EPISODE 175 | RELEASED July 11, 2022
Nationwide Dog Cancer Study and Breeds at Risk | Dr. Jules Benson
Nationwide is combing through their pet insurance claims to learn about cancer risk. Listen in for popular breeds with the highest risk – and lowest!
Dr. Jules Benson of Nationwide Pet Insurance breaks down the data from their first two white papers on dog cancer – Oodles of Doodles, which compares Poodles and Goldens to Poodle mixes, and Diversity of Risk, which looks at cancer risk in specific breeds and purebred dogs vs. mixed breed dogs. You might be surprised by some of the findings!
The goal of these studies is to one day provide guidelines for cancer screening in specific breeds, and in the meantime, to increase education and owner awareness about which particular cancer(s) they should be on the lookout for in their dog.
Links Mentioned in Today’s Show:
Nationwide Cancer Studies – Diversity of Risk and Oodles of Doodles are the primary ones discussed in this podcast
[00:00:00] >> Dr. Jules Benson: This is all controlled for population. So this is literally, you know, this is, this is Boxers within the population. They are four times more likely to submit a claim for skin cancer relative to any other dog.
[00:00:11] >> Announcer: Welcome to Dog Cancer Answers, where we help you help your dog with cancer.
[00:00:17] >> Molly Jacobson: Hello friend, as you know, at Dog Cancer Answers we like numbers, especially when they tell a story, which is why we’re particularly excited about two papers that came out from Nationwide Pet Insurance earlier this year. They’re white papers as opposed to journal papers, which we’ll talk about in a minute. And they’re looking at cancer risk in specific breeds, including an entire paper dedicated to Doodle dogs.
To talk about those, we have Dr. Jules Benson joining us. He’s the chief veterinary officer of Nationwide Pet Insurance.
Dr. Jules Benson, thanks for joining us today.
[00:00:56] >> Dr. Jules Benson: It’s lovely to join you virtually. I, I mean, I would, I wouldn’t hesitate to join you in Hawaii, but obviously budgets being what they are and practicality, this is great.
[00:01:04] >> Molly Jacobson: So you’re here from Nationwide to talk about these really exciting papers that you’ve published in the last couple of months. Now they’re called white papers.
[00:01:13] >> Dr. Jules Benson: Correct.
[00:01:14] >> Molly Jacobson: And could you just give us a quick definition of what a white paper is as opposed to a paper paper?
[00:01:19] >> Dr. Jules Benson: So generally if you, if it’s a paper paper, so, uh, if we’re gonna be published in a scientific journal, that has to be what’s called peer reviewed, right? So a group of scientists who understand the work intimately and who can see that it’s, you know, free of bias, and errors where possible, that becomes a peer reviewed paper.
So if we were gonna publish something in the, for example, the Journal of the American Veterinary Medical Association or JAVMA, that would be a peer reviewed paper. A white paper is something that you put out on your own. So while this has had, you know, many experts contribute to it, it hasn’t been reviewed anywhere outside of Nationwide.
And so it’s allowed to stand on its own two feet and certainly it’s, it’s received excellent scrutiny from, from some of our peers and others, but as such, it’s a, an independent publication.
[00:02:02] >> Molly Jacobson: And you were able to do that because really the papers are looking at your claim data. It’s data that you’ve been collecting to process insurance claims.
[00:02:12] >> Dr. Jules Benson: Yeah, that’s right.
[00:02:13] >> Molly Jacobson: How long a period are you looking at? How many dogs’ claims were involved in these papers?
[00:02:19] >> Dr. Jules Benson: Yes. So we’re looking at claims data and that’s another one of the reasons that it’s a white paper, because for some of these data, because they’re proprietary claims data, we’re not able to share some of that, externally, right. So as, as we look more and more at, how do we use these data and how do we get it out into more useful channels, we will look at peer review. The other thing about peer review, just to go backwards a second, is that it often, often takes a lot of time. So for us trying to get this out into the world as quickly as possible, the white paper route was certainly the easiest to do that.
So it’s a really good question. So we we’ve been doing this in Nationwide for, this year it will be 40 years, right? So we currently have 1.2 million pets insured at the moment. And so if you, if you think about how many years of data that accrues over time, and obviously we’re, you know, everyone’s growing, uh, the whole pet health insurance segment is growing massively every year.
But if we look back at even five or six years, when you start to go further back, you start to run into some issues, right? So not just about how has veterinary medicine changed over that period of time, but also, you know, is, is the population acting differently? We know that certainly at the moment, as we look at our industry data.
So using sources like, these are great companies, like VetSuccess, like VetWatch, and you can find these on the internet, they publish really interesting data about the state of, of veterinary medicine. And generally speaking, you know, people are spending more, there are more things available. Like it, it’s just, it’s a boom industry in terms of being able to take care of people’s pets.
So when you go back further, you know, the data starts to become less, less like what we’re seeing in the world today. So we looked at about six years of data and that was following the individual pets within that segment. And these were dogs we looked at specifically for the cancer, there’s about 1.6 million dogs.
So if you look at any study out in the animal world, that’s a, it’s an enormous number of pets.
[00:04:02] >> Molly Jacobson: Enormous. I mean, 1.6 million dogs, that’s a solid sample size.
[00:04:07] >> Dr. Jules Benson: It’s not bad. It’s not. And for, and for those, for those listeners, maybe who don’t spend all of their days, like we do looking at scientific journals for dog studies, it’s not unusual to see studies with, you know, tens of dogs or so sometimes hundreds of dogs. In retrospective studies, you can see thousands of dogs. So to have, you know, over one and a half million dogs as part of this study, it gives us enormous statistical power to start to look at the data and to slice it up and to feel good about the results we’re getting.
[00:04:34] >> Molly Jacobson: So when you started this process, were you just looking at the data as a whole and looking for patterns, and then following that to decide what papers to, to write out of this, or were you going in with some very specific questions that you wanted to get answers and pulling the data out that way?
[00:04:51] >> Dr. Jules Benson: So a little bit of both. And in today’s environment where we talk about, you know, certainly within Nationwide, we talk about being a data guided organization, even to know where to look at to apply those data starts with some intuition, right? You, you have to have an idea of where to look because, you know, we’re all aware increasingly every day that there is a world of data and it’s, you know, terabytes and petabytes of data are collected every second from the internet.
