A New Breed of Medicine

Specially trained canines can outsmart tech these days, often catching dangerous symptoms before even the cleverest of gadgets. You won't believe these dog stories, and their implications for the future of everyone's health.

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Katie Krampitz was just 3 years old when she was diagnosed with type 1 diabetes, a disease that sends her blood sugar soaring and plummeting several times a day. When it spikes, she feels nauseous and her mouth goes dry; then when it dips, she starts shaking, has difficulty focusing, and suffers excruciating headaches. Katie, now 17, typically feels fine until the symptoms hit, suddenly and sharply, allowing her only minutes to take medication that stabilizes her blood sugar levels.

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Even more troubling is the fact that these drastic fluctuations can take a toll on her internal organs. Two years ago, concerned about the possibility of kidney failure, Katie's parents began searching for a way to help regulate the seesawing of her blood sugar levels. Instead of a high-tech device or a pricey new drug, what they landed on was undeniably cuter: a 7-month-old black Labrador puppy named Rue.

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"She was already trained when she arrived," says Katie, a bubbly high school senior. "She knew to alert me when my blood sugar levels went beyond my normal range — pawing at me continuously when they'd get too high and nudging and licking me before they dropped too low." Eight months after Rue became part of the Krampitz clan, a blood test revealed that Katie's glucose levels were perfectly stable for the first time since her diagnosis 13 years earlier.

Today it's rare to find Katie without the dog by her side. Rue accompanies her to the movies with friends and to her job at the local mall. She's become increasingly sensitive to the teen's condition, tipping her off 30 to 40 minutes before Katie even begins to notice that something is wrong.

"I was at church one Sunday and Rue kept bothering me, but I felt fine," says Katie. "She wouldn't stop, so I used a finger prick and glucometer to check my blood sugar, and it was extremely low. I could've passed out, had a seizure, or even gone into a coma if it hadn't been for Rue."

Pup lovers don't need a doctor to tell them that dogs can be a boon to our health (OK, when they're not chewing on furniture or stealing dinner off the table). They help lower our stress levels, brighten our mood, and bring down blood pressure. And that's just the average house pet. Service dogs go further, whether guiding the visually impaired or providing psychiatric support for veterans with post-traumatic stress disorder. Now a growing number of dogs like Rue have been tapped for medical detection, alerting people to diabetes complications and other problems. What's more, dogs are being put to work in labs, where they're trained to sniff out cancers.

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Whether or not you're a dog person, you have to be wowed by the role these pups play, and moved by the stories their owners tell. Many of them owe their lives to canine detection, and it's possible that all of us could benefit in the future.

Heal, Dog

A pup performs during an ovarian cancer detection study at the Penn Vet Working Dog Center.

While stories about dogs pinpointing disease have likely been shared for decades, the first published report on the phenomenon appeared in a prestigious medical journal, the Lancet, in 1989, when a doctor wrote about a patient whose pet wouldn't stop sniffing one of her moles. It turned out to be melanoma. In 2001, another cancer-detecting dog was highlighted in the same journal, and scientists started to take notice. Since then, many more studies have been conducted on dogs' ability to decipher differences between healthy and cancerous tissue and blood.

The diabetes-dog connection began with anecdotes from pet owners, too. Researchers at Queen's University in Belfast caught on in 2008, and contacted hundreds of patients with type 1 diabetes who had dogs. Sixty-five percent said their pet had shown a behavioral reaction — whether barking, whining, licking, or nuzzling — to at least one of their hypoglycemic episodes, giving the team an indication that something special was going on. Since then, other researchers have found a similar link, including a small study that shows dogs correctly identified low blood sugar levels through sweat samples 87 percent of the time, even though, amazingly, those sweat samples were placed inside glass vials housed in steel cans. Yes, those are some keen noses!

