Dog Cancer Risk Linked to Size | Dr. Jules Benson

[00:00:00] >> Dr. Jules Benson: We were surprised by how dramatic the results were. When we cut the data by size, the relative risk for the different sizes of dogs, both purebred and mixed breed, we said it was a, it was a cell phone signal. It was literally for each individual size increasing, your Wi-Fi signal was increasing each, uh, at each step.

[00:00:20] >> Announcer: Welcome to Dog Cancer Answers, where we help you help your dog with cancer.

[00:00:27] >> Molly Jacobson: Hello, friend. This week on Dog Cancer Answers, we’re welcoming back Dr. Jules Benson, the Chief Veterinary Officer from Nationwide Pet Insurance. Previously, Dr. Benson has joined us to talk about white papers they’ve published looking at cancer risk in mixed breed versus purebred dogs. And today, we’re going to discuss a third paper out from Nationwide called About the Size of It that looks at mixed breed dogs and size and cancer risk.

Dr. Benson, welcome back.

[00:01:01] >> Dr. Jules Benson: I’m so happy to be here.

[00:01:02] >> Molly Jacobson: I’m really excited to talk to you about this new white paper that Nationwide has just released. About, I think it’s called About the Size of It.

[00:01:12] >> Dr. Jules Benson: About the Size of It.

[00:01:12] >> Molly Jacobson: Yeah.

[00:01:13] >> Dr. Jules Benson: We were gonna go with Size Matters, but that was, that was considered too sensitive. So we stuck with About the Size of It.

[00:01:18] >> Molly Jacobson: I could see that. That, that works. Yes.

[00:01:20] >> Dr. Jules Benson: It works.

[00:01:21] >> Molly Jacobson: So every vet has diagnosed cancer multiple times, right? But you are dealing with cancer claims at the largest pet insurer in the country. So you’re looking at over a million claims to get the data for your white paper.

[00:01:38] >> Dr. Jules Benson: Over 1.6 million dogs over a, uh, six year period. Yeah.

[00:01:42] >> Molly Jacobson: Yeah. So I wanna just briefly talk a little bit about the white papers you’ve already released, just to give people an overview of what you’ve been doing and what you hope to offer the public and veterinary professionals by doing this data analysis that you’re so carefully doing at Nationwide.

[00:01:58] >> Dr. Jules Benson: It’s been a journey for us. So when I, I started with Nationwide about three years ago, and we were able to found a pet health data insight analytics team within my department. And so being able to dig into 40 plus years of pet health data and having, you know, at any one time, right now we have over 1.1 million dogs insured.

So being able to have that aggregate over time, we’re talking about dog years being insured, and you can imagine that if you pile those up on top of each other, we have like, I think it was over 20 million dog years insured over the lifetime of Nationwide. So, uh, no, more than that. 200 million? I forget, I’m, I’m missing a decimal point somewhere, but it was, uh, it was back when sabertooth tigers roam the earth. Um, so we, we have that many pets insured.

And so we started looking at what could we do with these data, what could we do to make meaningful insights into pet health data? So we talked last time about, we, we were looking at Doodles, uh, initially, and we said, okay, if we look at the cancer population within a purebred, you know, within these pure breeds, and then we look at a, an offspring generation.

So the first generation from a purebred. So crossing, you know, a Labrador with a Poodle looking at Labradoodles and just had stunning uh, numbers of the, the decrease in claims that we saw for cancer in that what we call the F1 generation of the hybrid breeds. And then from there into what body systems are most affected by cancer in which breeds, that was kind of our second paper. And this has all been kind of feeling our way through the, being guided by what we see in the data. And that’s where this third white paper came from.

[00:03:30] >> Molly Jacobson: That’s great. So we’re gonna put a link to our previous discussion, which is, I found it totally fascinating to talk to you about everything you just said. I have so many thoughts now that I will not speak because we wanna talk about your new paper, which is on the size of dogs and what kinds of cancer, and you have so many insights to share. So let’s talk about, first, I wanna talk about what size dog you’re actually talking about. Like, a lot of people think they have a small dog and their dog’s 25 pounds, but that’s not a small dog according to you, to the statisticians.

So let’s talk about literally how small and big these dogs are.

[00:04:08] >> Dr. Jules Benson: I was thinking about this as as, as I was gonna come onto the call and, and it’s, I don’t wanna say it’s arbitrary, but anyone who’s switched from one heartworm medication to another will know that small dogs, they’re not small dogs, they’re not small dogs, right? So ultimately when we came to want to get greater granularity, especially around the mixed breed dogs, it was important for us to make a demarcation.

So, and I don’t remember how far back that goes, but it’s probably 10 plus years here at Nationwide. So we had to make a demarcation. And so at the time, looking at the five categories that we have for mixed breed dogs, which were toy, small, medium, large, and extra large. And the classifications between those, and I’m gonna pull ’em up cause I don’t wanna misspeak, were: toy is 10 pounds or less. Small, to your point, is 11 to 30 pounds. Medium was 31 to 50. Large was 51 to 110. And then extra large is 111 or more.

So, I have a million different arguments for large being 70 pounds or plus and for small being 20 pounds or below. So it’s not arbitrary, but, but once the die is cast, so to speak, you know, these are the data we have. And so, so what we did on top of that was looking at the demarcations we had, we then went and looked at all the purebreds and said, based on this, what is the average weight for this breed, and should they fit into a medium or large or a large or extra large.

And so there’s some, there’s always gonna be some fringe breeds in between those where it’s like, well, is a, uh, a Keeshond like, is that a 50 pound or is that like – so when trying to work out where some of these other breeds fit it can get a little bit tricky, but we’ve done the best we can with the tools we have, and the great thing is with enough numbers, those things tend to bear out, right? So knowing that we have a huge number of dogs to work with, we can be less concerned with some of the, uh, I guess the, the nitpicking around which dogs fall into which groups.

[00:05:54] >> Molly Jacobson: That’s a really good point because I know a lot of people when they look at white papers like this or they look at, even they hear a statistic of any kind, they think, well, my dog’s not in the large breed. So my 50 pound dog is a medium sized dog in this number, so therefore, everything that happens in the large breed section doesn’t apply to my dog. But that’s not necessarily true. There’s a little fuzziness at those edges in reality, in life.

[00:06:24] >> Dr. Jules Benson: But I’m loving your thinking on this because what we’ll talk about later is where we’re going next, and a lot of that is personalizing this. So it’s taking some of that guesswork out of it and trying to make these answers make as much sense to each pet family as possible.

[00:06:36] >> Molly Jacobson: Perfect. Because that’s where this data’s really gonna matter to those of us who are at home with our dogs, wondering how to care for them best.

[00:06:45] >> Dr. Jules Benson: Absolutely.

[00:06:45] >> Molly Jacobson: Wonderful. Okay, so I’m looking forward to that part of the discussion, but let’s talk first about what you found out. So, first I wanna ask you, when is a dog considered at its full weight?

[00:06:56] >> Dr. Jules Benson: So it depends on the breed. So early maturing, so small dogs, small dogs tend to get there earlier, I think, and larger dogs can take longer to mature. So generally speaking about 18 months tends to be full weight. So sometimes with, I think especially if they’re male entire dogs can take a little bit longer to build those secondary sexual characteristics like the, the additional weight and muscle.

But certainly from my own point of view, I look 18 months as a really good kind of judge as to what the overall weight they’re gonna be at.

[00:07:23] >> Molly Jacobson: Okay. So we have plenty of time once our dogs reach their full weight to know basically how big they are.

[00:07:30] >> Dr. Jules Benson: Sure. Yeah. Certainly from a mixed breed. And I think that the rule that I learned in practice was that at four months of age, if you approximately double the weight that’s gonna be around the, the weight for the adult.

[00:07:41] >> Molly Jacobson: Okay. So that can help people to know what they’re looking at in the future as they plan ahead for some of those more specific recommendations that you give at the conclusion.