So you have to have an idea of where to look. So certainly the goal from my team was really last year to help set up this foundation of being able to work, right? Because sometimes, you know, and if, if you don’t have all the data in the right places, in the right tables, in the right order and everything else, you can spend more time creating those kind of analytics than you do when actually looking at the data.
So we started out by looking at cancer because I think it was a disease where we thought we would have a really interesting story to tell around the genetics of the disease. So, because cancer is a disease that relies so heavily on the genetics that basically, you know, if you have too many copies of a gene, that’s gonna cause your body to write bad cells, basically, right, so that it can cause cancer.
So, because there’s such a highly genetic influence on cancer, we thought that’d be a really nice starting place from a data point of view to start looking at, you know, dogs and how they might differ across breeds and sizes and you know, all these different types of things.
And then once you’re in there, that’s when we start to be guided by the data of what are we seeing, which rabbit holes do we go down to chase those data. And even the, the Doodle story, we’ll talk about in a second, like kind of happened organically. You know, we were looking at the data and then we said, okay, how do we tell a better story with these data?
[00:06:25] >> Molly Jacobson: And that story is that Doodles, so Poodle crosses with other popular breeds-
[00:06:32] >> Dr. Jules Benson: Yep.
[00:06:32] >> Molly Jacobson: -have a much less likely chance of developing cancer than their parent breeds.
[00:06:37] >> Dr. Jules Benson: Right. So the, the data we’re looking at is prevalence data, right? So it says that, you know, is a dog, throughout its life with Nationwide, likely to have submitted a claim for cancer.
So again, one of our, kind of real tenants that we live by is trying to be specific about what the data do and don’t say, right. So we’re to, to be very specific, if you had a pet insured with Nationwide, we are looking at whether a pet submitted a claim for cancer or, not the pet, but probably the pet parent to be fair, ’cause the pets aren’t doing much of that. Um. But if-
[00:07:03] >> Molly Jacobson: The pet does not care whether those bills get paid.
[00:07:05] >> Dr. Jules Benson: They’re not using the app these days, which is terrible. Um, but uh, yes, it was, it was to look at what is the relative risk. So if we look at the whole population of pets and then we carve out a segment that is say Goldendoodles, and say, what is the relative risk a Goldendoodle will submit a claim for cancer versus the rest of the population. So that’s how we looked at the data.
And when we started looking at those data, we looked initially at purebred and mixed breed dogs, right? So purebred dogs, we know they come from genetically tighter populations, or as soon as you, as soon as you start breeding within a, a family, you are already automatically reducing the number of genes, the number of different genes that that dog has access to or its progeny have access to.
[00:07:44] >> Molly Jacobson: Right.
[00:07:44] >> Dr. Jules Benson: So conversely, when you have cross breeds, there’s a much bigger pool of genes and you’re like to get much wider variation in genes for those populations. And so we saw that immediately, we saw that if you just cut them into purebreds and mixed breeds, that the mixed breeds were almost half as likely to have submitted a claim for cancer as the purebreds.
It was a whole population, right? And we knew, you know, that we we’d start to see some variations as we went down, but it was, and it was Gina Spadafori, who’s one of our lead authors, you know, kind of suggested, well, what if we looked within specific crosses, like, could we tell a story that links, you know, what is happening, you know, from a, from a prevalence point of view between the parent breed, so in this case, the, the Golden Retriever and the Standard Poodle, down to a Goldendoodle. And you’re right. So for that specific cross, the prevalence we were seeing, the relative risk in those cross breeds and the Goldendoodle breeds was 75% lower than a combination of the parent breeds.
[00:08:37] >> Molly Jacobson: So Goldendoodle parents right now are saying, oh, I made a very good choice.
[00:08:42] >> Dr. Jules Benson: So Goldendoodle parents, as long as they’re not dealing with skin diseases or behavioral disorders, are probably feeling like they made a good choice. So this has been, it’s been an incendiary conversation. And I think that was another great choice to, to go after Doodles because I think they’re so polarizing.
I don’t think I had really any idea how polarizing this would be as part of the national conversation because people I know love, and so many people have Doodles now, of course, they, we just did some work for a Wall Street Journal article and found out that they are as popular as French Bulldogs. So if you look at the overall population, if you put them into the population of purebred dogs, they would come in about number four or five.
So they’re incredibly popular.
[00:09:20] >> Molly Jacobson: A Doodle meaning, a Poodle crossed with any other breed of dog.
[00:09:25] >> Dr. Jules Benson: Yeah. Yeah. And it’s a, it’s a more diverse population than obviously a French Bulldog, but they’re incredibly popular. So they have fans. First of all, people who have them and many vet professionals seem to have them as well.
And then they have some detractors who may feel that by singling out Goldendoodles as being a hero breed in this case of having much lower prevalence for cancer, that we were potentially ignoring some of the issues they see, which are, they pointed out skin and behavior issues that you know are very, uh, very specifically, but no it’s been, it’s been good feedback.
So it’s, it’s great. Either way it’s getting people talking to use a breed that seems to, to have such a specific set of camps was very good for us to be able to talk about.
[00:10:03] >> Molly Jacobson: Yeah. So what do you think is the, like, if I’m a pet parent and I’m thinking about getting my first dog or my next dog. I’m looking at this list of the 25 most popular breeds and their prevalence of cancer. And again, as you pointed out, these are all insured dogs with Nationwide who submitted claims. So we can’t really necessarily say, oh, all Goldens have this prevalence.
[00:10:28] >> Dr. Jules Benson: Sure.
[00:10:28] >> Molly Jacobson: But certainly in your group, this was happening that there are certain breeds that really submitted a lot more cancer claims than other purebred dogs.
[00:10:37] >> Dr. Jules Benson: Yeah. And I had a really interesting conversation with an epidemiologist about exactly that, the, the value of the insured population versus the quote wild population, right. And I think because cancer is so highly genetic, I think there’s definitely cause to say, okay, if you are looking at just dogs who are vomiting, for example, there’s a great case to be made that there might be higher prevalence in an insured population because they’re more likely to go to the vet. And we have data to support that there’s a lower barrier to care, right, with, with insured pets.
[00:11:02] >> Molly Jacobson: Right.