Learning to sniff out cancer at the In Situ Foundation in California.
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George Preti, PhD, an adjunct professor at the University of Pennsylvania School of Medicine, isn't surprised that the doggie-detection area of research continues to grow. He's been involved in ovarian cancer detection studies at the Penn Vet Working Dog Center, and says that the canines in the lab are far better than any tool we have for catching early-stage cancer right now. Preti's theory: Dogs can identify the odor of volatile organic compounds (VOCs) — chemical compositions that are naturally released into blood and bodily fluids. When someone has ovarian cancer, for example, the metabolism of cancer cells slightly changes the smell of these VOCs compared to those of someone who is cancer-free, and highly trained dogs pick up on this very specific scent.

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Sniffing Out Trouble

Mackay and protector-pup Jellybean.

To understand the power of a pup's nose, it helps to compare it to your own. Dogs have 300 million olfactory receptors, little proteins inside the nose that help the brain process odors, whereas humans have just 5 million, says Dina Zaphiris, founder of the In Situ Foundation, a nonprofit in Chico, CA, dedicated to teaching dogs to recognize early-stage cancer in humans. The sheer volume of those olfactory receptors lets canines detect odors in parts per trillion. She offers a comparison: "If we can smell a squirt of perfume in a room, a dog can smell that same squirt of perfume in a football stadium filled with people."

Their heightened sense is also at work with diabetes, allowing Katie's Rue and other alert dogs to detect the change in scent that occurs when blood sugar levels shift. But this takes dedicated training. For Jellybean, a diabetes-detection goldendoodle to 7-year-old Mackay Levine, schooling started as a puppy. At first he learned the basic obedience skills that are required of service dogs — how to work calmly on a leash and tolerate everyday sounds and distractions, for example. Then, when Jellybean was matched to the Levine family, Mackay received small jars labeled with different blood sugar level ranges. Each time he hit one of those ranges, he placed a saliva sample in the appropriate jar. The family mailed the whole collection to the training facility, where the samples were used to teach Jelly bean how to respond to each scent.

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Today the dog accompanies Mackay to school and sits quietly under his desk, on alert for any changes in blood sugar. "If he senses that something is really off, Jellybean will wrap his paws around Mackay's waist or continually nudge an adult who is nearby. It's impossible to ignore," says Brian Levine, Mackay's dad, adding that Jellybean once even alerted the school nurse to another diabetic child's dangerously high glucose levels.

Trainers, though, are quick to point out that these dogs aren't perfect, so patients who are paired with them should continue to use medical devices recommended by their doctor. A gust of wind can carry away the scent of plummeting blood sugar levels, for instance, or a dog may simply not be in the mood to work. (Can't we all relate?) But for Mackay and other diabetics, an added layer of security in the form of a four-legged shadow makes their condition less intimidating and far easier to live with.

New Territory

Dreyfus alerted Faye to a seizure the very first day they met.

Despite years of research, we've only made a dent in understanding dogs' knack for detecting health conditions in humans, and scientists are still undecided on how canines are able to sense certain issues, as is the case with seizures.

Faye Shank, 51, was diagnosed with lupus at age 19. The auto immune disease eventually affected her nervous system, leading to epileptic seizures that would happen so suddenly she was unable to move herself out of harm's way. "I have fallen down the stairs, knocked out some of my teeth, and even collapsed into a pot of boiling water while cooking," she says.

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The seizures, which occur about three times a week, didn't respond well to medication, so in 2005, her neurologist suggested a seizure alert and response dog. Enter Dreyfus, a specially trained standard poodle. He warns Faye of impending seizures, giving her time to get to a safe place such as a couch or a bed. Then he drapes himself across her convulsing body to prevent Faye from falling or injuring herself. He was also taught to push a large 911 alert button with his nose or paw should a more serious seizure occur.

It's unclear what Dreyfus and other seizure alert dogs are picking up on — it could be an odor or a chemical change in the body, says Cindy Otto, PhD, a veterinarian and executive director of the Penn Vet Working Dog Center. Unlike diabetes or cancer detection, this isn't something that can be taught; experts have found that only select dogs have a natural instinct to warn about seizures before they start. Those pups then undergo training to reinforce that behavior, and luckily for Faye, Dreyfus is a pro.

