Good evening everybody and welcome to tonight's webinar. My name is Bruce Stevenson and I have the privilege of chairing tonight's webinar. Huge thanks to our sponsors Nationwide Labs, who are the distributors of Orivet in the UK.
I'm sure we are going to learn a lot about them and we are going to need those phone numbers that are up on the screen now. So take those down while we're doing some introductions. Little bit of housekeeping for those of you that haven't been with us on the webinar that before.
If you do have a question for our presenter, simply hover your cursor over the screen. A little control bar normally at the bottom pops up. There's a Q&A box.
Click on that, type in your question into that and it'll come through to me and Noam has very kindly agreed to hang around at the end and answer some questions for us. And I'm sure there are going to be loads because we are in for a very interesting presentation tonight. So Noam graduated as a veterinary surgeon from Murdoch University in Western Australia in 1996.
After completing an independent research project on the effects of progesterone, on exercise physiology and racing layers. No gained further qualifications in business management and marketing and has lectured at the Core School of Veterinary Medicine at the Hebrew University of Jerusalem. Before returning to Australia in 2001 and then establishing the Southeastern Animal Emergency centre in 2003 and a veterinary referral hospital in 2005.
He's a member of ANZ CVS in the chapter of Emergency and critical care. In 2008, NOM established the Australian specialised Veterinary Pathology Laboratory, now part of the Primary Healthcare and Ori Genetics Laboratory in 2010. The latter is focused on delivering personalised medicine and genetic solutions to veterinarians, pet owners, and breeders of companion animals.
He also helped build the veterinary Genetics assurance programme to breeders in Australia and around the world. No Nome is a strategic consultant in Bio Tempus Limited, an Australian biotechnology company focusing on cancer and immune-mediated diseases in both humans and animals. He has a keen interest in delivering high-quality, clinically-oriented services to the veterinary community and especially in the fields of pathology, genetics, immunology, and applied bioinformatics.
Welcome to the webinar vet and it's over to you. Excellent, thank you very much, Bruce. Long introduction.
So, and I'm excited to, be talking to veterinarians in the UK about what, what we do and about personalised medicine and really, how it's, going to, Look at a long-term sort of preventative care for, for, for animals. So what is personalised healthcare? What, what do I mean when I say that?
So really what we're talking about is treating each pet as a unique individual, carrying very specific traits and health risks relating to their breed, their genetics, their age, their gender, their weight, where they are, and what they do. And the purpose of this is really to design a lifelong schedule of care or what we call a life plan to meet that pet's individual needs over their lifetime. It does allow the healthcare team to focus on prevention and early detection, hopefully leading to more effective, health management and improved outcomes.
And so the big picture of personalised medicine is really to identify inherit, you know, pre, you know, pet specific risks, something they're born with, collect relevant information with the pet owner, and then screen for any appropriate risk, . With the, with the idea that we're going to monitor, to detect, we want to detect trends and treat as appropriate, and then we want to engage in this continuous process of improvement where we're looking at what we've identified and how does that change the big picture and what we're going to change, with, going forward with the, with the health. Management of that individual.
So an ongoing, lifelong sort of process, it's not a once-off sort of sort of a thing. So there's been many challenges to the venerary community over the years to to implement this specialised medicine. There are many reasons, but the main reasons is basically there is a, a, a huge number of, a huge amount of information, and it's simply too large to tackle.
It's now estimated that medical information by 2020 will be doubling every 73 days. So it's almost impossible for the busy veterinarian to keep up, up to date with that. And most pet owners do want their care to be tailored specifically to their pet, but they don't actually know what that means or what their pet needs.
And so they rely on us as veterinarians to do that and with Us not having, you know, good mechanisms to systematically collect enough information, to help us predict, we're kind of, looking at, at ways to treat pets as, as dogs and cats rather than their individual, animal or individual, risks. And so predicting risks in individual pets is, is, is a multifactorial thing. There are a lot of things for us to consider, and that's part of the complexity of, of getting a life plan together for a pet, because we have to take into account, you know, their location, what they eat, their genetics, their breed, their vaccination status, you know, what are they doing?
Are they going out, you know, hunting in the woods, or are they just sitting as a couch potato in the house? And so forth. So just like humans, animal pass on diseases in families from one generation to another.
And one of the first things, a doctor would ask is, what is your family history in trying to assess your risk. Whereas we don't have family histories for our dogs and cats, but we do have what we call broad families or breeds, and we know that many diseases will carry over from, in, within the breed from one family to another. So can we think of any diseases that are normally, associated with breeds?
