Veterinary Vertex
Veterinary Vertex is a weekly podcast that takes you behind the scenes of the clinical and research discoveries published in the Journal of the American Veterinary Medical Association (JAVMA) and the American Journal of Veterinary Research (AJVR). Tune in to learn about cutting-edge veterinary research and gain in-depth insights you won’t find anywhere else. Come away with knowledge you can put to use in your own practice – along with a healthy dose of inspiration to remind you what you love about veterinary medicine.
Veterinary Vertex
Sniffing Out Solutions: The Revolutionary Role of Dogs in Detecting Disease
Have you ever wondered about the extraordinary capabilities of our four-legged friends' noses? Prepare to be amazed as Patty Ungar, Mackenzie Pellin, and Laurie Malone join us to share insights into the world of scent detection dogs, revealing how their remarkable noses could revolutionize disease detection—targeting ailments from cancer to COVID-19. We're not just sniffing around the edges; we're uncovering the science behind their ability to detect illness. From discussing research that shows dogs discerning cancerous cells from healthy ones to their role in sniffing out COVID-19 positive individuals, we're tracing the paw prints of a potential medical milestone.
It's a tale of serendipitous beginnings, the power of mentorship, and the seamless weaving of veterinary and human medicine through the One Health concept. Let your curiosity off the leash as we explore the expansive landscape of veterinary science, from the clinic floor to the frontier of research with our exceptional canine companions leading the way.
JAVMA article: https://doi.org/10.2460/javma.23.10.0550
AJVR article: https://doi.org/10.2460/ajvr.23.10.0222
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You're listening to Veterinary Vertex, a podcast of the AVMA journals. In this episode we chat about sent detection dogs with Patty Unger, mackenzie Pellin and Laurie Malone.
Speaker 2:Welcome to Veterinary Vertex. I'm Editor-in-Chief Lisa Fortier, and I'm joined by Associate Editor Sarah Wright. Sarah and I are super excited that today we have Patty Mackenzie and Laurie joining us. Thank you so much, all three of you, for taking your time to be here with us today. Thank you, thank you.
Speaker 1:All right, let's dive right in your JAVA and AJVR. Currentsendone Health Articles discuss sent detection or SNiffer dogs and how they can detect cancer. And. Covid, mackenzie and Laurie, please share the background on your study.
Speaker 3:Originally we had written an article about how SNiffer dogs could be trained to help detect differences between samples taken from dogs with cancer and then normal dogs in the clinic. The patient population was from my clinic, University of Wisconsin. Dogs that had been diagnosed with cancer had cheek swab samples taken and then there was a population of normal dogs, young, healthy dogs without problems, both from Wisconsin and then down in Alabama area from general practices. We did show Laurie's team showed that the SNiffer dogs were able to detect differences at a high accuracy rate. From that publication we then did this review article talking about our study as well as the other veterinary studies, which there aren't very many, Just one other study looking at dogs that have bladder tumors and how dogs were in that study not able to detect differences in urine sent from dogs with tumors versus other urine issues, other urine diseases.
Speaker 3:Then also reviewing human medicine, where they've, of course, studied this a little bit more. It's more highly studied in people who have breast cancer, lung cancer those are the top ones prostatic cancer as well. The article really just reviewed all those different findings from previous articles. Our summary is basically a lot of work still needs to be done, but it definitely seems to be a fascinating area of research and, I think, a lot of potential there, especially as we investigate more in our veterinary patients. We're just starting the investigation there.
Speaker 1:Patty, please share the background on your article.
Speaker 4:We're all pretty familiar with dogs being used for things like sniffing for explosives, drugs produce you see me at the airport and everything. What is less well known to this to the general public, I think, is that they're being used for a lot of health applications, especially internationally, a lot of cancer. There were published studies from dogs being used to sniff for Parkinson's, seizures, diabetes, colorectal cancer, breast cancer, melanoma I think a lot. I missed a couple on there when the pandemic first hit. I thought, well, we've got to find a way to get through this. I'd seen a couple studies about dogs being used, trained to sniff for COVID. How interesting is that? The theory is that when you have a disease whether it's COVID, parkinson's, anything above your body produces unique what are called valtoorganic compounds. There's a small chemical compounds that are unique to that disease process. Somebody who has COVID smells different than somebody who's got bladder cancer to a dog because they're sense of smell so incredibly good.
