Dan O’Neill, MVB, PhD, FRCVS: VetCompass and Inherited Disease

[Upbeat music intro]

Jessica Perry Hekman: Welcome to the Functional Breeding Podcast. I’m Jessica Hekman and I’m here interviewing folks about how to breed dogs for function and for health; behavioral and physical. This podcast is brought to you by the Functional Dog Collaborative, an organization founded to support the ethical breeding of healthy behaviorally sound dogs. The FDC’s goals include providing educational, social and technical resources to breeders of both purebred and mixed breed dogs. You can find out more at functionalbreeding.org, or at the Functional Breeding Facebook group, which we work hard to keep friendly and inclusive. I hope you have fun and learn something.

0:47

Jessica Perry Hekman: Dan, thank you so much for joining me on the podcast.

Dan O’Neill: It’s a real pleasure to be here, Jessica. Any chance to talk about dogs, I’m there.

JPH: Thank you. So yeah, well speaking of dogs, and we always start out by talking about – what dogs do you have or live with, or do you have dogs?

DO: Yeah, it’s actually a bit of a thorny question, that one, because I grew up in Southern Ireland. Ireland has a lot of dogs. The country has changed, it’s kind of gotten much richer. But when I grew up, we all had dogs. We would just open the door in the morning and let our little dog out, and then in the evening she’d be sitting there on the doorstep. She was… the first little dog was a little terrier called Sandy. But dogs kind of fill a lot of roles in our lives. And the second type of dogs that we grew up with were greyhounds, racing greyhounds, either track racing or coursing, and we had greyhounds all the time from when I was maybe four, five, six, all the way up till even the current time. And those racing greyhounds in Ireland were pets. They lived in our house with us but they would also race. So it was kind of like a dual purpose. Part of my childhood, grew up on a farm where we had farm dogs. They were just border collies, they weren’t particularly pets as such, they were working dogs. So really, it’s kind of fascinating. In England I met my wife via a dog. I put her dog to sleep. It was quite sad, really. It’s a little poodle, a little black poodle. And then about two years later when we were going out, I got her a present of a little black poodle called Kettle. And Kettle died when he was 17. So dogs are kind of woven into our fabric of our life. Unfortunately, we don’t have a dog now because our youngest child is horrendously allergic to animal hair. So cats, dogs, rabbits, especially. So we have tortoises, fish, birds, African pygmy hedgehog, basically anything that doesn’t have hair. So yeah, we’re kind of bereft of a dog, a living dog, at the moment. But all my life is spent mainly working as a vet, before my current role, with animals or currently working with virtual animals in the epidemiology world. So yeah, dogs are still very much a huge part of my life.

JPH: Your household sounds like a lot of fun. When I was a kid, my best friend, her mother was a biology teacher. Their household was like that. Except they also had dogs and cats, quite a few of them. I love houses that are passionate about things like that.

DO: It’s great though, isn’t it? It just brings the whole place to life. And certainly when my kids would have their friends coming around, you know, you often think it’s more they want to come in and play with your animals than it is actually seeing you or their own friends here. 

JPH: Well of course.

DO: [unintelligible]

JPH: Yeah, they do. Alright, so you talked about what your current role is and what your past role was. So you started out, did you start out your career as a vet? Did you do anything before that? Or did you step straight into vet school? 

DO: Yeah see, these are the things, everybody takes this kind of circuitous route. So I went straight into vet school. But you know, prior to that, I had lots of jobs as well, filling petrol and working in a factory and building sites and stuff. And then after graduation, I stayed in the university teaching for a year, then went to England in general practice for three years, then back to Dublin university to do a pharmacology degree. Then a year in large animal practice, year and a half large animal practice in Wales, then five years with a corporate life in Mars as an R&D technician and also working on pet food. Then took over a small animal practice in Kent, ran that for 12 years, and then went to the Royal Veterinary College in 2009, where I’m still working. So yeah, we take circuitous routes. I think we build up experiences as we go along. We get different views of the world. And that’s very much my perspective now is that we each have a view of the world, maybe we’ll come back to this later, and essentially we carry our own world in our own head based on our experiences. So I think the richer our experiences and the broader they are, maybe the more balanced our views of the world are.

JPH: I love that. I have had also a weird circuitous route to get to where I am. I think neither you nor I have jobs that when you are a kid you think “Oh, I want to grow up and do research studying epidemiology of dog disease, that’s what I wanna do!” It takes you a while to figure that out. So how did you figure it out? How did you do that?

DO: Actually what I wanted to be going through school was a primary school teacher. And that’s what I desperately wanted to be. In Ireland, you had to speak Irish to be a primary school teacher. And for some reason, I could just never get that language. And I just worked so hard to learn Irish, learned it and, and did get accepted. But then I also got accepted into vet school. And I had this horrible pull between the two, because teaching was what I wanted to do. But I think when you love animals, and you have a chance of being a vet, you’re gonna take it. So essentially, I think in my heart of hearts, there is always this kind of interest in teaching. So that was part of the drive to return to university as a lecturer. And then the other big drive was, as I was in practice, more and more and more I started to realize that when clients would ask me questions, I would answer their questions and I would believe my answers, but if I actually challenged myself, there was actually very, very little evidence behind my beliefs. And more and more as the years went by, I started to perceive that I was drifting more into eminence based evidence. So in other words, what other people would tell me was the truth. And if I believed them, and I thought they were good people, they knew their stuff, I would believe it. I wasn’t necessarily challenging things enough. And when I did go and challenge… somebody would ask me, say, “Should I neuter my bitch?” Well, how do you answer that? Well, A. There was very little evidence anyway. You know, “Should I give antibiotics for diarrhea?” And at the time, you know, that was standard practice here, we would give antibiotics for diarrhea. “Do I need antibiotics after a spay in a cat?” And you essentially go and look and you kind of think actually, there’s no evidence in any of this. So that was part of the drive, part of it was to try and fill a gap that I perceived that was there, and part of it was to drive to teach. But yeah, it’s been an interesting journey.

JPH: It’s interesting when I read papers. I’m reading a bunch of papers about this kind of stuff right now, I’m trying to put together a review article. And everyone writes about various inherited diseases of dogs. And they’ll sort of say, like, “Well, if the dog is this size, or this shape, then you can predict that they’ll have the disease.” So that’s useful for diagnosis. And I’m always like, “But oh, there’s something else you could do about that!” And then I was reading one of your papers, and it said and so perhaps people should breed dogs to be, in this case to be a little smaller. And I was like, “Wow, no one ever says that. Good job.” I actually said out loud “Good job, Dan.” 

DO: Oh, I like that. I like being told “Good job.” 

JPH: Yeah. Well, you didn’t hear because we’re a ways apart, but I’ll tell you now. 

DO: Yeah. Maybe the sensations had come through the ether. Even some of that, and you’re just triggering different thoughts as we go along. So I started a PhD when I left. In my mind, I retired in 2009. I left practice, I was working 60 hours a week in my practice, really busy small animal practice. And since then, I’ve worked 60 hours a week, every week doing research, but I haven’t actually worked a day because I love it. It’s just brilliant. And you just feel as though you’re giving back. So for me, I’m not working. I’m spending hours doing something joyful and pleasurable. But, I did a Master’s in Epidemiology at the Royal Veterinary College and then I did a PhD. The PhD was entitled Acquired and Inherited Diseases in Dogs and Cats, right? Now, how you could capture all of that within one PhD is beyond me because it’s the entire of small animal  medicine and surgery. Right? But it actually, the theory is…

JPH: Well there’s trauma, there’s trauma. You didn’t have to understand trauma.

DO: There’s trauma. Oh, aha! Okay, I’m gonna challenge you on that one, then. Where does trauma fit in? Is it acquired or inherited?

