Newfoundlands carry one of the highest recorded risks of an inherited heart defect called subvalvular aortic stenosis, along with giant-breed joint and stomach risks. Here is what the research shows, what care can cost, and how to time Newfoundland pet insurance.
A young Newfoundland goes weak or faints for a moment during play, then gets up as if nothing happened. It is easy to blame the heat or a clumsy puppy.
In this breed, it is a reason to ask your vet for a heart check. Weakness, exercise intolerance and fainting can all be signs of a narrowed heart outflow, and the breed is strongly overrepresented for one inherited form of it.
Quick answer
Fetch reports an average of $100 a month across its active Newfoundland policies in 2025, and Lemonade’s illustrative figures for its own policies rise from about $60 to $65 a month at age 1 to about $115 to $120 at age 6. Quotes vary widely by insurer, location and plan.
The bigger issue is timing. Subvalvular aortic stenosis is usually first suspected from a heart murmur, and a murmur recorded before coverage starts will likely make the condition pre-existing. Enrolling a young, healthy puppy gives the best chance that a later diagnosis is covered.
Subvalvular Aortic Stenosis: The Breed’s Best-Documented Heart Risk
Subvalvular aortic stenosis, or SAS, is a ridge or ring of tissue just below the aortic valve. It narrows the path blood takes out of the left ventricle, so the heart has to push harder with every beat. Over time the heart muscle can thicken in response.
A 2019 study in Frontiers in Veterinary Science reviewed dogs seen at the University of California, Davis veterinary teaching hospital from 2008 to 2017. Among Newfoundlands, 10 dogs were diagnosed with SAS, a breed prevalence of 4.46%. The breed’s odds ratio was 34.73, the second highest among the breeds analyzed, after the Bullmastiff at 52.43.
An odds ratio compares odds between groups, not risk, so it does not mean a Newfoundland is 34 times as likely to develop SAS as any other dog. With only 10 cases, the estimate is also imprecise: the study’s 95% confidence interval ran from 16.77 to 71.95. What the figure does show is a strong breed association.
The two prevalence figures come from very different groups. A teaching hospital sees many dogs referred because something is wrong, while a breed screening program mostly sees dogs being checked before breeding. Neither figure is a national rate for all Newfoundlands.
How Serious SAS Can Be
Severity is graded by the pressure gradient across the narrowing, which a vet measures with a Doppler echocardiogram. MSPCA-Angell, a large Boston animal hospital, classes a gradient above 80 mmHg as severe. The outlook differs sharply between grades, which is why one diagnosis can mean very different bills.
Mild or moderate SAS versus severe SAS
Treatment is usually medication rather than surgery. A 2023 review in Cardiology Research says atenolol, a beta-blocker, is the most common choice. The same 2014 study of 50 dogs found no survival difference between dogs given a beta-blocker and untreated dogs, so vets decide case by case.
A summary of that study in the journal Veterinary Evidence reports survival of about 2.8 years for dogs whose gradient was above 130 mmHg at diagnosis, compared with 8.3 years for dogs at 130 mmHg or below. These are figures from one group of 50 dogs, not a forecast for any individual dog.
Why a Murmur Can Be Missed Early
SAS is usually first suspected when a vet hears a heart murmur. MSPCA-Angell notes that the murmur may grow louder over the first 1 to 1.5 years of life, so a soft or absent murmur at an early puppy visit does not rule the condition out.
That matters for insurance as well as health. A murmur noted at a routine exam, even one the vet calls soft and suggests rechecking, is the kind of record an insurer reviews when a claim comes in. Ask your vet to listen carefully at every visit in the first two years.
What the PICALM Gene Finding Does and Does Not Mean
In 2014, a US research team published a study in Human Genetics of 93 Newfoundlands and 180 dogs from other breeds. It linked a three-nucleotide insertion in a gene called PICALM to SAS and suggested the condition is inherited in a dominant pattern.
