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How to Be Anything
10. How to Teach Dogs to Find Cancer
00:22:49
A conversation with Dr. Cindy Otto of the Penn Vet Working Dog Center
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ACAST powers the world's best podcasts.
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Here's a show that we recommend. I'm Eden Share and I'm Brock Ciarlelli. We played best friends on the Middle and became best friends in real life. We're here to rewatch the Middle with all of you. Each week we'll recap an episode with behind the scenes stories, guest interviews and what we think now, many years later, there's a lot to dive into. So let's get to middling.
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ACAST helps creators launch, grow and monetize their podcasts everywhere acast.com On September 11, 2001, Dr. Cindy Otto was an assistant professor of veterinary medicine at the University of Pennsylvania.
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And I remember sitting in my office and getting a phone call about, hey, did you hear about the plane that hit the towers? And I'm like, we're going to get called. I went and I found my supervisor and the chair of the department said, listen, there's going to be a call. Our team is going to go. I need to go.
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This is how to Be Anything. The podcast about people with unusual jobs. I'm Emily McCreary. Among the firefighters, police officers, medical teams and rescue teams dispatched to Ground Zero in Lower Manhattan that day were more than 300 dogs, police dogs, therapy dogs, and dogs trained for search and rescue there to find people trapped in the rubble of the collapse, which became known as the pile. At the time, Dr. Otto was part of the Pennsylvania Task Force 1, a search and rescue team that deployed to disasters all over the country. As part of the task force, Dr. Otto was responsible for the search and rescue dogs.
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We got called up about one o' clock on the 11th. We all gathered in Philadelphia on all the buses. There were at least 67 of us, probably closer to 80 of us. And we got on buses and we drove to New York. We arrived in New York close to midnight on the 11th. And then I spent 10 days at ground zero taking care of the dogs with our team. Mostly I was on actually exclusively on the night shift. I was down there at the base of operations there and just monitoring the dogs, taking care of the dogs, making sure everything was, was going okay with the dogs.
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The search and rescue dogs who worked the pile on 911 had to maneuver on crushed steel, concrete, broken glass, and drywall. Much of it was unstable or still on fire, and some parts were so hot their paws burned. Later, the dogs were made to wear booties to protect their feet.
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It was eye opening. Everyone wanted a dog in every location all the time. You know, it's like, bring a dog over here. And one of the things that, as a medical professional, I was really concerned about was these dogs need to have a break and they need some rest so that they can actually do their job as good as possible.
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The dogs needed to rest every 30 to 45 minutes, though it didn't always happen that way. There was simply too much demand. Search and rescue is difficult, Highly physical labor and mental, too. The dogs only want to do what they've been trained to do, and that's find people. As fewer and fewer were pulled out alive, dog handlers staged fines so that the dogs could have the satisfaction of locating a survivor. They would deliberately hide in rubble so the dog could sniff them out. The reward gave the dogs encouragement to keep going.
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There was dust everywhere, there was debris. We were checking their feet all the time. Cuts and scrapes were pretty common. The whole veterinary community in the area just surged forth to provide an incredible amount of support. We had one dog who did end up needing to be evacuated, and we got him off the pile and down to the animal medical center, which is an amazing veterinary facility in New York.
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The last survivor pulled from the wreckage 27 hours after the buildings fell was Janelle Guzman McMillan, an employee at the port authority who worked on the 64th floor of the north tower. Janelle was discovered by a certain rescue dog, A German shepherd named Tracker. What Dr. Otto saw at the pile convinced her that these working dogs deserved more attention. A closer look at their long term health and capabilities.
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I'd been working with the search dogs for close to 10 years at that time, but this was really kind of, we need to put some science behind this. We need to make sure that it's a bigger thing.
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Many of the human first responders to ground zero and to The Pentagon would go on to develop cancers and respiratory disease as a result of being exposed to the chemicals, toxins and dust from the disaster. Post traumatic stress disorder was also very common. Quite understandably, Dr. Otto wanted to know how the dogs would fare in the coming years. So beginning in October 2001, she and her colleagues followed 95 of the search and rescue dogs deployed to Ground zero. They kept up with them and their handlers for 15 years. The health of rescue dogs has been studied before, but Dr. Otto and her colleagues 15 year longitudinal study is the first of its kind because it tracks the health of these dogs outside of active deployment, and it gives us the first look at how this kind of work affects the animals long term. What did you learn in that time about those animals?
