I got the following email today and could not answer it. I wonder if anyone knows how the training for these dogs is started and maintained:

Hi, I am currently working with a juvenile dog (Chinese Crested Hairless) to detect low blood sugars in my young daughter.She has insulin dependent diabetes. Apparently they begin to naturally alert the person when the sugar levels drops and this is detected in the breath. My questions to you are,
How can I speed up the process and how do I teach the dog pick up the change in her breath rather than a swab. At present, I am working on getting my daughter to breath on a swab when she has various blood sugar readings and I am only reinforcing him for pawing at the desired one.
How do I know if he is smelling the sugar in her breath or if it is another scent. The swabs are sterile but I hold the corner with my fingers. Is there another way to introduce the object to him?
Thank you,
Chiara Perri
Point Cook Dog Training
Australia

Hi Ed

There's one organization I know that sells trained dogs, training programs, and DIY training for diabetes detection: http://www.heavenscentpaws.com/. The DIY training is like $600 (it includes basic ob), the training and the trained dogs are a lot more (I think like $16,000-$20,000). I have not heard anything bad about this group but some speculation about their training methods (i.e., do they induce lows and highs in diabetics to generate "tests" for the dog, etc.). I have seen one of their dogs profiled on a diabetes show that runs on one of those health channels on cable.

My three-year-old also has juvenile diabetes, like Chiara's. One of the reasons I actually got my first working dog last year was with diabetes alert training in mind. We haven't picked that up yet.

I would like to do this, eventually, though Annie will never be a 24/7 dog with Patrick.

I can't speculate on her training methods. I'm not sure a Chinese Crested would be my first dog of choice for service work, even the HeavenScent people are pretty strict about the dog having traditional working qualities and intelligence. She might be able to pick up swaps from a medical supply company that would get her finger away from the scent, etc.

I would strongly recommend that before she spent a lot of money on a dog-based solution, she check out the insulin pump Medtronic makes...the new Paradigm pump:

http://www.minimed.com

This is an insulin pump (which I strongly recommend for any Type I diabetic) along with an additional sensor which will give real-time glucose readings every five minutes. It has alarms on it and shows trends, etc. We've had it on my boy for two weeks and it is already changing our lives...he's gone from 10-12 fingersticks a day and highly variable blood sugars to just 4 a day (for callibration of the sensor) and very consistent sugars. Plus we almost get to sleep through the whole night now. ;-) It's way more effective than a dog can be in controlling sugars. It gathers way more information that a dog ever could about trends, cumulative activity, and is much faster to signal possible high and low situations.

The only drawback is that it's expensive. The pump is around $5,000, the sensor another $1,000, and supplies are about $400 a month. I was lucky with my own insurance on the pump cost but the sensor and supplies, to the best of my knowledge, are not covered by US insurance companies yet (I see your email is from Australia). I do not know if it's availible in Australia, I doubt it, but I'd urge your writer to call Medtronic. It's not approved for kids yet and I got one after being on a waiting list for four months.

By the way, Ed, I don't think it's rocket science to train a dog to do this...the trick is isolating the scent...you could make some big bucks coming out with a competitive product for self-training (meant to email you about this before). I'm about 90 miles from you, I'll send my kid over to use for practice, he kennels well and doesn't eat much. In all seriousness, diabetes is an official epidemic in this country and there is a need for service dog training...that will be reasonably priced relative to the pump/sensor apparatus I just described. A CD/Seminar based program you could put together would be very valuable in a market that's barely been tapped.

I realized I didn't make a few things clear...anybody thinking about messing around with this...it is not cool at all to either anticipate or cause lows and/or highs in diabetics, particularly children, for the purposes of training a service dog. Low blood sugars are quite dangerous for a child's brain development, and high blood sugars can cause diabetics to produce ketones, which are a nice way of blowing out your kidneys. My dog's training will only be as a back-up "fun service dog option." HeavenScentPaws has apparently figured out a way around this as they say explicitly on their site that they do not manipulate blood sugars.

Furthermore, the dog selected for this work needs to be very stable, agile, healthy, intelligent, and big enough to alert on people (one dog I've heard of was trained to lick his handler's face if he was asleep and in a deep low, and then wake up his spouse if there was no response). I still think a Chinese Crested would be a very questionable choice for a service dog like this.