Speaker 4:We started looking to see could we put this to use to maybe try to get us through the pandemic a little bit faster to get have some practical application. We said about planning out how to do it. I've reached out to a lot of experts to figure out what the process is, the concept you basically we found people who were diagnosed positive by PCR with COVID, had them use specially designed scent tubes that they put in their armpit for 15 minutes to capture the scent. We got those from about 60 different people. We train the dogs to find that scent. We use negative controls of people who did not have COVID and just unscented tubes. We would hide the tubes for the dogs. When they would find the right tube they would get a treat. These time we have two dogs that are very food motivated. They love to work and for them it's a big game of hide and seek. We would all get excited. Actually watching them do it was a really fun process for me because I had no idea dogs could do this so well.
Speaker 4:We then move to doing scent lineups. We take people who were not COVID positive, hide scent tubes on them and have maybe one or two people with a tube hidden in their clothing and five or six or eight people who were negative and when the dogs could find that, they get rewarded. Then we moved on to people who were actually infected, putting them in a lineup with negative people. Obviously massive social distance in 15, 20 feet apart, dogs on a 20 foot lead, everybody double masked and would wipe the dogs down. After this we wouldn't have any foam might transfer.
Speaker 4:When they got to where we were pretty sure that they were accurate doing this, we were ready to let them go to work. My thinking was that at a time when we were all afraid to go into the supermarket or go into any entertainment venue, how nice would it have been to have a dog sniffing people on the way in. You have a level of confidence that you weren't going to get infected. That was the basic work on it. It took us a while to get it going. I had just retired from my practice. I had to throw out how to make that part of it work.
Speaker 1:That's fascinating. I love the images, too, that you guys have in your articles as well. I think that's really great for social media promotion and just to get an idea of these dogs training and what they do. Thank you for those and Patty. What were some of the important findings from the JAPMA article?
Speaker 4:What a number of things. One, the dogs tested out at 95, 96% accurate, both positives and negatives, which that really surprised me. That made them better than most of the tests on the market, especially early on. A quick aside early in the pandemic I got infected in March of 2020. At that point the tests were not very good. It took months to prove that I'd had. I went into long haul. I was very personally aware of what COVID can do, so I was surprised the dogs were really good at this.
Speaker 4:One of our challenges the studies that have been previously published. They were having the dogs sniff inert objects masks, pieces of clothing and you'd have them breathe into a cotton, a gauze, sponge, things like that. I thought, well, that's not very efficient. If you're trying to screen a group of people walking into a theater, you can't say can you give me your mask, I'll be back in 10 minutes. We wanted to see how they would do sniffing a whole person. By and large, they did really well. They were distractible though. We had a couple scenarios, one particular reverse I had the dogs, actually another veterinarian and his wife who had both gotten infected.
Speaker 4:We had them in a little breezeway between their house and their little cottage. The dogs were going to work and then one of their cats ran out. I thought, whoa cat. Then their dog came out. Another cat came out. Let's have you do tubes instead. The dogs never did find it on those people because they were so distracted by the animals. When we got their scent tubes, they found on those. Every time there are some caveats to which you can and can't do the dogs. They're still dogs. They want to play and see things that are around them. To me, the main thing was the accuracy. These dogs absolutely deserve a bigger place at the public health table. There is so much they can do. We're not utilizing them. We are, in a great way, very science and technology oriented, as we should be. We have the ability, but I don't think we should be overlooking what these dogs can contribute. This is not going to be the last pandemic. We can be sure of that. There's going to be more around the corner.
Speaker 1:Yeah, very important information. Thank you, then, mackenzie. What were some of the important findings from the AJVR article?
Speaker 3:Well, again, the article was kind of summarizing some of the previous studies that have done. I think the important findings are that dogs can be utilized to have sent detection in these various cancers. Again, a lot more work still needs to be done to figure out to kind of what extent they can be used. Can they be used for early detection? Because ultimately that's the major goal for both veterinary and human medicine is can we detect cancer earlier than we are currently able to? Can we detect it at a very subclinical, preclinical state where treatment is gonna be more effective?
Speaker 3:And so our study looking at dogs with cancer, these were dogs that had bulky disease, they had diagnosed disease and this was a very proof of concept sort of thing. From there we can start to work backwards and see okay, are there differences for different types of cancer? Certainly, some of the samples we took from dogs with oral cancer probably had more than just the scent on them. They probably had actual parts of the tumor, versus dogs that had bladder tumors or hermangiosarcoma and the spleen. So I think, needing to work backwards and figure out what is the concentration, Does that vary for different tumors? Is it vary for different breeds or signal mints of dog as well. So I think the basic finding was like yes, this can happen, but now we need to figure out to how we can better utilize that and can we use that to get to that early detection goal.