So if we look at a German Shepherd, a classic example, over 70 documented genetic diseases, that have been listed for the German Shepherd. Now, as veterinarians, we know, you know, intuitively that they, that they're higher risk of developing things like cardiomyopathy or bloat or hip dysplasia. And we also know that these risks will vary with age, sex, and weight.
But which one of these are more important for my pet or for that individual pet that, that comes into the, into the practise? And that's really the challenges that we had with, with personalised medicine. Even if we have two identical breeds, we can have very different risks depending on their genetic attributes, or whether they have a genetic mutation or not.
There are opportunities for early detection and even the owner involvement that can, you know, influence, you know, the risk and, and, how we can manage, certain diseases. And despite predispositions, genetic testing can confirm for us specific diseases or predisposition for diseases while excluding others. So, running a genetic screen will let us know if that dog has that mutation or has a normal sort of variant.
But even with genetic analysis, we still need to screen pets for ongoing, you know, with ongoing tests to monitor, you know, the onset, the impact, and progression of diseases. And there's a lot of the genetic diseases that, we actually do not have a, a DNA test. And I'll cover that a little bit later.
And so our staff, or our team at the, at the hospital really need to tailor messages to specific pets to clearly convey recommendations to the owner. And that's very different to what we're doing now, where we just have a general recommendation for a dog or a puppy or a senior. And owners can really help, help us too, so in personalised medicine, it really requires the pet owners to take a more active role in the healthcare of their pets.
And so, as a veterinarian, I know that taking a medical history is very important. But, I also know that I'm very time poor and often I do not have, you know, the time to sort of get all the information I'd like to, keep on my medical record. And so, questionnair is a really good way to guarantee that we can, routinely and consistently ask the right questions from, from owners.
And pet owners, as we know, have much influence on the detection, progression, and, exacerbation of problems. And so compliance and or the new adherence for treatment is becoming very important and it will influence, you know, outcomes. And so, questionnaires and really, are a good, you know, mechanism to explore, to maintain contact with owners between office visits, which is kind of a time where we, we're in the dark, we don't know what's going on with that, with that pet.
And it's typically that we'll see them as a puppy for a few times, and then there might be a gap of 2 to 3 years. So just keeping in touch with owners through questionnaires can really help us bridge that gap. And so what can we gain from questionnaires, in, in more specific.
So, basically, we can look at capturing issues that the pet owners have, have, not necessarily conveyed to us or, or made the clinic aware of. We can learn about, you know, other animals, that live with that pet that may have an impact. We can learn more about the environment that the pet is exposed to, you know, if they're boarding frequently or they're going, travelling with their owners, you know, what, what are they eating, specifically, what are they feeding that, that is not therapeutic, and we may not be aware of.
Having and, and really having clients play an active role in identifying the pet, their pet's healthcare needs helps. Them be more engaged and be more compliant. And again, questionnaires are not a once-off thing.
It's important to closely review them and then repeat them with gaps and that they will help us identify any medical sort of record gaps. So why is, you know, identifying risks important in pet in, in for our pets? So really understanding risk help us appreciate which pet is at high risk, low risk, or average risk for a variety of diseases.
For some diseases, we would recommend intervention for all pets, regardless of the situation. So that, that goes for, you know, most of our routine call vaccinations. For non-core vaccines, we may vary that based on the individual risk.
You know, whether they're going to be boarding or not, or whether they're going to have any other specific risk, like risk to leptosquara if they're drinking from, you know, streams in the woods. And then breed predisposition and lifestyle questionnaires, help us, you know, make more informed decisions about risk, and genetic tests will help us more specifically identify risks. And that can also vary based on penetrance and expression, and I'll, I'll cover a little bit more of that, later.
Let's consider a few situations where knowing the risk can have an impact. So, for example, if we have a puppy with a documented genetic mutation of, Vaughan Willebrandt's disease, how is that going to, change the way we are planning for surgery, for example? Or if you have a young, healthy dog with a breed breed predisposition to hypothyroidism.
How is that going to change in, I guess, monitoring of their, of their thyroid levels in, in, in the future? Or a cat that attends cat shows and has a family history of ringworm. Is that really going to affect how we're going to manage the, the, the pets, you know, parasite control or otherwise?
Similarly, if we have a dog that's boarding with some frequency, likely to be exposed at some point to respiratory infections, you know, how we're gonna change the management of that, of that individual throughout their life. And there are other, other examples that I'm sure all of us can think of. And so the approach is really rather than concentrating on treating pets as they get sick, which is kind of what we tend to do now.
