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Archive for January, 2013

Too busy to remember to test

JDRF1110_DSC064This past weekend, Rainie and I attended a symposium in order to talk about diabetic alert dogs and Early Alert Canines.  Since one of the sponsors of the event was the Lucille Packard Children’s Hospital, there were many, many kids with diabetes attending, along with their families.  Since EAC is one of the few diabetic alert dog organizations that places dogs with young children, my table was incredibly busy.  And while I talked, Rainie was getting a lot of attention – so much, in fact, that she actually fell asleep under our display table with her head in a little boy’s lap.

It had been a very long and worthwhile day.  I was exhausted as I left the conference hall, but stopped as yet another young girl (about 5 years old and diagnosed with diabetes for 11 months) approached to pet Rainie. While the mom and I talked, Rainie began to ‘nudge’ me.  I praised and rewarded her, as I told the little girl that Rainie was alerting me to my dropping blood sugar – completely forgetting to treat myself.   Over time, Rainie began nudging me more and more while I continued praising her and talking about the wonders of diabetic alert dogs.  As Rainie escalated her alerts to where she was jumping at me, the little girl said, “I think you better go test your finger!”

She and Rainie were right.  My blood sugar had plummeted! *

*Please remember that low blood sugar (hypoglycemia) causes altered and illogical thinking.  This is due to too little blood sugar infusing the brain.  For a more complete  description please see “What Does It Feel Like?”

Characteristics of a Diabetic Alert Dog

Here is a copy of the article I just finished writing for the next edition of the Early Alert Canine’s newsletter, “The Scentinel”


1001168_10151459887301837_453287617_nCharacteristics of a Diabetic Alert Dog

Early Alert Canines is fortunate to have good relationships with other service dog training organizations that allow us to ‘adopt’ and customize the training of their “Career Change” dogs. EAC usually receives the dog candidates as young-adults between the ages of 18 and 24 months.

These dogs have been bred for their intelligence, work ethic and temperament. Early socialization to both the canine and human worlds is critical for a service dog.  It is important that the puppy remain with his litter for his first 8 to 12 weeks.  During this first stage, puppies learn canine social interaction, play, canine body language and moderating aggression from their mother and littermates. Without this, the puppy may grow up to be difficult and aggressive.

However, because a service dog’s bond to humans must be strong, a service dog-in-training must be removed from its litter, and placed in a human home at between 8 and 12 weeks old.  The window of opportunity to create a bond that is tighter to humans than to other dogs closes at about 12 weeks of age.  In the puppy-raiser’s home he begins learning the ‘human world’, basic obedience and learns his place as a member of the human pack.  The ‘puppy-in-training’ requires consistent and almost continual human interaction.  Early exposure to many different experiences is imperative to enable a dog to be successfully adaptive in the active human world.  A few examples of human-related experiences that an unsocialized puppy might otherwise shy away from are: Umbrellas, airplanes, trains, hats, cars, public transportation, shopping malls, schools, elevators, etc.

Dogs that are chosen to be trained as diabetic alert dogs are selected for their intelligence, scenting abilities and work ethics. Does the dog have a willingness to work and initiate the alerting action without being prompted?  He must be intelligent and motivated enough to smell the scent produced by the diabetic’s body when the blood sugar changes rapidly, and perform the desired behavior (alerting) with no verbal cuing or any other prompting.  He must be self-motivated to work at any time and in any surroundings, yet be able to remain quiet for hours at a time (such as sitting under a desk or attending the theater).

By playing games like hide-and-seek, the dog reveals whether he uses his eyes or nose to find food, and whether he is food motivated and thrives on praise.  For a diabetic alert dog, he must ‘seek’ with his nose, since the life-saving responsibilities are scent oriented.

Another characteristic that is imperative in a service dog is his desire to please humans and interact with us in a positive way.  Early Alert Canines finds dogs that want to give to and please their humans above all else.

After some initial testing of the dogs, and knowing their training and socialization histories, the trainers at EAC can then focus on the intense scent training and alert training that our dogs require.

Although every dog is fully scent trained, each dog has his own personality and energy needs, which must be taken into account when a match is being made for a human/dog team.

But, Does She Ever Get To Play?

