Diagnoses:

ARF secondary to melamine toxicity CRF secondary to melamine toxicity

1. Estimate maximum lifespan for that patient:
Small dog
Medium dog
Large dog
Cat
Ferret
Then extrapolate expected years of treatment based on current age of patient.

2. Determine if CRF is:
Mild: (PUPD, low USG, blood chemistries normal)
Moderate: Blood chemistries abnormal, resolved with treatment, no current Rx
Severe: Remains in compensated CRF with ongoing therapy
Then extrapolate level of care required in future based on current status.

3. In human medicine, if something (like a toxin or a trauma) makes an existing condition worse, the courts consider there is still liability for making the condition worse, rather than saying that because there was a preexisting, there is no liability. So, based on that, if a patient had pre-existing renal or other disease (such as diabetics on M/D for instance), the claim for melamine-related costs should still be valid. Other algorithms for human medicine (specifically women's health) look at the difference in costs to treat someone with the new condition versus those without the new condition. So, the pet food companies should not cover ALL the medical costs (i.e., not those related only to diabetes that were already being incurred) but only the costs of the damage caused by the melamine - the renal failure, liver inflammation, or perhaps a WORSENING of the pre-existing condition (such as diabetes).

4. Costs to consider:

Initial intensive treatment, lab tests, and follow up treatments to date.

Routine Lab work:

PTH level, electrolytes, BUN, Creatinine, U/A with culture, PCV, ALT (high in some cases of melamine toxicity) and T4, glucose, etc., if preexisting condition may be affected. Best cost may mean running a full feline profile rather than selected tests only; clarify that in the claim. On what time schedule - based on current severity and course.

Routine Imaging: Ultrasound imaging - initial only or repeat on a schedule?

Other tests: blood pressure

Long term treatment over lifetime: Routine care at home:

Calcitrol? Famotidine? SQ fluids? Potassium? Rx diet? What else?
Expect two or three exacerbations with inpatient care needed during lifetime - IV fluids, hospitalization, labs, medications.

6. Coverage for loss of breeding ability, loss of show ability, loss of service dog or search and rescue dog or police dog working ability, etc., but NOT for loss of companionship as a pet. However, note the law before New Jersey Assembly (see http://www.emaxhealth.com/116/13990.html) Personally, I believe reimbursement should be based only on loss of income generated by that animal or replacement cost if it can no longer perform a job it was trained to do as a bona fide working dog with documentation of that training and work.

7. Include consideration of inflation in lab fees, supply costs, professional fees, etc.

8. Respite care allowance for two weeks/year of increased boarding fees, increased pet sitter fees, or hospitalization during owner's vacation.