Navigating growing pains in the pet insurance industry with facts, perspective

Pet health insurance is a topic that comes up at least a couple of times per week in my work, & that’s no surprise. After well over 20 years participating in various professional capacities adjacent to veterinary medicine, & now working with families as a Certified Animal Hospice Practitioner focused on senior & geriatric care, animal hospice & palliative care support for pets of any age, the involvement of vet care is common. And, of course I’m frequently liaising with other members of veterinary interdisciplinary teams, so I’m part of these conversations when families are moving through decision making. 

I’ve made some interesting observations. 

The first of which is that pet guardians understand that they can expect a better experience in meeting the changing needs of their pets, no matter the life stage or health status. That’s due to advances made in vet med, including testing & treatments that weren’t available even 10 years ago, a better understanding of animal behavior & my wheelhouse: being able to address the needs of aging pets in meaningful ways. Pets are living longer, & better. 

And all of this means to some degree, more interventions from vet teams. 

Aside from the advances in vet med, there have also been changes in the industry as a whole. This includes the encroachment of private equity & its impact. And considering the trend of more specialty, small practices & micro vet practices pushing back & still having a robust foothold, along with the concierge model gaining traction, families have more options than ever to access the kind of care that makes most sense for them & their pets.

All of this means more spending in this area, along with higher costs. For that reason, families find pet health insurance to be attractive. Even after roughly 20 years of this option being available, pet guardians who’ve signed on for a policy still have flexibility in decision making when they need to regarding diagnostics & treatments recommended by their veterinarian. That differs from human medicine, where health insurance companies may dictate choices.

There are inherent problems with pet health insurance. One part of the equation is driven by consumer behavior. 

Many pet guardians who feel that purchasing a policy is a good investment when their pet is young & healthy quickly lose their enthusiasm with the idea since they’re not getting a lot of mileage out of that investment of money every month because the need to file a claim is pretty rare. So, they opt out early, within a year or two. And with an insurance company having fewer of those consumers participating, but retaining the ones who’ve seen the value in sticking with it—think those with pets with chronic conditions, or when a surgery, hospitalization or palliative & hospice care is needed—& they file claims that cost the company money. And that, from the perspective of the company, isn’t necessarily sustainable. So premium prices increase. Sometimes unfairly so, according to pet guardians. Even some of those in my sphere. 

And if those price increases & other decisions don’t provide a level of sustainability that makes good sense in the eyes of the company, then they sometimes decide to pull the product from their offerings. And that can mean cancelling policies, which hits pet guardians hard. Nationwide did this in 2024, when it nixed over 100,000 policies. That decision is being litigated. Situations like this are especially impactful when families have paid premiums over a period of years & then have a pet whose needs have increased to a point that they would finally see a return on that investment of money, as they see it, by way of having those claims paid—or at least in part.

Another factor to consider is there have been advances in vet med, those have understandably fueled a hike in prices. Coupled with ongoing rate increases needed to keep these services available (reflecting staff compensation that’s more appropriately aligned when it had lagged behind, increasing practice overhead costs, & more), along with inflation, pet health insurance companies say this supports their decision to raise premiums. 

Private equity has seized the opportunity to take a seat at the vet med table, not to mention in the pet health insurance industry, & that’s changed the landscape. German investment firm JAB Holding Co. has ventured into both. The firm owns National Veterinary Associates, with over 1000 general and specialty practices in North America. In recent years, JAB expanded its portfolio to include several pet health insurance offerings. 

Is pet health insurance here to stay? I think it’s fair to say that it is. 

But that’s only more likely if consumers feel like it's a good investment that even if it doesn’t feel like it’s paying off initially, it’s there when a crisis hits. And when a previously healthy pet is diagnosed with something like chronic skin allergies, liver disease, treatable cancer or they need to be hospitalized or have surgery—trust me, the list goes on & on—they’ll heave a sigh of relief. In many cases, I feel like it’s not a matter of if but when. And I can say for certain that the families I’m connected to who are moving through decision making with palliative care, hospice, end of life & euthanasia care (yes, some pet health insurance covers these care options, at least in part), they’re grateful to have some of the financial burden lifted so they can focus on what’s most important. And so, families report there are companies that they’ve have good experiences with. 

Want to tap into a resource that can help you sort through which pet health insurance is best for your own pet? Pet Insurance University, spearheaded by Frances Wilkerson, DVM, provides a comprehensive guide to do just that. 

With over 20 years of experience in pet care and the past 12 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is founder of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.