[00:07:51] >> Dr. Jules Benson: Certainly for the mixed breeds. I think for the, for the purebreds, we, we generally, well as someone who has a 12 pound Chihuahua, the, a lean 12 pound Chihuahua, she’s just a plus, we call her a plus size Chihuahua. So some of those things aren’t always predictable.

[00:08:02] >> Molly Jacobson: Right, exactly. Okay, so let’s talk about what you found out. First, you looked at all of the dogs and their sizes, and then you eliminated all the purebred dogs. So why’d you do that?

[00:08:13] >> Dr. Jules Benson: We excluded them from the results. We didn’t eliminate them. That would’ve been, that would’ve been cruel and unnecessary.

[00:08:19] >> Molly Jacobson: Oh.

[00:08:20] >> Dr. Jules Benson: We.

[00:08:20] >> Molly Jacobson: Yes.

[00:08:21] >> Dr. Jules Benson: We, um.

[00:08:21] >> Molly Jacobson: Nationwide doesn’t eliminate dogs.

[00:08:23] >> Dr. Jules Benson: We did, we did not, we did not believe in eliminating dogs based on, on purebred and mixed breed status.

[00:08:26] >> Molly Jacobson: Okay.

[00:08:27] >> Dr. Jules Benson: So we did, and, and it was, uh, it was as we were looking at the other, I think we talked about this a little bit in the last session. Um, as we were looking at the data, one of the nice things we’re able to do was to start segmenting in different ways. So we were looking at even continent of origin. We were looking at, you know, coat type, is it double coated or single coated? Is it, does it have, you know, dangling ears or erect ears and, and trying to slice the data in these different ways and just see if there’s anything in there that surprised us.

And when we did it by size, it’s hard to say, I think, I don’t think any of us were surprised at the result, we were surprised by how dramatic the results were. So when we cut the data by size, the relative risk for the different sizes of dogs, both purebred and mixed breed, we said it was a, it was a cell phone signal.

It was, it was literally for each, each individual size increasing, that your Wi-Fi signal was increasing each, uh, at each step. So it was, uh.

[00:09:17] >> Molly Jacobson: Like the little symbol that we see on our phones for Wi-Fi?

[00:09:20] >> Dr. Jules Benson: Exactly. So if you have four bars, you’re a large or extra large, and if you have one bar, you’re a small or a, you’re a small dog, yeah. So it was, it was seeing that and then as we moved forward, as we looked at the, uh, especially the individual cancers and the difference between mixed and purebreds – and again, going back to our previous conversation, there are so many familial specifics around the, um, susceptibility of purebreds to specific types cancer.

We talked about, you know, Beagles and bladder cancer and Labradors and splenic cancers, right? So we know that there is a concentrated risk for some cancers in some breeds, potentially regardless of size, though, again, we saw that there were more medium and large breed dogs were certainly overrepresented versus small dogs. So.

[00:10:01] >> Molly Jacobson: Okay.

[00:10:01] >> Dr. Jules Benson: Coming into that, as we start to break it down by purebred versus mixed breed, we saw there were some pretty significant bumps in that kind of medium and large that we wouldn’t have otherwise expected. And so to us, especially as you look at the breeds that are overrepresented in that purebred section, so think about Labradors, think about Golden Retrievers, think about German Shepherds, think about, you know, French Bulldogs, like going through the, the top 10, Corgis, et cetera.

Corgis? Dachshunds. Dachshunds are inin thetop 10 I think. They, they’re, they’re certainly manipulating the numbers a little bit. So given that, and given the, the way that these genetic pools were affecting, I think, the prevalence of cancer within those groups, we kind of stepped back and said, okay, well what do we have in terms of mixed breeds?

If we, if we can say that mixed breeds come from a much more, a much deeper genetic pool in that they’re, they’re not bred within a specific group of pets, and we can say that there’s a greater genetic diversity. And at this point, about 40% of the dogs that we insure are mixed breed. So we still have a huge, huge number of dogs to look at.

That’s still a massively significant number of dogs, right? So if we, if this is a 1.6 million dog analysis, we still have what, 600,000, 700,000 dogs that, that we will look at. So we eliminated the purebreds from the analysis just because we felt that the cleanest way to see it was like, let’s keep the genetic diversity aspect and eliminate the smaller genetic pools aspect and hopefully this will give us a much clearer picture of what size actually means.

[00:11:24] >> Molly Jacobson: Right.

[00:11:24] >> Dr. Jules Benson: As opposed to combining size with some of the breeding issues that that we see with cancer concentrating within certain breeds.

[00:11:32] >> Molly Jacobson: Right. Because we know for sure that there are certain breeds of dogs who are more likely to get certain types of cancer because it’s in the bloodlines and they’re being overbred essentially at the bottom line.

[00:11:46] >> Dr. Jules Benson: Yeah. Well, and and, and it’s hard. I mean, I don’t, I don’t, it’s certainly not something to, to put on, on breeders or anything else, but it’s a, it’s a simple genetic fact that the, the smaller your genetic group, the greater the chance you are, that you’re gonna have this combination of genes that’s gonna be deleterious, right? You just don’t have that genetic diversity. So.

[00:12:03] >> Molly Jacobson: Yeah.

[00:12:03] >> Dr. Jules Benson: Most bad diseases that are genetically driven come because of a, a recessive alleles. So you’ll need two bad alleles inherited from each parent in order to, to make the bad disease, right? So.

[00:12:13] >> Molly Jacobson: Right.

[00:12:13] >> Dr. Jules Benson: The chances of that happening within a closed genetic pool are just statistically much higher. And what, what we know about cancer genetics – and I’m certainly, this is, this is gleaned from my friends who are experts, not from my own knowledge, but there are multiple triggers for this, right?

So if you said that for, for a certain type of cancer there are 16 genes that are affected and in a mixed breed dog, you know, four of those are turned on and you’d have to have five others turned on in a specific individual if they get it, but in purebreds eight of them might be turned on, right, just because of the combination of genes.

[00:12:42] >> Molly Jacobson: Right. Just because of that combination of a small number of genes being mixed together, you’re more likely to get extra copies of things you prefer not to get.

[00:12:49] >> Dr. Jules Benson: Absolutely.

[00:12:50] >> Molly Jacobson: Okay, so you’ve still got 600,000 plus dogs to look at?

[00:12:55] >> Dr. Jules Benson: Only 600,000 dogs. Yeah, exactly. Yeah.

[00:12:57] >> Molly Jacobson: So it’s still a very large group and you’re able to pull a lot of data out of it. My understanding is that larger animals tend to live longer, so why are dogs who are larger, more prone to cancer than smaller dogs?

[00:13:11] >> Dr. Jules Benson: So on a species basis, so larger animals, so elephants live longer than us and we live longer than mice, right? So that’s what you’re talking about.

[00:13:18] >> Molly Jacobson: Yes.

[00:13:18] >> Dr. Jules Benson: So there’s a really interesting area of research and we looked at this, so it’s called Peto’s Paradox, P E T O. So Peto’s Paradox says that the number of cells you have in a larger individual, so if you look to an elephant or a blue whale, what we should see is that those, because they have a larger number of cells, they should be, um, having duplication errors or are prone to cancer more frequently, just cause they have a larger number of cells. And that’s not the case across species.

However, having said that, there is research within human beings that say a larger human being is more prone to cancer. And the way that it may, the way that I explain it in my own simple brain is that I think if you look across species, there are so many more factors into causing, you know, into, into the genetics of cancer, right?

So it could be that – and whether they’re epigenetic as well. So by epigenetic we mean those, that the things that are, that could affect our expression of genes in our environment. So it could be that living at, you know, minus 500 feet for a blue whale is a great epigenetic condition for not getting cancer. Like, we don’t, we don’t know, right? We don’t, we don’t understand enough about how those things happen.

[00:14:24] >> Molly Jacobson: Okay.

[00:14:24] >> Dr. Jules Benson: And again, you know, there’s this fallacy that, you know, sharks and other, you know, rays or those, those cartilaginous fishes, they don’t get cancer. And I, and my understanding is they do, it’s just at a much lower rate.

