Vet not reporting a noticeable disease

[user1473960648]

Hi, don't know if there are any vets out there!
Sadly our cat had to be out down in March as he was very unwell. He had lots of test and expensive treatment - £3,500 in two weeks. We thought it would be covered by the insurance. After he was put down some test results have come back showing he had Mycobacterium tuberculosis complex. The insurance have said they won't pay as its a notifiable diseases and should be reported to the APHA. We are obviously upset that the insurance won't pay but also concerned that the vet has not reported it or informed us as a family that it could be serious. What do I do? Should my kids be vaccinated against TB? Should I report that the vet hasn't notified the correct people!!!?

I don’t see why the fact that it’s a notifiable disease should mean that they don’t pay up? I’d think they are two different issues.
What does your vet practice say?

The vet thinks they should pay but not paying for a notifiable diseases is written in the pages of small print. The vet is going to look into further. If it was a notifiable disease surly the vet should have notified the authorities and let us know! They must have a legal obligation!

I suggest your vet should contact the University of Edinburgh for advice about how to proceed here - see

https://www.pure.ed.ac.uk/ws/portalfiles/portal/466478202/Feline_tuberculosis_in_raw_fed_cats_2023-24.pdf

for some advice. Bovine TB is notifiable, and government laboratories will help to investigate to establish whether this was bovine TB or not. The risk to your family is low but not zero, so you could also contact Public Health England (if you are in England) for advice about what to do yourselves (I’m a vet and they were very helpful when I was bitten by a bat, which can potentially carry rabies even in the UK!)

The insurance is a separate point and is absolutely outrageous, because neither you nor the vet could have known it would be a notifiable disease before running the tests without a crystal ball. Your best bet might be to throw a lot of publicity at that and see if they back down through shame!

I’m sorry you’ve lost your cat in such stressful circumstances.

Thank you for this information. I will share it with the vet.

I am frustrated with the insurance as I phoned them several times to check if we were covered. There was now doubt put in my mind that we may not be as he was just poorly. There was no doubt placed in my mind that if it later turned out to be a notifiable disease then we couldn't claim.

His symptoms were lethargy and loss off appetite. It was a week after we made the difficult decision to put him to sleep that we received the results
'infected with an organism that is part of the Mycobacterium tuberculosis complex, but does not identify the species. Further tests would be required for that. Our clinical experience suggests that most cutaneous/skin cases are M microti'
I am not sure if this is notifiable or not!
I feel that the insurance should pay for the treatment he had up until we knew it was (?) notifiable. Is the above Bovine TB?

I will take your advice and make complaints, Ombudsman, make it public, negative reviews.....

I may speak to my GP as TB isn't a vaccine given as routine on the NHS in my area but maybe my boys should have it or at least it's on their records and ours about the exposure.

I should have also added that he caught this from a rodent/vole as the bite could be seen on his leg.

Hello again! M. Microti is not the same thing as bovine TB, which is M bovis, and if he was bitten by a rodent it’s pretty likely he had microti as that is the vole organism. See here for a slightly less technical article.

https://www.veterinary-practice.com/article/companion-animal-tuberculosis-in-the-uk

I can’t work out whether M
microti is notifiable or not. Google AI seems to think not, but I’m not sure I’d trust it. The problem is that you don’t know for sure whether it was bovis or microti without further tests, so you can’t be sure it isn’t unless these are done, which depends on what tissue remains as well as cost and logistics. Your vet would need to contact the lab and see what they suggest, and/or ask Edinburgh for clarification. I expect there is a clear protocol, because although it’s unusual it’s not THAT rare, it’s just a matter of finding someone who knows. If you can get it in writing that it isn’t notifiable then that should solve the insurance problem. If it is notifiable and the insurance refuses to pay for the tragic death of your cat with a native (as opposed to imported) zoonotic disease through no fault of yours then that’s awful and they might back down if challenged. However, at least if it is microti then the likelihood of it infecting people is apparently very small, which is something I guess. Hope this helps.