Planning ahead can minimize unexpected gaps in pet’s custody & care

If it’s one thing I’m known for professionally, it’s thinking ahead to what things could happen & having a plan to pivot on the fly. Of course, this is essential working in animal hospice. Though from a practical standpoint, when we’re responsible for a pet of any health status or age it makes good sense to consider how we might navigate an unexpected situation since they can’t fend or advocate for themselves. I can’t count the number of occasions I’ve gotten a phone call from an accident scene, or the hospital from a frantic family-of-record after an unexpected event like that or a serious illness unfolds & their pets are waiting for them at home—alone. 

‘You’re the first person I thought to call, Lorrie.’

I’m usually able to step in at a moment’s notice when I get a call like this to bridge the gap with short term emergency visits for the pets, but given the nature of my work, providing longer term custodial care just isn’t feasible. And yet, there are cases where a pet guardian needs that additional support. 

Years ago, I’d implemented an additional layer to the framework of planning ahead for the unexpected, & it’s been evidenced to be a wise strategy. I have all of my families of record complete & sign an Emergency Companion Animal Guardianship form as I’m building their file. It allows me to coordinate transfer of physical custody to a designee who has agreed to take full responsibility for the pets & has the person’s name, address, phone number listed. This could be short or long term should the owners become ill, incapacitated, deceased—or even find themselves detained by law enforcement (yes, the latter has happened) with or without pets in the car. 

Many pet guardians live alone & don’t have trusted loved ones nearby, & so this is a good option if one, regardless of life circumstances, is concerned about any of these scenarios becoming a reality. 

Some members of the community might find these additional ideas to be sensible. My guidance is to fill out the document in advance, file one with the designee, keep one in your car, one at home & file one with your pet’s veterinarian.

• Some dog harnesses have a zip pocket & you could tuck a copy of the document inside that.

• Affixing a copy of the completed form to a pet’s travel carrier is also an excellent idea. 

• Adding a tag on your pet’s collar that has the following stamped on it: “Should my owner be separated from me, please contact [designee’s name] at 000-000-0000”. 

• Consider updating your pet’s microchip to include the designee’s contact information.

• Having a GPS-based tracking collar like Fi on your pet & ensuring the designee has access to the coordinating app could be an added measure of protection. They come in all sizes! 

These suggestions aren't a panacea, but pets can’t speak for themselves. So times of crisis, every measure taken to ensure a pet’s well being is critical, as well as supporting the human-animal bond. A customizable form I created for this purpose can be found by clicking here. 

With over 20 years of experience in pet care and the past 12 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.

Appetite challenges -vs- problems with the act of eating in pets

Eating is an activity of daily living (ADL) that looms large in the work that families & I do together. We track the usual aspects of this activity: the pet’s interest in food, how much they’re eating, when they’re doing so, & what they’re eating. And that gives the pet guardians, the core members of the vet interdisciplinary team (vets, vet techs) & me good information about how well a pet is doing & coping with symptoms & changing needs as they navigate this time, whether they’re senior or geriatric, coping with recovery through injury or illness, or, as is a focus of my practice—when they’re benefiting from the program of care that is animal hospice & palliative care (AHPC).

If a pet is demonstrating a change in appetite, our identifying what’s happening, when, how often, to what degree, & what has or hasn’t worked is par for the course & then relaying that information to the vet team. Routinely submitting quality of well being assessments & written logs to be added to the pet’s medical file can bolster this. From there, the vet can assess & make adjustments to their plan, & then reassess the situation to track improvements, or lack thereof. While I educate the pet guardians on the basics regarding appetite challenges by way of the learning hub, there are many factors that I hone in on as a veterinary interdisciplinary team member, whether I’m stepping in & providing that hands-on care with respite care or overnight stays—or supporting families in person or remotely with AHPC. And it’s not uncommon when a new-to-me family expresses that their pet struggles with appetite, or what’s seen as an appetite issue -vs- a problem eating—two very different things. At times, there isn’t a meaningful level of symptom management on board (pain, nausea, anxiousness top the list), & so next steps are to work with the vet to get that sorted out, because those are the priority. But if that’s been done & the vet has implemented strategies to bolster the comfort care plan, & there isn’t enough meaningful change—all is not lost.

There are other features of how the pet moves through the activity that can differ from what I commonly hear pet guardians & vet teams focus on, like medical causes: perhaps the effects of disease processes like chronic kidney dysfunction or cancer, that they’re dehydrated or nauseous, there’s a bad tooth/teeth, an appetite stimulant is needed or they have cognitive dysfunction. And it’s not to say that these aren’t part of the equation. They can be & often are. But another set of facts can also be true even after a vet exam, blood work & other tests indicate that things like subcutaneous fluids & other supportive care would help sort the situation. 