So Peto’s Paradox is, you’ve hit the nail on the head, right? That, that we would expect cancer would occur, you know, in these other animals and they would live less, less long. Knowing that cancer, of course, is only one of the factors that would cause, you know, mortality. However, we don’t see that within, within species.

It would appear that within humans and certainly within dogs based on our research, that cancer is more prevalent based on body mass or on the number of cells within. And again, to me that makes sense ’cause if we have, if I weigh, you know, 200 and generously, 205 pounds – probably more than that at the moment – but if I weigh 205 pounds and you weigh 120 pounds or 110 pounds-

[00:15:11] >> Molly Jacobson: You’re being very generous.

[00:15:12] >> Dr. Jules Benson: I was, I was trying to make sure, I’m trying to make sure I erred on the right side of that particular guess. Um.

[00:15:18] >> Molly Jacobson: You did.

[00:15:19] >> Dr. Jules Benson: So, uh, it would make sense that I have many more cells, right? So, so if, if we were, had the same parents, the risk for us of developing cancer should be about the same genetically – obviously we got the combination of the genes from the parents, so it’s not the same unless we were twins, I suppose, identical twins – but if our number of cells is different, then presumably the chances of one of my cells triggering is higher than yours, just cause I have a higher number of cells.

[00:15:43] >> Molly Jacobson: You have more.

[00:15:44] >> Dr. Jules Benson: I guess. I, so again, and not being a geneticist and not, certainly not being a, a cancer geneticist, this is just how I, I look at it in my simple brain. I’m always, always happy to be corrected by someone who knows more than I do.

[00:15:54] >> Molly Jacobson: Okay. So that generally is holding true for our dogs as well, and you’re getting that, like you said, a cell phone signal chart, so that small has small bar.

[00:16:02] >> Dr. Jules Benson: Yep.

[00:16:03] >> Molly Jacobson: You know, toy has smallest. Small has a small bar. Medium has a medium bar. Large, and it just goes up to extra large. It’s just like a step.

[00:16:13] >> Dr. Jules Benson: And it’s almost the same increase at every level as well, which was, again, startling to us. It wasn’t just that, oh hey, you know, small and toy dogs, they have a lower risk and then large and extra large have a massive risk. It is literally bam, bam, bam, bam. So, going back to your point about how we sliced the, the weight categories, I feel like we could have done that in any which way and probably seen some of the same things.

[00:16:33] >> Molly Jacobson: Really? It’s that consistent.

[00:16:36] >> Dr. Jules Benson: Well, I don’t know, but my feeling is, again, based on the consistency that we saw in our data, my feeling was if we, if we categorize that into 5, 6, 7, I’d be fascinated to see, you know, whether that increase holds at such a steady rate across those dogs. But I will say that we did end up combining, because there just aren’t that many – it’s funny when you, when you combine or when you breed purebred dogs, my understanding is that the offspring, if it’s between a large and an extra large, that the offspring don’t tend to go towards the extra large size.

They tend to go more towards the large size. So it would appear that we certainly don’t have that many extra large mix breed dogs.

[00:17:13] >> Molly Jacobson: Okay.

[00:17:13] >> Dr. Jules Benson: And so the, the strength of statistics, even within that 600 plus thousand dogs, we ended up combining the large and extra large. There wasn’t enough statistical significance to, to hold extra large separate.

[00:17:24] >> Molly Jacobson: Okay.

[00:17:25] >> Dr. Jules Benson: And then when, when we went down to the level of diseases, we also combined toy and small.

[00:17:30] >> Molly Jacobson: Okay.

[00:17:30] >> Dr. Jules Benson: And that was mostly because the number of toy dogs affected – it wasn’t the population of toy dogs, it was the number of toy dogs affected tend to be so small. So in order to preserve the statistical integrity, we ended up combining toy and small at that level as well.

[00:17:45] >> Molly Jacobson: Okay. So everything got cleaner and it wasn’t sacrificing accuracy.

[00:17:49] >> Dr. Jules Benson: Correct. We’re, we’re trying to err on the side of that our big push for this is not to make dramatic statements for the sake of making dramatic statements. And if you read the white paper, we had the opportunity to – and we’ll talk about relative risk a little bit later just to make sure that that term is understood well.

But when we look at relative risk, you can say within a population, you can say, okay, I want to compare this size of mixed breed to all of the other mixed breeds, and that would’ve artificially inflated our numbers and made them look cooler.

[00:18:16] >> Molly Jacobson: Right.

[00:18:17] >> Dr. Jules Benson: But it would also, it would, it would’ve been incongruent with how we looked at them across the, all the other dogs entirely. So throughout this analysis, we’re looking at each population compared to all other dogs, not just the mixed breed dogs. So the actual relative risk for those cancers may seem relatively low in some cases, but the way that we encourage people to look at them, if they look at the white paper, is to look at the shape of the data. To say, okay, if I, if I, if I know that a purebred is twice as likely to have cancer as a mixed breed in this area, let’s imagine that blown up a little bit, and that will help us understand what the shape of the data might be based on purebred versus mixed breed.

[00:18:53] >> Molly Jacobson: So when people are looking at these charts that you’re giving them, you want them to think about the shapes they’re seeing, not necessarily the numbers on the x and y axis, but more the shapes, like the heavier the dog is, the higher the rate of cancer likelihood, the higher the risk.

[00:19:10] >> Dr. Jules Benson: And, and the data are accurate for mixed breed dogs, but the mixed breed population, as we said, is not necessarily representative of the entire population. So we’re just, we make sure that we’re, that we’re not trying to grab headlines with artificially increased numbers. We’re just trying to be accurate.

[00:19:24] >> Molly Jacobson: Right. Well, that’s a relief in 2022 to have somebody who’s not looking to generate a clickbait headline.

[00:19:30] >> Dr. Jules Benson: I mean, we, we love the clickbait headlines, but, but.

[00:19:33] >> Molly Jacobson: Of course.

[00:19:33] >> Dr. Jules Benson: In this case, the data has to stand on its own as well, so we wanna make sure that there’s some integrity there.

[00:19:37] >> Molly Jacobson: Right. Well, and the reason it has to stand on its own is because you guys are hoping to help dogs.

[00:19:42] >> Dr. Jules Benson: Yeah.

[00:19:42] >> Molly Jacobson: And, uh, what helps dogs is actual real life information.

[00:19:46] >> Dr. Jules Benson: Absolutely.

[00:19:47] >> Molly Jacobson: That is actionable.

[00:19:48] >> Dr. Jules Benson: Yes.

[00:19:48] >> Molly Jacobson: Okay. So let’s talk about, you wanted to talk a little bit about relative risk. Let’s talk about what that means.

[00:19:55] >> Dr. Jules Benson: I thought of a fun example that will dwell on, on Americans’ preconceptions with British people. So if we think about a hundred people, and 13 of them have bad teeth, all right, we’ll go with the bad teeth angle here. So the prevalence of bad teeth within that population is 13%. Right? So 13 out of 100.

[00:20:13] >> Molly Jacobson: Okay.

[00:20:14] >> Dr. Jules Benson: Okay. If we break that into two populations, if we slice it and say, okay, there are 10 British people and ninety American people – you see where I’m going with this?

[00:20:20] >> Molly Jacobson: Mm-hmm.

[00:20:21] >> Dr. Jules Benson: Of the British people, four of them have bad teeth. So a 40% prevalence rate within that population. And of the Americans, 90 Americans, nine of them have bad teeth. That’s a 10% prevalence, right? The relative risk of being a British person with bad teeth in this purely hypothetical population is 400%. You’re four times more likely, so the relative risk is 400% versus the 100% of the American people, or you could say there’s a 300% increase in relative risk between those two populations.

[00:20:50] >> Molly Jacobson: Okay. I think I get it. So, so one out of, one out of 10 Americans has bad teeth.

[00:20:57] >> Dr. Jules Benson: For us.

[00:20:57] >> Molly Jacobson: Four out of.

[00:20:58] >> Dr. Jules Benson: This is entirely hypothetical, but yes. In, in this example.

[00:21:02] >> Molly Jacobson: Entirely.

[00:21:03] >> Dr. Jules Benson: But yes.