Most of what we do is treat sick sick, patients. Pest medicine really focus on preventing problems and detecting problems early, before they really affect the quality of life. And so we know that the DNA, for example, is fixed at birth.
There are inherent predisposition to diseases. Some of these predispositions can be identified by DNA test. It's about 30%.
And others we really need to wait for problems to start being detectable on more routine tests. And though some diseases are preventable, so we do things like vaccinations and desexing, others, if they're caught early by screening, that we normally do, you know, it's possible for us to kind of effect, a meaningful intervention. But really, everybody understands that the best way to promote quality of life for our pets is to address problems as early as possible.
Either through prevention or early detection, and that's really the goal of personalised medicine. So normally, how do we assess risk in the, in the clinic? How does that work?
So normally in, in, in, in the first sort of few visits as a puppy, during the initial examinations, we can identify con congenital problems that may already be evident. So we've all seen umbilical hernias or cleft palates or, things of that nature. Vaccinations, we, we typically start between 6 and 9 weeks.
We kind of make a decision based on risk, whether, we need just core vaccines or more. DNA testing, as we know, DNA does not change, so we can start them as early as, as one day of age, but typically in a practise, We start talking to people about that around the 12 weeks of age, simply because we have too much to cover as a puppy, before that. And then depending on risks that are identified early screening for adult onset disease may start as early as 4 months, and sort of depends on the risk, and I'll, I'll show some examples of that.
And really the optimal time for screening of seniors varies with breed and weight and, and based on, you know, their anticipated lifespan and risks. So that can vary as well. But that's a different conversation than later on in life that we have with pet owners.
So I'm saying team critical is, is, is, team training is critical, sorry, for, for personalised medicine. Most times that is driven by the hospital team rather than the veterinarians. It requires understanding of the team, why we're focusing on prevention and early detection.
Veterinarians, as we know, often have limited time to discuss medical topics with pet owners, so they, so this, this programme really relies heavily on, on the, the, the reception team and the, the nursing staff to accomplish that. And then we need to kind of remember that in most cases, this evaluation is done on, you know, well, you know, healthy animals and not on sick beds. So this approach is part of wellness counselling and not disease counselling.
A few words on DNA testing. So, generally, with genetic testing, there are, you know, few types of disease of, of diseases or tests that we have. The most common one by far is for genetic mutations, or variations.
And factor 7 deficiency in beagle would be one, but we have over 200 different genetic diseases. For, mutations, that are, you know, identifying risks in an individual. There are different types of tests we call association association markers or association tests.
These tests identify markers that, are often seen with that disease and with increased frequency, but not necessarily causing the disease. So copper toxicosis would be one of those. And then we have mixed breed, you know, DNA tests that helps us predict which breeds are likely to be present in a mixed breed pat.
And these are based on, on pure breed association markets. So again, it's like a statistical sort of marker, analysis. You know, are they 100%?
They no, they're not. They're probably, I would say, you know, 90, 97% in what we call a pure breed dog or an F1 cross. So that's a cross between a pure breed and a pure breed.
And they will sort of drop a little bit in the accuracy as they, as you get, you know, into a more mixed pet. So the more of a m you have, the less likely that, that, the result is going to be accurate. And if they fall below 87%, then we kind of report them as a, as a mixed breed dog and not, not kind of take a hazard as a guess of, what breed that dog might be.
So you may get a, a, a mixed breed DNA results where we cannot identify, you know, that dog with a level of accuracy and so we'll report it as a mixed breed. So I think with, we know that as veterinarians, you know, we're not very good at, identifying, you know, what breeds are in a mixed breed dog just by looking at that. And there's been a few studies that have been, sort of, documenting that, that effort of veterinarians and shelter, shelter staff.
At the end of, I think, with the mixed breed DNA test, at the end of the day, they are, if they're perfect, they're not, but they're still probably our best way, to, get an, an estimate of what breeds are in that dog. And we also have DNA tests that can use to, prove parentage or, that's what we call a fingerprint or a unique, you know, DNA profile for that individual, that can, can be used as a method of, identification or parentage sort of verifications, much like a forensic sort of profile, you know, that's. Well, there's been a huge growth in companion animal DNA tests that are available to us as veterinarians over the last few years.
We now have over 350, you know, individual genetic tests that are available, and that, that rate of growth is, is growing, you know, it's continuing to, to grow, you know, exponentially, and, mainly because, of, you know, improvements in technologies of mass sequencing and, you know, our ability to, categorise sort of certain diseases and then genotype, you know, huge numbers of, animals, you know, a reasonably lower cost than it used to be. Well, we do have limitations of genetic testing in identifying inherited, you know, inherited disorders. And this graph shows, for example, the German Shepherd on the left with, you know, 70 genetic diseases.
