I LOVE this topic and I LOVE diabetes alert dogs!  I’ve met many over the past few years and I just want to take them all home!  I’ve “talked” with my Westie, Hey Buddy, about learning to alert … not so sure he’s that into it! 

Want to know more about diabetes alert dogs?  Here you go, compliments of Jessica Ching …  FETCH!  (if you read all the way to the bottom, you will be rewarded with GREAT photos of Jessica with Diabetes Alert Dogs … WOOF!)

 

I foster and train dogs for a local organization in N Cal (www.Dogs4Diabetics.com also called “D4D”), so my perspectives on diabetes alert dogs started here.  The organization provides a lot of info on their website.  However, some of the realistic and day-to-day info are questions that I get asked a lot.  These questions are based on my experiences and observations.

Thanks … Jessica

What does a Diabetes Alert dog do?  

A diabetes alert dog should be trained to let you know your blood sugar is going down.  Some dogs are also trained to let you know BG is going up (and this is helpful too, because the highest highs tend to cause the lowest lows!). In this way, dogs are similar to CGMs.  The dogs will alert when BG starts to drop, i.e. you are 180 and BG is starting to move downward.  The dog will likely continue to alert until BG flattens out.  Sometimes dogs also alert at a set threshold, for example when your BG goes below 80.  Dogs can alert for both situations but it depends how they are trained, and especially how they are reinforced/rewarded.

There are a range of experiences in how far in advance the dog can alert.  For lows, dogs can alert before the drop/downward trend starts.  Sometimes they alert several minutes before the drop starts. Some people say it’s 5-10 minutes ahead.  I recently had a personal experience with the single most reliable dog I know— she alerted approximately 25 minutes before the drop started.  I wouldn’t have believed this but I saw it myself and that was the only plausible explanation.

How do they do it?

Diabetes alert dogs use their extraordinary sense of smell to identify the chemical scent in the body that is released prior to blood sugar decline. Like CGM, the “BG falling” dog alert does not necessarily mean you are low, just that your BG is moving downward.  The chemical precursor to a BG decline is not detectable by humans, but dogs can smell it in your breath and on your skin.  The scent is not currently measured in laboratories, and the field of olfactory detection (such as electronic noses) is very young.  BTW I’m really interested in this— I would love to eventually have an e-nose on my watch!

Retrievers like the ones I work with (both laborador retrievers and golden retrievers which are considered to be in the upper ranking of dog sniffers) can smell this chemical precursor around 20 foot+ from the source.  I’ve known a dog to coming running inside from out in the yard when they smelled the smell of dropping BG (the person was inside, in the kitchen).

Some dogs alert when a different diabetic gives off the smell.  If you’re ever at a diabetes conference with a lot of diabetes dogs, they will definitely be working overtime that day.  One of my favorite dogs alerts on planes, and when her human confirms her BG is stable, she knows that someone around her is declining.  This dog will alert if she smells either of us are dropping.  The dog reports the drop only to her human (my friend), even if I’m the one dropping.

 

How is a dog different from CGM?

A CGM never “fakes” a low alert to get a reward, but a dog’s accuracy never “drifts” the way CGMs sometimes do.  I think the reliability of a trained dog compared to a CGM is similar (I say this because you will ask.  It’s my opinion after using both. There are people who feel one way or the other).  My opinion of the major differences between a diabetes alert dog and CGM:

     DOG advantages:  

• Dog alerts before the drop in BG starts
• A dog “alarm” is harder to ignore than CGM
• A dog feels more friendly, less mechanical, and less judgmental than an alert from a device or nagging human
• Your ‘medical device’ loves you! 
• Dogs are supportive and comforting based on an indelible bond between the two of you
• Dog does not need to be charged or batteries changed

     CGM advantages:  

• CGM is widely available including the wait time to get one
• CGM cost is generally covered by insurance
• CGM requires less daily care and maintenance
• CGM can be taken any place (i.e. crowded concert) and anywhere in the world
• CGM does not need to be fed or taken to pee at the crack of dawn 

An interesting note:  most people I know who have a diabetes alert dog also have a CGM, because they have different benefits.

Another comment:  CGM comes with all the data you ever wanted, but this is a benefit mostly to nerdy types like me 

How do I get a dog?  How much does it cost?  

This is an evolving answer in my opinion.  The reason is that the supply of tested diabetes alert dogs is far lower than demand, so methods, expectations, and techniques are evolving.

The D4D way:  This  program I volunteer for requires a potential client (person who will receive a dog) to attend an information session.  They then apply to the program including an interview.  If accepted they attend classes every weekend for around 10-12 weeks.  There is a period of time when the human takes a different dog home for a weekend, several times, to see what the experience is like and most importantly what the chemistry/dog-human bond is like (kind of like dating!). Then you wait for a dog that matches you/your personality and tendencies to become available.  Wait time can be 2 weeks to 2 years.  D4D current wait time is definitely longer than shorter, given the recent balance of supply and demand.  A note, it takes D4D 2 yrs to train a diabetes dog including the first year of the dog’s life spent as a Guide Dog for the Blind (they get disqualified, but sometimes can do another job like diabetes alerting).  The process of dog training is lengthy although it does tend to ensure a dog of very high quality/standards. The D4D website has info on their standards including the requirement that the dog pass ADI (Assistance Dogs International) testing.  People who take this route will definitely end up with a reliable dog that matches them.