[00:21:04] >> Molly Jacobson: Four out of 10 British people have bad teeth.

[00:21:08] >> Dr. Jules Benson: Correct.

[00:21:08] >> Molly Jacobson: So that’s one in four are the numbers we’re working with.

[00:21:11] >> Dr. Jules Benson: Yeah.

[00:21:11] >> Molly Jacobson: So, okay.

[00:21:12] >> Dr. Jules Benson: So they’re four times more likely, which can be expressed in a, in a relative risk as 400%, or you can say the difference between, you know, the, the Americans’ at 100% and the UK at 400% is a 300% increase in relative risk.

[00:21:26] >> Molly Jacobson: Okay. 100 plus 300 equals 400.

[00:21:29] >> Dr. Jules Benson: That’s right.

[00:21:30] >> Molly Jacobson: Okay.

[00:21:30] >> Dr. Jules Benson: So, so it’s, it sounds more complex than it is. It really is, so the way that we look at it internally is that when we talk about relative risk we’re talking about if you are seeing your dog, which is a five year-old Rottweiler or something else, what is a relative risk compared to all the other dogs in the population that that dog will have bone cancer, for example. And spoiler is that it’s 10 times more than the general population, right? So that’s how we’re looking at relative risk in these ways.

[00:21:56] >> Molly Jacobson: Okay. That’s helpful. So when it comes to size, what is the relative risk from small to large?

[00:22:03] >> Dr. Jules Benson: So the relative risk from small to large. So if we look at it from a purebred point of view, you kind of break even. A small purebred is about a hundred percent. So if you compare a small purebred to the rest of the population, their relative risk is about the same as the rest of the combination, the rest of the population combined. So if you take all the other, toy, the medium and the large and extra large dogs, combined they’ll have about the same risk as a small breed. Right?

But we know that’s not the case within each of their different segments. And so look at, looking at toy purebred, it’s about 70%.

[00:22:33] >> Molly Jacobson: Okay.

[00:22:34] >> Dr. Jules Benson: So they are 30% less likely than the general population.

[00:22:37] >> Molly Jacobson: Okay.

[00:22:38] >> Dr. Jules Benson: If you look at the small, we said it’s about, it’s 100, it’s 104 actually. Medium was about 131. And then for a large or extra large purebred, it’s about 185%.

[00:22:47] >> Molly Jacobson: And these are all for purebred dogs.

[00:22:48] >> Dr. Jules Benson: These are all for purebred.

[00:22:49] >> Molly Jacobson: Right.

[00:22:50] >> Dr. Jules Benson: So when we look at, uh, the mixed breeds, they’re actually all less than a hundred percent. So, so your chance, if you have a mixed breed dog, your chances of them, you know, having a, uh, a cancer overall are less than the rest of the population because the rest of the population is, tends to be purebreds, right?

[00:23:08] >> Molly Jacobson: Right.

[00:23:08] >> Dr. Jules Benson: So coming down from the top for mixed breeds, it’s about 92% for large or extra large.

[00:23:13] >> Molly Jacobson: Okay.

[00:23:13] >> Dr. Jules Benson: About 63% for medium, 47% for small, and about 27% for toy.

[00:23:19] >> Molly Jacobson: Okay.

[00:23:19] >> Dr. Jules Benson: So your your chances of, if you have a toy mixed breed dog – this is why, again, in my opinion, this is why they tend to, you know, if you have a Jack Russell or a Jack Russell cross, they live forever. ‘Cause they’re not getting anything. They get, they don’t get any metabolic disease. They don’t get any – and I apologize to those people who have Jack Russells who have diabetics or whatever else, but, generally speak-

[00:23:39] >> Molly Jacobson: Right, there are always exceptions to the rule. But generally.

[00:23:41] >> Dr. Jules Benson: Absolutely. Absolutely. They-

[00:23:42] >> Molly Jacobson: A JRT cross.

[00:23:43] >> Dr. Jules Benson: Indestructible. Absolutely indestructible. Yeah, absolutely. Should live until infinity. Yeah.

[00:23:51] >> Molly Jacobson: Aw, that would be nice to have a dog who lived to infinity.

[00:23:53] >> Dr. Jules Benson: It’s funny when you think about Jack Russell Terriers and, and I think people see them as those, you know, the, the barky, mouthy and I, I had a client when I was, uh, practicing in Pennsylvania and they had four, they had two or three JRTs and some Rat Terriers and, um, they were all therapy dogs. And they used to go to hospitals and they were just the nicest little dogs. And it was obviously, again, it was a nice, uh, counter to the, the breed stereotypes.

[00:24:14] >> Molly Jacobson: Yeah. I like JRTs personally. I think they’re a wonderful dog.

[00:24:18] >> Dr. Jules Benson: Yeah, I do too.

[00:24:18] >> Molly Jacobson: They’re super fun too.

[00:24:19] >> Dr. Jules Benson: Yeah, and super smart. I think our Chihuahua is, is, is more JRT than, than most other things.

[00:24:25] >> Molly Jacobson: Okay. That sounds like a good place for us to stop, take a pause, listen to some of our generous sponsors, and we’ll be back in a moment with Dr. Jules Benson.

And we’re back with Dr. Jules Benson. So what else did you find out about size and mixed breed dogs that we need to know about?

[00:24:47] >> Dr. Jules Benson: So we started looking basically by body systems. So body systems that are affected by cancers. I mean we, we looked to them by purebred and mixed breed, and that’s why we basically said we should probably look at the mixed breeds because the data are cleaner and they’re probably more indicative of what the actual genetic risk is across these than anything else.

[00:25:06] >> Molly Jacobson: Okay.

[00:25:06] >> Dr. Jules Benson: And it was interesting starting to look at, I think if you look at there’s there’s a chart that shows, um, the different types of body system we looked at, which we looked at bone cancer, liver cancer, lymphatic cancer, mammary cancer, and splenic cancer.

[00:25:19] >> Molly Jacobson: Those are the big ones, right?

[00:25:21] >> Dr. Jules Benson: Those are the big ones, yeah. Yeah, absolutely. So they do make up, and I, I apologize top of my head I can’t remember what proportion of claims they make up, but between them they are, you know, the major significant cancer body systems. And I think what was most interesting, just looking at bone for example, was that – we already discussed a lot of it in the, in the previous white paper, everything in the previous session – that bone cancer is massively associated with purebred large and extra large dogs. And, and so the-

[00:25:48] >> Molly Jacobson: Right.

[00:25:49] >> Dr. Jules Benson: -the relative risk of bone cancer in those breeds, regardless of age, just as a, as a whole is about 550%. So if you have a large or extra large dog. Right, exactly. So, but even across, even as we look at bone cancer across the mixed breeds, the increase from medium to large and extra large was also dramatic.

So I think, um, we have that number in front of me here, but the, the difference from, and again, this is where the shape of the data rather than the absolute numbers of the data are helpful, but the increase from medium to large and extra large for bone cancer in mixed breed dogs was from about 38% relative risk to 122%.

So it’s a, over a three times increase of relative risk between medium and large and extra large. And my understanding is that bone cancer is even more heavily weighted, if I can – excuse the pun, it was unintentional – it’s even more heavily weighted because it tends to be a biomechanical disease as well. So the additional stresses on those cells seems to have some factor around the, the predilection towards that disease as well.

[00:26:52] >> Molly Jacobson: That’s interesting.

[00:26:52] >> Dr. Jules Benson: Yeah. Yeah. I mean, again, and, and I don’t pretend to know the mechanisms behind these, but based on very much smarter people than me, my understanding is that the biomechanics of that are super interesting as well.

So bone cancer is, is one of those where there’s such a, a focus, such a concentration. That’s the one we saw the most dramatic increase between the medium and the large and extra large. When you taking out that biomechanical portion, and you start to look at some of the other conditions, splenic cancer was more stepwise, right?

So the, the toy and small was about, you know, 24% or so. Goes up to about almost 60% in medium, and then up to about a hundred or so percent, uh 110%, in large and extra large. So some increases and some good increases, but more stepwise rather than that dramatic increase we saw in bone cancer. And I think this goes back to your questions earlier around, how does that affect age, or age of onset.