But, you can see that only, you know, the blue sort of column next to it is showing how many of these we can actually test for. So, for the majority of genetic diseases that we see in, in our patients, we do not have a, a DNA test. So that's important to keep in mind.
And it really only means that veterinarians, will have to do the work in identifying the genetic disease by another way, other than a DNA test and such, . And the reason is that most of these genetic diseases are either polygenetics, i.e., they, they have, more than one gene that are responsible for the disease, or it could have more what we call epigenetics or interactions with other genes or the environment.
For example, nutrition, you know, may play a role in certain genetic diseases. So interpreting DNA tests, We, we get questions from veterinarians, quite often. I guess the main thing is, don't worry if you haven't heard of any, of the diseases that are being tested for in a, in a huge screen.
So if we screen for, you know, a mixed breed dog for 200 genetic diseases, some of these may be quite rare. But there's always resources available to go and find out. And there's usually within our reports, there is a clique or you can go, to the list of diseases and read more about them.
Typically results tend to be binary, so for a recessive, you know, or what we call autosomal recessive mode of inheritance. As you know, going back to genetics classes, if you are a carrier, you only have one copy of the gene, and that would not show any, any disease. But obviously, the reports will, will, will let you know, if it's a dominant disease, for example, even, even carrying one gene, you know, will lead to you developing the disease or the patient developing the disease.
The, the most important thing I think to take on with interpreting DNA results is that, they only typically identify risk. So even if that dog or cat has the genetic variation or mutation in both copies of their DNA, they, Their, their, development of the disease can vary with age or severity. And so this concept of, of, penetrance, you know, is, is important in genetics.
But for us, I think as veterinarians, if we just, address that as being a risk for that disease, that will be, really all we can expect, the DNA test to, to let us know about that individual. And we, with DNA tests or especially the screens, we, we're looking that as, we're looking at them as a wellness measure. So the expectation is that most panels will have very few, if any, variants.
And the purpose is really to be able to develop an evidence-based life plan that focus on Identifying risks and then building, you know, on plans for prevention and early detections. So, you're not going to get, a lot of, mutations or or variations when you're screening a whole lot of dogs. And it's it'll be similar to what we do with, for example, pre-anesthetic, you know, blood screening.
Most of the time, we don't expect to see anything wrong. We are, just looking to identify that, you know, 1 in the 10 individuals that might have a problem and if we can identify that early, we can plan for how, how we're going to, tackle the, the, the anaesthetic. So I have a question.
Not sure if Bruce you take over from here. Yep. No, thanks very much.
So I've launched the poll, guys. It's very simple. All you need to do is just click on the answer that represents you or as best and as close as possible.
It is completely and utterly anonymous, so don't be worried about the answers, just simply click on it. It'll come through to me and it just gives No some valuable feedback. On the audience that he's talking to.
So, let's get clicking and, Let's give Nome some feedback. Webinars can be very interesting when you are used to lecturing to a hall of people and now you are sitting alone somewhere speaking to yourself. So let's give him some feedback.
We'll give you another 15 seconds or so to answer. Come on guys, let's get off the fence there. It's not a difficult one.
Are you currently using DNA testing in your practise? Just click on the answer that best represents what you are doing and we will feed those back to No. Right, we've got some stragglers who are not voting no, but I'm gonna end that poll and share it with you.
And there you have the results. Can you see it? Yeah, I can.
That's excellent. Thank you. So I can see that, the majority of engineerians are not using DNA tests.
And that is not surprising. And I'm, I'm glad to hear that some of the, some of you are using DNA testing. And I think, as I said before, the majority, of veterinarians would either use DNA tests for diagnostics.
So if you have a dog with, you know, an MDR mutation or you have a dog with suspect, clotting disorder or a dog with suspect degenerative myelopathy veterinarians tend to do that. I think part of it is because, the large panels, there is this issue or not sure of how to interpret results. But, as I said, if we look at genetic screening as a way of identifying risk and risk only, not necessarily finding out the disease.
Or confirming a diagnosis of a disease, you know, I think we'll get a lot more value out of, DNA testing. So thank you very much for, for answering that for me. OK, so now that we've identified risks, we know, we have, ways to kind of screen for that through genetics, but there's also a lot of other tests that we can do in the practise to what we call do, what we call phenotypic screening or screening that will tell us whether there is an existing, you know, of a problem or the beginning of a, of a problem.