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I learned they're amazing. If I didn't know that already. Their handlers are amazing and dedicated. The most important thing, because we figured here are these dogs in this environment without any kind of protective equipment, they were breathing all of these hazards. They didn't have boots on, they didn't have masks, masks on. We really anticipated that if there were going to be some problems, they would show up in the dogs before they even showed up in the people. And surprisingly, we weren't correct on that. The dogs did remarkably well. We did have dogs die of cancer that went to 9, 11, but we also know that it was exactly the same percentage of dogs that didn't go died of cancer. The most important thing that came out of that study was that the dogs were incredibly resilient.
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Their study found no remarkable difference between the health of dogs who worked the pile and a control group of search and rescue dogs not deployed that day. In fact, for the most part, the dogs continued working after 9, 11.
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Dogs that retired would often retire because their handlers retired. We also worked with a psychologist that interviewed the handlers, and we found that dog handlers were more resistant to PTSD as first responders if they had their dogs, that the dogs were helpful. But if their dog died in the three years following this event, they were at higher risk for developing PTSD because they lost their, their grounding. You know, I mean, the dog and the handler are there. We talk about things going up and down the leash. They are so connected. There is a huge and amazing and beautiful relationship that they have.
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After working at ground zero, Dr. Otto wanted to create a place, a kind of lab, where working dogs could be trained and studied.
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Having been at the University of Pennsylvania at that time, like, I've got all of these amazing, talented veterinarians and scientists who could team together, we could figure out from the genetic side, from the orthopedic side, from the behavioral side, how do we do our best for these dogs? And so we thought we needed a center, we need a center of excellence for working dogs. And so on September 11th of 2012, we opened the Penn Vet Working Dog center and really consider it to be the legacy of 9, 11. So taking the disaster and the horror and turning it into something that can sort of pay forward and be positive.
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In May 2025, the Penn Vet Working Dog center welcomed its 200th puppy into the training program. The Penn Vet Working Dog center is in an industrial park by the edge of the Schuylkill river in downtown Philly. They're dog trained for all sorts of careers. Some become search and rescue dogs. Others go on to work with police units. The working dog center has even trained two dogs to detect an invasive species called the spotted lanternfly, which can wreak havoc on native plants. While in training, dogs live with foster families who drop them off in the morning and collect them in the afternoon, just like a 9 to 5. At the center, dogs preparing for physical work train like elite athletes, stretching every morning before exercises begin and jogging on treadmills to keep their cardio health strong. The training zones at the working dog center, both indoor and outdoor, are made to simulate the real world chaos the dogs will work in. They learn to traverse unstable ground, wiggle through tangled debris, and maneuver across broken concrete, cinder blocks and bricks. They run through tunnels and search for their handlers and barrels and cages. And even in an old school bus or staged office, they scale ladders and run wood pallets. The dogs learn to balance on the fulcrum of a seesaw and how to climb stairs backward. And then the handlers throw a barrage of distractions and obstacles at the dog, like sirens or complete darkness.
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Sports medicine is all about the physical abilities, you know, maintaining mobility and performance in our athletes, and particularly for us, the canine athlete. And physical fitness is huge.
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How do you teach a dog to climb a ladder? By the way, please don't try this yourself.
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The first thing you have to do is you have to teach them. They have back feet. So what we do is we do a lot of work with proprioception, which is a fancy term for body awareness. One of the first exercises we have them do is to try and get all four feet in a cardboard box.
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Dr. Otto says dogs are front wheel drive, meaning they use their front legs and head for steering, and the back half, more or less just Follows along. Most dogs have to be taught that they can use their back legs purposefully, like they already use the ones in front.
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Then we'll work on what we call targeting their back feet. So backing up onto something and touching something with a back foot. So again, knowing they have a back foot, then we start with a very. It's not even a ladder. It's, I guess it's sort of like a ladder, but instead of being an upright ladder, it's flat on the ground and there's two by fours across it that they have to step across. And so they, they learn that each foot has to move independently. And then we put the ladder at an angle and then we change and make it, you know, narrower steps. And my dog Vaugh can climb a six foot ladder, metal ladder, up to a platform. And just the other day, not only did she climb up it, she climbed down it. She was part of our breeding program. Her breeding lines came out of the TSA breeding lines. Those dogs are named after victims of 9 11. So Vaugh is named after Ronald J. Vaugh, who lost his life in the Pentagon. And so we're just really proud that we can honor his memory with her amazingness.
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Not all dogs who train at the center are well suited for highly athletic careers. Some are a little tweedier, and they stay to work in the lab, learning to identify disease in humans. Dr. Otto and her team are at the forefront of using dogs to recognize the odor fingerprint associated with ovarian cancer. To teach dogs to recognize ovarian cancer in a blood sample, they use a method called click on sniff.