[00:11:02] >> Dr. Jules Benson: I think with something like cancer, especially in purebred, well, especially in owned dogs who, who are already seeking veterinary care, because the risk is relative, it feels like the prevalence overall should be fairly in line with what we’d see in the regular population, unless we’re literally saying that Golden Retriever owners are more likely to take their pet in than others.
So because the, the breeds are spread out and again, that’s one of the beauties of having so much data is that we even out some of those potential inadequacies in the population. But it’s, it’s very important to point out that yes it’s an insured population and going forward that probably has more importance as we look at other diseases.
But yes, I would always, always, always take care to point out that it is a, a specific population and there is inherent bias in that population.
[00:11:44] >> Molly Jacobson: How many dogs had to be included in your claims data for you to think that the sample size was large enough? So like I have a Maltese, so how many Maltese were you looking at?
[00:11:53] >> Dr. Jules Benson: So for the list of 25 that you talked about, so that’s the top 25 purebred dogs that we had insured at that time. There was no breed in that population that was less than 10,000 dogs.
[00:12:02] >> Molly Jacobson: Okay. So we’re still talking about a lot of dogs.
[00:12:06] >> Dr. Jules Benson: Yeah. Which is, which is, which is why we felt comfortable going to the body system level next. Right. So we, we talked about general relativity within those breeds, but we had the, because we were using such high populations of dogs or large populations of dogs, we felt comfortable going to the next level to start picking out some of the larger body system cancers that are occurring in those breeds. That was one of the reasons to be able to dig that deep. And one of the tools that we have, of course.
[00:12:29] >> Molly Jacobson: So what are the dogs that have the highest prevalence of cancer claims and what were those cancers?
[00:12:37] >> Dr. Jules Benson: So we had our friends the Boxers, who who came out highest. And so knowing that, you know, Boxers tend to have, you know, some fairly specific diseases, skin disease, and mast cell tumors are very prevalent in Boxers. They had a higher prevalence of lymphatic tumors, so probably lymphoma, some neurological tumors, and some cardiac tumors.
Now, again, those are all relative. So when we talk about how often we’re seeing those, because skin is such a common cancer overall, skin is probably overrepresented in Boxers, you know, generally speaking. So their, their relative risk for having submitted a cancer claim for skin – I’m trying to choose my words in the correct order – uh, is about four times higher than an average dog.
[00:13:19] >> Molly Jacobson: Right. And that’s possibly because they’re so popular, they’re one of the most popular breeds.
[00:13:24] >> Dr. Jules Benson: No, no. This, this is all controlled for population.
So this is literally, you know, this is, this is Boxers within the population. They are four times more likely to submit a claim for skin cancer relative to any other dog.
[00:13:34] >> Molly Jacobson: Wow.
[00:13:35] >> Dr. Jules Benson: So that’s, that’s literally, if you, if you look at all the other groups of dogs that sit outside of Boxers, including the mixed breeds, and you say, okay, let’s look at the, the percentage of dogs that we’re looking at that had this a claim in skin cancer, four times more within the, the Boxer population.
[00:13:49] >> Molly Jacobson: Oh, okay. I see.
[00:13:50] >> Dr. Jules Benson: Yeah.
[00:13:51] >> Molly Jacobson: Wow.
[00:13:51] >> Dr. Jules Benson: Yeah.
[00:13:51] >> Molly Jacobson: Okay.
[00:13:52] >> Dr. Jules Benson: Yeah.
[00:13:53] >> Molly Jacobson: So they get a lot of skin cancer.
[00:13:54] >> Dr. Jules Benson: A lot of skin cancer.
[00:13:55] >> Molly Jacobson: And that would be mast cell tumors.
[00:13:57] >> Dr. Jules Benson: Predominantly mast cell tumors. Those are some of the data we have, but they’re not as clean as the body system data. So again, that’s one of our challenges of being able to dig into these data, what are responsible to call out and what are things where, do we have the granularity that we need to be able to give useful information on this?
[00:14:13] >> Molly Jacobson: Right. So what are some of the other things you are confident in calling out in your data?
[00:14:18] >> Dr. Jules Benson: I think, I think we did around those 25 breeds, I’m confident calling out those body systems. Right? So as we look at the, the other three breeds were Golden Retrievers and Beagles.
[00:14:26] >> Molly Jacobson: Okay.
[00:14:26] >> Dr. Jules Benson: Within the top 25.
[00:14:27] >> Molly Jacobson: Those were the top three.
[00:14:28] >> Dr. Jules Benson: Yeah.
[00:14:29] >> Molly Jacobson: In terms of cancer claims.
[00:14:30] >> Dr. Jules Benson: Correct.
So there were other dogs further down the list that had some higher relative risk for cancer. You know, and when you call out, you know, famously some of the breeds like Flat Coat Retrievers, who, you know, who, who we know have very high levels of cancer, again, looking at statistical significance, we wanted to keep it high level.
We wanted to make sure that we had the, to your point, the huge number of dogs that we have to be able to confidently talk about this. So again, within this top 25, very high confidence level. So the Golden Retrievers and the, uh, Beagles. So those are the other two within the, the top 25. And, again, the thing we saw when we looked at them from a body system point of view, is that they weren’t just overrepresented in one body system for cancer, which you might think of with Boxers, right?
You might say, okay, well, mast cell tumors, of course, you know, we’re gonna think about Boxers, but the fact that they were also overrepresented in cardiac tumors, lymphatic tumors, and in neurological tumors, again puts together this kind of genetic picture of like, okay, what else is going on here that there’s so much of different types of cancer. And we saw that reflected across those other two breeds as well.
[00:15:30] >> Molly Jacobson: Oh really?
[00:15:30] >> Dr. Jules Benson: So, I’m gonna reference my chart with my other eye here just to make sure I know what it’s , but, um, but for, for Beagles, you know, seeing increase in liver tumors, increase in mammary tumors, and then a massive increase in urinary tumors. So Beagles are six times more likely to have submitted a claim for bladder cancer as any other breed.
Or as, as your average dog, I’m sorry, not any other breed. And then similarly for Golden Retrievers, anyone who’s had Golden Retrievers probably knows somebody or has a friend who’s had a splenic tumor, or has had lymphoma. Those seem to be the top two. And then also some cardiac tumors in Goldens as well.