Speaker 4:So one thing I think with the time that you just said we found with the dogs, with COVID, they were repeatedly able to pick up the scent on people several days before they tested positive or had symptoms, which was really shocking. Two, three, four days ahead of time. I would say do you have any symptoms? No, we go back a few days later. Dog would still alert on them and the person who's testing positive at that point. So I think there's a decent chance that that should play out with cancer as well.
Speaker 3:You agree, which is, our clinical detection skills have to kind of catch up and you know the typical lumens of veterinary research is we need a big enough population and enough money to be able to fully stage and track these patients.
Speaker 4:Yeah, I was hoping to try to pivot our dogs to early pancreatic cancer because it's such a killer disease. But that was just the issue. How do you find a population to screen? Because we don't know how to screen for them who's at risk. So we're looking at colon cancer instead.
Speaker 5:but now yeah, following up from McKinsey, we, you know, since our previous article I've had a couple of people approach knowing what we're doing. And so one friend, she had taken her dog to the veterinary and they could not pinpoint, you know, something was wrong. But none of the tests were showing anything. So they provided us with a sample and our team of six dogs trained on cancer, another canines, all of them alerted on this sample, and so this is an example. So we'll follow now and see you know the progression of that individual's dog as they continue, you know, further down the road in their healthcare. So you know, using more cases like that to really see you know how early are the dogs picking it up.
Speaker 2:That's so fascinating and there's so much to be done with the science behind all of this. That's what I really learned from your two manuscripts, so thank you for educating me and everybody else who read them. Patty, I thought when you said the dogs got distracted because you just mentioned theater, I thought it was gonna be the popcorn.
Speaker 4:That would also do with the, for sure.
Speaker 2:It distracts me. When we opened the episode, everybody spoke to how this is interesting to the public. But really, what sparked each of your research interest in Sniffer Dogs and Patty? Maybe we'll start with you.
Speaker 4:I sort of backed into it. Honestly, I had sold my practice, I was deciding what I was gonna do as I was not retiring but rewiring and redirecting. And I started seeing these articles about Sniffer Dogs and just got intrigued Cause I had not worked with them before. I had a couple, I had some in my practice and I had his patients and a lot of working dogs. But I thought this is something that's just fascinating and I'm in a time and a space where I can do something with it. I, to be honest I mean, you know this, I never saw myself as a researcher, that's not been my background I sort of fell into it. It was very serendipitous.
Speaker 4:I stumbled on some of the articles. I think it was Dominique Grangeon from France had published a couple of things that were just fascinating. Really they're able to do this. Really Dogs can do that. And there was an article about a dog in Sarasota, florida, who was sniffing people going into a hospital and actually the woman who trained that dog helped me train our dogs. This is early on. They had a dog, they were screening people come into the hospital so that people coming to visit patients would not bring COVID in with them, and that was just for that. Just before I started that article, I was actually about to give it up and say this is not going to work, and a friend had sent me that article. I said I should read it and I read it. Oh, ok, this is working. I guess I'm supposed to do this.
Speaker 2:Serendipity sometimes is the best research. Yeah, yeah, Mackenzie. What sparked your research interest?
Speaker 3:I certainly have to give a lot of credit to Lori and I'm sure she'll, I think, has the true passion for it, and I was, again, serendipitous, in the right place the right time.
Speaker 3:We were contacted to see if we could help provide some samples, being just a high-volume oncology center, and initially it was me being junior faculty and like, oh, you should do this because you need a project, and certainly as an academic oncologist the goal is to teach students, teach residents, teach interns, see patients myself and then also to provide research, and my research interests have been much more clinically focused. I appreciate the benchtop research, but I much prefer working whole animal and then trying to figure out ways that we could make life a little bit easier for a veterinary oncology patients, whether it's detecting things earlier or just making treatment easier and providing a better prognosis. So I think this was a very fascinating project from that. And then, furthermore, I think it just really nicely illustrates our whole idea of one health, one oncology, that we do something with our canine patients that hopefully benefits both human patients and veterinary patients, and so I think what better way to illustrate that than using a dog to benefit both dog and cats and humans? So it really is a nice illustration of that.
Speaker 2:That's a really, really lovely summary. All right, Laurie, the basic scientist in the group, bring it home what sparked your interest.
Speaker 5:So yeah, as a researcher and a dog lover, it was actually. It stems back to my little pet dog, penny, who had survived living in a puppy mill for four years, and so the puppy mill was busted. All the dogs were distributed throughout the state to various humane societies, so I was volunteering there. Of course, the sweet little, scared to death doxin, came, little Minchard doxin Ended up bringing her home. She actually needed heart surgery, so veterinary medicine helped her with that and survived. But she was just terrified of the world just really not engaging.