And I think we talked last time about we know that the longevity of large and extra large dogs is much smaller than, you know, it’s, it’s the inverse of our species or of our elephants and blue whales, right? Is that our smaller dog breeds tend to last longer versus our bigger dog breeds, uh, are notoriously short-lived.

[00:27:58] >> Molly Jacobson: Right.

[00:27:59] >> Dr. Jules Benson: And at this point, I don’t know how much of that has to do with their predilection to cancer. We haven’t done the full analysis of mortality. We’ve, we have looked, uh, at some preliminary numbers around what are the mortality causes for different breeds of dogs.

[00:28:12] >> Molly Jacobson: Yeah.

[00:28:12] >> Dr. Jules Benson: We’ll talk about mammary cancer later, but is there a, an argument to be made for, you know, the, these earlier prevalence of diseases are some of the reason behind the shorter longevity and it makes sense, right? If, if cancers are affecting dogs earlier, then surely that affects their survival or their, their-

[00:28:28] >> Molly Jacobson: Their overall survival.

[00:28:30] >> Dr. Jules Benson: Exactly.

[00:28:30] >> Molly Jacobson: Length in time.

[00:28:30] >> Dr. Jules Benson: Yeah.

[00:28:31] >> Molly Jacobson: Yeah. That makes sense. I was just looking at the bone cancer in mixed breed dogs chart in your white paper, and I’m looking at how the, so, and this is what you’re talking about, the toy and small category, it barely rises. It starts to rise at around the age of seven, between seven and eight you start to see it showing up. Medium, it’s between five and six, there’s a little bump before that, but it’s really between five and six years of age.

[00:28:58] >> Dr. Jules Benson: Yep.

[00:28:58] >> Molly Jacobson: And then the large and extra large green line starts to bump between three and four.

[00:29:05] >> Dr. Jules Benson: Yeah. I think that’s exactly the right way to look at the shape of the data as we talked about. But I think it’s, it’s interesting even within these, um, you know, to look at the a hundred percent line, right? So a hundred percent is parity, right? So at that age, they’re about as likely to get, you know, bone cancer as any other dog in the rest of the population. And so when you, you see where that one hundred percent line crosses.

[00:29:24] >> Molly Jacobson: Oh, I see what you’re saying.

[00:29:25] >> Dr. Jules Benson: Yeah. So at large and extra large, it crosses about five years of age, or between five and six.

[00:29:30] >> Molly Jacobson: Between five and six.

[00:29:31] >> Dr. Jules Benson: For the medium breed dogs it crosses between about eight and nine. And then for the toy and small, it never reaches that, that a hundred percent line.

[00:29:36] >> Molly Jacobson: Never reaches it.

[00:29:37] >> Dr. Jules Benson: Yeah, and I think that’s a, a great way to look at what are the chances of age affecting some of these cancers, is by looking at the differences between those hundred percent as we look through the conditions. And there’s, there’s nothing more exciting to an audience than talking about graphs, you know, that they can’t see, which I-

[00:29:50] >> Molly Jacobson: I know that they can’t see. We’re gonna put the links in the show notes and maybe even cut these for the video so that people can look at them.

[00:29:57] >> Dr. Jules Benson: Awesome.

[00:29:58] >> Molly Jacobson: But just to put a fine point on it, that green line for extra large and large dogs crosses at around, I’m gonna say five and a half.

[00:30:06] >> Dr. Jules Benson: Yep.

[00:30:06] >> Molly Jacobson: Years of age.

[00:30:07] >> Dr. Jules Benson: Yep.

[00:30:07] >> Molly Jacobson: At five and a half years of age, a large, which is 51 pounds, mixed breed, 51 pounds or higher is at average risk.

[00:30:17] >> Dr. Jules Benson: Yep.

[00:30:18] >> Molly Jacobson: For bone cancer.

[00:30:19] >> Dr. Jules Benson: Correct.

[00:30:20] >> Molly Jacobson: And then it just skyrockets from there.

[00:30:21] >> Dr. Jules Benson: Then it goes up to 500% at age 11.

[00:30:24] >> Molly Jacobson: 500%.

[00:30:25] >> Dr. Jules Benson: Yeah.

[00:30:25] >> Molly Jacobson: So they’re at incredible risk, even as a mixed breed, at a young age, a five year old dog is not an old dog to me.

[00:30:34] >> Dr. Jules Benson: So everything you said is dead on. And I, and I love the fact that you, you get the data entirely. So, but I would say the hundred percent, the hundred percent is, is the average risk, right? So I think it’s.

[00:30:42] >> Molly Jacobson: Right.

[00:30:42] >> Dr. Jules Benson: To me, that area between a hundred and 200 that’s when you start to say, okay, like now we need to start to be worried. And then over 200% is where you say like, okay, there’s a significant chance that this dog, you know, statistically is gonna have a condition.

And so, so to that point, at seven years of age, that’s where those large and extra large, you know, they’re twice as likely to develop bone cancer as the rest of the general population.

[00:31:04] >> Molly Jacobson: Right.

[00:31:04] >> Dr. Jules Benson: So exactly to your point, like as soon as you get into that 7, 8, 9, 10, if you have a – and this is all mixed breed, so again, we can probably step this back a year or two for purebreds, right? So this is all mixed breed, but knowing these things, and again that that’s where we feel we have a responsibility and the, we can talk about what’s coming, uh, out, hopefully next year. But the, the ability to, to personalize these data, to be able to say, what kind of dog do I have and what are the risks around this pet that I should be aware of?

And frankly, for the veterinary healthcare team. You know, there are so many things out there and so many things for us to have to talk about in the exam room. To be able to say what are the top three things statistically that we could be looking at for this dog in the next year or so that I have to make sure I touch on when I go into the exam room with these folks.

And so how, especially for mixed breeds we don’t really think about it that much ’cause we’re like, uh, mixed breeds are mixed breeds are mixed breeds. They’re, they’re all, you know, like if, if it looks like a German Shepherd, maybe we’ll talk about hips or arthritis or whatever else, right? But having these data specifically to talk about when do these risks increase, you know, not dramatically even, but when are they over a hundred fifty percent?

When are they over 200%? When do I really need to start knowing that there’s a, there’s something I should or could be doing? And even, I mean, I’m, I’m a bit of a, again I’m very concerned about the increase in obesity we have in our pets. And I know that we’re not, all of our brains don’t work the same way, in that even if we have the numbers, some of us, it’s hard for us to adjust our behavior. But for me, certainly, I think for the, if there’s any of the population that we can urge more towards healthy habits for their pets because we can tell them your pet is X percent more likely to develop arthritis and the best prevention for that is, you know, keeping your pet lean and you know, at a healthy weight, et cetera, so.

[00:32:37] >> Molly Jacobson: Right.

[00:32:37] >> Dr. Jules Benson: I’m aware that it’s not gonna affect everybody, but as an advocate of, you know, nudge theory and, and behavioral economics, if we can, if we can even shift a few percentage points over, hopefully, that’s happier and healthier pets.

[00:32:47] >> Molly Jacobson: Yeah. And we know that obesity can also be a contributor to cancer development.

[00:32:52] >> Dr. Jules Benson: Yes.

[00:32:52] >> Molly Jacobson: And then it’s also pushing you into a higher weight range, which statistically means higher risk.

[00:32:59] >> Dr. Jules Benson: Yep, absolutely.

[00:33:00] >> Molly Jacobson: Okay. All right. So that’s a really good pitch for keeping our dogs trim .

[00:33:05] >> Dr. Jules Benson: It’s so hard and, and I, I understand, I mean, for all of us as well. I mean, again, it’s a daily struggle to pick something healthy over something not healthy, and especially when food translate into, into love for so many of our pets.

[00:33:16] >> Molly Jacobson: Yeah.

[00:33:17] >> Dr. Jules Benson: I appreciate it’s hard. It’s just we, we are their only source of calories, so it really is incumbent on us to, to be disciplined and to find our best ways to interact with our pets that don’t necessarily result into being overweight.