JPH: It’s acquired, but I see where you’re going with this because sometimes I talk to people about spay/neuter and how that associates with orthopedic diseases and so it’s sort of like… like cranial cruciate ligament disease. Clearly there’s an inherited aspect of it. But there’s also an acquired aspect of it. So is that where you’re headed? 

DO: That is the exact answer! 

[laughter]

JPH: But hit by car!

DO: So hit by car, acquired, yeah?

JPH: Acquired, but maybe there was a behavioral tendency to roam?

DO: Okay. Okay. That is exactly where I ended up. So it took me months to get there, you’ve got there in two minutes, right? So you’re…

JPH: Ahhh, it took me awhile to get there too, but I got there eventually.

[laughter]

DO: So the theory at the time was disorders were acquired or they were inherited. Inherited, fine, we accept that some of them could be the single gene ones that you could do a gene test for and you can maybe breed out and then we had the polygenic ones that might be a little bit harder, the hip dysplasia as you know. We can still breed them out, right? And then there’s the acquired stuff, the road traffic accidents. Whatever term you’re using there, RTA we use here. Road traffic collision, you use, is it? RTC, yeah?

JPH: Yeah, we say “hit by car”.

DO: Or hit by car. 

JPH: Same thing.

DO: And you know, and you have all the other ones that are standard, the diarrhea ones or the [unintelligible] or whatever, the bite wounds, right? But it

JPH: Or my favorite, “big dog, little dog”. Yeah. Which would be abbreviated, BD LD on the ER board.

DO: Exactly. And these are all the ways that we would categorize it, it’s kind of, people talk about cognitive economy. It’s a way of subdividing a very complex world, universe, into boxes that our brains can see. And we can have acquired, we can have inherited. It’s what we do with everything we categorize. But essentially, to my mind now, there are no “acquired diseases”, as in just acquired. There are no, zero, “inherited diseases” as in just inherited. Every single disease, condition, presentation, is a combination of both. And it’s like a pendulum, it’s just whether it switches more towards being inherited or more towards being acquired. And over the years, I’ve done so many VetCompass, and we’ll come back to talk about VetCompass maybe later, but so many VetCompass studies. My focus is breed. And if I run an analysis, and there is a breed predisposition, then the only reason a breed is a breed is because somebody has chosen to breed the breed as a breed. And that means that it’s genetics, yeah? So a dachshund has a different set of genetics to a collie. Therefore, if I have a disease that’s predisposed in a dachshund or predisposed in the collie, by definition, there is a genetic component. Therefore, it’s an inherited disease. When we did, and I’ve done studies in cats and dogs on RTA, road traffic accident, collision, hit by car, there are breed predispositions. There are some dogs, some types of dogs that have poor recall, for example, so when they’re off the lead they just run. So road traffic accident is an inherited condition. It has an inherited component, it also has a very large environmental or non-inherited component. So it’s just interesting. And this is one of the beauties of when you start going into PhD, you can actually sit there and think and mull stuff over, you can be Rodin’s Thinker. And you can, you know, clench your fist and put it to your forehead and spend a day or a week or a month thinking stuff over. And it’s incredible. I go back to what I said earlier – once you start thinking, you see the world differently. And when you see the world differently, the world is different. Because the world is only ever as we see it. So yeah, so it is fascinating. And these are just the insights, the light bulb moments as we go along. The beauty with seeing the world, that everything is acquired and everything is inherited, is that it gives you a much different perspective on how we can make the world better for dogs. And certainly when I did the very first paper of my PhD was the most common disorders in dogs. So it was a paper, went through 3885 dogs, I still remember like it was yesterday, and listed all the disorders of dogs. The paper published at the top 20. When I presented a top 20 to the eminent scientists of the day, they said “This is wonderful, this is great, and the really good news here is not a single one of them is inherited.”, you know, and the top disorders were otitis externa, obesity, you know, looking down through them, periodontal disease, road traffic accidents, diarrhea, da da da da da. None of them were, at the time, recognized inherited disorders, as in, on the list of standard polygenic or monogenic disorders. The reality is, every single one of them are inherited. They’re just not inherited to the degree that we accept them as inherited. So yeah, we live and learn as we go along. And the trick, and if there is a listener, or hopefully more than one listener, listening to this podcast, the trick is – challenge everything you know, because I do it every single day. The first step towards enlightenment is accepting that everything you know is wrong. And I know everything I know is wrong. Everything I’m saying on this podcast is wrong. It might only be 1% off being perfectly correct, but it is not perfectly correct. I know it isn’t, it’s just at the moment I don’t know in which direction and in what way it’s wrong. But by tomorrow, I will have updated some of my views. Anyone who has a view and isn’t prepared to update it probably has stopped growing. So yeah, just accept we’re all wrong. And everything you say, Jessica, you might not like me to say it, but it’s wrong.

[laughter]

JPH: No, I was actually just thinking that I had this conversation with my husband just like three days ago, where I was talking about how going through the process of vet school and then a PhD changed the way I looked at the world and the way I think about truth and perception so deeply. And I was remembering, so I had this weird relationship with science where I hated science when I was younger and thought I was bad at it. I hated it because I was bad at it, and I was bad at it because I hated it, right? 

DO: Yeah. 

JPH: And then I decided I wanted to be a vet and I had to take all of my basic science requirements before I could apply. And even just that changed my perception of the world. And I remember being on the bus going into class, and I was reading a book by Steven Pinker about how the brain works. The book may even have been titled How the Brain Works. And it was talking about how vision and how our brains fill in so much of what we see, right? And we think that what we see, what we perceive in the world, is reality, is truth. But our brains are filling in a massive percentage of it. And I just remember setting the book down and being like, “What?! What I see is not really there?”, and that was that first moment of how I perceive the world and the things that I assume are solid and basic truths are not necessarily. Sort of like your perception of, “Well, do we give antibiotics for diarrhea? It’s how I’ve always done it, and therefore it’s correct and true.” But sometimes when you think about it then you start realizing, I don’t actually have evidence for that.

DO: And that’s the beautiful word. Actually, your guy, Steven Pinker, he’s – actually I’ve moved on to a second book now, but the book I was reading last week is one of his, it’s his latest one, it’s called Rationality. 

JPH: Oh I haven’t read that one. 

DO: Yeah. Oh it’s got a black cover on it. It is outstanding. But I think a lot of these guys, they kind of have themes, so I would imagine it’s probably similar to the previous books and just building on them. But it is outstanding. And, you know, it’s fine. We’re humans, we behave and we think as humans. But the problem is we do believe what we believe. And that was kind of the lightbulb moment for me, is saying, “I’m still okay believing stuff, it’s just I no longer believe what I believe. I know it’s all wrong.” And it’s a weirdly comfortable place when you get there, but it’s hard to get there. Because most people cling to the fact that actually what I believe is true. And it just ain’t so. So yeah, and the diarrhea one? That was one of the ones in practice, you know, my standard thing for diarrhea was antibiotics and corticosteroids. And…

JPH: That is the golden pair, right? 

DO: Yeah!

JPH: Knock down the immune system and build it back up! Just to handle everything yourself.

DO: Yeah, put them together, you know, and it’s great. And the really nice thing was, and this is the confirmation bias and it’s why it’s so hard to stop doing certain things, is that the dogs that were treated generally got better. Now, we’ve just finished, I’ve got a PhD student called Camilla Pegram. We’re doing this causal inference PhD trying to go beyond standard epidemiology which is looking for associations, trying to actually look for causes. X causes Y. So one of the studies within our PhD is that particular question, dog antibiotics and diarrhea. So you know, we’re getting dogs within VetCompass with an uncomplicated diarrhea. Some got antibiotics, some don’t. You do various… like she’s doing some really weird stuff in the background trying to create counterfactuals of those dogs and the equivalent dog with the same background, other health issues, breed, whatever, but it didn’t get the antibiotic if the one we had did. And essentially that’s showing no benefit whatsoever from antibiotics. But the beautiful thing is it shows the vast majority of those dogs get better, regardless of what you do. So my confirmation bias was, this is what I give them, they get better, therefore I need to keep giving them the steroids and antibiotics. 

