be like excluding all small white fluffies for skin disease or Cushings.

RE: Are cruciate ruptures traumatic? A new question on claim form

Linda Filshie — Fri, 05 Feb 2016 20:51:32 GMT

Just received my (RSA) insurance renewal - it specifically excludes ANY treatment for ANY cruciate ligament problems - however caused - on the "accident only" policy. So it would appear to me they've essentially decided it is NEVER traumatic. Seems a little disingenuous to say the least.

RE: Are cruciate ruptures traumatic? A new question on claim form

Michael Woodhouse — Fri, 05 Feb 2016 20:06:20 GMT

[quote user="Emily Rainbow"]

There are already some who do. I had to PTS an 18m rottie with bilateral cruciates because the small print on the insurance policy said they would only contribute up to £350 for cruciate repair.

[/quote]

RE: Are cruciate ruptures traumatic? A new question on claim form

Emily Rainbow — Fri, 05 Feb 2016 19:25:03 GMT

There are already some who do. I had to PTS an 18m rottie with bilateral cruciates because the small print on the insurance policy said they would only contribute up to £350 for cruciate repair.

RE: Are cruciate ruptures traumatic? A new question on claim form

Andrew Henfrey — Fri, 05 Feb 2016 19:00:50 GMT

Surely RSA would need to ask an orthopod panel about breed dispositions, and they will have already factored this into their premiums based on breed, ie mastiffs, for example, are more expensive and not just because of their size but because they "have breed disposition or conformation issues".

Does this mean they will now limit cover for cruciates of certain breeds?

RE: Are cruciate ruptures traumatic? A new question on claim form

Hannah Wynne Richards — Fri, 05 Feb 2016 13:32:36 GMT

It is more than a little naughty, in fact, I'd say it's unethical. A cruciate may be pre-dispsed to rupture, but I'd say that there's usually a traumatic episode involved in its actual rupture - they don't suddenly ping when an animal is asleep.

Wynne