But knowing that cardiac tumors have such low prevalence, generally even a high – that those high relative risks are significant, but there’s not a huge number of dogs who are getting them. But it’s still important statistically to say, okay, goodness gracious, when you look at Boxers and Golden Retrievers, they’re massively overrepresented in these other body system areas.
So knowing these are different types of tumors in these different areas, most of the time, you know, what is going on from a genetic point of view that is causing some of these across the board.
[00:16:30] >> Molly Jacobson: So if I’m looking at Goldens or Beagles or Boxers as a group.
[00:16:35] >> Dr. Jules Benson: Yes.
[00:16:35] >> Molly Jacobson: What percentage of those breeds would you say will get cancer based on this data?
[00:16:42] >> Dr. Jules Benson: So it’s a little tricky because we’re looking at them across a kind of wider range across bo-, across body systems. I mean, there are stats out there that talk about cancer being the most common disease of aging pets. And that, you know, I think at the stand, that off the top of my head is 50% of pets are, you know, affected by cancer at one point in their lives or another. So I can’t speak to precise, you know, percentages of pets that are affected.
[00:17:05] >> Molly Jacobson: Okay.
[00:17:05] >> Dr. Jules Benson: But certainly as we start to look at, you know, there’s very common, there’s, there’s overwhelming evidence that certainly, you know, five to 10% of pets are gonna be affected by some of these more serious cancers at some point in their life.
[00:17:15] >> Molly Jacobson: Okay.
And what are the breeds that are the purebred dogs who are least likely?
[00:17:22] >> Dr. Jules Benson: So there’s a Chihuahua running around our office at the moment. So Chihuahuas are one of them.
[00:17:27] >> Molly Jacobson: Okay.
[00:17:27] >> Dr. Jules Benson: French Bulldog is the other.
[00:17:29] >> Molly Jacobson: Oh, really?
[00:17:29] >> Dr. Jules Benson: And Pomeranian is the lowest, so.
[00:17:32] >> Molly Jacobson: Wow. Little guys.
[00:17:33] >> Dr. Jules Benson: Little guys.
[00:17:34] >> Molly Jacobson: Mm-hmm.
[00:17:34] >> Dr. Jules Benson: Exactly. So we have another paper coming out, hopefully in the next, uh, three or four weeks or so, which we’ll talk about size, specifically, ’cause there’s some very specific data related to the size of dogs. And if we look at that, you know, Golden Retrievers, Boxers, and Beagles, while none of them are giant breed dogs, they’re all, you know, medium to large breed dogs.
And when you look at the, the three that are least affected, and this is a conversation we wanted to make sure we had with people as well when they ask, ’cause people say French Bulldog, oh my God, that’s, they can be so unhealthy. And again, being very specific in that this is cancer data. This is not talking about, you know, airway syndromes or anything else, or skin or anything else. And we know our goal, you know, transparently is to be able to provide data for all those things down the line.
Right? Because without looking at this from a holistic point of view, it’s easy to draw conclusions that that may feel off, to say that the French Bulldog is, you know, one of the healthier dogs within this population. Just talking about submission for cancer claims. So just to be-
[00:18:28] >> Molly Jacobson: Right.
[00:18:28] >> Dr. Jules Benson: -very Clear on that. Yep, absolutely.
[00:18:30] >> Molly Jacobson: Right. So the future papers will look at other disease conditions, talk about breeds from that perspective. And then maybe someday you’ll be able to say, this is the healthiest dog in the world.
[00:18:41] >> Dr. Jules Benson: This, this, this Jack Russell, ’cause it will, without doubt, it’ll be some, some small scruffy Jack Russell or something similar is the healthiest dog in the world.
[00:18:48] >> Molly Jacobson: Is that your prediction?
Are you making that claim right now? Can you test it?
[00:18:51] >> Dr. Jules Benson: It’ll be, it’ll be a pretty mixed breed dog, but, of the purebreds, my experience has been that Jack Russells are almost indestructible. They they’re, they’re incredible.
[00:18:59] >> Molly Jacobson: They are, they’re certainly indestructible in their attitude.
[00:19:02] >> Dr. Jules Benson: They are. They are. Actually, when I was in practice, I had, um, a client who had four, uh, Jack Russells and Rat Terriers. And they were all therapy dogs, which for the attitude of that breed, I thought was amazing that they’d been able to take the time to certify them and for them all to be so calm. Anyway, we’re off topic.
Um, but the, the goal is absolutely to bring more papers out and we have a full calendar ahead of us this year. But the goal for me really is to, for us down the road, to be able to provide tools for pet families and for veterinary healthcare teams that help them make more informed decisions. So to my mind, what we should be able to do, and I’m hoping in the next year or so, is to be able to say, okay, if you’re going into the vet clinic with your five year old Rottweiler, you know, what do you need to know?
What do you need to ask questions about? And the, you know, red light, orange light, green light, and the red light should be, Hey, talk about limping with your dog, because if your dog is limping and it’s a five year old Rottweiler, that breed is 10 times more likely to get bone cancer than the average dog. So.
[00:19:55] >> Molly Jacobson: Oh my word.
[00:19:56] >> Dr. Jules Benson: So you don’t want to wait, like, because early diagnosis and treatment on osteosarcoma, you know, can make all the difference. So this is, this is where we’re trying to get to. Right? It’s like, how can we use these data to make better informed decisions about, not just pet selection – ’cause that’s great, if you have more data on the pet selection period, then fantastic. But most people are living with their pets and they wanna know the best thing to do for their pets.
[00:20:17] >> Molly Jacobson: Right.
[00:20:17] >> Dr. Jules Benson: And so the goal of this really is to, how do we create more data or more useful data that people can use in their everyday lives to help make decisions about their pets. And then do the same thing with the veterinary healthcare teams, to be able to say, Hey, you know, look over this information, you know, what do you understand, what do you not understand? And how can we get to the best, you know, preventive care for your pet.
[00:20:35] >> Molly Jacobson: So at some point you wanna be able to provide like a little cheat sheet for vets and for owners saying, oh, you have a Beagle, be on the lookout for these common problems, and this is how to get an early diagnosis and what to watch for.
[00:20:49] >> Dr. Jules Benson: Absolutely.
Or even beyond that. So again, going back to, we know that obesity, for example, is a huge, you know, problem in cats and dogs across the US. You know, knowing what diseases are most impacted by having some additional weight on the pet, being able to offer advice about nutrition and behavior and, you know, exercise and all those types of things.