JPH: I made them better! 

DO: Yeah! It’s the god complex, of course I’ve made them better. And it’s really hard to stop doing the thing you’re doing, that you believe is making a good effect. Because why would I stop? That means I’m actively doing something potentially bad, and it’s really hard. And this is the power of evidence. So when we then release our paper and we say, look, here’s the paper that shows hundreds of dogs, some treated with, some treated without, it makes no difference whatsoever. But in the background we’re now using more antibiotics, we’re contributing to antibiotic resistance, this is a really bad public outcome, even though for the dogs it makes no difference one way or the other. Then suddenly, you can encourage people to take a leap of faith and stop doing the thing they’re doing, they believe is right. But the big trigger point there is encouraging folk to accept that what they believe isn’t necessarily true. And once you cross that river, that rubric, once you cross there, you’re open into a whole new world of learning and growth and advancement. 

JPH: Yeah, I think part of the trick is not looking back and saying I did something wrong in the past, but looking forward and saying how can I do something better in the future? And I think a lot of us have brains, I know, my brain really wants to punish me for things that I did in the past. It would really like, particularly at two o’clock in the morning, it would really like to do that. And I have to continually start saying, “Okay, but what am I doing, you know, how am I trying to contribute to the world now? How have I changed? How am I doing better?” And I think that’s the way through, right? Is not saying, “Oh my God, all this time was contributing to antibiotic resistance and I wasn’t even helping the dogs”, but to say, “Well, but look what I’m doing now. I’m doing a great job now.” Except for that I’m still wrong!

DO: But we accept we’re still wrong! Because by the time you get to the point when you’ve got everything right, you’ve got there. There’s no place else to go. That human thing of looking back and blame, that’s so human. It’s just how we’re wired. The way around that is to look back, it’s not so much blame, it’s to look back and understand. My default position is that nobody… there probably are occasional exceptions, but my default is absolutely nobody sets out to do something bad. Everybody sets out to do something good, yeah? So when I look back, and I was giving antibiotics, right? I wasn’t trying to do something bad. What I was doing was bad. But I didn’t know that at the time. So therefore, there isn’t a sense of blame, in that sense. There is no point, that’s a pointless cul-de-sac to go down. It’s more, you look back, you learn from the past, you say, “Well, actually, I was doing something I thought was right, it wasn’t creating a good outcome. However, if I learn from it, then actually, it now is creating a good outcome.” Therefore, it’s a way of reframing the “bad” thing you’re doing, I’m using inverted commas here, to actually generate a good, a positive good. And it’s, you know, at some stage here, we’ll probably talk about a dog maybe along the way, but it’s the same with dogs, and the sort of dogs that we decide to acquire. The body shapes or whatever. Nobody sets out to buy a dog that is going to be sick, we do it in a positive way. We set out to buy dogs that somehow we love, or were manipulated by social media into thinking we love or whatever. Nobody sets out to do something bad. But we can look back and think, actually, that wasn’t a good thing. I didn’t know what I was doing was bad, but it wasn’t a good thing. However, I can learn from it, do things better in the future, and therefore that previous bad or poor choice actually is leading to a better future. So it’s just a matter of reframing and doing the best that we can. And so long as we keep actively learning, and that’s a hard thing to do to actively learn. It’s to seek knowledge as opposed to passively just floating along and being pushed wherever the wind draws you, actively seeking out new truths and better truths. I think that’s the best we can ever do.

JPH: And remembering that having done something “bad” and again, I like that you put that in quotes. Having done something “bad” does not make you a bad person. Separating out actions from whether you’re a good or a bad person. It’s trying to do your best that makes you a good person.

DO: And that’s absolutely huge. That’s absolutely huge because the behavior might be perceived as “bad”, but the person himself isn’t defined by the behavior. That’s just one behavior, it’s one event, it might be one moment in time. So for to say somebody is bad because they did X, Y and Zed is incorrect. Unfortunately, and again, we might come to it later if we have time, but unfortunately that is how the legal system works. And within the whole dog world, a lot of the issues with dogs’ extreme conformations are now falling back on legal processes because a lot of the behavioral change isn’t landing, it’s not working. But personally, I feel it’s a bad place to be deciding about dog welfare issues; dog welfare issues should be decided in a certain place that exists between each of our ears, not in a courtroom. However, you know, that is where it’s going. And once you get into…

JPH: In the UK. In the US, not so much. But I would say that in the US we mediate it on social media, where we do then call each other bad people. And there’s a lot of you know, “You’re part of that group and so I’m angry at that group of people and you’re all terrible. None of you are good people if you belong to that group.” So that’s how we do it. Also not the best way.

DO: Yeah, that’s not a good place to be arguing things, either, unfortunately.

JPH: No, no.

DO: I often think that we talk about humans and inclusivity, and that this is a wonderful thing. But I often think the worst, most harmful, dangerous word in the English language is “we”, because we talk about inclusivity and we say “we” is a great word. But by definition as soon as we say we, there must be a they. And now all of a sudden this wonderful way to inclusivity, absolutely wonderful, actually has created division. And we’re very fluid in our definitions of who the “we” are. So sometimes it’s male, female, it’s young or old, it’s different states if you’re in the US, you know in the UK it might be different football teams, different levels of education, socio-economic – we’re really fluid, we can just move between all these different ways. Generally, we find that the “we” we exist to in whichever paradigm it is the good “we”. And everybody else is the bad “we”. So that my football team – I support Liverpool, best football team in the world – so my “we” obviously is the best football team in the world. And Chelsea, man, you know, they’re useless. It might be the same with, you know, “we” supporting baseball teams or American football or whatever. Likewise, it could be “we”, you know, the owners of French bulldogs versus the owners of German shepherds. It is a really dangerous world to go into. And we digress a little bit here, but it is important because the dog… Increasingly one of the other revelations that I had as I was going through my PhD was that dog health issues related to breed and conformation are not dog issues, they’re human issues. The dogs are the ones that suffer, they’re the end of the line, the receivers of our decisions and our thinking and our perceptions, but the issues themselves are not dog issues. Nature is not defining these extreme conformations; they wouldn’t exist in nature. These are human issues, and therefore they have to be solved by humans. And unfortunately, at the moment, I’m not sure we’re making a very good job of it, as humans, resolving some of those. 

JPH: It’s interesting, I say much the same thing, but I use different words. So I say that figuring out how to breed dogs well is something that science understands. It’s not scientifically difficult. But there are a lot of social barriers. 

DO: Yes. 

JPH: Which is, I think, essentially the same thing as what you’re saying. 

DO: So extreme conformation, right. So the first thing is, you’re absolutely correct. When I first started talking about extreme conformation, in the UK we have a wonderful group called The Brachycephalic Working Group. So, brachycephaly means flat-faced dogs, so French bulldogs, Shih Tzus even. The Brachycephalic Working Group has got the kennel clubs and the breed clubs – French bulldog, English bulldog and pug breed clubs – so people who really love these dogs, and love the look of these dogs and breeding them to a breed standard. We’ve also got the veterinary associations, we’ve got the government, we’ve got the universities – The Royal Veterinary College and Cambridge University, and we’ve got the big charities – so the PDSA, Dogs Trust and Blue Cross. It is a wonderful organization for learning from each other, but also for agreeing on positions and definitions. Because it represents all the major stakeholder groups in dogs. When we first started having these conversations about extreme conformations, it was very much that the current breeds are breeds and exist, and extreme conformation is something that’s worse, more extreme than the current breeds. So in other words, we take a standard English bulldog, that’s a breed, it exists, it’s existed for 100 years. So an extreme conformation is a dog with even more skinfolds, or more twisted leg, or more flattened face, or more bulging eyes. But over the past couple of years I’ve been developing the definition. We now have set up a group called The International Collaborative for Extreme Conformation in Dogs. That is like the brachy working group, we’ve just extended it where it’s now got countries involved. And the big missing country, I hate to say it Jessica is… yep Jessica. For those of you who are out there… 

JPH: The United States, yeah. 