[00:33:28] >> Molly Jacobson: Right. Find other ways to love your dog other than food.

[00:33:30] >> Dr. Jules Benson: Exactly.

[00:33:31] >> Molly Jacobson: So that’s not your, the only love you’re sharing.

[00:33:33] >> Dr. Jules Benson: It’s easy though, that’s the problem, right?

[00:33:35] >> Molly Jacobson: It is.

[00:33:36] >> Dr. Jules Benson: Yeah.

[00:33:36] >> Molly Jacobson: And it’s fun.

[00:33:37] >> Dr. Jules Benson: Yeah. And it’s, for sure.

[00:33:38] >> Molly Jacobson: It’s really fun to see a dog.

[00:33:40] >> Dr. Jules Benson: Absolutely.

[00:33:40] >> Molly Jacobson: Enjoy their treat.

[00:33:41] >> Dr. Jules Benson: Yep.

[00:33:41] >> Molly Jacobson: It’s fun.

[00:33:42] >> Dr. Jules Benson: It is.

[00:33:44] >> Molly Jacobson: Okay, so what else do we need to talk about in these – with splenic cancer, we’ve talked about bone cancer, splenic cancer, liver cancer, lymphatic cancer, which is, I know, a big one, but also very treatable. And then mammary cancer is the weird one that proves everything else is correct.

[00:34:01] >> Dr. Jules Benson: Absolutely. Yeah, mammary cancer.

[00:34:02] >> Molly Jacobson: Where do we go next?

[00:34:04] >> Dr. Jules Benson: So I think, I think it’s, it’s useful, I mean that that what we’re trying to call out with, I think the shapes of the other cancers is that splenic cancer is that, it’s useful as a, as a picture because it shows a really nice spread, right? If you, again, if we look at the risk between those three groups, the toy/small, the medium, and the large and extra large, the stepwise fashion is nice and clear.

It goes from, you know, about 30% to 60% to 110%. So a really nice distribution of – you know, nice, we’re talking about cancer. It’s a, it’s a clear, uh, statistical distribution from those. And then when you look at it on the age graph, it’s got a great trifurcation of like, it’s very clear to see that large breeds, large and extra large, are much clearly that all breeds are at risk but it’s amplified very clearly for each age group you go to, right?

And you can see that this resonates for what we see in the, in the, the real world, right? Is that we see these large and extra large dogs coming in around 7, 8, 9, 10 years of age when you’re seeing this, you know, kind of big increase in splenic hemangiosarcoma especially, but that we’re still seeing it in other breeds as well.

So for us, I think it was really just a, the baseline rates across all of these are increasing about, you know, uh that they’re slightly shallower for the smaller dogs, but we’re seeing a nice, you know, gentle pattern for pretty much all of the, the sizes. And I think that was the contrast between things like liver cancer, right?

So we see instead of gently rising, you know, from, and, and I think, you know, when we looked at that, that splenic cancer, if we look at that a hundred percent range, there’s a nice distribution of age, right? So a hundred percent is about seven years for large and extra large, eight years for medium, and then about nine years for toy and small.

So super neat as far as the data goes. But I think when you look at liver cancer, there’s a much greater grouping of that, right? So all the dogs are about the same up until six years of age. And we still see that nice stepwise, you know, toy, medium, large and extra large on the overall distribution.

[00:35:53] >> Molly Jacobson: Right.

[00:35:54] >> Dr. Jules Benson: But the way that’s affected by age is markedly different.

[00:35:57] >> Molly Jacobson: Yeah.

[00:35:57] >> Dr. Jules Benson: So large and extra large, and medium, they both increase about the same rate. As soon as you hit eight for large and extra large, it kind of skyrockets upwards. And medium has about the same shape, but it’s delayed by a year.

[00:36:10] >> Molly Jacobson: Right.

[00:36:10] >> Dr. Jules Benson: So that difference we’re seeing on the left hand side between the bar graphs of, of all the dogs affected, that’s due to that space between the eight and the nine year old kind of onset of these cancers. So it’s the space in between, we can measure those dogs that are less affected and it’s because we have that year delay in the increase of the, the disease.

[00:36:31] >> Molly Jacobson: That’s really interesting. So that toy and small breed group is really delayed in its skyrocketing, like when the line starts going up sharply, then it’s several years after, it’s one two at least three years that I’m counting before it starts going up at around 11.

[00:36:49] >> Dr. Jules Benson: Again, that skyrocketing compared to that gentle picture that we see in the splenic cancer, right. So as soon as they start to be prone to, to splenic cancer, there’s a more gentle progression up towards those high numbers. But for liver cancer, it seems as soon as you hit one of those, you know, 7, 8, 9, it tends to go upwards at a, at a much higher rate. And I think the axes are about the same. And they both go up to about seven or 800%.

[00:37:10] >> Molly Jacobson: Okay. So I’m interested in this, but tell me why you are interested in this as a data guy? Like when you’re looking at this chart and you’re like, now why are these all kind of parallel to each other in splenic cancer – I’m sorry, in liver cancer, they’re all sort of parallel.

[00:37:25] >> Dr. Jules Benson: Yep.

[00:37:26] >> Molly Jacobson: And, and they all sort of work and they’re just evenly spaced out. Why is that true, and then in splenic cancer, there’s this real difference?

[00:37:34] >> Dr. Jules Benson: So not understanding the mechanism, I guess that’s one of the things that that we don’t know, right? Is that, so to me, it raises more questions than answers. And I think that’s fascinating, right? I think when you, when you look at why is that the same, why is there a delayed onset for medium breed dogs but the pitch at which they increase in risk is about the same.

I don’t know. And, and again, it’s, it’s how much of it is genetic, how much is epigenetic, how much of it you know is down to, well, you know, again, what they’re eating or like, again, these are, this is why discussing this with oncologist friends or friends who are in the industry is super interesting ’cause I don’t think we have the answers to these things, but to me, they raise more interesting questions that hopefully – and I don’t have the tools to solve, I’ll be very clear, like.

[00:38:14] >> Molly Jacobson: Right.

[00:38:14] >> Dr. Jules Benson: But hopefully we’re contributing towards a, uh, a massive knowledge that can help push things forwards.

[00:38:19] >> Molly Jacobson: Yeah, I think that’s kind of what I’m thinking about is that, you know, a lot of times, and I’m sure every listener will have that internal feeling of like, well, why don’t you just tell me what I need to know? The answer is because when we look at numbers, when we look at science, when we look at data, we’re actually often coming up with more questions as a result. The search for answers generates more questions sometimes.

[00:38:44] >> Dr. Jules Benson: And it’s really hard and I think, I think we’ve seen over the past two or three years the difficulty in understanding complex science, right? So I think we saw a lot with, with COVID and, and I, like, you know, I have a huge amount of empathy with, with those public health professionals who were tasked with understanding and communicating that disease that was being understood or being more understood as we were going through it.

And I think I was reading a quote the other day of, you know, if you’re a scientist changing your mind in the face of, of new evidence, it’s not flip flopping, it’s the scientific method, right? It’s, it’s

[00:39:10] >> Molly Jacobson: That’s right.

[00:39:10] >> Dr. Jules Benson: Better understanding things based on the evidence in front of you.

[00:39:13] >> Molly Jacobson: Right.

[00:39:13] >> Dr. Jules Benson: And to me, you know, coming up with these data and again, having these data be so compelling because of the pure number of dogs that we’re dealing with, and we, we have another white paper out there about aging pets which has some really great breed tables, you know, the top 25 breeds that are affected by arthritis, for example. And when we look in the literature, those kinds of things, the breed tables we have are usually from one university, from a limited study.

And so being able to throw these kinds of numbers, to me that’s super exciting, to be able to contribute at that level to the, the knowledge that exists out in the space and hopefully have other people ask, other smarter people ask better questions about how to go from there. That’s what’s exciting to me as a pure data nerd as opposed to the, hopefully the contribution we can make to pets as well.