A year later, a European team reported in the same journal that the PICALM insertion was not associated with SAS in the Newfoundlands they studied. The 2023 Cardiology Research review notes that the finding has not been replicated in a European sample. So there is no validated DNA test that can clear a Newfoundland of SAS.
For now, screening relies on a heart exam and, where advised, an echocardiogram. The AKC lists a cardiac exam among the health tests recommended by the Newfoundland’s national breed club, alongside hip and elbow evaluations and a DNA test for cystinuria.
What screening has achieved in France. A 2025 PLOS ONE study by Chetboul and colleagues reviewed a French cardiovascular screening program covering 921 Newfoundlands from 2010 to 2023. About 99.1% of the dogs were free of aortic stenosis, the defect group that includes SAS, and the authors describe a decreasing trend.
The last aortic stenosis case in the program was detected in 2019. The authors note limits: the data were retrospective and most echocardiograms were done by non-specialist vets. If you are buying a puppy, ask the breeder for the parents’ cardiac exam results.
What Newfoundland Vet Care Can Cost
We did not find a published price for long-term SAS treatment, because it depends on severity and the drugs prescribed. Ask your vet for a monthly estimate once treatment starts. The table below lists published figures for tests and for the breed’s other main risks.
| Item | Published cost | Source |
|---|---|---|
| Echocardiogram, initial or follow-up (Embrace’s estimate in its cardiomyopathy guide) | Up to $500 to $600 | Embrace |
| Hip dysplasia treatment | $1,500 to $6,000 | Lemonade |
| Elbow dysplasia treatment | $1,200 to $3,500 | Lemonade |
| Bloat (GDV) treatment | $2,500 to $7,500 | Lemonade |
| Preventive gastropexy | $1,400 to $1,600 | Figo |
| One Newfoundland’s emergency bloat surgery, including gastropexy (Embrace claim story) | $4,991 bill, $3,726.90 reimbursed | Embrace |
These are averages and single examples from insurer pages, not quotes. Prices for giant breeds can run higher because drug and anesthesia doses scale with body weight. Use them to judge whether an annual limit would cover a serious year, not to predict your own bill.
Newfoundland Pet Insurance Cost
Fetch reports that the average plan across its active Newfoundland policies was $100 a month, based on all policy configurations from January 1 to November 1, 2025. Fetch notes that puppies can cost less. That is one insurer’s average, not a market-wide figure.
Lemonade publishes what owners of its own Newfoundland policies typically pay by age. It describes the figures as illustrative, and other insurers price differently, but the table shows how quickly price rises with age.
| Newfoundland’s age | Typical monthly premium (Lemonade data) |
|---|---|
| 1 year | $60 to $65 |
| 2 years | $65 to $70 |
| 3 to 4 years | $70 to $75 |
| 5 years | $95 to $100 |
| 6 years | $115 to $120 |
| 7 years | $110 to $115 |
For context, NAPHIA reports that the average U.S. accident and illness premium for dogs of all breeds was $836 a year in 2025, about $69.67 a month. That is a national all-breed average, not a Newfoundland figure. Our pet insurance cost calculator gives a first estimate before you request quotes.
How Insurers Treat SAS and Heart Murmurs
SAS is congenital, meaning the dog is born with the tendency, so hereditary and congenital coverage matters. Embrace says it covers hereditary and congenital conditions as long as the pet has not been diagnosed before coverage starts. Healthy Paws says its plans place no restrictions on hereditary or congenital conditions whose signs first appear after enrollment and waiting periods.
Fetch and Trupanion also state that they cover hereditary and congenital conditions that were not pre-existing. Confirm the wording in the sample policy for your state, since terms can differ.
The pre-existing rule is where most SAS claims would be decided. Embrace defines a pre-existing condition as “any injury, illness, or irregularity noticed by you or your veterinarian before the end of your waiting period.” Healthy Paws says symptoms present before enrollment count even if the condition was never diagnosed.