DO: She’s too embarrassed to answer but she is pointing to herself.

JPH: I didn’t want to interrupt you, Dan.

[laughter]

JPH: No, for sure. We feel very strongly about our individual freedoms. And while I also feel strongly about my individual freedoms, I also think that there’s… you can be free and you can also be socially responsible, and we’re having trouble as a country right now reconciling that, I think.

DO: Well, we’re like, we’ve got Canada. So you know, there’s that.

JPH: Oh, you have Canada now?

DO: A piece of land over there, you know, some of you can join. But we’ve got Australia, New Zealand, you know, loads of European countries. But essentially, the definition that we’ve put through I like. In psychology they say all of us follow the rules of three, always have three things you know. So basically extreme conformation, we’ve now put it through as my original definition, describes a physical appearance that has been so significantly altered by humankind – so that’s number one. Away from the ancestral, natural canine appearance – that’s number two. So in other words, a dog such that affected dogs commonly suffer from poor health and welfare, with negative impacts on their quality and quantity of life. So basically, the extreme conformation is something that mankind has invented, doesn’t exist in nature, that is different to the natural dog, the dog that nature would evolve, and it has to be associated commonly with suffering. That means that this is not anti-breed, this is pro-breed. I believe the world should all have French bulldogs, they just cannot look as extreme as they are now. We can have French bulldogs that don’t have extreme conformations but are still clearly recognizable as French bulldogs. So this is an effort to preserve and protect breeds, but at the same time to preserve and protect the dogs that we choose to live in the body of that breed. And at the moment, I think we’re failing on the second one. That definition of extreme conformation, it now solves a lot of the issues, because it now relies on evidence to determine whether we accept the conformation, extreme or not, rather than our opinion. Previously, it was my opinion versus yours as to how flat the nose is and, you know, how twisted the spine needs to be. This one is all down to whether the dogs commonly suffer and that’s now down to evidence. So epidemiologically if we have evidence that skin folds are associated with skin fold dermatitis, then skin folds are an extreme conformation, by definition. There is no argument, there is no space for my opinion versus your opinion, it is purely an evidence based decision. And that’s the big progress that over the past decade developing VetCompass that I have realized is that we need to move the argument away from my opinion versus your opinion into the evidence based view, where we both discuss the evidence. We might disagree with it, but it is the evidence. And it’s the evidence that determines what we should be believing. Obviously, some people will then reject the evidence. But that’s fine, you can’t change everybody’s opinion, but you can certainly have a debate based upon an external reality, which is evidence. So that’s where we’re going with extreme conformation. The brachy working group has trimmed out a small bit of that to shorten it, to make it more user friendly, but have accepted that group. And The Brachycephalic Working Group in the UK has a statement that says that we are all working to reduce and avoid extreme conformations. Wonderful! That is where 100 years of issues with dogs hasn’t got to, because it was all tied up in the concept of breed. And somehow, when we wanted to change dogs to make them healthier, somehow that was anti-breed because it was being anti-French bulldogs or English bulldogs or pugs or Shar Peis, or whatever the breed is. Whereas with the new extreme conformation, it is pro-breed – we are trying to keep you owning Shar Peis if you love them, but somehow moving away from the extreme conformations within those breeds. 

JPH: I like that, I like the concept of pro-breed. I had someone once say that Jessica Hekman is anti-breed. In this case, it was because I am in favor of increasing genetic diversity through outcrossing. And they asserted that that meant that I didn’t think there should be breeds. And I do think that there should be breeds, I do like there being some predictability. I just think that we shouldn’t sacrifice the dog’s welfare for what you’re referring to as extreme conformation, or the other thing that I battle with is the decreased genetic diversity. So I think we’ve been dancing around VetCompass a lot, and we probably should talk about what that is so that people know. So that then we’re able to talk more about what kinds of evidence it’s producing. Because I think the really interesting conversation is what you do with that evidence, how you think about that evidence, where the evidence comes from. But in order to have that conversation, we actually have to talk about what VetCompass is, so why don’t you tell us that? 

DO: So VetCompass, this is my hobby horse, right? So now you’re gonna have to tell me “Shut up.” at some stage, Jessica. So VetCompass is-

JPH: It’s fine, I’m gonna just mute myself. I’m gonna go make lunch. I’ll be back in 15 minutes when you’re done talking, okay?

[laughter]

DO: 15? I’m just getting started in 15!

JPH: 45 minutes then. Maybe lunch and dinner back to back.

[laughter]

DO: So the elevator pitch or explanation of VetCompass is fairly simple, right? Essentially, I was in veterinary practice. As a veterinary practitioner, I was seeing dogs, I was diagnosing them, I was tracing them, I was following them over time. There is a huge amount of evidence on that, but it’s just me. And it’s my biased view of the world and what I was doing. So when I left veterinary practice and went to the Royal Veterinary College, I was really lucky to start a PhD with Professor Dave Brodbelt and Professor David Church, who had this concept already started of putting together the clinical records from lots of different veterinary practices. I came into it with very much a primary care view, so I changed quite a few bits on it. But essentially, we developed this concept called VetCompass. Which is just an acronym, people like acronyms, Veterinary Companion Animal Surveillance System, VetCompass. I like the idea of it being a compass for vets, helping to point us towards the true north, hopefully, the true guiding star. Essentially what we do is we collect anonymized clinical records from veterinary clinics, we set up an extract where we pull those data and we pull them each night. So it’s quasi real time. We’re always within 24 hours of the events happening, and we pull them on an ongoing basis. So every interaction that’s recorded in the computerized system of the veterinary practices come to us. Those interactions can be the surgeries, it can be the consults, it can be the owner rang up to make a comment about the dog’s health, could be popping in to buy some wormer, could be popping in to weigh the dog, everything gets recorded. We amalgamate them from different veterinary clinics and different computerized systems, reframe them so they all look the same, and then they go into a single database. In the UK, there are about 5,000 vet practices, much smaller population obviously than the US. At the moment in the UK, we have about 30% of those, 1,800, feeding us data every single night. Already that has given us – I started my PhD in 2010, so since 2010 – data on 26 million companion animals, but half of them are dogs, about 13 million dogs. But huge volumes; 260 million clinical records, half a billion treatments. So we do a lot of work on things like antibiotic usage. So the database is huge. As I say, I came into it with very much a primary care and naive perspective and I think that’s hugely beneficial. The prior research world was based upon PhD students having the research question, designing their data collection, collecting their data, analyzing their data, publishing their data, publishing their results, and then moving on to whatever their next job was. I looked at that, and I thought, “Well, this is absolutely daft.” What we need is, we need one huge database where each person works on their component of it, but then the next person can continue working on it. So everybody is working on the same dataset, none of them are thrown away. We need it to be available to researchers anywhere in the world. And we needed to be intuitive, so that undergrads can use it, postgrads, postdocs, whatever. And that’s essentially what we’ve built. So VetCompass offers online access. So I have research students in the US, quite a few papers published with US people. You know, Australia, Malaysia, Singapore, China, I’ve got one at the moment in China. I wasn’t even sure if VetCompass would be accessible there, but it is, perfectly. So essentially, you’re breaking down all these barriers. But it means that you can then design your research question, the researchers go into the database, answer the questions in the database, everything stays in there, and then at the end they press a button and their data just comes out as an Excel. So essentially, conceptually, that’s the mechanics. Conceptually, my idea was that each veterinary professional, so it could be a nurse, it could be a receptionist could be a veterinary surgeon, anyone who types in records, what you’re actually doing is you’re putting a little invisible wire from their brain into the computer, and you’re sucking their knowledge into the computer. Or VC is just sucking all this knowledge from all these hundreds, thousands of veterinary professionals, sucking it all into this single database that the researchers can then tap into. And really what we’re doing is we’re getting the cumulative experiences of veterinary professionals right across the UK. That then avoids the issue of me studying my dogs in my practice, where there is huge amounts of bias, because now we have hundreds, thousands, tens of thousands in fact, of veterinary professionals involved. So, it’s called the wisdom of the crowds. It’s kind of a statistical quirk, where any one expert is likely to be well away from the true value. But if you ask hundreds and hundreds of people, generally the median, the middle value of all their opinions, is pretty accurate. And that’s what VetCompass is, is the wisdom of the crowds.

