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Tarra Robinson was afraid that she was going to lose her job. Diagnosed with type 1 diabetes when she was 18 months old, Tarra had recently developed hypoglycemic unawareness, which affects about 17% of type 1 diabetics. Tarra was passing out at work, and once she even crashed her car when her blood sugar dropped unexpectedly. She went on a pump and tried a CGM, but nothing seemed to help. She was still having frequent, dangerous lows.
Scared of losing her job and her license, Tarra began to research Diabetes Alert Dogs. It took a year and a half to raise the nearly $10,000 dollars required, and then the training process for Duchess, her Labrador/Golden Retriever mix, began. "I can't explain what she's done to my world," Tarra says.
Trainers say that Diabetes Alert Dogs are right 90 percent of the time. These service dogs are "scent trained" with cotton balls of sweat from a person's body during a low blood sugar. After a period of extensive training, Duchess came home to Texas with Tarra. Now, when she senses a low blood sugar, Duchess knows what to do. First, she will lick Tarra's hand. If Tarra doesn't respond by saying, "Glucose" which is the command for the dog to go get the glucose tabs, then Duchess will paw her leg or thigh and eventually her chest. Duchess sleeps next to Tarra at night, and will get on top of her to wake her up if she senses a low. "She doesn't give up," Tarra says. "She's very good at her job."
Thus far, attempts to demonstrate that dogs can detect hypoglycemia are based on little more than anecdotal reports. Dr. Deborah L. Wells, Senior Lecturer at the School of Psychology at Queen's University in Belfast, has studied dog responses to their type 1 owners. Her study, Canine Responses to Hypoglycemia in Patients with Type 1 Diabetes, was designed to explore whether there is any validity to the notion that untrained domestic dogs can detect hypoglycemia in people with type 1 diabetes. Dr. Wells says, "We interviewed (by survey) over a hundred people with type 1 diabetes to quiz them on their dogs' responses to their hypoglycemic episodes. In a nutshell, we discovered that a very high proportion of owners believed their dogs were responding to their lows, displaying 'alert-style' behavior (e.g. pawing at the owner, barking, etc.). Many dogs also woke their owners up from sleep at night when they were going low."
According to her report, "The findings from this study suggest that many dogs can detect hypoglycemia, often without the use of visual cues and before the animals' caregivers are aware of their own symptoms. Although it was not the goal of this project to explore how dogs detect hypoglycemia, the results hint at an odor cue, although other signals (e.g., changes in owner behavior due to impaired cognitive functioning) cannot be dismissed. Research is required to elucidate what mechanisms might underlie the ability of dogs to detect hypoglycemia and to determine whether animals can be trained to consistently alert their owners to the onset of hypoglycemia."
Rachel Thornton was a desperate mom willing to try anything to keep her daughter Abi safe. Diagnosed when she was 11 years old, Abi experienced several scary low blood sugar episodes that prompted her mom to search for help. Rachel was excited when she found a kennel with diabetes service dogs. The Thorntons were given an untrained dog, however, and ultimately lost a great deal of money. "There is a sense of urgency that drives a parent's desperation, and these places can take advantage of people." Rachel says the Diabetes Alert Dog world is small and growing too quickly. Many kennels have popped up in the last few years, and several lawsuits have been filed. "The service industry has some problems," she says. "There is no governing agency, no standards for DAD's, no certification process, and agencies are cropping up overnight." After her negative experience, Rachel decided to make a concerted effort to educate the public about diabetes service dogs. She now works as a trainer for Wildrose Kennels in Mississippi.
The Wildrose Diabetes Alert Dogs Foundation (www.uklabs.com/alert_dogs.php), located in Tupelo Mississippi, has been training hunting and sporting dogs since the 1970s. The foundation (Wildrose DAD) provides service dogs to type 1 diabetics. Funds donated to the foundation are used to support programs designed to deliver trained dogs to qualified individuals with type 1 diabetes. Cost depends on the amount of training and ranges from $1500-$8,000.
According to the website, "Wildrose British Labradors are known for their amazing scenting ability, temperament and trainability, the perfect sporting companion. In the spring of 2008, we received a request for a diabetic alert dog. We were informed that some Wildrose dogs were being effectively used to alert children with type I diabetes. Upon further investigation, it was discovered that puppies from Wildrose progeny were alerting high and low blood sugar levels for diabetics across the United States and in Canada. Since that time an intensive training program has been developed utilizing the natural scenting instincts, intelligence, desire to please and the smaller size of Wildrose Labradors, making them exceptional candidates for Diabetic Alert Dogs.