Anything we can do to get ahead, to have a, an evidence base of data that helps us provide – you know, it’s easy to say, Hey, your pet’s, you know, carrying a few pounds, and that could be dangerous. To be able to say, Hey, for every five pounds that your pet has, it has an X percent greater chance of tearing a crucial ligament or having this type of cancer or whatever else. So, trying to help people with, you know, what is an evidence based approach to medicine. So that’s, that’s really our goal within our team.
[00:21:29] >> Molly Jacobson: That is so important because those numbers, people, they may or may not understand numbers, but they understand that numbers are important.
[00:21:37] >> Dr. Jules Benson: Yeah.
[00:21:37] >> Molly Jacobson: And oftentimes, a number that they hear will kind of lodge in their memory, in a way that a, that a sort of generalized warning doesn’t.
[00:21:45] >> Dr. Jules Benson: Yeah. And, and for those healthcare teams, you know, to be entirely fair, there’s not a lot of, of data that we have on these. I mean, again, to go back to the size of our data set, that’s an enormous data set that, you know, we haven’t seen many studies of this size before.
And I think if we can bring that cohesively in a way that – ’cause, ’cause you’re right about communication as well. Some people react to the numbers. Some people react to a story. Some people react to, you know, they have to see it for themselves, they have to know somebody. So trying to find as many different ways as possible to get into people’s kinda communication spheres and make it work for them, that’s a large part of this as well.
[00:22:16] >> Molly Jacobson: So in the paper, I see numbers like 261% of dogs. And I didn’t quite understand how those numbers work. When you state relative risk and I’m seeing more than a hundred and less than a hundred percent, can you just explain that a little bit?
[00:22:32] >> Dr. Jules Benson: Absolutely. So if you have, you know, John Q Dog, right, who is getting, you know, cancer, at the rate that almost all of the dogs get, right? So averaged out, he is the average dog. So the relative risks are basically saying, okay, if we look at the John Q dog population, and then we call out specific breeds, like the Boxer, what is the relative risk of a Boxer getting a cancer or to make a claim for cancer or specifically skin cancer over and above John Q Dog. And you can interpret that relative risk to, if it’s 300%, that means it’s three times more likely.
[00:23:04] >> Molly Jacobson: Three times. Okay.
[00:23:05] >> Dr. Jules Benson: Yeah. Or a 200% increase, if you, again, there’s, there’s three different ways of looking at it.
You can either look at it as a, an overall relative risk. You can look at it as you can take a hundred percent off and say, that’s the increased risk that you see from those breeds. Or you can just divide it by a hundred and say it’s X times the risk. So that’s, where there’s a little subsection on the, um, on the white paper, because I think that’s an excellent question. And I think it’s easy to get confused about percentages.
[00:23:28] >> Molly Jacobson: Yeah.
[00:23:29] >> Dr. Jules Benson: So yeah, our team, when I was just running around numbers, they’re like, yeah, you gotta, probably should explain that because you know, not everyone’s a, like, is an Excel nerd like you are.
[00:23:38] >> Molly Jacobson: So if I’m looking at the paper and it says this dog has 260% relative risk, that means it is 2.6 times more likely.
[00:23:48] >> Dr. Jules Benson: Correct.
[00:23:49] >> Molly Jacobson: And if it says 50% relative risk it’s half as likely.
[00:23:54] >> Dr. Jules Benson: Exactly.
[00:23:55] >> Molly Jacobson: Okay.
[00:23:55] >> Dr. Jules Benson: You’re gonna write the next paper for me, Molly. That’s, this, this is going well. I found co-authors.
[00:24:01] >> Molly Jacobson: Are you going to be doing any other dog breeds, looking at those large 10,000 plus sample size, for others that aren’t in that top 25 in the future?
[00:24:10] >> Dr. Jules Benson: It’s a good question. And, and we could, I mean, so we could do it tomorrow. I mean, so for pet cancer month, uh, later this year, which is November, we might expand it a little bit to provide some more data. I think if we’re not slicing into the system data, then I think we have a higher confidence level of using smaller populations of breeds.
So I think, you know, we could probably go to the top 50 or something if we wanted to look at, you know, just what is the overall relative risk of cancer.
[00:24:36] >> Molly Jacobson: Okay.
[00:24:36] >> Dr. Jules Benson: I think it’s when you start slicing and dicing into some of those other body system areas that our kind of overall integrity around data feels less comfortable so we don’t want to put information out there that, while it’s technically correct, it’s five dogs versus, you know, 500 dogs.
[00:24:51] >> Molly Jacobson: Right. You wanna make sure that you’ve got the sample size and that the information is really going to help people.
[00:24:56] >> Dr. Jules Benson: Yeah, absolutely. Yeah.
[00:24:57] >> Molly Jacobson: So you’re prioritizing all of these topics and the, the next paper is on size of dog. And are there any others that are lined up already?
[00:25:07] >> Dr. Jules Benson: There are. And I’m trying to think of which ones I can talk about.
[00:25:09] >> Molly Jacobson: Okay.
[00:25:10] >> Dr. Jules Benson: Uh, I think we already, um.
[00:25:11] >> Molly Jacobson: Some are super secret.
[00:25:12] >> Dr. Jules Benson: Super secret. Uh, we’re gonna talk about, uh, diseases of aging pets next.
[00:25:16] >> Molly Jacobson: Oh.
[00:25:17] >> Dr. Jules Benson: So after this, after this next one with cancer size, I think we have time to talk on it at, um, the American Veterinary Medical Association meeting in July.
So we have diseases of aging pets. So it’s out in the world now, so I can probably say something about it, but it’s, uh, it’s gonna be, uh, specifically diseases of aging pets, and what are those things look like across different breeds, you know, when are we starting to see some of these really – and trying to make some contrast between juvenile diseases versus aging diseases as well.
So we’re still chasing the data on that, back to our early conversation of we’re looking through the data, seeing what they tell us, and then trying to find out what rabbit holes we want to go down.
[00:25:48] >> Molly Jacobson: Another question is, are you going to be adding data from 2022? Are you gonna keep adding to the last six years or are you gonna keep looking at that sample size for now?