When those strategies don’t move the needle, it can be posited that things have reached the ‘end of the line’ or the pet has entered the stage where their body is signaling that food is no longer needed & the dying process has begun. But I submit that more curiosity is in order. As an experienced Certified Animal Hospice Practitioner, I’m never comfortable landing on the notion that a pet has reached that pivotal point unless symptom management has been adequately assessed & addressed, if it can, along with other things.

And so, in addition to the usual suspects that we associate with fueling appetite issues, I also observe the other possibility: the pet is having trouble with the act of eating. That is, how long it is taking the pet to finish a portion of food, & how they physically manage the activity. For example:

• Can they stand long enough to do so?
• Do they seem comfortable & focused?
• Are they struggling/working harder than seems sensible to do such a simple task?
• Do they seem frustrated?
• Are they making more of a mess of their feeding station than I’d expect?
• Are they able to prehend their food, or is their food just getting pushed the food around the bowl & the pet can’t get ahold of it?

Sometimes I find that yes: a pet is having difficulty standing long enough or remaining comfortable during the activity, & they might be working really hard to manage such a simple & important activity of daily living. They can become frustrated for those or other reasons, like they can’t actually pick up (prehend) their food or because their feeding dishes or feeding station no longer fit for their current abilities. 

And so, the pet gives up. 

Imagine, not being able to get through a meal because you can’t get the food into your mouth for various reasons, but you still have a normal sense of hunger & enjoyment of food. We don’t want that for anyone.

And so as I observe & assess a pet for all of this, I ponder these questions, keeping in mind that one or more can be true,

& then trialing key things known to be helpful:

• Is their feeding station in a location that is accessible & physically/emotionally comfortable for them? (Cats can feel like they’ll be ambushed by other cats in the household, & any pet may simply have a preference for one area over another due to physical or emotional needs.) 

• Are they feeling confident in their ability to walk up to the feeding station & eat? That is, are they slipping or losing their footing? (Yoga mats & rugs at & around the feeding station are the heroes here, as are booties for dogs. Also, ensuring a dog’s better grip by trimming the fur that grows too long on their paws is good.) 

• Is the height of the feeding station adequate to allow them to perform the activity? Do they need to reach down too far, or do range of motion limitations or physical discomfort & pain limit them? (Making or purchasing a raised feeder appropriate for their height & physical ability is helpful.)

• The size & shape of the dish can matter—perhaps it’s too deep or concave (My observations are that when a more shallow dish, like a pie plate is used, this helps improve things dramatically. Flat silicone mats can be much easier, too.)

• The material of the bowl can be extra slick, like stainless steel, causing some foods to slide away from the pet’s mouth when they try to grab it, especially if the bowl is too concave. (Swapping out a stainless steel dish or bowl for ceramic or even silicone can help.)

• The food’s texture, while appetizing to the pet, may not be manageable for them to lap up or pick up with their mouth—I see this frequently with fresh or fresh/frozen diets, whether they’re prescription or homemade. (I love that giving dog food a go round in my handy personal smoothie blender makes a big difference, here. A few blitzes with a little water to produce a smoother texture, like a gruel, is all that’s needed in some cases. With cats, when feeding canned, pâté can be easier for them, especially if it’s mounded up.)

More: 

Changes in swallowing can be present, primarily in dogs, & so having that assessed by the vet first is key. In these cases, to make it less challenging for the pet, it’s often suggested that soaking their kibble in warm water until softened before feeding can prevent any dry food from crumbling & accidentally making its way into the airway, or switching to canned, homemade or fresh/frozen. Feeding the pet at a 45° angle helps, too. 

I do notice that for some dogs, it can be time to retire the slow feeder dishes, since they can be especially frustrating. It’s likely they’re not inhaling food like they once had, so you’re probably safe in making the switch to a regular bowl, dish or mat. 

When trying to figure out any change in a pet’s eating patterns, it’s vital to discern the differences between changes in appetite -vs- having trouble performing the act of eating. Doing so promotes better well being for the pet, & the pet guardian’s sense of mastery of caregiving. I want the families I’m working with—all families—to look back on this time with the perspective that they pursued everything that made sense for their pet, because that significantly reduces the feelings of ‘…did we miss anything—were decisions made too soon or without enough context?’.

With over 20 years of experience in pet care and the past 12 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.