Located in California, Dogs 4 Diabetics (www.dogs4diabetics.com) was incorporated as a non-profit in 2004. Most of their dogs are obtained from Guide Dogs for the Blind in San Rafael, California, and retrained for diabetic alert work. D4D estimates the cost of training each dog to be approximately $20,000. However, as a non-profit, D4D places dogs with diabetics at a minimal cost. ($150 for application fee and materials).
According to their website, "In order to qualify, the diabetic must be at least 12 years old and have been diagnosed and on insulin therapy for at least one year. Due to the high level of interest in this program, it may take up to two months before you hear back from D4D, though you are always welcome to email any questions. If, after being reviewed, we find that your request meets our criteria, we will forward you an in-depth formal application. D4D's dogs are placed by matching them with each client's individual needs, not on a first-come first-serve basis. The matching process takes into consideration the lifestyle, personality and abilities of each client. The other consideration is the client's ability to attend our 2-week team training class. Please note that participation in classes does not automatically guarantee you a dog. D4D works primarily with black and yellow Labrador Retrievers because of the breed's intelligence and willingness to work with people, but occasionally other breeds may become available.
Dogs at Wildrose and D4D are scent trained. Using cotton balls and "bucket training," dogs learn to pick up the scent of low blood sugar and to perform a customized behavior when they alert to that scent.
Reb Boyd was diagnosed with type 1 diabetes in the fourth grade. Reb says he always struggled with lows and that his mom got up several times during the night to check his sugars. Reb's parents went to Wildrose kennels and now he is the proud owner of Lilly, a British Labrador Retriever who, Reb says "goes everywhere with me." Reb is now living away from home at Furman University in Greenville, South Carolina, and says he hasn't had any lows since he's had Lilly. He continues to train the dog and says it's an ongoing process.
Rachel Thornton's daughter Abi is also living away from home in her freshman year of college, accompanied by her dog Mr. Darcy.. On the Wildrose website she writes, "Mr. Darcy is officially a college student starting Friday! We registered for classes today - Darcy was a show-off and alerted to three lows while we were standing in the never-ending lines! Thanks Darcy!" Mr. Darcy even has his own Facebook page, where you can follow his adventures: (http://www.facebook.com/pages/Mr-Darcy/117723032874?v=wall)
While Reb's experience at his small college has been positive, Tarra had some resistance bringing her service dog to class. "I have also had some issues with professors not wanting me to bring Duchess to class with me, but now, after having her with me for the past couple of months, they have seen how helpful and necessary it is for me to have her. By law, of course, I can bring her to class, but one professor let me know he did not agree with the law."
The Dogs 4 Diabetics website explains, "In accordance with the federal American Disabilities Act, businesses and organizations that serve the public must allow people with disabilities to bring their service animals into all areas of the facility where customers are normally allowed. Diabetes is covered under this law, and your medical alert dog will come equipped with a service vest to be worn when entering places pet dogs aren't allowed to go. Some of the education you will receive before getting your dog involves this very issue; the diabetic is encouraged to have the dog with him or her at all times, as you never know when low blood sugars will occur. Your service dog will accompany you to restaurants, grocery stores, on public transportation, and to movies and business meetings. Younger diabetics take their dogs to school and after-school activities. These are working animals, not pets, and have special rights that enable them to do their jobs."
At first glance, these dogs seem like the perfect solution. For many people living with diabetes, the challenge to maintain healthy blood sugars feels like a constant struggle. How much easier would it be if there were someone else to share the burden, a guardian angel that could tap on your shoulder (or lick your hand) when your sugars started to drop? And who wouldn't prefer a furry pet to another piece of durable medical equipment? Diabetes Alert Dogs may be the next great answer for many people living with diabetes. However, no good answer is ever easy.
Do Your Research
Rachel gets three to four calls a day from parents wanting dogs. "I do my best to talk everyone out of it," she says. Bringing a service dog into your home is a long-term commitment. With most reputable organizations, there is a one-to-two-year wait because the demand is so great and the training so intense. It's important to do your research and to understand the responsibility that will fall on your child's shoulders. The dog will need to sit under the child's desk at school. It can't be touched by other children while working, so the school needs to be supportive. Diabetes alert dogs take time, training, and commitment. But the rewards can be great. Rachel Thornton says that her daughter has more confidence now than ever before. She adds, "Abi is no longer scared to go to sleep at night. I don't have the science or the facts, but I see it happening."
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Canine Responses to Hypoglycemia in Patients with Type 1 Diabetes, Deborah L. Wells, Ph.D., Shaun W. Lawson, Ph.D., and Niroshan Siriwardena, PH.D. The Journal of Alternative and Complimentary Medicine, vol. 14, number 10, 2008.