[00:25:59] >> Dr. Jules Benson: I think it’s gonna depend. I think we’ll start to, depending on the questions we’re asking, we may need to either expand or contract the sample size. So for example, if we were to look at, we wanna make sure we look at the longitudinal journey of pets through the lifetime experience. So we were to say, we wanna look at GI disease, right?
So if you have chronic GI disease, when does it first occur, when is it recurring, how do you follow that? We’re gonna end up having to look at a much wider swath of data, but we might have a smaller number of dogs who we have from ages zero through to six or seven or something like that. So it’s, it’s gonna depend a lot on the questions we’re asking.
[00:26:29] >> Molly Jacobson: Well, that seems like a good place to just put a pin in this discussion and take a quick break. We’ll be back with Dr. Jules Benson shortly.
And we’re back with Dr. Jules Benson from Nationwide Pet Insurance. So obviously Nationwide is an insurance company and sells pet insurance to dog lovers and pet lovers.
[00:26:55] >> Dr. Jules Benson: And avian and exotic pet lovers also, I will add.
[00:26:57] >> Molly Jacobson: Right.
So one of the sort of missions at Dog Podcast Network – it’s not an official network mission, but we all feel very strongly that, I think it’s 1% of American pets are insured, and that I personally, in our Facebook group, see people all the time who have to make very difficult decisions based almost completely on finances. Because if finances were not, if it was covered, they would not hesitate to take whatever course of treatment they’re being offered.
[00:27:30] >> Dr. Jules Benson: Sure.
[00:27:30] >> Molly Jacobson: I want more people to insure their dogs.
[00:27:32] >> Dr. Jules Benson: I appreciate that. Well, it’s, it’s-
[00:27:35] >> Molly Jacobson: I’d like you to have more data to look at.
[00:27:36] >> Dr. Jules Benson: That’s good. Well, so we’re in a great position, right? So it’s between two and 3% of pets are insured in the US at the moment.
[00:27:41] >> Molly Jacobson: Okay.
[00:27:42] >> Dr. Jules Benson: And the common thing is to compare that to more developed markets, right? So like the UK or, or the Scandinavian countries where insurance is utilized at a much higher rate.
[00:27:50] >> Molly Jacobson: Mm-hmm.
[00:27:50] >> Dr. Jules Benson: Having said that, we are also a very fast growing industry when you look at insurance and you say that, okay, and, and the North American Pet Health Insurance Association just came out with recent data that showed that as an industry we’re growing over 20% per year, over the past six years.
So when you talk about that as an industry, I think everything’s going very well for the insurance companies. So, so there’s no, no tears shed for us as insurance companies. I think what’s on us is the 97% of people who aren’t insured, how do we find products that work for them? So I think, you know, right now we have some very specific products that work for people in very specific circumstances.
And I think that the next kind of generation of millennial pet owners, of pet owners who are of more modest means, for example, certainly at Nationwide we’re very interested in talking about, you know, how do we encourage a spectrum of care approach to veterinary medicine? How do we ensure that people, you know, are making the best or the most well informed decisions around pet healthcare?
I think that’s on us a little bit to say, okay, well, if 97% of people aren’t insured, what are the products that would make sense to them and what are their expectations around how those products should work. And, and it’s always, it’s always easy to lament not having pet insurance after, you know, there’s something wrong with the pet, and we can talk about preexisting conditions if that’s something that’s useful to people, but I think at least having an idea –
and what I tell to people who are looking at pet health insurance is to think about three circumstances you would want a pet protection product to work for you. So what are your expectations around wellness? Like, do you want a product that provides, you know, your flea and tick medication, do you have vaccines and everything else?
I tend to, you know, think that that might not be a best use of dollars sometimes because we, those tend to be fairly predictable things. So if we know what those are, then we can probably plan around them as pet families. I tend to ask people to look at acute situations, so a broken leg or an injury of some type. How would you like a pet protection product to work for you under those circumstances?
[00:29:38] >> Molly Jacobson: Okay.
[00:29:38] >> Dr. Jules Benson: And then thinking about chronic disease, whether that’s a diabetes or anything else, like what are your expectations for how you would get, you know, what would happen in a pet protection product under those circumstances, and then balance all those against what your budget is.
So aligning what your expectations are against what is out there on the market. It sounds like more work, and it is, but it’s better than, than I think buying something and it not being what you want it to be.
[00:29:58] >> Molly Jacobson: Right. It not ending up covering what you actually wanted to cover later. And it seems to me that the work you’re doing now with your team of experts where you’re analyzing all the data will help all of us to say, okay, so I really like this particular breed or this particular mix, or I have a mixed breed dog, and I know that they’re part Doxie and part Beagle and part Lab.
[00:30:22] >> Dr. Jules Benson: Yeah.
[00:30:23] >> Molly Jacobson: So these three animals are the ones I’m looking at.
[00:30:26] >> Dr. Jules Benson: Right.
[00:30:26] >> Molly Jacobson: These are the things that are probably gonna come up for me.
[00:30:28] >> Dr. Jules Benson: Absolutely.
[00:30:29] >> Molly Jacobson: And I can choose a product based on that. Or if I can’t do that for financial reasons, then at least I know what’s coming down the pike and what to really focus on in my care at home.
[00:30:40] >> Dr. Jules Benson: Yep. Yep. No, can we bring more. And it’s um, we’re entering a golden age of pet care, I think, there’s more things available than ever before. And I think there’s also gonna be more options available for more pet parents going forward. So I think as we look at the evolution of pet healthcare, we have these great, you know, amazing gold and platinum standard, you know, veterinary healthcare centers where you can get almost anything done that you would do to a human.
And we’re seeing more and more in between kind of veterinary healthcare facilities pop up as well, which I think, as we look at almost 50% of pets not receiving regular veterinary care at the moment, you know, it’s gonna be more and more important, how do we get more pets to access more care, and how do companies like Nationwide, you know, kinda help facilitate that and, and kind of meet people where they are and find the solutions that fit for them.
[00:31:24] >> Molly Jacobson: Right. So should someone who has a Golden Retriever right now start panicking?
[00:31:31] >> Dr. Jules Benson: No. I mean, unless, unless they’re worried about hair on their furniture, ’cause that, that ship has has already sailed. No, I don’t think so. And, and it’s funny, I have, one of the other co-authors, Dr. Emily Tincher, has a Golden Retriever and I, I think it’s more about being informed, going back to your point, like what can people learn about their pets and what can they expect.