 Quote: Ed Frawley

I got the following email today and could not answer it. I wonder if anyone knows how the training for these dogs is started and maintained:

Hi, I am currently working with a juvenile dog (Chinese Crested Hairless) to detect low blood sugars in my young daughter.She has insulin dependent diabetes. Apparently they begin to naturally alert the person when the sugar levels drops and this is detected in the breath. My questions to you are,
How can I speed up the process and how do I teach the dog pick up the change in her breath rather than a swab. At present, I am working on getting my daughter to breath on a swab when she has various blood sugar readings and I am only reinforcing him for pawing at the desired one.
How do I know if he is smelling the sugar in her breath or if it is another scent. The swabs are sterile but I hold the corner with my fingers. Is there another way to introduce the object to him?
Thank you,
Chiara Perri
Point Cook Dog Training
Australia

Hi Ed. I sent an e-mail to an acquaintence of mine who is very involved in following leading edge research related to Diabetes. His son is Type 1, and that has led to his following and researching Type 2 as well. My Dad is type 2 so it's a topic of great interest to me as well.

I suspect I will hear back from him with interest in at least exploring this topic.

Thanks,
Beth

I did some obedience work with a small group of assistance dogs last month, and although they were different breeds, they were all larger breeds (Lab, Golden, GSD). I have no expertise in this; I was just doing ob work on dogs who were well along in their alert training. But the trainer (an old seeing eye trainer) said exactly what Woody says: big enough to alert on people. (She said that the dogs had to learn two of three "appropriate responses," such as physical contact, vocal alert, operating an alarm, if I recall correctly. Larger breeds have an obvious edge, it seems, as long as they are not so large that they can't fit easily under restaurant tables, etc.)

I just sent an email to dogs4diabetics in Concord, CA, to find out whether they too use all larger breeds. (From the pictures at http://dogs4diabetics.com, I'd guess yes.) I asked about the manipulation of blood sugars in training, too.

I'll let you know whatever they answer.

That was a bad URL. It's
http://dogs4diabetics.com

I sent this information in an email to the folks who wrote. I am surprised there is this much information out there. I have trained a lot of narcotics dogs but this seems to be a difficult thing to do.


Thanks everyone.

I think some of the difficulty--just speculating here as a newb who has not trained scent recognition and alerting--are the degrees of sensitivity a dog has to have. It's not just a yes/no "is something there"...it's a qualitative decision that you're training the dog for (is there enough of this scent present for it to matter) and is probably subjective by person (how my kid smells (and definitely how he acts) when his glucose is at 350 might be different from how somebody else smells/acts. And just because somebody has ketones on their breath does not mean it's at a concentration that's dangerous (this was one of the old debates about the Atkins protein diet, that forced metabolisms into ketonic states). That's why I'd be interested in how these groups train their dogs.

I'd still be hesitant to do it with a very young kid, like mine. His levels are kept somewhat artificially higher because lows are so damaging for his development right now...that will change as he gets older...so now we target for glucose levels of 100-150 whereas a normal adult is at about 70-120. So there's a challenge, and I wonder how different human breath smells at like increments of 70 versus 100. I have no doubt a dog could detect sensitivities but I would think you'd have to have a really, really controlled setting for the training and would really have to have your act together for training.

So...I keep on thinking about this, because it's pretty close to home for me...another thing I might add to the inquiry you got is whether the kid's levels are stable enough that she won't have to "reprogram" the dog to detect different sensitivities later. And what kind of setting and repetition and scent control you have in place to train the dog. Again, if that person has access to that new glucose monitor, I'd go with that in a second versus a self-trained dog. Not to knock the pooch or anything.

Dogs 4 Diabetics used to use career change Guide Dogs. I saw all or mostly labs the times I've met up with them.

One of the people that helps them train works for Guide Dogs, used to work for Hearing Dogs and did some of the work on training dogs to detect cancer. It's the same process as training for cancer detection.

Clicker training- all the cancer and low blod sugar detection training I've seen uses clickers.

I did a quick Google search and came up with this article published on November 5, 2006. It highlights Mark Ruefenacht who raised Guide Dogs for the blind. After his own close call with a diabetic incident, he began pursuing a hunch that a Guide Dog could smell a chemical imbalance on a diabetic. He then founded Dogs 4 Diabetics.

Here's the link for the article.
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/11/05/CMGE9LDTK31.DTL

Here's the link for Dogs 4 Diabetics.

http://www.dogs4diabetics.com