TSFMLS Eligibility Requirements
and Management Suggestions






Step 1 – SERUM BILE ACID TEST
Step 2 – advanced diagnostics (See 1. f. below)
Step 3 –surgery, if indicated, by the ameroid constrictor method.

1.  Please have your veterinarian report the following information to Lorraine Iervolino, so we may consult our expert medical adviser, so that we can evaluate your vet’s diagnosis of liver shunt and determine your eligibility for funds:

a.  What is the dog’s bile acids concentration after a 12 hour fast?
(normal <10)

b.  What is the dog's bile acids concentration 2 hours after eating?
(normal <15 or 20)

c.  What is the dog's albumin concentration?

d.  What is the dog's blood urea nitrogen (BUN)?

e.  What was the dog's blood glucose?

f.  Did the dog have scintigraphy, ultrasound, MRI, portogram, or liver biopsy to help diagnose the condition?  If so, what were the results?


All this information should be sent to:

Terri Shumsky Fanny Mae Liver Shunt Fund
C/O Lorraine Iervolino
316 Gladstone Street
Corsicana, TX 75110-1857



2.  The owner of the victim who is applying for help, will send us the estimate, medical records of the victim from the vet where she is located, and pedigree (if available) to Lorraine Iervolino prior to surgery no matter who does the surgery so that it can be a part of her study.  

3.  Before any funds are disbursed, the applicant must have sent the victim’s medical records to  Lorraine Iervolino along with the pedigree (if available) of the affected dog.  Referrals for surgery must be approved by TSFMLS.  The Committee will consider, on a case-by-case basis, each applicant’s income level in making its determination.  We also expect that the patient will be neutered or spayed at the time of the liver shunt surgery.

4.  The owner of the victim must have provided TSFMLS with the breeder's name, address and telephone number and have notified the breeder of the victim, in writing via certified mail, about the diagnosis, and request that the purchase price of the dog be refunded to the buyer/owner of the dog to help with the costs of surgery.  Such amount must be disclosed to the TSFMLS Fund Eligibility Committee.  In the letter, the following information MUST be stated:

“This is an inherited disease as is clinically proven in several breeds and the sire and dam of this affected dog should not to be used in a breeding program again.  It is also highly recommended that siblings of this affected dog should not be used in a breeding program either to ensure that they are not potentially throwing the gene that is linked to this disease as well since they could be carrying the same genetic combination.”

The owner must also make sure the breeder knows that an attempt will be made in Small Claims Court to claim a refund if the breeder is not forthcoming in making the refund like any other responsible breeder would do.  The TSFMLS Eligibility Committee will support and assist with information to prepare this claim.  If the breeder refuses to compensate the buyer, the buyer must sign a statement that the breeder has refused to be responsible for this inherited disease by giving a complete purchase price refund, and make sure that the breeder knows that this information will be available to anyone inquiring.  

5.  The owner of the victim must provide - in advance of any funds being disbursed - a photo and brief write up of the victim to be included on the TSFMLS dedication page.

6.  The victim’s owner will allow the TSFMLS Eligibility Committee the final choice of surgeon, and will depend on the locality of the victim and availability in order to eliminate the problem of transporting the dogs whenever possible.  The applicant understands fully that at this time funds will be allowed only on surgery with the ameroid constrictor which is the technique preferred by our medical advisor.

7.  The TSFMLS Eligibility Committee (comprised of 5 people) will determine eligibility for funding on a case-by-case basis. In cases where financial need is indicated, every effort will be made to provide at least 50% of the surgeon's cost if sufficient funds are available in TSFMLS. Disbursements from the TSFMLS Fund account can be awarded after the surgery and will be made directly to the facility, clinic or surgeon performing the surgery. Only in very rare situations, where the circumstances render it necessary, will disbursements be made directly to the victim's owner.

8.  The TSFMLS Eligibility Committee, assigned to determine the disbursement of funds, reserves the right to request financial background or references on the person or persons requesting financial aid for surgery to substantiate the need for financial assistance. With each application, the committee requires a copy of the previous year’s #1040 for Adjusted Gross Income.

9.  Breeders are not eligible for TSFMLS assistance.  When a person decides to be a breeder, they must have the finances to take care of inherited problems or they shouldn’t be breeding.  It’s a responsibility that one accepts when they enter into this undertaking of breeding healthy dogs.



First page of #1040 for Gross Annual Income (SS # should be blocked out)

Free Online Credit Report
http://www.freecreditreport.com

Copy of Pedigree, and/or Registration papers showing name of sire and dam and date of birth.

Copy of the Bill of sale

Full name and address of Breeder

Picture of the victim

Copy of Vet report showing bile acid numbers from blood test, or at least the numbers “fasting numbers and fed numbers”.






TSFMLS Eligibility Committee
Lori Burch - Indiana
Brenda Smith - Tennessee
Janet Wilshire - Tennessee
Arlene Gilbert -  Rhode Island
Vicci Doyle - Indiana


Alternate Eligibility Committee
Darinda Tanner - Louisiana





TSFMLS Founder

Terri Shumsky


















Terri Shumsky and her husband, John

May Terri & John Rest in Eternal Peace with all of our Yorkies at
Rainbow Bridge.


You can scan the application and #1040, pedigree and other required papers * in Adobe Acrobat and send to:

tsfmls.fund@gmail.com
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Terri Shumsky Fanny Mae Liver Shunt Fund
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Terri Shumsky Fanny Mae Liver Shunt Fund
Eligibility
This page was last updated: August 4, 2007
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