We got our Lab/Pyrenees mix (Macaroni) when she was 2 months old. When she wasn't even 2 years old, we learned she had congenital kidney failure, and a rare muscular disease called masticatory myositis. Trupanion has been essential in the level of care we are able to provide Macaroni. The customer service is excellent each time we call, and payment is prompt. Macaroni's health is unfortunately going downhill again, but because of Trupanion, we are going to do all we can so she'll be happy and as healthy as can be.