So we, we, we mentioned hyperthyroidism, you know, for dogs, female dogs that are predisposed to thyroid disease. So we can use, you know, blood tests for that. We can use, other means like imaging, for, identifying, you know, whether there is a problem with the hips or the elbows.
And there are other diagnostic tools that we can use, and they're listed there. So, Another example, if we know a dog is predisposed to dry-eyed, and Sherma tea tests, you know, could be a good way of, screening or monitoring, you know, the performance of the T glands. A dog that's pretty exposed to glaucoma, we can, we can screen by doing tonometry.
And there's other things that we can do as a clinical assessment, for example, joint stability or airway obstructions. So all of these are ways that you can use in your practise to kind of screen, or monitor, you know, progression of disease. If you know ahead of time that the dog is at risk or it can.
So another poll, do you currently, offer, you know, I guess non DNA screen, non-genetic screens for healthy pets as opposed to, you know, sick pets? Is that something you do in your practise? Here we go guys.
The poll has been launched. So the question is, are you currently offering non-genetic screening like blood tests and radiographs for healthy pets? In other words, are we trying to look for these problems before they become a clinical manifestation of the disease that is there?
Simply just, yeah, no worries. Click on the answer that best represents what you do in your practise. It's As again I said before, it's great feedback for Nome because then he knows exactly who and what he's talking to as far as the audience is concerned.
So we'll give you another 5 seconds to vote there. And right, let's end that poll and share that with you. No, there you go.
Excellent, thank you. And it's great. I'm, I'm, I'm, I'm very, excited to see that 50% of you, would, would be doing it, for certain breeds or pets you suspect there might be an issue.
So that's, that's excellent. Thank you very much. OK, so let's talk a little bit about the life plan.
So the purpose of this personalised medicine is to be able to craft this meaningful life plan for each pet based on their unique individual risk factors. And so this helps pet owners know what kind of care their pet will need and when intervention will be needed. And it even helps pet owners plan financially for such an intervention.
So if they know that their, their dog is predisposed to disease, and they're going to need to screen for that, and it may come, you know, regardless, of what we do, they, they, they, they will need to, they will actually start thinking about that, and it will be less of a surprise. So when pet owners know when to test, you know, what test needs to be done and when. They normally see, you know, value in such screening and discussions of a financial nature can be less adversarial for them.
Oh, here is a, a couple of examples for you of what a combined lifetime schedule, you know, can look like. And you can see in certain, ages, there are certain suggestions for diseases screening, you know, what the veterinarian does, and it kind of bakes into, the routine care of vaccinations and, you know, parasite control. This is another, example of a life plan.
This one is, more of a digital one where you can click and expand different areas. You can see that for Sammy, there are recommendations to consider elbow X-rays just because of a, a pre predisposition to, elbow dysplasia. We also know this breed is, predisposed to my cell tumours, so there will be, a recommendation to, check for lumps and bumps, you know, annually.
And that's something you can teach the pet owners to, to do, themselves as well, if you know that the, that the breed or that individual is predisposed to. With, with the life plans, they are usually, customizable by the clinics. So this digital one, for example, you can click on the red bits and edit or remove them if you don't feel that you want to do that with an individual bed.
So the reports, and I'll show you the, an example in a minute, is, in many cases, is the place where all the alignment sort of happens. It's one place where all the risk and, medications are, are being shared with the pet owner and the practise sees the same thing. So it doesn't matter if, if a different veterinarian sort of sees the patient, or a different member of the family brings the patient to the clinic.
It provides, you know, a capsulized version of what the owners' concerns are. So remember, they would have filled a lifestyle questionnaire. They would have, put, you know, what they think, you know, is the problems or what concerns them.
So it's a good place for us veterinarians to kind of focus on, you know, where the owner sees the, the, the problems. And it will be the place where the schedule of recommendation is and all the, the medical record is, kind of kept in with regards to nutritional sort of, recommendations, medication, and so forth. Reports also serves as an important communication tool, promoting, you know, logical discussions on pet healthcare, topics, but also, you know, allowing pet owners to within their report, you know, request a, an office visit or request, visited to the, to the practise for a consultation about any of their concerns they might have with their pets.
So this is an example of a, of a demo sort of life, life plan. You can, you know, pet owners' concerns and information that was captured from their questionnaires, you know, what medication they're, they're getting, you know, any confirmed medical conditions and the health risks are sort of listed, underneath and there's some sort of, A prevalence sort of score. So you can see that 1 in 200 pets, you know, would have, like, Sammy would, would, would be predisposed to allergy, and they can read more about it, they can select the results, or they can, you know, request screening, directly from the practise.