JPH: That wasn’t 15 minutes.

[laughter]

DO: No, and I could keep on going. And I could keep on going for another 10 hours. But I have a feeling we might go on a little bit here anyway, so.

JPH: We might have other things to talk about. And I’ve been aware of VetCompass for a while, and you have used it to generate some really interesting papers with some really interesting conclusions about dogs shapes, and sizes, and diseases that are not related to shapes and sizes. So where do we want to go from here? Do we want to talk about what kinds of things? Yeah, how about, can you give us an overview of what are some of the things that you have found using VetCompass? Or what are some of the papers you’ve published? What’s your favorite paper, Dan?

DO: So actually, that’s a good question. That’s like saying, what’s my favorite child? Except that papers aren’t sentient, so I can answer it, whereas I probably wouldn’t answer one about my favorite child.

[laughter]

DO: So basically, within the papers, the power of VetCompass is huge, right? So it’s limited only by our imagination, and what research questions to ask, and time. So epidemiology isn’t an easy discipline. There is quite a learning curve on how to understand epidemiological principles. You can get it wrong if you dabble without having some experience and some guidance and supervisorship. So really, the limiting factors come down to supervisors, people who understand epidemiology. Generally, I think people who are good at VetCompass studies as a supervisor, not the researcher, a supervisor need to be polymaths. So that means you need to have a really good understanding of epidemiology, you need a really good understanding of primary care, veterinary practice, because it’s very different to referral care. In referral care, which is where the vast majority of the research came from before VetCompass, the aim very much is diagnostics, getting a good diagnosis, and then treating generally to what we call the gold standard, the best possible treatment, and that’s fine. That is why people go for referral care. Primary care is not interested in the diagnosis. It’s really weird. My students hate when I say that, because they’re taught based on a kind of a referral mentality that it’s all about the diagnosis. Primary Care is all-

JPH: I had a moment just from vet school. I was like, “What are you talking about? Of course, primary care is about diagnosis!”, but go ahead and say what you’re saying. But I had a moment of horror.

DO: Yeah, it absolutely is not about the diagnosis. The majority, more than 50% of cases – I’ve done it in VetCompass, I’ve done the studies repeatedly – more than 50% of cases that are seen are not formally diagnosed. The referral practitioners hate it. And there are certain mentalities of people that just can’t cope with that and they will go back and work in referral, because it gives you certainty. Primary care is all about getting the animal better. So as I said earlier, treating diarrhea with antibiotics, right? I said diarrhea. Diarrhea isn’t a diagnosis, it’s a presenting sign. But in veterinary practice, I was very comfortable diagnosing diarrhea, diagnosing coughing, diagnosing lameness, I’m very comfortable with that. The owner presents an animal with a problem, the owner wants that problem to stop, “I want my dog to stop having diarrhea”. The referral mindset is, I work up the case, I get to some very specific diagnosis, and then I institute the precise treatment. The primary care approach is how do I get the problem to go away. And the vast majority of problems don’t need a full formal diagnosis. You need to go part of the way there, the skill of the primary care practitioner is to rule out the bad stuff. So I do a thorough clinical exam of my dog with diarrhea. I’m trying to rule out toxicities, I’m trying to rule out foreign bodies, I’m trying to rule out kidney failure, liver failure. It isn’t about diagnosing what the animal has, it’s about ruling out the things the animal doesn’t have. And then what I’m left with, I can deal with, I can use trial therapy and most animals will get better because I have ruled out all the bad stuff. So that really is where VetCompass comes in. It’s kind of giving a different mindset on what we’re exploring in animals. Your question was about the favorite study, I would say one of the favorite studies I had was a longevity study from maybe two years ago, where it was with a researcher called Kendy Teng, who had done a PhD with VetCompass Australia – we also have VetCompass set up in Australia – but we did it on UK dogs. We were looking at how long dogs live. But we were exploring it based on common breeds and then considering the role of extreme conformation. And that study was a life table study, which means that we’re able to predict at each year of an animal’s life, how long they would have left in their life, which is different to overall lifespan. But that very clearly showed that dogs lived, the typical average overall was 11.2 years from the first year of life. Some dogs lived longer than that; they were living 12-13 years on average. But, we had a bunch of dogs that lived very short lives. So French bulldogs lived, on average from the first year of life, 4.5 years. The Pugs and the English bulldogs were in the mid seven years. Whereas the dogs that were living the really long lives were the Jack Russell terriers, the miniature poodles. So there was a very clear distinction between types of dogs that commonly… not all French bulldogs are extreme conformation. There are French bulldogs with tails, there are French bulldogs with longer noses, so they’re not all extreme conformation, but by and large, most of them do. And it was a very clear demarcation between the breeds with very shortened lives were extreme conformation breeds and all extreme brachycephalic conformation breeds, versus the ones at the top, which were just dogs. There were recognizable breeds, some of them were small, some of them were large, but they weren’t extreme in any way. And that paper I just really liked because lifespan is a standard method of exploring and comparing the overall summary health of humans, it’s used all the time. In the US I think you do censuses every year maybe? The UK, I think we do them every three years, but looking at lifespan. And, you know, it would be reported between different towns or parts of the country, the differential health, because your lifespan kind of summates all your different health issues, and similarly with dogs. So this was just a beautiful way to just finally allow all of us, humanity, to slam our fist on the counter and say, “Extreme conformation, at a global summary health level, for dogs is costing them 1/3 of their life”. And it’s just such a wonderful summary statistic that is inarguable when you start looking at the data. And that’s the power of good evidence. And those same results are borne out by study after study after study. Dogs just had a paper out a month ago showing exactly the same thing, really shortened lives in French bulldogs and English bulldogs. There was another paper came out two weeks ago, longevity of dogs in Italy showed exactly the same thing. So this isn’t just an aberration. This isn’t just the UK and VetCompass data. This is being shown repeatedly study after study after study. What it’s now up to us to actually act on that information. 

JPH: Yeah, to figure out what to do with it. I agree that’s a very powerful finding. I noticed that you said it was inarguable. 

DO: Yep. 

[laughter]

JPH: So when I present evidence similar to that publicly, on our best friend ‘social media’, some of the arguments that I am familiar with hearing are along the lines of “You can have dogs with extreme conformation, you know, insert whatever extreme conformation you like, you can have dogs with this extreme conformation, who live longer than that. If you are doing a careful job of breeding for it, if you know how to breed for it right, and you’re selecting for a longer lifespan, then you will get these dogs having a longer lifespan. And the dogs that are dying young with those extreme conformations, it’s because they are part of the cohort of dogs that are being bred by breeders who are not being careful about how they produce dogs with extreme conformation.” And I’m always a bit flummoxed about how to answer that, because I have no way to reach into the data and show what kinds of breeders are producing the dogs that are being assessed. And I’d be curious what your answer would be?