[00:39:53] >> Molly Jacobson: Right. I mean these questions, the extra space in the toy and small breed line will possibly generate even another white paper to like look at that specifically. Like why is there delay in onset in these smaller dogs than in the larger dogs in splenic cancer. And that might lead to more studies being designed in a lab that could lead to treatments depending on what you’re finding. It’s all pointing us towards eventually really helping.

[00:40:22] >> Dr. Jules Benson: Absolutely. If you could create a, you know, the experiment where you’re collecting DNA from, you know, large breed and medium breed and small breed dogs, some with, you know, lymphatic cancer, some without, that to me then starts to say, okay, what, what are the genes that could be responsible for this?

And then to your point, how do we have, you know, targeted therapies that could either, uh, improve outcomes or treat them or even vaccinate them against some of these conditions, right?

[00:40:44] >> Molly Jacobson: Right. And when people are insuring themselves through Nationwide, ’cause you’re not, you’re not working directly with vets, you’re just looking at your claims data, right? So anybody who has ever insured their dog might be included in these sample, right?

[00:40:57] >> Dr. Jules Benson: Correct.

[00:40:58] >> Molly Jacobson: Okay. So is there something you wanna talk about with lymphatic cancer?

[00:41:02] >> Dr. Jules Benson: So lymphatic cancer is interesting ’cause I, I swear when I was in school, feels like a million years ago now, is that there was a, what they call a binomial distribution in cancer, in, in lymphatic cancer, right? That there was a population of younger dogs and then a population of older dogs. And so I was super interested to see that it was this, uh, if you look at the, the graphs for large and extra large, and for medium, there’s a bump around age seven for both of those groups. And, and it’s, and it’s a.

[00:41:27] >> Molly Jacobson: And then it goes down.

[00:41:28] >> Dr. Jules Benson: And then it goes down. And I’ve been trying to find the literature that I must have heard this from, or whether it was another veterinarian that told me, but it stuck in my brain. The same as with Beagles and bladder cancer. When we had Beagles and bladder cancer last time, and I said, oh, we all know other Beagles get bladder cancer.

And my other veterinarians are like, I don’t think we ever heard that. So I don’t know where. So , I’m very, I have to be very careful about the anecdotal evidence that is out in the world.

[00:41:48] >> Molly Jacobson: Right.

[00:41:48] >> Dr. Jules Benson: But the fact that, that we now have data to support them makes me feel a little bit better. I must have heard it somewhere and maybe there’s some evidence to it. But I think this is what was super interesting, that there’s seemingly, there’s this bump. It’s significant enough that it’s pretty clear on these graphs where, you know, the Y axis, the up and down axis is, you know, hundreds of percent. So it’s enough that we can see this fairly clearly. Uh, and then there’s this dip at age eight, and then it goes up from there again.

So again, no idea why. No idea what genes might be responsible for this. No idea why this might be the case. But they’re certainly super interesting based on, you know, my historically muddled head as to what I may have heard, you know, 15, 20 years ago when I was in practice, that there perhaps is this break between these two disease onsets, whether they’re, and again, whether they’re due to different genes turning on, and that these genes tend to turn on at six and the others wait until – so, uh, unknown, but certainly, oop, super interesting. Almost pulled my headphones out there in my excitement gesticulating.

[00:42:43] >> Molly Jacobson: Lymphatic cancer!

[00:42:44] >> Dr. Jules Benson: I know. Let’s say, obviously, I remember we’re talking about cancer, so I have to be less excited about the fact that it is, this is uh terrible, terrible diseases, but exciting that we’re finding more information.

[00:42:53] >> Molly Jacobson: It is. It’s terrible. And that’s why it’s exciting that you’re finding out more information that will directly benefit dog lovers and veterinarians. This is rich territory.

[00:43:02] >> Dr. Jules Benson: It is.

[00:43:03] >> Molly Jacobson: I’m glad you’re, I’m glad you’re looking at these large data sets so that you can pull some really good information out of it. So we have to talk about mammary cancer.

[00:43:11] >> Dr. Jules Benson: Let’s talk about mammary cancer.

[00:43:12] >> Molly Jacobson: And how all of a sudden small dogs are at real risk.

[00:43:15] >> Dr. Jules Benson: Yeah. Yeah. It’s uh.

[00:43:17] >> Molly Jacobson: And larger dogs and medium sized dogs, they’re still at risk, but not nearly at the same rates. So weird.

[00:43:23] >> Dr. Jules Benson: It’s super weird. And the numbers were still significant, so it wasn’t, it’s not like we’re worried about the statistical significance of this, but it’s just mammary cancer was a weird one. So I think there, there are so many things we don’t know about our population. Again, just being very clear about this is an insured population. We know the breeds, we know the ages, we know where they live and we know the claims they’ve had. We don’t tend to know along the journey. We have some information about spayed or neutered, but it’s not like it’s updated every year.

We don’t necessarily know when they’re spayed or neutered unless we’re paying for the spay or neuter. And we have some data for that we’re looking at to see whether we can work out, ’cause if there’s a lot of data, or I shouldn’t say a lot of data, there are some studies that are now fairly old that suggest that, you know, and I’m sure some of us have heard this, that the longer you delay spaying, especially for female dogs, right, there’s an increase in the risk for mammary cancer up to about the sixth or seventh heat.

Right? And after that, it’s pretty much uh, a wash. So we don’t know. We don’t know whether any of these small or toy dogs are spayed later. We don’t know whether, you know, we have this in the white paper, whether they just live long enough that mammary cancer is the one that gets ’em. You know, like, or, and, and again, these are, even these diagnoses are not, they’re not necessarily differentiated between the aggressive forms and the benign forms of mammary cancer.

So we know that benign mammary masses go up as pets age as well. And I’m sure any of us who have had dogs, you know, live long enough, we start to feel the fatty lumps and, you know, is it surgical, do we have to do anything about it? So, again, more and more questions. Fascinating data point and just more questions coming out of this. So we, we certainly have in inside efforts into looking at some of our data in different ways to see if we can answer some of these questions.

But yeah, it was just, it was, it was, to your point, it was the, the great exception that proves the rule.

[00:45:01] >> Molly Jacobson: Yeah. It’s very interesting. I suppose if I, if I were going to wish for a – mammary cancer tends to be slower moving in general. That’s very nice-

[00:45:10] >> Dr. Jules Benson: Yeah.

[00:45:10] >> Molly Jacobson: -if it has to be.

[00:45:11] >> Dr. Jules Benson: It’s 50/50, right? So it’s, uh, generally tends to be that 50% of them are aggressive and so 50% of them benign and.

[00:45:17] >> Molly Jacobson: Right.

[00:45:18] >> Dr. Jules Benson: You know, 50% of them surgically successful and 50% of them are not. So it’s, yeah. It’s, uh, if you’re gonna get one, it’s, it’s not the worst.

[00:45:23] >> Molly Jacobson: It’s not the worst. It’s not the worst cancer to get.

[00:45:26] >> Dr. Jules Benson: It’s not the worst. It’s not, it’s not great, but it’s also, yeah.

[00:45:29] >> Molly Jacobson: Right. So do you have concrete suggestions for veterinarians or for dog lovers directly based on this white paper? What’s your takeaway?

[00:45:40] >> Dr. Jules Benson: So within each section there’s, you know, a clinical significance section, which looks at these around, like, more around education. So I think, for cancer especially, there’s not that much prevention, uh, except, you know, as we talked about, you know, uh, keeping a healthy weight, especially, but being aware of the signs around some of these. So being aware, especially around bone cancer, like in the, and we talked about this a little bit last time, like if you have a large breed, you know, mixed breed dog, then as it’s 6, 7, 8, Hey, if you, if you notice your dog limping, maybe don’t wait to bring that in. You know, maybe don’t wait to see if it’s a sprain that goes away. This could be more actionable than you think.

And the, the sooner you can get these things – I mean, to me, if we can use these to better educate pet families and veterinary healthcare teams about the risks that they may face or they may be facing currently, for cancer especially, it’s more about what can we do to speed diagnosis and then potentially open up the funnel to what are the, the ways forward to have a positive outcome.