So, So this is, I guess a basic sort of, health tab in the life plan and there's some, as you can see at the top, there's other, tabs there that will, hone in on different areas, like nutrition or exactly, you know, what screening needs to be done at what age and so forth. So they can see for the lifetime of their pet, where, you know, what will need to happen and, at what age. So what happens when we do diagnose disease?
Well, early detection is our goal. This is what we, this is what we want. So, hopefully we've, detected it early and then we have more options for treatment and a chance to have a better outcome.
Owners also should be ready and, and be aware that this was a possibility for their pet, and therefore, we'll be more likely to comply with our recommendations. And hopefully we'll be financially prepared to afford treatment or have pet insurance in place to, to take care of, of that, problem. So, Diagnosing disease early, although, you know, it can be scary for, some pet owners and I guess veterinarians.
It's, it's, actually the goal of what we want to do. And this kind of, brings me to an important note on pet health insurance. So we do know that, you know, prevention, you know, early detection, you know, will save clients money in the long run.
However, this approach of, you know, screening and, you know, having to do all these extra things, for, you know, allowing us to arrive at, you know, golden early detection or prevention is kind of more front loaded with cost for clients, than they currently experience. So now we're asking them not only to pay for vaccinations and parasite control, but also pay for blood tests or, you know, radiographs. And, and for many clients, this is best addressed through pet insurance and especially those policies that cover diagnostic screening as recommended by veterinarians, and those policies that cover hereditary diseases and chronic care.
So as we know, not all pet insurance coverage is the same as our and our role as veterinarians in the clinic is to help clients really select the appropriate policies that will meet these long-term needs for their, for their pets. So pet health insurance is pivotal and, you know, we know in the UK, you know, there, there's, there's a really high rate of pet health insurance, Amongst pet owners, which, which will help with implementing personalised medicine in practises. So Talking about personalised medicine, you know, and talking about risk, you know, is, is, Really not going to, go a long way without talking about managing these risks and disease.
So as, as I mentioned in the, in the beginning, this is an ongoing process, a lifelong process. That will will be required, you know, for, for many, many of our patients with a lot of conditions, even as we are without practising any of these, you know, personalised medicine. So things like allergies or diabetes, or epilepsy, obesity and arthritis are just very, you know, small list of examples of what we normally manage anyway with, with, Any of these, you know, heritable, you know, genetic diseases that we see.
So having diagnostic tools to continue to monitor progression and improvement are, are going to be key to successful management of these conditions. And having started that early or having at least implanted the idea in the heads of the, the, The pet owners, early on is, is a good way to help manage that. So communication, you know, planning and early detection all improves pet owner engagement, as we said, and, and compliance, and also leading to better, better outcomes, .
So, when we, when we're Considering or starting to implement personalised medicine in our practises, it's important to try to prioritise that. So although we know all pet owners, would want to engage in personalised medicine, it's, kind of a new approach or a new concept, and universal adoption will take time. And so it's natural to start with first-time pet owners or owners of, of new pets will be more receptive to messaging about what is best for their pets, you know, in the long term, and joining, you know, kind of a, a, a programme or a life plan that is going to help them manage that.
So you have, everybody has, you know, those, those pet parents or that market segment, of, you know, those precious, you know, high maintenance clients that we all love. And these, you know, will be, you know, a good, you know, segment of the market to, that will be more receptive, to, to that kind of approach. And then once you have a cohort of, people on life plans with, with, new pets or puppy owners, you can slowly kind of expand that to the remaining clients.
Once you can kind of demonstrate to your team and to the practise that you have, you know, those benefits that you can share, with other customers. Why do we want to do this now? There is a shift to wellness and prevention across the veterinary industry.
And I think, you know, our pets are, you know, there's less sort of, hit by cars and there's less of the, you know, the endemic sort of, or, you know, you know, disease that we see. So there's a need for veterinarians to kind of, Create new revenue streams based on wellness and prevention. We know that pet owners, especially the millennials and the, the white generations, really want to be more involved with wellness and planning, especially of the cost of their pets healthcare.
It's been shown that, in humans, when we have, identified for ourselves a genetic disease or a genetic risk, we're actually 50 to 70% more likely to act upon that information. So it does breed compliance. So and allowing us to create new revenue stream streams that are relying on in clinic sort of services as opposed to, you know, merchandizing or dispensing medication.
These are sort of revenue streams that are being threatened by, you know, by other, sort of retailers, I guess, in the venerary clinics. And these new tools, I guess, are now available for us to help us automate risk assessment and, and, you know, screening schedules in, in, in our pets, these tools that can use, you know, complicated algorithms to kind of go through information and, and allow us to, build these, you know, with ease. So putting it all together.