That creates a timing question for screening. If an echocardiogram finds SAS before you enroll, or during the waiting period, the condition will likely be excluded. The insurer pages we checked do not say whether a screening echocardiogram on a dog with no signs is itself eligible, so ask before you book one.
Our pre-existing conditions guide explains how insurers review records, and our waiting periods guide compares how long each insurer makes you wait.
Beyond SAS: Joints, Bloat and Cystinuria
Hip and elbow dysplasia
Hip and elbow evaluations are on the breed club’s recommended health test list, and Lemonade lists hip dysplasia first among common Newfoundland conditions. Healthy Paws covers hip dysplasia only if you enroll before the dog is six. Embrace’s orthopedic waiting period varies by state, so check it for yours.
Our hip dysplasia coverage guide explains how insurers handle joint conditions. For another giant breed with joint and heart risks, see our Bernese Mountain Dog pet insurance guide.
Bloat and gastropexy
Trupanion lists the Newfoundland among breeds at risk of bloat, or gastric dilatation volvulus, where the stomach fills with gas and can twist. It is an emergency. Embrace publishes the claim of a Newfoundland named Mariner whose stomach had twisted about 200 degrees on Christmas Eve.
Mariner’s vets released the gas, repositioned the stomach and performed a gastropexy, which tacks the stomach to the body wall to help prevent a repeat. The bill was $4,991, and Embrace reimbursed $3,726.90 after an $850 deductible and a 10% co-pay.
A preventive gastropexy on a healthy dog is different, because nothing has gone wrong yet. Figo puts a typical preventive gastropexy at $1,400 to $1,600. The insurer pages we checked did not say whether a preventive gastropexy is covered, so ask in writing. Our bloat coverage guide covers the details.
Cystinuria
Cystinuria is an inherited condition in which the kidneys fail to reabsorb the amino acid cystine, which can then form stones in the urinary tract. DogWellNet reports that in Newfoundlands, problems start early, at 6 to 12 months. Males are affected more often because stones can block their narrower urethra.
The Newfoundland form is recessive and has a DNA test. If you are buying a puppy, ask whether the parents were tested. Our guide to dog DNA testing and pet insurance covers questions to ask an insurer about genetic test results.
What Newfoundland Owners Should Do
- Enroll early. Get a policy in place soon after the puppy comes home, before routine exams fill the record.
- Ask for a careful heart check at every visit. The murmur can grow louder over the first 1 to 1.5 years, so one clear exam is not the end of it.
- Time any screening echocardiogram. Talk to your vet and your insurer about when to book it, and whether the plan pays for it.
- Ask breeders for health results. The breed club recommends cardiac, hip, elbow and cystinuria testing. A breeder should be able to show results for the parents.
- Choose a limit that fits a giant breed. Compare the annual limit with the cost table above, since a bloat surgery and a joint surgery in one year are both possible.
Is Newfoundland Pet Insurance Worth It?
It depends on what you could pay yourself. A severe heart diagnosis, an emergency bloat surgery or a hip operation can each cost thousands, and giant breeds tend to cost more per treatment. If a bill of several thousand dollars would strain your budget, a policy bought early is likely worth considering.
If you have substantial savings set aside for vet care, a higher deductible may fit better. Insurance cannot remove the breed’s risks; it only limits how much of a covered bill you pay. Our guide on whether pet insurance is worth it and our comparison of major pet insurance companies can help you decide.
The Bottom Line on Newfoundland Pet Insurance
Subvalvular aortic stenosis is strongly associated with the Newfoundland, there is no validated DNA test for it, and it is usually first noticed as a murmur. That makes enrollment timing more important than small differences in premium.
Enroll young, keep up routine heart checks, and ask each insurer in writing how it treats murmurs, screening tests and preventive gastropexy. For a different heart risk in another giant breed, see our Great Dane pet insurance guide, and read how we research every guide on our About page.