We have a white paper out there as well on aging pets, which I mentioned earlier, that becomes a little bit more concrete. That becomes a little bit more, Hey, arthritis. Hey, uh, you know, diabetes. Hey pancreatitis. There are specific things we can do in each one of those cases to prevent the onset of disease.

And so knowing, just knowing that your pet has a relatively increased risk, it really creates definitive steps. And so there are ways of not just preventing, but also managing. And then, you know, what is the best way to get a good outcome with this condition? So that’s where we are headed. So as I said earlier, we’re, we’re headed to, Hey, I have a dog of this breed, of this age, what do I need to know about?

So our goal really is to create, you know, more of a, not just a traffic light system, but also some fun stuff around, you know, what is, you know, how popular is your pet’s name, you know, like, so other stuff that I think – actually I, I find like it’s one of those things, oh, I just really wanna know how popular my pet’s name is.

But, but the things around pet health as well, what can we do, and it’s exactly to that point. What do I need to know now at this point in time to be able to either A, prevent these things happening or to decrease the risk of my dog, or B, if it’s gonna happen anyway, to know what the signs are so that I can be aware of it and so I can try and get them in as soon as possible to get the best possible outcome.

[00:47:44] >> Molly Jacobson: Right, because early detection is correlated with better outcomes in treatment.

[00:47:49] >> Dr. Jules Benson: It is, absolutely. Yep, for sure.

[00:47:51] >> Molly Jacobson: Okay, so my, I’m looking at the top and I really encourage people to actually read the white paper. It is written for the general public. I don’t think it’s too medical or too statistical. But I’m seeing that for sure, those large and extra large dogs, we wanna not wait and see, as you just said, if they start limping and they’re six years old, go to the vet.

[00:48:13] >> Dr. Jules Benson: Yeah, we, we have, yeah. And you may be familiar with this as well, right? So, so ADR, are you familiar with the term ADR?

[00:48:19] >> Molly Jacobson: I probably am, but it’s not in my head at this moment.

[00:48:21] >> Dr. Jules Benson: So we use it, um, a lot in, in, you’ll see it in medical records for, in the veterinary hospital. And it, and it stands for Ain’t Doing Right.

[00:48:27] >> Molly Jacobson: Oh, Ain’t Doing Right. We talked about this last time. I’ve been using it. I didn’t, I just didn’t use that acronym.

[00:48:33] >> Dr. Jules Benson: It’s one of those things where, and I have friends call me and they’re like, Hey, my pet’s doing this, and the other thing. I’m like, Hey, if it’s an older pet, it’s never wrong to go to the vet and just to get some blood work done. And I know there’s an expense associated with that, but I mean, the risk for these things really does go up, uh, as they age and so you, as a pet parent, are the best judge of whether your pet is doing right or not.

Anyway, if it ain’t doing right, you, you know, you can, you can second guess yourself over like, is this really a problem? It might not be, and hopefully it’s not. And you know, again, uh, the whole rationale behind pet insurance hopefully should be, Hey, nothing goes wrong with your pet, but if it does, you’ve got ways to deal with that. You don’t have to worry about the financial aspect of it. But especially when it comes to cancer, the signs are so non-specific and it can be tricky.

And you, you guys know this, I’m sure you’ve talked about this a lot, that it’s not as simple as coming in and getting a blood test. It is, it is about, hey, if my pet’s lost 10% of its weight over the past year, we have to make a decision over whether to do some digging or whether, you know, we’ve been out in the backyard throwing a ball for them every day for the past year and never having done that before.

Right. So, to me, the pet parent is still the best judge of whether your pet is doing well. And if it’s not doing well, then it ain’t doing right, and you get, you should have it come in and see and, and let’s take a look. Let’s take a poke around under the hood, as they say.

[00:49:41] >> Molly Jacobson: Right. And it sounds like there’s a certain age at which it’s worthwhile for people to just keep in mind, like maybe when my dog’s like six or seven, I’m gonna start doing routine imaging to look at the spleen and the liver and make sure that everything’s okay in there.

[00:49:56] >> Dr. Jules Benson: Funny you should say that. So the next white paper that we published was on aging pets, and we used the AAHA Life Stages. So the AAHA Life Stages are fantastic because they don’t say, Hey, if your pet is six, they say, Hey, if your pet is a senior pet. And a senior pet for some dogs might be, and actually I think we have some examples up, but a senior pet for some dogs might be five, you know, for a Bulldog, and it might be 10 for a Jack Russell.

So having, again, more specific answers around what, what life stage means to your pet and what you should be doing in those life stages, uh, you can find and, and you guys can maybe link to the AAHA Life Stages.

[00:50:30] >> Molly Jacobson: Yeah, sure.

[00:50:30] >> Dr. Jules Benson: And they have an online tool that you can, you can look, look at your breed or your mixed breed and, and help to understand better and take a life stage approach rather than just a pure chronological year approach.

[00:50:40] >> Molly Jacobson: That’s a really great idea. And it would be really nice too, I know some veterinarians do this, but it would be nice if there was a sort of a standard like, Hey, you have a new puppy, or you have a young dog, and again, an orientation to what to look for over the course of their lifetime. Because I think, you know, you’re looking at your beautiful little 18 month old dog and you’re thinking this dog’s gonna be here for years and years and.

[00:51:00] >> Dr. Jules Benson: Right.

[00:51:01] >> Molly Jacobson: And your vet might have a different perspective, like yes.

[00:51:03] >> Dr. Jules Benson: Yeah. Yeah.

[00:51:04] >> Molly Jacobson: Hopefully so. But at age four, this is a Rottie mix and I want you to bring that dog in, you know, on a routine basis after that, because we wanna make sure that that 10 times risk of, uh, osteosarcoma is not-

[00:51:17] >> Dr. Jules Benson: And, and you guys, I’m sure we’ve talked about this before, but someone on my team, Gina, has had Flat-coated Retrievers for many years and you know, for whatever reason there they appear to be cancer magnets. And it’s just one of those things where to your point, I mean, Flat-coat people know this, but you know, somebody who has bought one without knowledge, you know, they might not know that, you know, the life expectancy can be dramatically reduced because of some of these rare cancers that are within the breed.

[00:51:39] >> Molly Jacobson: Right. So I look forward to your next white paper and you coming back and all of the other things you’re doing. Please think of us.

[00:51:47] >> Dr. Jules Benson: Well, let’s talk about spectrum of care sometime. I think that’s a great topic for especially the Canine Cancer Answers audience. I think there’s, uh, some really good conversations to be had there.

[00:51:55] >> Molly Jacobson: Yeah. Thank you very much for joining us today, Dr. Jules Benson of Nationwide Pet Insurance.

[00:52:00] >> Dr. Jules Benson: Thank you so much.

[00:52:03] >> Molly Jacobson: And thank you listener. To see all the charts and the full white paper we discussed today, and also to listen to our previous episode with Dr. Jules Benson, check the show notes for links.

Here’s my bottom line for our discussion today. If you have a dog 51 pounds or over, they are at a higher risk for cancer in general than dogs who are medium or small or toy sized. Now this is for mixed breed dogs. Remember to head to dogcancer.com for the latest information on dog cancer. If you haven’t already, subscribe to our podcast in your app of choice or YouTube so you never miss another episode.

I’m Molly Jacobson. And for all of us here at Dog Podcast Network, I’m wishing you and your dog a very warm, Aloha.

[00:52:52] >> Announcer: Thank you for listening to Dog Cancer Answers. If you’d like to connect, please visit our website at dogcanceranswers.com or call our Listener Line at (808) 868-3200. And here’s a friendly reminder that you probably already know: this podcast is provided for informational and educational purposes only. It’s not meant to take the place of the advice you receive from your dog’s veterinarian.

Only veterinarians who examine your dog can give you veterinary advice or diagnose your dog’s medical condition. Your reliance on the information you hear on this podcast is solely at your own risk. If your dog has a specific health problem, contact your veterinarian. Also, please keep in mind that veterinary information can change rapidly, therefore, some information may be out of date.

Dog Cancer Answers is a presentation of Maui Media in association with Dog Podcast Network.