Speaker 5:I thought what can I do for this poor little dog? Of course she was comfortable with me and in my quiet household, but still I wanted to give her some stimulation. So I got found out about just the activity of sniffing for dogs and how it taps into their inherent instinctual drive to survive through their senses, particularly olfactory. So I found a sport called nosework, started training her, watching her blossom Fascinating, and then my research brain kicked in. I started reading, like Patty, about the science of scent and was, wow, just intrigued. And of course it always known about military dogs, various police dogs that were utilized, with their scent and drive.
Speaker 5:So then reading a few articles related to cancer and most of my work is related, health related. So I became fascinated in those lines, started saying, ok, we need to pull together a team of dogs and start training them and so finding partners, and that's how McKenzie and I came together. Especially of interest to me a little penny in the end ended up getting cancer herself, and so several dogs have. And so it's a passion from a research perspective, a dog loving perspective, and just watching the amazing ability of these dogs and what we can do since they've gone back into public health. And so I love the concept of One Health that we've talked about with these two articles, because I figured I needed to put that on top of my other studies to support our endeavors going forward with this venture.
Speaker 1:You're just amazing adventures, all of you, honestly, 16 points. Thank you for sharing with our listeners. If our listeners is joining, we're talking about scent detection dogs the emphasis on COVID and cancer sniffing dogs. With our guests Patty, mackenzie and Laurie, it's always nice to look back and see where you started and then where you are today. Mackenzie, how did your advanced training prepare you to write this manuscripts?
Speaker 3:Well, I've been interested in oncology pretty much since I became interested in veterinary medicine and going through again veterinary school and residency and again trying to figure out where my niche was, knowing that it was more clinical research and clinically applicable sort of things. So lots of training, reading manuscripts and preparation for boards, getting to know the rhythms there, and then just lots of practice for the last several years. So again just kind of learning what kind of research I like to do and trying to apply all the things that I've learned from people who have gone before me.
Speaker 1:So it's nice to look back to Journal Club and say thanks for the help. Yes, yep, May not feel like it when you're in it, but it does help.
Speaker 3:It's actually for a purpose.
Speaker 1:yes, and then Patty, how did your advanced training prepare you to write this manuscripts?
Speaker 4:So I'm the opposite end of the spectrum here. I graduated Ohio State excuse me, the Ohio State in 1984, which, yes, is a long time ago. I was an equine veterinarian for a while. I started my own practice in 1990, became a very successful integrative swallowing of practice. Research never crossed my mind. It was day to day running of the business, it was learning how to do that. It was managing 20 plus employees, all the stuff that goes with that. When this idea sparked my interest, I had sold the practice I'd sold one of my associates in early the beginning of 2021.
Speaker 4:And this idea hit me. I thought well, do I know how to do this? I mean, I don't have a university behind me, I don't have anybody behind me, it's just me. And one of my techs did it with me. So I reached out to friends Once. They said I was going to try to do this. I reached out.
Speaker 4:I spent a lot of time poring over journals, thinking what is the structure of a journal article, going word by word. It's last name, comma, first name. At which point one of my sons said mom, you know that there's an online citation generator. Oh, really, ok, that's good. I hadn't done this kind of writing since undergrad, which is a long time ago.
Speaker 4:I want to shout out to a couple of friends who were hugely supportive. I reach out to people who know more about it than I do. Nico Skirfield is a county vet here who was really supportive. Encourage me. He said this is a great idea, you need to run with it. And also Kevin Fitzgerald, who helped me with some of the editing because he had us for a couple journals, because this is a new world to me.
Speaker 4:Sure you guys noticed it reading my original manuscript, by the way. I want to big shout out to both of you for your help and support. You've been really encouraging along the way at the moments when I thought do I know how to do this? Which, honestly, I think we're all told in veterinary school that there's this wide range of things you can do as a vet and there really is. It's very true, whether you're talking about pharmaceutical practice, whatever, but that I could go from 36 years of being a general practice veterinarian and business owner to writing an article and having it published in an excellent journal. That's pretty cool. So it was not a path I ever anticipated. My training prepared me because I knew that there was a way I could figure it out. We're problem solvers. That's what we're trained to do Solve challenges, solve problems.
Speaker 1:Very well said and that's so true. We definitely are problem solvers. Now, moving into this next set of questions there are going to be really important for our listeners. Lori, what is one piece of information that general public should know about sniffer dogs and a public health capacity?
