Dogs as Continuous Glucose Sensors
To my knowledge, at the moment there are two available mechanical continuous glucose sensors: the combined Medtronic minimed pump-sensor system and the Dexcom (a stand-alone CGM). These are the rudiments of the eventual artificial pancreas. There also is a living glucose sensor: trained hypoglycemia dogs. In the past, I wrote about Gunner, a lively golden retriever who not only sniffed out low blood sugars in his young master, but also in several octogenerians in church!
I just met "Hannah," an adorable doggie that accompanied my young patient to clinic several weeks ago. According to Hannah's owners, the training process is extensive and the animal does not get to live with his future owners until he or she is ready!
What is involved in training a "hypoglycemia dog? An incredible amount of work for both the trainer and the person with diabetes. According to Hannah's owners, there is an extensive learning curve for the future hypoglycemia dog. The animal not only has to be trained in basic obedience, but will learn to sense (or sniff out) both low and high blood sugars. What is the process?
Whenever my young patient experienced high or low blood sugars, he spit into a specially treated cotton ball. The cotton ball was labelled high or low blood sugar. The family then sent the treated cotton balls to the dog trainers. Hannah learned to distinguish between my patient's high and low blood sugars by smelling the cotton balls. Each dog has its own method to alert his person of high or lows. Hannah's method is to paw his person with diabetes consistently until the blood sugar is brought in range. Clearly this pawing behavior alerts the child or family to check the blood sugar and treat accordingly.
Hannah also made home visits to her future "person" to directly sniff and reinforce her training. Finally, when Hannah was ready, she moved in to join her new family. Hannah wears a special jacket when she is working and assumes a very calm and serious demeanor, except when her person experienced hypoglycemia in our clinic visit. During our time together, Hannah began vigorously pawing my young man. His Mom was actually very pleased that I had the experience of directly observing Hannah "in action." His blood sugar was checked and it was, indeed, low! Treatment ensued and the pawing finally ceased when the blood sugar returned to an acceptable range. Hannah was then rewarded with a treat to reinforce her correct behavior. The biggest problem so far is that Hannah's pawing behavior has resulted in occasional scratches on arms and legs, especially if highs and lows have occurred overnight.
My understanding is that Hannah will not accompany her person to school to avoid standing out amongst peers. His family really appreciates Hannah's night time surveillance. When Hannah is not "working," her jacket is removed and she plays just like a regular pet and is enjoyed by the entire family.
If you are interested in further information about hypoglycemia dogs, there are several websites that can provide further details. If you live in the Annapolis area, the next diabetes support group will be about hypoglycemia dogs, check it out online!
And, speaking of dogs, Knickers continues to attend Intermediate Obedience classes where he is practicing agility and intermittently responding to the "come" command! We are working hard to become a certified pet therapy team. Knickers and I made our debut at Children's National Medical Center last Saturday morning to celebrate Neonatal ICU graduates. We walked around and met many children who thought he was a stuffed animal until he moved! I was gratified to see that he remained calm and seemed to intuitively know whose lap to sit on and whose arm to paw, as well as providing a few face-to-face encounters!