D4D dog cost:  D4D is a non-profit and follows many of the principles established by Guide Dogs for the Blind.  Guide Dogs was formed after WWII to aid servicemen who returned home from war without eyesight; they were seen a deserving of an assistance dog (at no cost to them). D4D follows this principle and does not charge for placing the dog with a client.  There are some costs such as books/materials for class, buying your own leash and dog training supplies, but these are generally manageable.  Dogs provided by D4D include lifetime training support for the dog, annual recertification service for the dog’s reliability and health, and access to the professional staff if you have problems with the dog (either diabetes scent detection or other behavior problem)

There are diabetes alert dogs for sale on the internet.  I don’t personally know anyone who has bought one but I’ve heard the cost is in the $10-20k range.  I am not sure of the reliability of the dog bought this way, or if the dog is specifically paired for you and your personality.  I will say to both sides of the argument that (1) D4D dogs receive 2 yrs of training and maybe 10-20% of the puppies go on to be a seeing eye or D4D dog, YET (2) I’ve seen a person successfully train a throwaway dog that was so abused it was not expected to live.  The dog learned to alert as reliably as a D4D dog because her human was able to take advantage of the dog’s intuition.

There many be other organizations similar to D4D can have high standards/high quality dogs, who place the dogs for nominal costs, and require training/classes on the human’s part.  One that I’m familiar with is Early Alert Canines (http://www.EarlyAlertCanines.org).  There may be others and maybe even an organization in So Cal, but I just don’t know about them personally.

What kinds of dogs are best for this job?

All of the dogs from D4D (Dogs4Diabetics) are either Labrador Retrievers (~90%) or Golden Retrievers (~10%).  These are the dogs that Guide Dogs for the Blind uses, so that is the supply of pre-trained dogs that D4D receives for diabetes scent detection.  Disqualified Guide Dogs are not eligible to be a seeing eye dog, but many have enough capabilities to do another job.  The ones that D4D takes in their program still have good public and in-home behavior, but they have minor personality or physical traits that make then ineligible.  In general, Retrievers tend to make good diabetes dogs because they are:

• Smart
• Have good nose
• Willing to reliably work all the time (for reliable alerting)

Most of the dogs are 50-60 lbs.  The larger ones are 70+ lb. The smallest I’ve seen is a little black lab named Vera at 37 lb.  The smaller ones are more unusual than the larger ones.  A note, when the trainers match the dogs to the people, size of person or dog isn’t a consideration— the personality chemistry and bond between the two are much more important. This determines if the dog will be willing to work, 24/7 (every minute actually) for a specific person.  Some dogs will do the alerting for a person they respect/like, and refuse to alert for others, so this is a real consideration.  I’ve actually experienced this… the dog alerted for me but not someone else.

Can I train my own dog?

I think there’s 2 factors to this answer (my opinion):  Your dog’s willingness/ability to meet public behavior standards, and your willingness/ability to train the dog to achieve this.  I’ve seen that the alerting part is not the most difficult thing for the dog to learn; most D4D dogs get disqualified for reasons other than their ability to alert.  An option for training your own dog could be to train him for in-home alerting only (no public access). This is the most viable option, and I would guess that dogs who have a strong bond with their human can do this.  

There’s some internet info on training your own dog.  Debby Kay has written books on how to train diabetes alert dogs. She has a recognized reputation and seems to be focused on spreading the knowledge of “how to” for dog scent detection.   http://www.DebbyKay.com/

The demand for dogs is high so D4D is opening a new program to place rescue dogs who are then trained as diabetes alert dogs.  This potentially would mean a smaller dog and/or a dog without a Guide Dogs for the Blind pedigree would become a full service dog.  The dogs will be trained as they are now, except that they would come from a shelter instead of from Guide Dogs for the Blind (D4D will still do the training of both people and dogs).  I think it will take quite some time to get this newer program going.  But I think the takeaway here is that training rescue dogs can be done.

Will I have a problem getting access (i.e. into restaurants, stores, my office, etc) for my service dog?

There are a number of different kinds of working dogs; not all are covered under the U.S. Americans with Disabilities Act.  The law is deliberate vague, I’ve been told, to favor and give the benefit of the doubt to the disabled person needing the dog.  Diabetes Alert Dogs are covered under ADA if the dog is individually trained to perform a task for a person with a disability (if the dog is specifically trained to alert for BG changes due to your T1diabetes).  The D4D website has good info and links under Resoruces/PublicAccessLaws.  

In my experience this works both for and against the favor of a T1. Here is my assessment of the types of working dogs; not all working dogs are equal and not all are entitled to ADA-based access.

— General working dog:  Any working dog that does a “job;” could be health or non-health related

— Health/medical Assistance dog:  this would include therapy dogs and comfort dogs

— (Full Access) Service dog:  Includes working dogs that have a medical function.  Examples:  Diabetes Alert dog, Seizure Detection dog, Seeing Eye dog, PTSD dogs, other.  Most of these dogs are with their designated human 24/7

Full Service dogs basically are like a wheelchair:  they go everywhere their disabled person goes, and everyone is required by law to make accommodation for that person and her dog.  If you go to a nail salon and another customer complains they are allergic to dogs, you have the right with your dog over that person (you wouldn’t make the disabled person and her wheelchair leave if a person was allergic to steel, right?).  The nail salon experience happened to me recently.  I had to calmly let the management know the law, and that my dog would be staying (the grouchy lady left; I believe she thought I had a ‘fake’ dog since didn’t look “disabled”)

Note, although Service dogs legally are allowed to go everywhere with you, I’ve observed many businesses allowing comfort and therapy dogs in their stores.  This is up to the discretion of the store.  Most stores don’t know their rights, and they are afraid to both offend people with true disabilities and afraid to break the law.  The pendulum is swinging on the side of the public feeling it’s their right to bring their pets everywhere, and business are unaware, so there are a lot of fake service dogs in the public domain.  It is abuse of the ADA law, but hey there a lot of abuse of handicap parking too.  It’s something to be aware of if you are considering a dog.