Lameness work ups and insurance

E

emfen1305

Well-Known Member
Joined
2 December 2015
Messages
1,046
Visit site
I decided to change vets for a fresh pair of eyes as not overly happy with answers from my old vet. New vet seems lovely, well spoken of practice and lots of people of my yard are registered there meaning more chance of a shared call out! I was planning on having his hocks remedicated in January to see if that's what was causing our issues so called up and spoke to the new vet to see what she thinks and she recommended coming out to look at him and do a full work up which I'd be happy to do so that someone totally new can take a look. She already happened to be coming tomorrow so asked if I wanted to split callout which I agreed. All fine and looking forward to seeing what she thinks (albeit a little sooner than I was planning, Christmas will be a homemade one this year i think!!) From months of on and off research into his "symptoms" he could have anything from KS, SI Joint pain, stifle issues, bilateral PSD, any multiples or all of the above - the joys!

Anyway, my question is about insurance related. He has already been excluded from arthritis (the entire condition!) as he has mild arthritic changes in both hocks. He has also been excluded from ulcers, both on the same claim and claim has just run out. Does anyone know where I stand now in terms of opening up a new claim for further investigations? If i were to open up a claim, get the vet to do all of the various checks (back xrays, ultrasounds etc) and they all came back squeaky clean, am i right in thinking the insurance will refuse to pay out? I am with a reputable insurance company who paid out everything on my last claim without quibbling including a bone scan so I am just thinking about what would happen if we started doing tests that came back clean, I don't have that kind of spare money! Just wondering if others had been through a similar experience? I am kicking myself and not pushing my old vet to continue with investigations but hey ho, hindsight is grand! Thanks!
 
I can't answer all of the questions, but mine has arthritis in her hocks and it is ONLY her hocks that are excluded from insurance - not all of her! I'd argue that point with the insurers because they do try and take the P.

Does the new vet know what has been looked at before? It needs to be a totally new problem at least in terms of the description given to the insurers and so they will need to be very careful what they write on your records. I doubt the insurance company will keep paying, so my advice would be to control the vet tightly in terms of what they do and make sure they know you probably are not insured. If they think the insurance will pay then its a free for all with some of them. I suspect from what you're saying nerve blocking the hocks would be the starting point.


I did get a 2nd opinion on my mare and was lucky enough to find a vet who basically told me to get her muscular condition under control and then we'd assess her lameness again. The lameness is not apparent with the PSSM managed, so he probably saved me a fortune in bone scans etc.
 
I did try to argue with them as it makes no sense but they said their policy now is to exclude conditions rather than limbs but if it comes to me having to make another claim I am going to ask again! It really doesn't make sense, it's not like it can spread!

Yes new vet has full clinical history from my old vet and the referral hospital, I am paying for the visit tomorrow so I just wanted a lameness work up to see what she thought of him and whether she thinks there's something worth investigating other than the hocks or just to press on with the hock injections. The problem with nerve blocking was when he was originally found to have problems with his hocks on the bone scan, they did nerve block the worst hock and didn't see any improvement so they just did the xrays and found mild changes so I am a bit worried about paying out for the nerve blocks and there being no difference!

I have just put him back on the vit e oil to see if that improves the tightness over his hind end. There is just nothing to go off so spend half the time i feel like i am going bonkers and the other worried sick about him!
 
I wouldn’t be jumping in headfirst on this. I’d plan for the assumption insurance won’t pay out - set yourself a budget. If you do have a successful claim then it’s a bonus. IME once you are managing a couple of diagnosed conditions little inter related things start coming out of the woodwork!
 
ihatework said:
I wouldn’t be jumping in headfirst on this. I’d plan for the assumption insurance won’t pay out - set yourself a budget. If you do have a successful claim then it’s a bonus. IME once you are managing a couple of diagnosed conditions little inter related things start coming out of the woodwork!
Click to expand...

Thanks, just struggling a bit with where to go next and don't have £££s to plough into investigations, he's definitely not right behind but don't know whether it's just a hock issue or something else and it's a risky game with the insurance! Kicking myself that I didn't push for more investigations when I had the claim open!
 
I think you'll have to proceed cautiously. The new vet needs to confirm there's pain coming from the hocks before medicating- a simple flexion should confirm that. If medicating the hocks doesn't then improve the horse there may be scope for investigating further
 
TheMule said:
I think you'll have to proceed cautiously. The new vet needs to confirm there's pain coming from the hocks before medicating- a simple flexion should confirm that. If medicating the hocks doesn't then improve the horse there may be scope for investigating further
Click to expand...