IMG_0042Not long ago, Rainie and I went to talk with a Cub Scout troop about diabetes, service dogs and diabetic alert dogs.  I had completed my presentation and soon the group of 50 scouts was bombarding me with questions.  They were pretty standard queries for a 2nd to 4th grade crowd: “Where does she sleep?”  (Mostly on the floor next to my bed.), “Does she always have to wear her jacket?” (No.  She wears it when we’re in public), “Can service dogs have other dogs in the house?” (Yes.  However, the service dog needs to know that he/she is the most important dog in the house in the eyes of the person that he/she is taking care of.), “How much do they cost?” (Early Alert Canines does not charge for placing a dog.), “How can I get one?” (You have to be diabetic and been on insulin for at least a year.), “Does that mean taking a shot?” etc., etc.

Then came a question I’d never been asked before. “Why is she lying down?”  I’d never considered thinking about it – especially from a child’s perspective.  Yes, she had been active and alert moments before, and now she was lying on her side with her eyes open.  So, I decided to explore the possibilities with the scouts.  We agreed that a few reasons could be that she was lying down because it was getting towards evening.  And it was possible that she was tired.  But then I explained that Rainie was “always making sure that each one of their blood sugars was safe, and that was a big job.”  I told them that Rainie did not know that they were not diabetic, but she did know that there were at least two diabetics in the room.  She was continually monitoring everyone, all the time; and although she looked like she was resting, she was actually alert and taking her job seriously.  Then there were many nods and ahh-hahs.

After the meeting was over, the boys came to pet Rainie.  I felt a young scout name Jeffery tap me on the shoulder to ask, “But, does she ever get to play?”

Yes Jeffery.  She does get time off to play!

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IMG_0409     photo    DSCF0694

Service Dogs Pick Up Scent of Diabetes Danger

Here is an incredible article posted by the Wall Street Journal (December 10, 2012) that does a phenomenal job explaining the life saving role and purpose of Diabetic Alert Dogs.


Service Dogs Pick Up Scent of Diabetes Danger


About two times a night, Shana Eppler wakes up to an alarm and slips into her daughter Abbie’s room to test the 8-year-old’s blood sugar.

The growing field of diabetic-alert dogs that save their diabetic owners’ lives by sniffing out when blood sugar levels get out of whack.

 Diagnosed with Type 1 diabetes at the age of 4, Abbie experiences low blood-sugar levels, a potentially dangerous condition known as hypoglycemia that can cause the loss of consciousness.


Celeste, a yellow Labrador, has been at the side of 15-year-old Type 1 diabetes patient Dylan Calamoneri for about a year.

The alarm Ms. Eppler uses to avoid a health emergency is a furry one named Gracie, an 70-pound, 3-year-old British Labrador retriever trained to sniff out high and low blood-sugar levels. When Abbie’s sugar level rises or falls below a certain target at night, Gracie rings a bell and Ms. Eppler gets up.”The scenting part comes naturally,” says Ms. Eppler, of Colorado Springs, Colo. “They are hunting blood sugars instead of ducks.”

Diabetic, or hypoglycemic, “alert dogs” are a growing class of service dogs best known for guiding the visually impaired, sniffing out drugs and bombs, or providing mobility assistance for people with severe disabilities. Most recently, they have been trained to sniff out cancer and oncoming seizures. Toni Eames, president of International Association of Assistance Dog Partners, estimates there are over 30,000 assistance dogs working in the U.S., including dogs that have been trained by individuals.

The dog’s accuracy and speed can beat medical devices, such as glucose meters and continuous glucose monitors, according to doctors, owners and trainers. With their acute sense of smell, the dogs—mostly retrievers—are able to react to a scent that researchers haven’t yet identified.


Eight-year-old Abbie Eppler has avoided health emergencies thanks to Gracie, a 70-pound British Labrador retriever who wakes up Abbie’s mother when the child’s blood-sugar level rises or falls below a certain target at night.

For centuries, doctors diagnosed diabetes by identifying sweetness in the urine of a patient. That scent comes from glucose that isn’t absorbed when a person lacks insulin, but the chemicals produced during low-blood-sugar incidents have yet to be identified.

“Whatever is being secreted in that drop in blood sugar…we just don’t know what it is,” says Dana Hardin, a pediatric endocrinologist who works for Eli Lilly & Co. in Indianapolis. Her goal is to identify what chemical compound the dogs smell, “not only to train dogs but to possibly make a device,” she says.

Most of the interest in diabetic-alert dogs comes from people with Type 1 diabetes—and parents of children with Type 1—because they are more susceptible than people with Type 2 diabetes to serious problems of low blood sugar. Type 1 diabetes is an autoimmune disease characterized by the absence of insulin production, and requires daily insulin injections. People with Type 2, which is brought on by a combination of genetics, inactivity and obesity, have trouble processing insulin but don’t necessarily require external insulin.