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Let's say it's a blood sample from a patient with ovarian cancer. Dog comes up, it sniffs the sample. We use a clicker to mark the behavior, to tell the dog they were right. It's like they sniff, they hear this click, they get a treat. The game changes a little bit. It gets a little harder because now we have this sample here from our patient with ovarian cancer. And in this little container, we have a blood sample from a similar aged, the same race, same smoking history, you know, similarly matched woman without ovarian cancer. And now the dog comes up and they've got two choices. They put their nose on the one with a healthy person. Nothing happens.
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If the dog puts their nose on the positive sample, they hear the click and get a treat.
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But then we have to start introducing lots of other people, both healthy people and people with ovarian cancer. So they don't just learn that this is Jane with ovarian cancer. I'm going to find Jane. I need to find Jane and Sally and Susan and Kathy and everybody that's got ovarian cancer. And I need to ignore all of.
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The samples from the healthy people to make it harder. The scientists introduce samples from people who have benign ovarian cancer or who have.
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Ovarian cysts, because we know that when people are sick, there's a lot of inflammation, there's a lot of stress, and we don't want the dog to be relying on those cues because we know stress itself has its own odor. And so when we started all of this, we came from the background of, you know, we can train dogs to detect a bomb. Of course we can train them to detect a disease. Well, we learned a lot. It's not the same.
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When training a dog to detect something like explosives or drugs, they're more or less looking for a single consistent odor. Cocaine tends to smell like cocaine, explosives like explosives. But when dogs are asked to identify the presence of something like ovarian cancer, they're sniffing a blood sample which contains troves of information about the person it came from. There's a lot of noise. That person might be a smoker or they might have another disease in addition to ovarian cancer. And the dogs must separate the signal from the noise. With these cancer sniffing dogs, researchers are hoping to identify the volatile organic compounds, or VOCs, unique to ovarian cancer. VOCs are basically just smells that dogs are really good at identifying. And humans, even when aided by technology, aren't as good. To be clear, Dr. Otto and her team aren't teaching these dogs to diagnose cancer. There's no plan to let friendly dogs lose upon the world to go with diagnosing. As much as we might want that using dogs for detection isn't scalable. Dogs are expensive to train, impossible to replicate, and not easy to travel. On the other hand, machines can test hundreds of thousands of samples. And like humans, dogs have bad days, too.
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They're only human, as I like to say. They, you know, there are factors, emotional factors, physical factors that impact their performance. And, you know, we don't always know what they are.
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These dogs are being trained and then studied so scientists and engineers can replicate what they do with electronic noses or other systems that can more accurately screen thousands of people. Think of it like reverse engineering a dog's capabilities.
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The ultimate question is, how do we identify a pattern that can tell us information that is helpful for diagnosing a disease?
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Dr. Otto and her team have also trained dogs to identify COVID 19. They compare the ability of their dogs against a process called gas chromatography, mass spectrometry, a two part process that separates the components of a chemical mixture so they can be identified. GC Ms. Took decades and dozens of scientists to develop. Here's how their experiment worked. The researcher sent t shirts to 293 people all over the U.S. some who tested positive for Covid and some who tested negative. And they asked them to wear the t shirt for 48 hours, then ship it back. Then Dr. Otto cut the shirts into two pieces, one for the dogs and one for the chemists and put them head to head. Could they identify the T shirts worn by people who had Covid?
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And the dogs were like, yeah, got it. This was a COVID positive, this one's not. The chemists were able to do pretty well. But if the shirt had pet hair on it, the chemistry really struggled. Whereas the dogs were like, ah, you got a cat, oh, that's cool, no problem. But you also have Covid. The dogs have this huge, not even an artificial natural intelligence that allows them to really process and decide that that's a relevant factor and that's not. And it's much, much harder when we're just trying to look at things from a chemistry perspective. So the dogs are going to hopefully help us refine the other techniques and hopefully the other techniques will start to come close to how good the dogs can be.