DO: Well, it’s kind of a wonderful argument. And that one is kind of an unwinnable argument if somebody really believes it, because the aim isn’t really to win the argument. The aim is for us all to get to a truth. And it may well be in the discussion with those people, we get to a truth where actually we believe that you can. The approach that I would take to that is, the first line you said is that you can breed dogs with extreme conformation. This is where the definition is really important. The definition of extreme conformation is A) that it’s something that we have invented as mankind, B) it’s where the dogs we have invented are different to the ones that nature would have, and C) it has to commonly be associated with suffering. So by definition, you can’t breed dogs with extreme conformation if it’s not commonly associated with suffering, by definition. So the second thing is that the longevity argument there, there actually is a truth in some people saying that their level of care for their dog means that their dogs aren’t living shorter lives. 85% – this is, again, VetCompass data – 85% of dogs are euthanized. Euthanasia is a human choice. Obviously for young dogs, a lot of them, the choice is made because of behavioral issues. It’s not that the dogs need to die biologically, they just need to die because humans have decided they need to die because they have behaviors that either we are unhappy with or that cause the dogs to have problems. But as dogs get older, we often make the decision to euthanize based on the dog’s welfare. So if we believe that the dog’s welfare is good or acceptable to our standards, then we can defer euthanasia so dogs can live for longer. So there is an argument that somebody who really believes that their dog with extreme conformation is not suffering, despite the fact that it has struggles breathing, despite the fact that it has struggles moving, despite the fact that It has severe skin inflammation because of skin folds. Then those dogs can live longer. French bulldogs, it used to be that the Royal Veterinary College, we’ve got a hospital, the Queen Mother Hospital for Animals – it is the largest referral hospital in Europe, it’s huge – the neurology ward used to be full of dachshunds, it is now full of French bulldogs. French bulldogs have just taken over on the spinal ward. So there are lots and lots of French bulldogs with trolleys, you know, just so we can keep these dogs alive even though they’re paralyzed or incontinent. So the point is that we can generate our own truth. But probably what we’re missing is some of the quality of life aspects. The second thing is, if we set out to do all this work to breed these dogs with extreme conformation, but yet to be healthy, why would we not just breed dogs that don’t have extreme conformation? It kind of seems like a pointless thing to do, that we’re breeding dogs that have this high risk of issues, but somehow we believe how we breed them will avoid these risks or reduce these risks. Why not just breed the ones that don’t have extreme conformation? And that can either be we choose to breed French bulldogs or English bulldogs with nostrils, and with flat skin, and with a flexible spine and with a tail, and they look beautiful, they look absolutely beautiful, those dogs. Or we choose to breed a different type of dog. You know, we’re not if I’m currently breeding French bulldogs, that doesn’t mean I’m wedded to French bulldogs the rest of my life, I could choose to breed a different breed. As I said, we shouldn’t look back and blame ourselves for anything we’ve done in the past, we should accept that everything we do, including what I’m saying right now is wrong, and we can learn from it and we can grow and we can change. So the bottom line, though, is that we do need to look at the evidence. And the broad evidence clearly says, by definition, extreme conformations are associated with higher risks of suffering, therefore we need to move away from extreme conformation.

JPH: Yeah, I like that answer. Answers that I’ve given to people sometimes are, so rather than starting with dogs with extreme conformation and struggling to get them to a healthy place, perhaps we start with dogs without extreme conformation and then we start moving back towards that direction and see how far we can get and stop when we can’t get any further.

DO: Yeah, even just – again, I’m just picking up on one little trigger that you have in each sentence, you had loads in the last sentence as well – but even though you’ve said, “I’m starting with dogs and trying to get them to a healthy place”,  we’re talking about definitions. I will challenge anyone to define health. Absolutely challenge anyone to define health. We all say it, we all know what we mean, we’re absolutely certain “I know about health, I’m doing this, that, and the other, I’m going running to improve my health”. Well, yeah, you might be better on your knees. Maybe running actually is harming your health. So we all understand what we mean by health, but the reality is there are definitions. If we follow the definitions, not a single one of us on this planet is healthy. You know, health is defined in various different ways, states of complete emotional, physical, behavioral, and psychological well-being. Well, heck, you know, who among us is healthy in that case? To get over that, and this goes back to the definition thing, I’ve looked and looked and looked over the past 10 years at health. And you mentioned earlier about well-bred dogs are health tested, right? There is not a single health test on this planet. Well-bred dogs are not health tested. And I will challenge and I will keep on saying it to all the different veterinary associations and kennel clubs, but they will not change that word. We are not health testing dogs when we do those tests, we are disorder testing them. Those tests are a test for a disorder. It’s either a specific genetic disorder, or it’s a specific hip dysplasia if we believe in those tests, or elbow dysplasia. As soon as you call it a health test, when I test my dog, if my dog passes the test, it was a health test therefore it means the dog is healthy. Well, a dog that has passed a test for hip dysplasia really isn’t that much healthier than a dog that hasn’t passed, because hip dysplasia is just one of hundreds and hundreds of potential disorders. We might have reduced the possibility of that one disorder, but the incremental health gain at an overall level to that dog from passing that test is tiny, because it still has all the other risks. So to try and get around that – and again, to have a definition we can all do – I had developed, two or three years ago, a concept called ‘innate health’. And this has now been accepted, and we’re working it up in the UK, we’re using it to apply within the legislative concept. Innate health is defined as – I’m literally going to read the definition – all dogs, so it isn’t about breeds, this is pro-breed, we’re trying to protect breeds here. So it’s all dogs, regardless of type and breed, should be capable – these are the three things – so it’s all dogs should be capable of performing all the typical activities necessary for their well-being within their anatomical, physiological, and behavioral evolutionary norms. So in other words, a dog should be able to do what a dog can do. Now, if we have certain types of dogs that can only exercise for three or four or ten minutes, and after that they’re running into respiratory distress. That is not good innate health, right? It is never normal for that in dogs, never acceptable, but it is extremely common. So innate health measures, the baked-in health of dogs. Extreme conformation means the baked-in health of dogs with the extreme conformation is reduced compared to dogs that haven’t got the extreme conformation. So now we have a definition of health that, again, can be measured, because the short answer is dogs with poor innate health are dogs with extreme conformation. And because we can define and measure extreme conformation, we know the ones with poor innate health. So when we have types of dogs, well-bred dogs that are being bred with extreme conformation that have been having these magic health tests, if they already have an extreme conformation, by definition, they cannot be innately healthy, fully innately healthy. And this is the loop we go on. And this is just trying to break it by the use of evidence and good definitions.

JPH: Yeah, I was just reminded when I was in high school and we had the infirmary, and they wanted to rename it to the wellness center. And that’s the inverse of what you’re talking about here. And now I’m thinking about whether I can get away with referring to this as disorder testing. So I think people will know what I mean if I say that, and I’m wondering if I’ll get in hot water if I do. 