Thanks - i'll see what the vet says this afternoon!
 
I'd tell vet that essentially he is so excluded as to be uninsured so you need to address the obvious/most likely first. They have history and would want to see the horse before agreeing to medicate obviously but doing the hocks would seem a sensible place to start for me.
 
emfen1305 said:
I decided to change vets for a fresh pair of eyes as not overly happy with answers from my old vet. New vet seems lovely, well spoken of practice and lots of people of my yard are registered there meaning more chance of a shared call out! I was planning on having his hocks remedicated in January to see if that's what was causing our issues so called up and spoke to the new vet to see what she thinks and she recommended coming out to look at him and do a full work up which I'd be happy to do so that someone totally new can take a look. She already happened to be coming tomorrow so asked if I wanted to split callout which I agreed. All fine and looking forward to seeing what she thinks (albeit a little sooner than I was planning, Christmas will be a homemade one this year i think!!) From months of on and off research into his "symptoms" he could have anything from KS, SI Joint pain, stifle issues, bilateral PSD, any multiples or all of the above - the joys!

Anyway, my question is about insurance related. He has already been excluded from arthritis (the entire condition!) as he has mild arthritic changes in both hocks. He has also been excluded from ulcers, both on the same claim and claim has just run out. Does anyone know where I stand now in terms of opening up a new claim for further investigations? If i were to open up a claim, get the vet to do all of the various checks (back xrays, ultrasounds etc) and they all came back squeaky clean, am i right in thinking the insurance will refuse to pay out? I am with a reputable insurance company who paid out everything on my last claim without quibbling including a bone scan so I am just thinking about what would happen if we started doing tests that came back clean, I don't have that kind of spare money! Just wondering if others had been through a similar experience? I am kicking myself and not pushing my old vet to continue with investigations but hey ho, hindsight is grand! Thanks!
Click to expand...
The vet might be happy to class this as a 'loss of performance' basis which is something than can be investigated further under a new claim, its cover all term of phrase. Then if it is related to the hocks you will be on sticky ground as you will be excluded but if it is something else then you will be okay. Friend did this with her horse when hers was excluded from coffin joint and hocks. It was found to be neck arthritis which meant she claimed under a new claim for 'loss of performance' as it was not related to either condition.
 
ester said:
I'd tell vet that essentially he is so excluded as to be uninsured so you need to address the obvious/most likely first. They have history and would want to see the horse before agreeing to medicate obviously but doing the hocks would seem a sensible place to start for me.
Click to expand...

Thank you, that was my thinking, medicate the hocks, if he improves then assume it is hocks only and if he doesn't improve then look elsewhere!
 
hopscotch bandit said:
The vet might be happy to class this as a 'loss of performance' basis which is something than can be investigated further under a new claim, its cover all term of phrase. Then if it is related to the hocks you will be on sticky ground as you will be excluded but if it is something else then you will be okay. Friend did this with her horse when hers was excluded from coffin joint and hocks. It was found to be neck arthritis which meant she claimed under a new claim for 'loss of performance' as it was not related to either condition.
Click to expand...

My first claim went in as "poor performance" when he was scoped for ulcers, once the ulcers were treated and he still wasn't right he went for the bone scan where they found changes to the hocks but it was all paid under the same poor performance claim. I guess my worry is that my gut tells me that his issues over the last few months are not necessarily just hock related but as you say, I am on sticky ground if they do other investigations and nothing else comes back as will be lumbered with the bill AND the cost of the hock injections! Hopefully they vet will be able to give some more answers today, I have become obsessive about his hind end that I just can't look at it objectively anymore so a fresh pair of eyes is much needed!
 
The lovely vet came and was lovely! Doesn't suspect it's his hocks due to history and way he is moving, she thinks its suspensories or SI so off he goes into horspital on Tuesday for nerve blocks. If the blocks show nothing in the hocks we are in for a fairly good chance that the insurance will pay for whatever it is (unless it's arthritis elsewhere of course!) So pleased that I have not been paranoid for the last few months but gutted he has actually been pronounced lame, worse on his right hind! The poor lad! He was a really good boy though and the vet really liked him! I will keep this updated with the outcome in case anyone else has these issues in future!
 
You must log in or register to reply here.
Top