There are some things, you know, and unfortunately one of our team members, uh, lost a dog with spinal hemangiosarcoma in the last couple of years. And there’s some things that you just can’t do much about. I think for us, it’s what can we put out into the world that could maybe help spur some conversations. So I think if there’s the opportunity, if we see breeds where there are very highly, you know, spiking genetic diseases, is there an opportunity for us to provide, you know, that information to a breed club or somebody else, and just have a conversation about what does this mean.
Is there something that, that is concerning within the breed, are there options for introducing genetic diversity or decreasing, you know, in breeding or line breeding. Again, I’m not qualified to, to lead those conversations, but I think what we do see is the opportunity that these kinds of data, you know, could introduce into the conversation.
So. I think for us long term, do we see an opportunity to make more pets healthier? I think that’s what we’re trying to do with some of this as well is to say yes, like if we can call out and say there are opportunities to make our pets healthier, that’s great. I don’t think we should put our Golden Retrievers out in a box on the curb with a for sale sign.
I think we should all keep them at home. Um, not that anybody would. Um, but, uh, but no, I, I, I think it’s more awareness than anything else. So if we, again, the goal would be for us to say, okay, if you have a Boxer, you know, you are more likely to see, you know, skin diseases. These are the types of things I’m gonna watch out for, how can we catch them early, how can we catch a grade one mast cell tumor instead of letting it get to a grade three, right. So I think that’s where we see the biggest opportunity for this is how can we help keep these pets as healthy as they can be for as long as they can be.
[00:33:20] >> Molly Jacobson: Yeah. And maybe start doing some cross breeding between the lowest risk for cancer.
[00:33:26] >> Dr. Jules Benson: I would never tell breeders, uh, what to do in, under these circumstances, but I think, I think, I think there are opportunities, uh, certainly opportunities and I, and I think there’s been some very successful out crossing breeding in the, in Scandinavia and other areas. But again, that’s, it’s a very personal conversation, it’s something that I know there are a lot of strong feelings about and opinions.
I think it’s easy to sit back and just say, Hey, these are the data. Make of them what you will. But I think it’s, uh, it’s, it’s a great conversation to have.
[00:33:51] >> Molly Jacobson: I have to bring up something that is a little off topic. I listened to a podcast that you were on about bicycling.
[00:33:58] >> Dr. Jules Benson: Yes, yes.
[00:33:59] >> Molly Jacobson: And as you spoke about why you bicycle, which sounded like you bike for fun-
[00:34:05] >> Dr. Jules Benson: I do. I do.
[00:34:06] >> Molly Jacobson: -the way that you described riding a bicycle sounded a lot like the way a dog seems to feel when they are leaning out the window.
[00:34:14] >> Dr. Jules Benson: Yes. It’s.
[00:34:15] >> Molly Jacobson: Of the car.
[00:34:16] >> Dr. Jules Benson: It’s as close to flying as you can get, right. I think that’s the, yeah. And it’s, and it’s so funny. So we, even since we’ve gone, I know which one you’re talking about, even since recording that podcast, like I lost my motivation for a while. It was, I, we moved and not having, you know, friends around you to ride with ’cause that’s a great part as well, to have that kind of, that shared meditation almost, uh, with, with people of a shared mindset.
So my last couple of years have been more about seemingly fixing bikes because I have like six or seven bikes and I, they change stuff on them all the time. And, and as much as I do miss riding as much as I used to, that is also meditative to me is to be able to do something very physical and to be able to solve problems and to be able to, you know, look something up and work out how to service a bunch of bearings, which you have no idea how to do so.
But yes, the cycling. I still do ride, but not as much as I used to unfortunately.
[00:35:01] >> Molly Jacobson: Yeah. I was just really struck by how those of us who love dogs, kind of understand that like – meditative movement is a really good way to describe it.
[00:35:09] >> Dr. Jules Benson: Yeah.
[00:35:09] >> Molly Jacobson: Just being outside and moving and letting the world sort of pass you by as you pass by it, it’s so satisfying.
[00:35:19] >> Dr. Jules Benson: If you can get a nice gravel downhill and let go of the brakes and feel fairly safe about that, that’s a very nice feeling. So yeah, that’s, that’s one of my favorite things to do.
[00:35:27] >> Molly Jacobson: Yeah. Wonderful. So I’d like to wrap up with just a question about what’s the one thing you would like dog lovers to remember when they are caring for their dogs at home?
[00:35:41] >> Dr. Jules Benson: The one thing that I would like to remember, I think, um, generally speaking, I would like them to enjoy that time as much as possible. Be aware, know that you are the best advocate your pet has. There’s something that we talk about in veterinary medicine, which is there’s a dog comes in, we call it ADR and it stands for ain’t doing right.
And often that will come from the pet owner. And if you think there’s something off about your pet, you are the best judge of that over and above anybody else. So even if we don’t find something on a blood test, even if we don’t find something on an x-ray, you know, your, your intuition around your pet, you are the best advocate for that person.
There’s so many subliminal and subconscious things that, that we see on a daily basis that our conscious brain can’t always put together. But I would say that the pet family, that people around the pet, you are the people who will know your pet best and will know whether things are going well or not. So I would appreciate that and appreciate the bond that you have with your pet.
[00:36:37] >> Molly Jacobson: That is so nice. And it’s so true that people often feel that something’s wrong, but they can’t articulate the why and so then don’t trust that they’re correct that there’s something going on.
[00:36:49] >> Dr. Jules Benson: And you don’t always have to find something, but don’t second guess yourself just because there was nothing found like this is you, you know, your pet best.
[00:36:55] >> Molly Jacobson: Yeah.
Well Dr. Jules Benson. Thank you so much for joining us here today on Dog Cancer Answers. It’s been wonderful having you here. I hope you’ll come back and talk to us about future papers as well.
[00:37:07] >> Dr. Jules Benson: Absolutely. I’d be glad to. It has been great to talk to you, Molly, and I’m glad that you’re here for your listeners. It’s great to have a really informed discussion. I appreciate it.
[00:37:15] >> Molly Jacobson: Thanks so much.
Well, that was a really fascinating conversation with Dr. Jules Benson of Nationwide Insurance. And to debrief that a little bit with me, let’s talk to our producer, Kate.