DO: I’ve been promoting this for years and nobody disagrees, but nobody will change the wording either. The reason being that the wording gives a warm sense, a glow. Because when I do a health test, this is a really positive thing. But the exact same test, if I call it a disorder test, that’s a negative because I’m looking for something bad. Whereas the first one is looking for something good. But the first one is not correct, it is not what we are doing, we are fooling ourselves when we say that. We are giving ourselves a sense of false security. Because we have, I’m using inverted commas again, “health-tested dogs”, where the words tell us we’re testing their health. We’re not testing their health, we’re testing their disorders. And unless we’re capable of, for each individual type of dog or breed of dog, prioritizing the dogs, identifying their most common disorders, the most serious disorders, and the ones with the greatest duration. So those are the ones with the highest welfare impact – frequency times duration times severity. Unless we have a priority list where we know the most important disorders, from a welfare point of view, and we can test for all of them, we’re not testing for health. We’re not even scratching the surface. And the second thing is that a lot of the disorders we do health test for, the sum effect for dogs of that breed probably is negative. Because we’re health testing for disorders that may not be very common. But when we get the result back, we then kind of have a sense that this dog is better somehow than the other dogs. So we’re more likely to breed from this dog. And over a period of generations health testing is encouraging reduced genetic diversity. But we are doing it, as I said earlier, nobody sets out to do something bad. We’re doing it because we bought into this concept that health testing is good. Dogs that do better on the health test must be better ones to breed from. So we think we are improving the dogs. But overall, at a population level, will probably not because the reduced genetic diversity, probably more than outweighs any marginal, tiny, incremental gain by using these health tested dogs. It’s just so complex. But the first approach to health testing just feels so intuitive and warm, that we get sucked into it.

JPH: I 100%, hear what you’re saying, about how there’s this idea that if you do all of the disorder tests that are appropriate, then you’re safe. And that if you produce a dog – so I often pick on golden retrievers, you can’t do a disorder test for cancer. But if you do all the other disorder tests for, you know, then you’re a responsible breeder and no one can get upset if your dog develops cancer, skin allergies, epilepsy, all things that are very common in that breed but can’t be tested for. And so, while I’m not ready to let go of disorder testing yet, I do feel that the system that we’ve embraced is broken. Where we feel that there’s a set of tests that you do, you do the tests and then you have checked the boxes, you have done your due diligence, and if something else happens, it’s not your fault. And I don’t say that to demonize breeders, either. I know that people who are producing these dogs really want to produce healthy puppies. But what I am saying is there’s this nuance in the extreme conformation and in genetic diversity that we need to bring into the conversation as well. And I think that’s what you and I have been talking about is that that’s very difficult to do, and yet very necessary.

DO: It is. And it’s interesting you’ve picked on golden retrievers as well, just as an example. So again, that’s it’s a breed, and because it’s a breed we have our mental image of the body shape. And really, when you have your mental image of the body shape of a golden retriever, there’s not really much extreme about them. So the idea is within each type of dog, you set your priorities as to what the main issues are. So if I’m dealing with golden retrievers, you know, that’s not an extreme breed. Therefore, all of the points I was making about extreme conformation, innate health, don’t really apply because the dog already has good innate health. So we then look at what are the priority issues. Now, if we believe the longevity issues and the cancer issues, they’re related to genetic diversity, then that is where we tackle it. You can tackle that by trying to test your way out of it. Or you could tackle it by actually saying “What is the problem?” It’s called root cause analysis. Actually get to the root cause. The health testing – if a root cause analysis says that genetic diversity is the issue, if we follow a line of health testing, and trying to breed from selected subsets of those dogs to improve health… you can see where I’m going with this. That’s just crazy, because the health testing is specifically designed to exclude certain dogs, and then we breed from the remaining dogs. That means the genetic diversity is reducing, therefore the problem gets worse. So you can’t health test your way out of that particular problem, if it’s a genetic diversity problem. So you really have to look at each group of dogs. The UK Kennel Club – some of the stuff that Kennel Club is doing in the UK is outstanding. They’re just leading the world with a fresh way of looking at things. They have a program called the Breed Health and Conservation Plan that’s doing exactly that. It’s looking at each individual breed. It’s trying to identify what are the priority issues in that breed, and then approach it from a very logical perspective. If I’m breeding an extreme breed, like say, a shar pei, we had a shar pei paper out a month ago from VetCompass. Generally, in VetCompass studies, when we do the most common disorder studies, generally the most common disorder comes out at about 10% of dogs. So of dogs under veterinary care, it’s about 10% that will have whatever the top disorder is. It’s generally things like or otitis externa, obesity, osteoarthritis, diarrhea, vomiting, anal sac impaction. And overgrown nails, I include them as a disorder, some people will disagree, but it’s better to report it and people can ignore it if they don’t think that’s a disorder. Normally they’ll come out maybe 10. And the top disorders will vary, the top five will vary between 7% and 10%. With the shar peis, 17.6% had one particular disorder, entropion. Now entropion, for, you know, anyone who’s got eyes, if you’ve had laser surgery, or whatever, you will know how sensitive your eyes are. If you get a bit of grit in there. So we have a breed, where 17.6% every year are diagnosed with a disorder that involves the skin, the hairs on the skin of your eyes, rasping up and down your corneas. Day in, day out, minute in, minute out, right? That’s not a genetic diversity issue, you look to the problem, you say, “What is the problem?”, and then you identify the issue to it. It is a genetic issue based on repeats of a certain gene. So it is a genetic issue, but it can be tackled. So essentially, we set a plan for each breed. For other breeds, like say, bulldogs, English bulldogs, the top disorders are going to be skin fold dermatitis. Also ocular problems. So there it is a physical kind of test. So in a way you were talking about health testing as if… this is the other weird thing we have as humans, we believe a health test has to be a test. So I somehow have to x-ray, or take a blood sample, or a hair sample, or do something. A health test – and this is, again, the primary care vet coming out in me – a health test, it can be a clinical exam or a physical exam. So if I’m a breeder, I can health test my dogs. If the main criterion is skin folds, and certainly a lot of those around the tail base or around the face, I can health test my dog by seeing if it’s got a tail. And if it’s got a long tail, then it’s likely not to have skin folds around the base of its tail. If it’s got a longer nose, it’s likely not to have skin folds on its face. Therefore, I have health tested my dog. I have said this dog has got a long nose, it’s got flattish skin, therefore this is a dog I can breed from. We don’t need to do expensive laboratory tests or x-rays. You know, we can do a test that doesn’t need any of that. But somehow we don’t accept that as being a health test because it’s just too simple. It’s too obvious, right? We need some technology involved. So essentially, it is root cause analysis, it’s looking at each type of dog, what is the main issue, or the main issues plural often, and then designing a plan for it.

JPH: I like that. I am going to try to wrap this up here. Despite all the fascinating things you’ve been saying. I think we can talk about having you back to have more conversations.

DO: I think we could have lots of conversations here. Completely different, completely unique because we can tackle, you know, the extreme conformation. It’s also tackling, like with the paper, these are triggering for future ones, with a paper came out last week, which was looking at the world of extreme conformation from the veterinary surgeons perspective. And this identified within practicing veterinary surgeons huge levels of moral distress, where they’re trying their best to improve the health of these dogs. But constantly, relentlessly being faced with more and more of these dogs. With innate health, the concept I developed, just pouring it and baked in health. So from the moment that dog has purchased by the owner, it already is sick from the extreme conformation, or it is highly likely to become sick as they get older. So we have this whole veterinary side, which I think is huge. And to my mind, practicing veterinary surgeons are yet another victim of extreme conformation. Even though there’s a lot of view from the public that all vets are, you know, they just deal with it. It’s just sick animals, or maybe they even want sick animals and they make lots of money from them. I can assure you, the practicing arm of the veterinary profession does not want to be seeing animals coming in with poor innate health, with extreme conformation. So we have all of that, lots and lots of different disorders studies. Specifically, if you’re interested in lots of longevity studies, we do lots of studies of different treatments, causal inference, as I said earlier, we probably have 10 to 15 podcasts that you could do and each one would be unique.

