The science of olfactory detection of human disease: Medical Detection Dogs past and future Dr Claire Guest CEO. Medical Detection Dogs

Evidence based research canine effect on human health 1980’s1990’s2000+ (canine/human relationship) (olfactory detection) Indirect effect Psychological & social  health Direct effect Physiological  health  blood pressure  heart rate  blood lipids Health management Diagnosis 4

Dogs detecting human disease Medical Detection Dogs approach 3 Diagnosis – Cancer detection dogs Management – Medical alert dogs

Olfactory detection of human disease Basic scientific principle Metabolic diseases & cancers cause changes in body cells As these changes occur the cells produce volatile organic compounds (VOC’s) which the body needs to diffuse & excrete Each disease has it’s own VOC ‘fingerprint’ Dogs are trained to detect a specific fingerprint at very low concentrations 7

Canine Olfactory Detection Proof of principle Willis et al, (2004). Olfactory detection of human bladder cancer by dogs: proof of principle study, British Medical Journal, 329: 712. First clinically robust trial Demonstrated proof dogs could identify a unique odour associated with bladder cancer Cornu, et al, (2011) Olfactory detection of prostate cancer by dogs sniffing urine. A step forward in early diagnosis. J.Urology Sensitivity and sensitivity 91% / 91% 9

6 Proof of Principle study Photos courtesy of Emma Jeffery

Thresholds - Kizzy 32

8 Daisy Total Number of samples searched

Studies Currently In Progress Breast cancer study in association with Buckinghamshire NHS Trust Urological cancer study in association with Milton Keynes University Hospital UTI infection Lung, Ovarian, Colorectal cancer Parkinson’s disease 9

10 Canine Olfactory Detection Management of human disease Response Dogs (Responding to things happening) Medical Alert Assistance Dogs (Warning to make aware of impending episode for appropriate preventative medication/action) Type 1 diabetes, Addisons disease, POTS, severe allergies.

17 partnerships Breath Reduced paramedic call-outs  unconscious episodes  independence  in glycaemic control Rooney, et al, (2013), Investigation into the value of trained glycaemia alert dogs to clients with Type I diabetes PLOS One /journal.pone Diabetes Alert Dogs 24

Medical Detection Dogs – Addenbrooks Hospital collaboration Does having a diabetes alert dog reduce the diabetes-related anxiety in people with hypoglycaemia unawareness? 12 Stage 1 - Retrospective X3 Quality of Life Measure questionnaires X1 Hypo Fear questionnaire Stage 2 - Longitudinal 2-5 year

13 Robust scientific study will validate information for medical stakeholders & decision makers Evidence based research - the way forward