Pestilized medicine relies on the hospital team to counsel pet owners, with the focus being on prevention, detection, and, And rather than sort of treating disease, so it's a, it's a, you know, health versus or wellness versus disease sort of, approach. It relies on teams to use genetic and non-genetic, you know, tests as well as input from pet owners to appreciate risk factors from individual animals and make recommendations accordingly. So as we mentioned, the combination of all of these efforts, is that life plan.
It's a schedule of recommendation and intervention throughout the pet's life, it's a place for people to interact with their veterinarians and update their records. It is the hospital team working closely together with pet owners that will successfully, you know, deliver personalised medicine and its benefits in a practise. So, Yeah, I wonder if there's any questions, .
Yeah, I know. You, I think you've excuse the pun, you've put the cat amongst the pigeons with this one, which is absolutely fabulous. It's great.
We, we want people to be thinking and asking questions and everything else. I, I'm not going to read out individual questions because a lot of them have got very, very similar themes. So folks, forgive me if I, if I don't put your name to a specific, question, but one of the questions know that's coming through a lot is, how much does this cost?
OK, so yeah, that's a good question. . Not sure I have the prices in pounds, but I'm, I'm sure you can translate, so.
A DNA test, you know, would, would vary between sort of $60 to, you know, $120 to the veterinarians, depending on whether you want to do breed identification or genetic screening. And Lifeline is a digital product, so if you know the breeds, you can actually generate that for as little as about $20. So it's not, the algorithm will run and the questionnaire will be answered.
So getting access to the platform. Is, is not expensive, I'm sure nationwide will be able to help with local, you know, Pricing for veterinarians. So typically a veterinarian, that, is, is using this programme will have, you know, DNA collection brushes in the practise, and, they would, discuss that with pet owners as a matter of routine and, and, would, collect sort of DNA and then run, the, the questionnaires.
So it's, it's kind of a process. Try to, if I have a slide to show that. No.
So yeah, the price does vary anywhere from $20 to for a life plan on its own up to about $120 for a full screen with a breed identification test. So hopefully that answered the question. Yeah, and I, I don't know off the top of my head, but I, I have a feeling that we are looking at about 10 to 1 as an exchange rate at the moment.
So those are not not very high figures at all. Know loads and loads of comments coming through with with saying how fascinating and how interesting and saying thank you to you. So I'm sure there's lots of people that you have stimulated to look further into this.
Yep. One of the, common themes that's coming through here is about insurance. And I'm not sure whether you have spoken to the insurance companies here or if you have any knowledge of how the insurance companies here work.
I know personally for a fact that some of the insurance companies actually have a clause in their contracts that exclude genetic diseases. Can you comment on any of these? Have you spoken to the insurance companies in the UK?
Yeah, we have met with, a couple of insurance companies in the UK. We're working with, 4 or 5 insurance companies in the, in the US and, and 2 of them in Australia. So generally, the discussion has been, you know, is genetic testing or, you know, mutations, going to be considered as, pre-existing conditions?
And the general question for that is no, it is not a pre-existing condition, it just identifies risk. The general discussions we had with pet insurance companies is that, you know, by doing a DNA test, you're not actually changing. The population sort of, Risk for disease.
The risk for disease remains the same. So as far as the insurance companies, we're not actually changing anything. They're, in fact, what we're seeing, over time is that, they are actually paying less for people, that have a lifeline because they, they don't tend to, blow out into this, nasty disease.
You're at the end stage where, where we have, you know, a really expensive sort of bill. And, and this especially is with, orthopaedic conditions or things like, you know, GDV where it's, you know, preventable conditions or those that you can manage early. So, at the end of the day, what they're seeing is that they're actually paying less.
And, and for most, of the insurance, policies that we recommend, they do cover, you know, genetic, conditions. Some of these won't cover the actual single, you know, DNA test, but the good thing about DNA test is you only do it once, and it's not a huge expense as we know, DNA does not change. But most of these will, cover for all the other genetic screenings.
So all the blood tests or radiographs, or any other procedure or test that the veterinarian recommends. So although, you know, intuitively as veterinarians, we think, oh, you know, this is going to be a problem for pet, you know, health insurance companies, we have not seen that in practise, you know, in the last probably 4 or 5 years where this, this has been sort of, being practised so . You know, overall, I think it's to do with the, with the, policy itself.