Incidence of Type 1 has been rising in the U.S. by about 2.5% to 4% a year for reasons scientists can’t explain, according to several large-scale studies published in peer-reviewed medical journals. The number of people with Type 1 diabetes in the U.S. is between 1.3 million and 2.6 million, accounting for 5% to 10% of the total diabetic

Type 1 diabetics work to balance their daily intake of carbohydrates with external insulin. Prolonged high sugar levels can lead to complications such as heart disease, kidney failure and neuropathy. But trying to keep sugars at a low level raises the risk of hypoglycemia, which can be lethal, particularly if a patient loses consciousness while driving or alone.

Many people develop a condition known as hypoglycemia unawareness, meaning they no longer feel the hunger, listlessness and irritability that typically alerts diabetics that their blood-sugar level is falling.

“They don’t get the signs. They just can be having a normal conversation, go from feeling fine to passing out,” says Dr. Hardin.

Diabetics can use technologies such as continuous glucose monitors to help prevent these episodes, but these don’t record blood-sugar drops until after they happen. So hypoglycemic-alert dogs can be lifesavers, says Dr. Hardin, who presented the first scientific research on the dogs at this year’s annual American Diabetes Association conference in Philadelphia.

Using perspiration samples from patients whose sugars were below 65 milligrams a deciliter—normal is 80-120 mg/dL—she trained a two-year-old Labrador/Golden retriever mix to recognize low blood-sugar samples placed in blinded containers on a Lazy Susan-like wheel. Modeled after how police sniffing dogs are trained, trainers around the country use similar techniques. Dr. Hardin’s dog was then paired with Dustin Hillman, a 36-year-old patient who suffered severe hypoglycemic unawareness.

Before he got the dog, Mr. Hillman lost consciousness due to hypoglycemia more than six times over the previous two weeks, requiring emergency services. In the three months after, the owner only lost consciousness once and never required emergency service, according to the study.

Since having Tippy—short for Tippecanoe—Mr. Hillman has finished his dissertation and will receive his Master’s in Chemistry on Sunday from Purdue University. He had been on the verge of dropping out of school and moving back in with his parents, he says.

A fully trained diabetic-alert dog can cost as much as $20,000. Many families conduct fundraisers to afford them. Nonprofit training centers offer dogs free of charge, or ask for a nominal fee, but the waiting lists are long.

Andrea Calamoneri, whose 15-year-old son Dylan has had Type 1 diabetes for nearly a decade, said she was initially skeptical. “I wasn’t about to trust my son’s life to something that is voodoo,” she says. Seeing a dog respond to a low sugar reading convinced her. “It gives you chills when you see it happen.”

Celeste, a 60-pound yellow Labrador, has been at Dylan’s side for about a year. A few weeks ago, when Dylan got home from a 2½-hour wrestling practice, Ms. Calamoneri expected his sugars to drop. By bedtime, they hadn’t. In the middle of the night, Celeste nudged the Danville, Calif., mother of three awake. Dylan’s sugar level was 56, well below the target of 80.

“Your first reaction when you wake up is you almost want to say go back to bed, but you have to trust her and, sure enough, she’s right,” Ms. Calamoneri says.

She says the dog has alerted them of a pending drop in blood sugar well before the drop occurred. Celeste has missed an occasional alert, she says, which she attributes to a busy day when the dog got overly tired. Mostly, the dog naps whenever she is able, and typically the smell of a dropping sugar level will jolt her awake, Ms. Calamoneri says.

Interest in diabetic-alert dogs is rising, says Ed Peebles, president of the Las Vegas-based National Institute for Diabetic Alert Dogs, who says he gets up to 20 applications for a dog daily.

A family business his mother, a nurse, started a decade ago, the for-profit group has four locations, is hiring trainers and can’t prepare enough dogs to keep up with demand, Mr. Peebles says. He charges $18,000 for one fully trained dog between 10 months and a 1½ years old.

“We have seen a huge, huge spike in interest,” Mr. Peebles said. “I am five dogs behind.”

Ms. Eppler’s dog, Gracie, is always working. She bows to signal a low blood sugar and waves a raised paw to show a high level. When Gracie waves and then bows, it means that Abbie’s sugar is high but falling. “Rarely will Gracie let Abbie get below 90,” she says. “We joke that they are angels with fur.”

Write to Kate Linebaugh at kate.linebaugh@wsj.com