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On New Year's Eve 2024, I took my dog Tallulah to the park to play ball. She was a 12 year old German shepherd red heeler mix. A beautiful dog, lean and athletic with a dark red coat and a black mask. I threw the ball, she sprinted. I threw it again. She sprinted. But on the return trip her back legs buckled and she fell over. At the emergency vet we learned that the sac surrounding her heart had filled with blood. A condition called pericardial effusion. It was like a straight jacket tightening around the organization which struggled to pump and it made every beat and every breath a struggle. We let them drain it. The causes are usually serious, but Tallulah had passed her physical just weeks earlier in October. She and I had camped and hiked for three days. Thirty seconds before she collapsed, she was chasing the ball. We convinced ourselves it couldn't be the worst case scenario. She spent two days in the ICU and when I picked her up, she was her usual self. Bright, eager, ready to go and ready to please. But a week later, my husband came back from their morning walk Carrying her, she had collapsed again and she died. Later that morning in the er we found out only after the fact what it was. A fast moving cancer of the blood cells called hemangiosarcoma. Multiple ultrasounds the week before Patton revealed it, and most likely the tumor had ruptured and never stopped bleeding.
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The dog can be totally fine, and then he collapses because he's bleeding internally because this cancer has ruptured. And then most dogs that come in in that condition have weeks to months to live. They were totally fine yesterday. And we've seen this with some of the dogs in our program, and we've seen this with a lot of the dogs that the search and rescue dogs that died of cancer died of hemangiosarcoma. It is a devastating cancer.
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Dr. Otto had trained dogs to identify other silent cancers before, so why not this one?
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There was a previous study that was done that showed that dogs could detect, I believe, bladder cancer from dogs. And so that was like, yes, there is definitely some evidence, and why would it be any different in dogs than in people? But we're actually to the point where we're absolutely convinced that there is an odor associated with this cancer. They're having to say, there's this sample. Here's a normal, healthy dog, Here's a dog with some other illness, and here's a dog with hemangiosarcoma. Can you find the one with hemangiosarcoma? They're in the 70 to 80% ability to do that. Our hope is that this will help inspire some of the chemists and the other folks that are building some of these electronic noses to see if. If they're as good with their system. And I think in some ways, that's what we always come back to. The dogs are going to be our gold standard for telling if it's there or not, because the dogs don't care about some of these confounding factors.
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In 2002, a fluffy white puppy was brought into the Veterinary Hospital where Dr. Otto was working at the time. He had been diagnosed with parvo, a highly contagious virus that attacks a dog's blood cells, GI tract, and heart muscle. It's very fatal. The owners of the dog, unable to afford treatment, surrendered him. Dr. Otto decided she would treat him and take him home.
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His name was Dolce Dolcetto was his full name, named after a wine grape. That dog taught me so much. He. He definitely taught me how to train dogs. He taught me how to communicate with dogs. He taught me how to listen to Dogs and, you know, he was my, my companion for almost 17 years.
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What is it that builds a really strong relationship between a person and a dog? And is it an experience?
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Is it a.
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An indescribable alchemy?
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What is it? What I think I learned, and Dolce taught me this, was that working together builds the relationship, taking the time to do some kind of training. And for Dolce and I, it was tricks. But that's what changed it for me, because when we were training tricks, and I'm a big positive reinforcement trainer, you know, so it's all about cooperation and listening and working together. It just changed it. Instead of yelling at the dog, whispering at the dog, telling the dog, you're listening to the dog and you're actually sort of in a dance and a partnership. And we know that there's actual neurochemistry that changes when you connect. You know, by looking in a dog's eyes, you elicit oxytocin, the bonding hormone, both in you and in the dog. But you have to take the time. And we're so busy moving about and talking that we don't listen to what our dogs are trying to tell us. And I think that by doing things with your dog, I think that's the strongest thing to enhance the bond. There are some dogs that are just naturally. You know, there is alchemy, there's total alchemy, and it just happens. But with Dolce and I, we had to build it, but we built it and it was so strong. It was really, really strong.
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How to Be Anything is written by me, Emily McCreary. Our producer is Lily I. Johnson and our editor is Caden Boffman. Visual design by Nika Simevich Fisher at Labud. You can learn more about Dr. Otto and the dogs at the Penn Vet Working Dog center at our substack howtobeanything.com or on our Instagram how to Be Anything. We post outtakes and behind the scenes looks like at how the show is made there as well. We're an indie podcast, so show us your support by rating and reviewing the show wherever you listen. And if you like how to be anything, please text it to a friend.
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Here's a show that we recommend.
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I'm Eden Cher. And I'm Brock Ciarlelli. We play best friends on the Middle and became best friends in real life. We're here to rewatch the Middle with all of you. Each week we'll recap an episode with behind the scenes stories, guest interviews and what we think now, many years later, there's a lot to dive into. So let's get to Middle.
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ACAST helps creators launch, grow and monetize their podcasts everywhere. Acast.
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Com.