And, you know, how the veterinarians sort of, You know, conveys, you know, the, the, the reasoning for, for screening. Excellent. You've, you've answered two or three other questions that have come up all in the same one they know, so that's great.
Thank you. Caroline makes a fabulous comment. She says, please could you go and speak to the NHS and recommend this for humans as well.
It would save the company millions. Yeah. Yeah, when we're working with a company called the Morris Animal Foundation in the US and they're kind of saying the same thing.
So we're doing that, you know, voluntarily, and they, they, their research, you know, leads to a lot of the human research. So it kind of it's got to start somewhere. Yeah, it's all great ideas start with a small seed somewhere along the line.
Hm. Noam, another question that I have for you is, are these tests already available through nationwide in the UK? Yes, absolutely they are available, so .
Anyone can contact, you know, nationwide, and I'm sure they will have, they can, they can send out a, a free kit to you for you to start using these. Excellent, excellent. I'm just scrolling through there's lots and lots of comments coming through about how much people have enjoyed this and and how insightful it's been and thought provoking, which is absolutely fabulous.
I'm sure that was one of your goals when we started this. Yeah, absolutely. I mean, we, we would love to see any, any pet, you know, on a lifeline from, you know, an early age because we, we truly see the benefits, you know, over the lifetime.
Yeah. I, I know you've said DNA doesn't change and that sort of thing, but there's a question that's come through asking in relation to vaccines. Does this, should this be done apart from vaccines or can it be done at the same time as vaccines?
It can be done at the same time. We have not seen, DNA change, you know, especially not those markers that we're looking for, they tend to be, you know, very fixed. We are involved with some cancer research that we do see DNA changing all the time, even within the tumour.
So, so DNA, I guess, you know, At its core, and, in a, in a normal animal will not change. The only time we see changes to, to DNA would be, you know, in a really old, you know, patients, but even then, probably not the mutations we're looking for. And in cancer in patients with cancer, the, the, the cancer tissue and tumour actually changes within itself.
So even, you know, Running a full sequencing sort of, of a tumour day one and then doing the same thing, you know, two months later, you know, you will get different results. So it's a dynamic process. But overall, DNA does not change as a general sort of, statement.
Right. Along those same lines you were talking about the accuracy of tests and identifying breeds and that sort of thing. Hillary has asked a question about cross reactivity and you know, picking up one condition when it could be mistaken by the test for another one.
In other words, specificity and that. Right, yeah, no, no, OK. So, for the mutation, markers, they are 100%, so they are, you know, as black as white as you can get.
So we are honing in on a specific location on the DNA. So it's a very specific glossi, and that is either, you know, there is a mutation there or there is not. So there is no, there's none of these sort of grey area, as opposed to, you know, what we call, an association market.
So breed identification can vary because we're basically looking at a signature. So, it's a, it's a statistical analysis as opposed to, you know, having a measurement of, you know, a specific sort of, base pair in a specific location. I can explain a bit more about the the the marker.
Sort of, how, how we developed and how we, work with breed signatures, but, the, the genetic mutation are, are, are very accurate. Excellent. Dogs have featured very prominently in this presentation.
What about cats? I know you mentioned that there are some, are we far behind on cats or right up there? Yeah, no, where cats have been, there's, there's a lot less tests.
So if we have, you know, 300 sort of tests for dogs, we probably have, you know, 40 or 50 only for cats. There are no breed identification tests currently available for cats. There's been, there's been a lot of work that, that is being done with, with that.
So we, I, I would say we're fairly close to developing a breed ID to having a breed ID test for cats, but we're not there yet. The cats are a lot more similar, than dogs are. There's a huge variation with dogs and sort of when we, when we develop markets for dogs, we look at things like The ratio between the, the body and the legs, and, you know, the position of the tail and the position of the ears, and these things do not vary much with cats.
So, it's a lot tougher to actually create breed signatures. Genetically, it's, it's coming but it's not there yet. Excellent.
No, I know it's it's been a very early morning for you down there in Australia. I think you you got up at about 3 or 3:30 in the morning to present this to us. From myself and everybody who's attended, we really do appreciate the effort that you have made in getting up to come and present this to us.
Thank you, thank you. I hope it hasn't, shown. I'm sort of starting to wake up now, but yeah, you've done very, very well and as I say, for 3:30 in the morning, that's pretty impressive.
So thank you for your time and for all the information. Once again to Nationwide Labs and Orivet, thank you for the sponsorship of this evening's webinar. We really do appreciate it for everybody attending.
Thanks folks. My controllers in the background, Dawn and Paul. It's much appreciated the work you do in the background and from myself.
Good night everybody.