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Since she brought him home, Dreyfus has predicted every single one of her seizures — all exactly 47 minutes before they started.

"I used to be scared to leave the house, and even simple tasks like taking a bath by myself were impossible," she says. "Dreyfus has helped me regain my independence. He's always by my side, like super glue."

Dreyfus's finest moment? In 2009, Faye was home alone when she had a stroke that left her unconscious. Three weeks later, she came to in the hospital, only to learn that Dreyfus had saved her life by pushing the emergency button.

Dog Scans — the New CAT Scans?

Don't expect to see cancer-detecting hounds wagging their tails in hospitals anytime soon. Unlike clinical medical devices, dogs' noses haven't received an FDA stamp of approval to be used outside research centers, and some experts don't believe they will ever be put to use in real-world settings.

It's not an efficient system, says Otto. "There's so much money, nuance, and training that goes into getting dogs ready to do this kind of work." Plus, not every patient would want — or trust — a cold, wet muzzle to sniff out a diagnosis.

"Our best bet for moving this science into the mainstream realm is to transfer what dogs have taught us to a medical instrument that can be used by doctors," says Preti. That's why he and other researchers are taking what they've learned from dogs to create a handheld electronic "nose" that could be used for cancer scans during checkups.

But some people still believe that cancer detection pups have a shot in medical settings, despite the time and money that would be required to get them ready for sniff sessions with actual patients. Zaphiris, for one, would like more trainers to teach canines the necessary skills so that they're ready to get to work should the opportunity arise.

"My dogs can examine upwards of 300 samples of blood or urine a day with incredible accuracy, and those specimens could be mailed to us from all over the world," she says. "I see a future where, along with using the tests and screenings that we currently rely on, we'll have these dogs to help confirm cancer diagnoses in patients."

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Donna Waugh, president of the American Scent Dog Association in Little Rock, AR, has another goal. She's partnered with doctors at the University of Arkansas for Medical Sciences on a program that teaches dogs to detect specific types of cancer that have a high likelihood of recurring. Then, she says, these dogs could be paired with cancer survivors who have a heightened risk of the disease coming back.

The owners could count on an early warning from their pet instead of anxiously waiting months for their next scan. Once Waugh's dogs are trained, she'll be able to place them with patients, though more funding is needed in order to make this happen on a larger scale — a barrier that many researchers and trainers face.

In the meantime, alert dogs like Dreyfus, Jellybean, and Rue will continue to be used in homes, assisting their owners in a way that top doctors, medications, and technologies can't.

"For patients like Faye, there is no comparison," says Colleen Diering, CRNP, the nurse practitioner at Faye's neurology practice. "These dogs are filling a void that nothing else can, and I hope that someday they're available to everyone who could use the help."

And It's Not Just Dogs...

A pigeon checks out a breast cancer slide at the University of Iowa.

A number of other animals have disease-detection skills, though more studies are needed before their talents can be put to use by docs.

Pigeons were trained to differentiate between malignant and healthy breast tissue in slides containing very thin slices of tissue, and experts found that the birds could tell the difference an impressive 85 percent of the time. Pigeons have vision skills similar to those of humans, potentially making them a helpful addition to pathology experts' work one day.

Rats are able to sniff out tuberculosis (TB) — the most fatal infectious disease in the world — in mucus samples. The rodents are currently being used as backup for technicians' work in labs in Africa, where TB causes thousands of deaths each year.

Fruit Flies can be genetically modified to glow in different patterns when exposed to volatile compounds emitted from various cancer cells, allowing the insects to differentiate between five different kinds of breast cancer. This ability may perhaps aid cancer prescreenings in the future.

Want to support these hero dogs and the people who work with them? You can give money to accredited dog-training programs (go to assistancedogsinternational.org for a list) or to research centers like Zaphiris's In Situ Foundation or the Penn Working Vet Dog Center. Another option: Help a family with fundraising efforts. Training a detection dog can cost $20,000 or more, which is why many people set up online crowdsourcing pages to cover the bill.

This story originally appeared in the July/August 2016 issue of Dr. Oz The Good Life.

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