[00:37:34] >> Kate Basedow: Hi, Molly. Happy to join.
[00:37:37] >> Molly Jacobson: Yeah. So what did you really get excited about in our conversation with Dr. Benson? I know you had a lot of thoughts.
[00:37:43] >> Kate Basedow: So yeah. I thought that, such a cool interview and really fascinating studies as well. I love that they didn’t just look at purebreds versus mixed breeds and that they actually broke down and looked at some of the breeds in depth. And I’m looking forward to seeing more data on specific breeds, both with cancer and other conditions as they continue looking at all of this data in their huge database.
Because having those, I mean, as a licensed vet tech, certainly we see anecdotally certain breeds show up more often than others, but it was really interesting to see that data reflected in hard numbers with a massive sample size. And so cool to see that some breeds did have a much higher risk for cancer than others, but also that some breeds had that lower risk even than the average mixed breed dog. Genetics are complicated.
[00:38:43] >> Molly Jacobson: It does make things complicated. The fact that a Chihuahua has a lower cancer risk than the average dog is, well, it’s good news for Chihuahua lovers, for sure.
[00:38:54] >> Kate Basedow: Yeah.
[00:38:55] >> Molly Jacobson: I was really struck by how, you know, there’s a lot of things to say about the insurance industry, but one of the things that you could say is that it’s exceptionally data driven. That if they have the numbers, they will be able to confidently report. And so having an insurance company do these kinds of surveys of their own claims data is really useful because the claims are backed up by codes and those codes are selected by veterinarians. And so it’s not what we think is going on, but what we know is going on with dogs.
[00:39:29] >> Kate Basedow: Yeah.
[00:39:30] >> Molly Jacobson: And that’s different.
[00:39:31] >> Kate Basedow: With each claim in their database, we know that a real veterinarian gave a real diagnosis.
[00:39:37] >> Molly Jacobson: Right.
[00:39:37] >> Kate Basedow: So that dog actually had that condition as opposed to – I mean, some things look the same, even though they’re different conditions and an owner might think, oh, my dog has this, and is actually something else.
[00:39:49] >> Molly Jacobson: Right. Right. Absolutely. Especially when you get to, you know, so many of the symptoms of cancer are actually pretty general.
[00:39:55] >> Kate Basedow: Yeah.
[00:39:55] >> Molly Jacobson: You can’t tell if a dog’s not eating, or losing weight because they have cancer. That could be from several different things. You can’t tell what is causing the vomiting. There’s dozens of things that can cause a dog to vomit. So.
[00:40:09] >> Kate Basedow: Mm-hmm.
[00:40:09] >> Molly Jacobson: We don’t always know until we know.
[00:40:11] >> Kate Basedow: Yeah.
[00:40:12] >> Molly Jacobson: And then sometimes depending on what the tests say, we might still not know.
[00:40:15] >> Kate Basedow: Yeah. Yep. That is the sad truth.
[00:40:20] >> Molly Jacobson: Isn’t it?
[00:40:22] >> Kate Basedow: Trust me owners, your veterinarians and their staff are just as frustrated when this happens to your pet as you are.
[00:40:29] >> Molly Jacobson: Right? It’s so frustrating. And then of course, we go to the place where we’re like, well, I go to this place because I’ve heard from so many people over the years, it’s like, no, I don’t know exactly what kind of cancer it is.
However it is cancer. And the bottom line is my dog has cancer. And I’m not sure that knowing this specific illness or what stage it’s in is as useful. The most important question is, is this thing gonna go away? And the answer’s usually not. Or how long do I have with my dog? And those are the things we can’t tell.
[00:40:59] >> Kate Basedow: Though, we can get a lot closer to those answers when we do have a very specific diagnosis, ’cause if you know exactly what type of cancer and the stage and grade that can direct you to treatment options that are more likely to succeed.
[00:41:14] >> Molly Jacobson: Right. And that’s what I really, really liked about this conversation with Dr. Benson, was that the concrete and practical outcome of these papers is not just to say, Hey, look, we have all this data and we can manipulate it, but actually to make real life suggestions, tips, checklists eventually, for specific types of dogs, breeds of dogs and conditions to really say, okay, I’ve got – I thought it was funny when he said Jack Russell Terriers are gonna be-
[00:41:44] >> Kate Basedow: Indestructible.
[00:41:46] >> Molly Jacobson: Indestructible.
[00:41:48] >> Kate Basedow: I do love me some Terriers.
[00:41:51] >> Molly Jacobson: I love Jack Russells. I think Jack Russells are so much fun. I have a friend who lost 50 pounds because she got a Jack Russell Terrier and she had no idea that was in her future when she got it.
[00:42:03] >> Kate Basedow: I love it.
[00:42:05] >> Molly Jacobson: Yeah. Well, was there anything else that really struck you? It felt like it was, there’s so much data for them to look at and I’m looking forward to their upcoming papers. I’m really interested in the one on size, because of course I’ve always been a small dog person since I was a little kid, and, uh, that makes me happy that we’re gonna learn more about how size affects dogs’ health in general.
[00:42:26] >> Kate Basedow: Yeah. I’m definitely looking forward to seeing those results and what the numbers show. It’ll be fascinating.
[00:42:34] >> Molly Jacobson: Yeah. Thanks, Kate. Thanks for debriefing with me. As you know, I think out loud. So it’s very helpful to have you here.
[00:42:41] >> Kate Basedow: You’re very welcome.
[00:42:44] >> Molly Jacobson: And thank you listener for joining us today on Dog Cancer Answers. I hope you found this episode useful, and I hope that you will subscribe in your podcast app of choice so you get future episodes automatically in your feed. And don’t forget to share it with a friend, because the number one way that dog lovers help each other out is by pointing them towards solid, helpful, practical, and pragmatic evidence based conversations like we have here on Dog Cancer Answers.
And as cancer is the number one killer of dogs, sometimes you might have a friend who needs to listen to this podcast. And of course you should follow us on all the socials, join our Facebook group, and give your dog a cuddle from all of us here at Team Dog.
I’m Molly Jacobson. And from all of us here at Dog Podcast Network, wishing you and your dog, a very warm Aloha.
[00:43:44] >> 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 was 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.
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Dog Cancer Answers is a presentation of Maui Media in association with Dog Podcast Network.