Speaker 5:Back to how McKenzie described. So we're still really in the early phases of understanding how it works. But again, as Patty will, I think, urge, there is a need, there's a place for these dogs sniffer dogs in public health. They have so much capacity, there's so much that can be done with them, that just the support is needed and the understanding of what they can provide across so many domains of health. It's just fascinating and just needing to tap into it and have the belief and I think just some people don't have the confidence that dogs can serve a role in our health and until, like those of us who have read these articles and then seen it in practice as we're training these dogs, working with these dogs, hard to believe. And so just more studies like these are needed. Future research needs to be published and then also going out into more layman's journals to make sure that everybody is aware and that more support is garnered to move forward.
Speaker 1:Yeah, these articles have definitely garnered a lot of media attention too, especially on social media, because I think it's such an interesting topic and apt to compute the general public, so it's great to be able to share those on social and really just promote the content that these articles contain. Mackenzie, what is one piece of information investigational or commercial entities should know about sniffer dogs?
Speaker 3:The big question is just how can we better apply this knowledge. Obviously, again, it's an insincipancy, we need to do it. But, like then, what is the ultimate goal? I think it would be lovely from many aspects to think about having in a clinic, like your therapy dog and then your screening sniffer dog but obviously there's a lot of regulations surrounding that.
Speaker 3:That may not be the most practical application, but how can we take this information and try to make it into a more of a diagnostic? So you know, lori gave a great example where her team has already taken like a sample from this kind of nebulous medical case and try to screen it there. Whether it is like people can send samples from their own pet or veterinarians can send samples to a team of sniffer dogs that can then screen it is that we do more investigation into figuring out these volatile organic compounds, chemicals, and trying to pinpoint exactly what it is that dogs are detecting and then use like a blood assay for that that we can better screen. So I think again, infancy stages, but I think it would be nice from commercial laboratories kind of some support for some of this research so that we can figure out more and hopefully develop better diagnostic assays.
Speaker 2:I think of it too, on some of the global health issues malaria, tb you know, like there's just so much. I can't imagine the Gates Foundation or others wouldn't be super interested in something like this.
Speaker 3:Well, and that's interesting too because you know, certainly in some developing countries dogs are not given the same status, you know, and influences they have in the United States. So if that could be useful and somehow kind of change the perception of dogs in some of those countries, that would be huge yeah so much potential.
Speaker 2:I've learned so much from you guys, from reading your manuscripts, and even more today. So thank you all three of you for taking your time and as we wind down, we start to ask a little bit more of a fun personal question. So, patty, we'll start with you what is the first concert you attended?
Speaker 4:The who in Cincinnati, Ohio, Back in the day they were young then I saw them two years ago.
Speaker 2:They're still going strong, Still playing Mackenzie. What was your first concert?
Speaker 3:I'm from Minnesota and I think you'll remember from the early 2000s closing time by Semi-Sonic. They were local so I actually ended up seeing them like three times in concert. So very, very one-hit wonder, but that was it.
Speaker 2:Well, I'm a little less jealous. I thought you were going to say Prince, so I never quite made it into signal.
Speaker 3:I wish.
Speaker 2:Laurie, what's your favorite of the most unique place you've ever traveled?
Speaker 5:Ooh, as mentioned, this is a very tough question. So I had a goal before I was age of 40 to go to every continent, and so that was achieved. Of course, antarctica was the most distant and far-reaching place to get to. So on the one hand, that still, I mean, I remember I wrote poems when I came home from Antarctica and I am not a poet, so it triggered something in me, just the fascination of this far away, remote, other world. But then I have a love of Africa, actually Africa and Australia, and I think it's because of all the unique and interesting mammals on both continents, and so those might be at the top of my list.
Speaker 1:I love Africa. I've been twice. One was for a study abroad trip, another for a professional conference, and just amazing both times and it's just so cool, the biodiversity, and just really makes you appreciate, like you know. Yeah, special place for sure. And just thank you again, patty Mackenzie and Laurie, for being here with us today and for your contribution to our journals. We really appreciate it, thank you. Thank you for having us and to our listeners. You can read Patty Mackenzie and Laurie's articles in print, javma or on our journals website. I'm Sarah Wright, at least of 48. We want to thank each of you for joining us on this episode of the Veterinary Vertex Podcast. We love sharing cutting edge veterinary research with you and we want to hear from you. Be sure to leave us a rating and review on Apple Podcasts or whatever platform you listen to.
