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Pet Hernia and Insurance Coverage: Explained Simply

Hernias aren’t uncommon in pets, and many will require surgical intervention. Unfortunately, the surgery can be costly, especially if your pet needs a more complex repair. Luckily, your pet insurance policy might cover the cost — depending on the specifics of your plan and provider.

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Understanding hernias in pets

Like in humans, pet hernias involve the protrusion (a bump or bulge) of an organ or tissue through an abnormal opening in the body wall. While many pets, including most mammals, are at risk of developing hernias, they’re more common in dogs than in other common household pets.

inguinal and umbilical hernias

Your pet may develop multiple types of hernias, although inguinal and umbilical hernias are most common.

Type of herniaOccurs whenMay affect
Inguinal The intestines or fatty tissue pops through the weak spot in the groin areaDogs, particularly Weimaraners, Pekingese, Basenjis, and Airedale Terriers, and cats, horses, and pigs
UmbilicalA section of the intestines or fatty tissue protrudes through a weak spot in the belly button areaDogs, cats, horses, particularly drafts and warmbloods, and cattle
Peritoneopericardial diaphragmaticA hole in the diaphragm allows the abdominal organs into the pericardial sac, which encases the heartDogs and cats, particularly Weimaraners and domestic long-haired cats
HiatalThe opening in the diaphragm allows the internal organs, particularly the stomach, to move between the chest and abdomenDogs, particularly brachycephalic (flat-faced) breeds, such as French Bulldogs
PleuroperitonealA defect in the diaphragm that allows the abdominal organs, usually the stomach, to protrude into the upper chest cavity Small animals and horses
Perineal The pelvic diaphragm becomes weakened or damaged, allowing the abdominal organs to protrude throughDogs and cats
Traumatic diaphragmaticBlunt force trauma that causes increased pressure, allowing the abdominal organs to protrude through the diaphragm Dogs and cats
Incisional A surgical incision opens, allowing organs to push through, usually occurring if animals don't follow post-operative instructions, such as activity restrictionsAll

Note: This table is not inclusive of all potential types of hernias

Risk factors

Hernia causes and symptoms in pets fluctuate from one to the next. Your pet can develop a hernia for multiple reasons, from genetics to traumatic accidents. However, over 90% of hernia cases result from genetics or are congenital, leading to the chance of puppies and kittens being born with them. These are most often umbilical hernias.

Other predisposing factors that can contribute to hernia development include obesity and pregnancy.

Symptoms of a hernia in your pet

While some hernias, like a minor puppy umbilical hernia, may cause little to no symptoms in your pet, more severe cases can involve behavioral or physical signs. Symptoms of hernias in dogs may include:

  • Nausea
  • Vomiting or regurgitation
  • Straining to urinate or defecate
  • Drooling
  • Difficulty breathing
  • Lethargy
  • Appetite loss

Hernias are much less common in cats and other pets, but many of the same symptoms apply, including vomiting, appetite loss, and lethargy.

Different types of hernias cause specific symptoms, such as difficulty breathing in the case of a diaphragmatic hernia or vomiting in the case of a hiatal hernia. If you notice abnormalities in your pet’s behavior and suspect the hernia may be to blame, talk to your veterinarian as soon as possible.

Some hernias, such as traumatic hernias, can be life-threatening, so it’s important to act quickly to be on the safe side.

Diagnosing hernias in pets

Veterinarians may use a simple physical examination to diagnose your pet with a hernia. Palpating the area can tell your veterinarian much about the hernia, including the pain level and if it’s soft or reducible. Sometimes, your vet may use imaging tools, like X-rays, to visualize inside your pet’s body.

Once diagnosed, your vet can offer insight into the best course of action based on your pet’s specific situation, including the severity of the hernia and the likelihood of resolution on its own.

Does pet insurance cover hernia repair surgery?

While some pet insurance policies cover the repair surgery needed to correct a hernia, not all do. It all depends on the specifics of your policy and provider, including specified conditions, policy type, and coverage caps.

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Several pet insurance providers, like Lemonade, cover the surgery, even in more basic plans. However, since coverage can vary dramatically from one policy and provider to the next, it’s important to check.

Pre-existing, congenital, and hereditary conditions

Most pet insurance providers outline specific exclusions that they will not cover. Pre-existing, congenital, and hereditary conditions often fall under this umbrella, leaving pet owners without coverage.

Some providers consider many hernia types to be congenital or hereditary conditions; if that’s the case, your policy likely won’t cover it. Or, if the hernia was diagnosed before purchasing your policy or during the waiting period, it’s probably excluded from coverage.

Of course, this can vary from provider to provider, so it doesn’t hurt to double-check with your insurer if you’re unsure.

Policy type

The type of pet insurance policy you choose also impacts whether you’ll receive coverage for the surgery.

Most comprehensive pet insurance plans, often called accident and illness plans, cover hernia surgery if it isn’t considered a pre-existing, congenital, or hereditary condition. This means that the most common type of hernia, the umbilical hernia, is unlikely to be covered.

If you opted for a wellness or accident-only policy, your plan may not cover it. Of course, there may be some exclusions in specific cases. For example, suppose your pet’s hernia results from a car accident, and you have an accident-only policy. In that case, you may receive reimbursement.

Coverage caps and reimbursement rates

Pay attention to your policy’s coverage caps, as some providers outline a per-pet, per-year, or per-incident limit that may affect coverage.

For example, suppose you have a $3,000 per-year limit, and your pet needs a $2,000 surgery for complex hernia repair, but you already used most of the annual coverage amount. You may be responsible for footing most of the bill in this case.

Additionally, take note of your policy’s reimbursement rates, deductibles, and copays, as these factors will also impact the coverage you receive. Higher reimbursement rates translate to more coverage, while higher deductibles and copays mean you must pay more before your policy kicks in.

Ultimately, hernia treatment options and pet insurance implications vary based on the policy and provider. The specifics of pet insurance coverage for hernias vary, with some providers covering them and others excluding them. Talk to your provider if you’re unsure whether your insurance policy will cover your pet’s hernia surgery. They can offer insight into navigating pet insurance for hernia costs specific to your policy.

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