Thank you. I am going to try and get it in writing that it's not a notifiable diseases, if this is the case.

The test results are - Mycobacterium tuberculosis complex - Positive.
M microti is what the vet thinks it might have been.
I will see what this week brings. I will keep you posted.

It's not a notifiable disease

In the UK, Mycobacterium bovis infection in cats is notifiable, but not Mycobacterium tuberculosis infection in cats. While M. bovis TB in pets is notifiable, M. tuberculosis TB in cats is very rare and the risk to humans is low, according to the UK government.

They haven’t said whether it’s bovis or not because they haven’t done that further test. It probably isn’t, but both species are part of the complex so without species ID they can’t know for sure one way or the other.

Thank you all. We have no way of doing further tests. I am going to try and get something in writing from the APHA.

If the lab cultures something that is notifiable they have to notify APHA who notify public health England. The notification of public health England is what triggers the response.

This may not help me one bit when it comes to renewal, but my pet insurer rectly turned me down on spurious grounds - a lot less money involved, but they insisted that my dog had a pre-existing condition when he did not. I was pretty annoyed, and discovered that there is a appeals procedure and also an ombudsman, so I wrote back saying that I was appealing because he had never had the condition (or anything like it) before and that I also wanted the details of the ombudsman appeals for use if they refused again. They very "nicely" decided to review the claim and gave up. Apparently the ombudsman can consider the fairness of terms, not just the decision.

What I found interesting is that it took them less than 2 days to "review" the original claim and refuse it; but two weeks for the "review team" to consider the second vets report (which said the same thing - no pre-existing condition). Now I may be imagining this, but I feel sure that the original claims team are not qualified in veterinary medicine and their main job is to find reason to say no, because in most things people accept what they are told. So even if it is true that there was a notifiable disease, and it appears there wasn't, that term simply couldn't be reasonable or fair. The animal is sick, you did nothing to cause that sickness.

So I'd fight back - we pay a bloody fortune for insurance and deserve better than this.

Your kids were probably vaccinated against TB when they were either babies or teens, unless you refused it. That's nothing to do with the cats illness.
I'm so sorry for your poor cat. You need to look at the small print and clauses etc in the policy.
I had a vet fail to diagnose something very badly in my cat when he was a kitten. It was really upsetting.
If the vet is to blame you can report to the RVC which I think is their regulation body. But first contact the owner of the practice or manager.

Thank you for all your messages and advice. It's really helping us put a case to the insurance. APHA have said M. Microti isn't notifiable. I have it in writing. We didn't do further tests but the vet suspected m microti when the results came back as he had all the symptoms. I am sure the insurance will try and find another reason not to pay but this is a good start 🤞🏻

Or unless you live in an area where it’s not offered to babies and they’re not yet teens? Where I am in London some boroughs offer TB vax and some don’t.

Thank you. I haven't had any recent dealing with it admittedly.
I worked on a research study once for a couple of years among people who'd had TB and also the vaccine. It emerged the BCG was only effective for about 5 years. This was about 15 years ago. I think they were aiming to find a new, better one. Not sure if they managed to or not as I left the project. I hope so though.

The regulatory body is the RCVS, not the RVC, and in any case the vet hasn’t done anything wrong, they have treated the poor cat appropriately and the OP hasn’t said they’re unhelpful. Reporting to the regulator is for serious professional misconduct, not struggling a bit with a tricky case. It sounds as if the OP is making good progress with the insurance claim - good luck, OP 😕

Ok thank you. I said I thought that was the name, but wasn't sure of it exactly.
I didn't necessarily say that it warranted reporting, I was just trying to say to speak to the practice before the regulator if there is a complaint.

Hi All, I have just received some good news. The insurance have agreed to pay. Dave, our cat did not have a notifiable disease. The type of TB he had isn't notifiable. The APHA agreed. So relieved and glad I made a complaint. All your advice gave me the confidence to complain. Thank you.

Brilliant news OP. Well done for your persistence.