JPH: I don’t need any more guests. I can just interview you for the rest of this podcast. As tempting as that is. But no, I think digging into that stuff would be really useful. I have been wanting to talk more about, and I’ve been noticing as you and I have been talking that you tend to focus more on extreme conformation. And I tend to focus more on decreased genetic diversity. And I think that’s because when I have focused on extreme conformation, I have dealt with a lot of angry people. And I need to get over that and start pushing that information out more because it’s something that’s honestly so straightforward to deal with. And so important. And, you know, when you talk about dogs that are suffering day in and day out, you mentioned entropion. But there are any number of disorders, that dogs… minute by minute, as you said. I think it’s something that’s really important for us to start grappling with as a society. Trying to figure out ways forward.

DO: And it is baked into the definition. That’s why the definition is really important. Extreme conformation, a conformation chosen by a man, it’s different to nature, and it’s associated with higher levels of suffering. And yet, I, as an owner, actively go and choose that dog, and I go and choose that dog because I say I love that dog. But were I to ask the dog would you like to be born into the body with, you know, no nose so you’re going to struggle to breathe or no tail so you can’t communicate well with other dogs? Or would you like to be born into a body that has a tail and a nose? You know, it doesn’t take a genius to work out which one of those two the dog would prefer. But yet, we’re choosing the extreme conformation because of our love of the dog. And again, this could be a whole other podcast. But when, this is my current working belief, as I said earlier, everything’s a working belief. Tomorrow, I could change my mind, right? I’m open to that. But my current working belief is that people fall in love with the look of a dog, maybe from social media, or the dogs they had as a child, or what the current celebrities have, or whatever. But when they get their dog, that’s when they actually love the dog. And they may well then spend the next 5, 10 years loving the dog, which is the personality, the actual dog, but regretting the body that they chose that dog to be in. And really it’s almost that there’s two different things with each dog, there’s the actual dog, and then there’s the box the dog comes in. And unfortunately we buy the box, but we live with and share our lives with what’s in the box. And it’s too late at that point, we can try and do all the surgery to try and cut off the skin folds, or the poor shar peis will have their eyelids tacked or pieces taken out of them, stenosis surgeries, you know, we can do brachycephalic BOAS surgeries, you know, we can do all the things to try and reshape the box. But none of them really work. Those dogs will still suffer for their lives. But again, that could be a whole nother podcast, which is the dogs that we buy versus the dogs we live with. And they’re two totally different entities. But again, that’s a whole nother podcast. I’m amazed you find that there’s pushback on the extreme conformation. Generally when you approach it logically, and you say the whole extreme conformation argument is about protecting the breeds, making the breeds healthier. And actually the way Europe is going, not the US because you’ve said you’re taking a different approach, Europe is very strongly moving towards legislation to ban breeds. Norway has banned the Cavalier, the English bulldog. The ban was reversed by the supreme government, but it’s on a bit of a moratorium so that ban may come back in another few years. The Netherlands has effectively banned the pedigree lines of 13 different breeds. Germany is going towards a ban. So Europe is very much giving up on saving these breeds. I think we absolutely can save the breeds. But it does require that the breeds change. And again, we could do that on another podcast. I have a beautiful plan. It’s an EI thing of French bulldogs and pugs moving from what they currently look like to non-extreme dogs. And we have a study going on at this moment, when we show them to the public, the public, if they were offered the non extreme version, say it’s much prettier than the extreme. It’s just they’re not offered it, because our human perception is the extreme one is the breed. Your second, and I know we’re out of time. But again, we’ll come back to it maybe in another podcast, you were talking about genetic diversity. We’re doing a huge amount of work within our VC and VetCompass on crossbreeds, various types of designer dogs, with a bunch of studies going on where we’re physically, a researcher called Lizzie Youens with Rowena Packer, is physically looking at pugs, and comparing them with their health and their function and actually their intelligence as well, comparing them to “jugs”, so Jack Russells crossed pugs, and to “puggles”, so pugs crossed beagles. And we’ve just submitted a paper today actually, which was an MRES from Gina Bryson, really wonderful researcher, looking at labradoodles, cockapoos, and cavapoos as compared to their progenitor breeds, looking at their health. When I say that one to breeders, they will say, “Well, that’s a pointless study to do because we know that crossbreeds are sick. You know, they’re an absolute disaster.” When I say it to the general public, they will say, “Well, that’s a pointless thing to do because we know the pedigree dogs are sick, and the crossbreeds are hybrid vigor, you know, they’re just bursting with health, and those things are fit as fiddles and live forever.” The truth for each of us does live in our own head. And hopefully, by us producing the evidence and sharing the evidence, we can maybe at least open the door for people to move away from their current view, if their current view doesn’t fit with the evidence. I won’t spoil it by telling you the answer, unless you want me to tell you the answer to the crossbreeds.

JPH: Now we’ll definitely cover that paper when it comes out. Yeah, that sounds fabulous.

DO: The answer will surprise you. 

JPH: Oh dear.

[laughter]

JPH: Yeah, I think the theme of this conversation has definitely been about truth. It lives in your own head. How hard it is to actually find, you know, is there even a ground truth, but if there is, how hard it is to actually find it. But how important it is to keep looking for it.

DO: Exactly. Exactly. And that is the thing about life, it is just a constant search for truth. And there is, well, it’s a whole epistemological thing about whether there is a ground truth. The philosophers would say there isn’t, you know, that kind of Descartes type thing. Cogito, ergo sum – I think, therefore I am, beyond that I know nothing. All I know is I exist. And maybe I don’t, maybe I’m just sitting in the Matrix in a blob of green gloop, just waiting for Neo to come and free me and follow the White Rabbit. But we can assume, and this is one of the reasons why I went into epidemiology, we can assume that even if there is a ground truth, we can never really know it. But the nearest we can get to it is epidemiology. I see it as the closest we can get to a truth, where if we gather up as much evidence as possible, then the wisdom of the crowds will take us away from each of our individual biases and get us towards the ground truth. It will never be at the ground truth. But we’re approximating more and more and more as we get there. And that means not just one study, but it means, that’s why I said earlier we had the VetCompass studies, but I look at lots of other people’s research. And where I see all of the pieces of research using different data sources, different methods, different researchers, and they’re all saying the same thing, then I am more and more and more convinced that that same thing is an approximation or a mirror of the truth, as close as we can get. And that gives me a sense of security that now is much stronger than my sense of security, my own belief, which was 10 years ago where I lived, where if I believed something that was good enough for me. Now to be honest, I don’t believe anything until I see the evidence. I certainly don’t believe my eyes. I think your man Pinker is dead right. The day that we believe everything we see and everything we hear just because we saw and heard it is the day that we’re probably fooling ourselves. 

JPH: Perfect. Thank you, Dan.

DO: And with that, I’ll leave you. It’s been a real pleasure chatting with you, Jessica. Hopefully we’ll chat with you again. And thank you very much to the listener for spending this time with us.

JPH: Hey, friends, some of you have asked how to support the podcast, so we’ve set up a Patreon page for it. For a small monthly pledge you help us pay for producing this podcast, and in exchange you get a chance to suggest questions for podcast guests and you get early access to podcast episodes. To find out more go to patreon.com/functionalbreeding. You could also help promote the podcast through subscribing to it through the podcast app of your choice and by leaving favorable reviews. If you’re interested in supporting the Functional Dog Collaborative more generally, or finding ways to get involved, go to the functionalbreeding.org website and click the support link. Thanks to everyone who has helped out we could not do this without you.

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JPH: Thanks so much for listening. The Functional Breeding Podcast is a product of the Functional Dog Collaborative and was produced by Attila Martin. Come join us at the Functional Breeding Facebook group to talk about this episode, or about responsible breeding practices in general. To learn more about the FDC, check out the functionalbreeding.org website. Enjoy your dogs!

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