Frequently Asked Questions
It can, if no sign of the condition, such as a heart murmur, was recorded before coverage began or during the waiting period. Embrace, Healthy Paws, Fetch and Trupanion all say they cover hereditary and congenital conditions that are not pre-existing. Check the sample policy for your state before you buy.
At the UC Davis veterinary teaching hospital from 2008 to 2017, 10 Newfoundlands were diagnosed with SAS, a breed prevalence of 4.46%, with an odds ratio of 34.73, second only to the Bullmastiff. In a French screening program of 921 Newfoundlands, about 0.9% had aortic stenosis. The two studies looked at very different groups of dogs.
Not a validated one. A 2014 US study linked a small insertion in the PICALM gene to SAS in Newfoundlands, but a 2015 European study found no association. Diagnosis still relies on a vet listening for a murmur and an echocardiogram. Cystinuria, a separate inherited condition in the breed, does have a DNA test.
Fetch reports an average of $100 a month across its active Newfoundland policies in 2025. Lemonade’s illustrative figures for its own policies run from about $60 to $65 a month at age 1 to about $115 to $120 at age 6. Your quote will depend on age, ZIP code, deductible, reimbursement rate and annual limit.
Severity is graded by the pressure gradient across the narrowing, measured on an echocardiogram. MSPCA-Angell classes severe SAS as a gradient above 80 mmHg. Dogs with mild or moderate SAS usually have a good outlook, while severe SAS often carries a poor long-term prognosis, with weakness, exercise intolerance and a risk of sudden death.
As early as possible, ideally soon after the puppy comes home and before any vet visit records a murmur. A murmur from SAS may grow louder over the first 1 to 1.5 years of life. Healthy Paws also covers hip dysplasia only if the dog is enrolled before age six.
Sources
- Ontiveros ES et al. (2019), Frontiers in Veterinary Science: Congenital Cardiac Outflow Tract Abnormalities in Dogs: Prevalence and Pattern of Inheritance From 2008 to 2017
- Crofton AE, Kovacs SL, Stern JA (2023), Cardiology Research: Subvalvular Aortic Stenosis: Learning From Human and Canine Clinical Research
- Stern JA et al. (2014), Human Genetics: A single codon insertion in PICALM is associated with development of familial subvalvular aortic stenosis in Newfoundland dogs
- Drögemüller M et al. (2015), Human Genetics: A single codon insertion in the PICALM gene is not associated with subvalvular aortic stenosis in Newfoundland dogs
- Chetboul V, Fauveau C, Passavin P (2025), PLOS ONE: Congenital pulmonic and aortic stenosis in Newfoundland dogs: Results of a 14-year French cardiovascular screening program (921 dogs)
- Eason BD et al. (2014), Journal of Veterinary Internal Medicine: Influence of beta blockers on survival in dogs with severe subaortic stenosis, summarized in Veterinary Evidence: Does medical or surgical treatment for aortic stenosis improve outcome in dogs?
- MSPCA-Angell: Subaortic Stenosis
- DogWellNet: Cystinuria Type I-A
- American Kennel Club: Working Group Health Testing Requirements
- Fetch: Pet insurance for Newfoundlands, hereditary and congenital conditions
- Lemonade: Pet Insurance for Newfoundlands
- NAPHIA: State of the Industry Report 2026, highlights
- Embrace Pet Insurance: genetic and breed-specific conditions, pre-existing conditions, waiting periods, cardiomyopathy, Newfoundland bloat claim story
- Healthy Paws: Pet insurance for dogs, hereditary and congenital conditions
- Trupanion: Hereditary and congenital conditions, Bloat in dogs
- Figo: Gastric dilatation volvulus (bloat) in dogs
The PetCoverToday Editorial Team develops and maintains the guides on this site, checking cost figures, coverage terms, and policy rules against insurers' own published pages and, where relevant, veterinary and industry sources. PetCoverToday is an informational website, not a licensed insurance agency, and does not sell policies. Read more about our editorial approach.