Could DEVIN GRAyson’s WORLD WAS SHRINKING. The 36-year-old California a comic-book author and video game writer had been diagnosed with type 1 diabetes when she was 15, and like many people with insulin-dependent diabetes, she Dogsuffered wild swings in her blood glucose. Over time, she’d also de- veloped hypoglycemia unaware- ness, the inability to recognize symptoms of severe glucose lows. “One night I woke up and my ave blood sugar was 17,” she recalls. “It’s amazing I woke up at all and didn’t die in my sleep.” By the summer of 2005, Grayson was restricting her activi- ties because of her fear of hypo- S glycemic episodes. She gave up many of her favorite pursuits, like hiking in the redwoods north of San Francisco, and became reluc- tant to go out alone. She even moved into a house with friends because she worried that her dia- betes made it dangerous to live alone any longer. And still she felt trapped. “There’s a real psychic burden attached to diabetes,” she says. “You never get a break. (Your Life?) Every meal, every day, you have to monitor. It’s lonely. There are No one knows for sure how they do it, but a growing days when you would do anything number of canine companions are helping people with just to have a weekend off.” diabetes avoid dangerous hypoglycemia. Then Grayson met Cody, and everything changed. It was an By Amanda Spake Internet hook-up, of sorts: Online, Grayson had discovered Dogs for Diabetics, a Concord, Calif.–based organization that trains dogs to respond to serious blood glucose drops in humans. She registered for classes in the summer of 2005, 40 DIABETES FORECAST | MARCH 2008 PHOTOGRAPH BY ROBERT HOUSER Devin Grayson AND GOLDENCody RETRIEVER DIABETES FORECAST | MARCH 2008 41 and in six months she was teamed will be to identify the sensory cue insulin-dependent diabetes, one up with Cody, a male Golden the dogs are reacting to. with type 1 diabetes and two with Retriever. Not only has Cody saved Part of what is so uncanny about type 2, whose pet dogs predicted Grayson’s life, he’s given her a life these dogs is their reliability: the onset of a hypoglycemic epi- to enjoy, she says: “For the first Trainers say they are right 90 per- sode. The dogs dramatically time since I was diagnosed, I feel cent of the time. They also seem to changed their behavior when they this enormous burden has been have a skill that no test kit or piece sensed their owners’ drop in blood lifted. I’m not alone with it of machinery offers: the ability to glucose—jumping up, running anymore.” sense a dangerous drop in blood around the house, hiding under a glucose before the drop occurs. chair, rousting them out of bed, ASSIST A NCE DOGS , such as guide Some dogs become so good at pacing, or putting their heads or dogs for blind people, dogs that sensing low and high blood glu- paws in their owners’ lap until their “hear” for the hearing impaired, or cose that they “diagnose” people owners ingested carbohydrates to dogs that retrieve items for the around them. At Grayson’s office, normalize their glucose levels. wheelchair-bound, have been help- for example, a coworker men- “The three patients who I wrote ing humans for decades. But Cody tioned that Cody had been anx- about in the British Medical is part of a new trend in which iously pawing the woman’s knee. Journal paper all had impaired dogs are trained to identify the “Wait a minute,” Grayson said, and awareness of hypoglycemia,” says onset of hypoglycemia in people went to get her glucose monitor. Gareth Williams, MD, a professor with insulin-dependent diabetes. When she checked the woman, her of medicine at the University of For the dogs, it’s a game. Once blood glucose was 180. She was Bristol in England. “Their lives they alert, they receive their treat, later diagnosed with type 2 were made miserable by their fear plus lots of positive reinforcement diabetes. of going hypo.” That is, until their from their owners. But for the hu- dogs began to help them out. mans they live with, the results are A STUDY PUBLISHED in Diabetic Still, many people who experi- nothing short of miraculous. Medicine in 1992 showed that as ence hypoglycemic episodes may And yet science tells us nothing many as one-third of the pets living do well to try further diabetes about whether dogs can really do with people with diabetes—usually education on how to safely adjust this. Or how: “We believe the dogs dogs, but also cats, rabbits, and insulin and diet to activity, and are picking up on scents that are even birds—exhibit dramatic to talk to their doctor about new created by chemical changes going changes in behavior when they regimens including insulin-pump on in the person’s body before we sense a drop in their owners’ blood therapy or continuous glucose humans see the actual symptoms of glucose. A British Medical Journal monitoring, counsels Diabetes the illness,” says Darlene Sullivan, article in 2000 further piqued the Forecast Editor-in-Chief Paris executiveA director of Canine interest of both dog trainers and Roach, MD, of the Indiana Partners for Life. But the scent has diabetes experts. It reported the University School of Medicine. not been identified. In fact, the first experiences of three women with “While these dogs apparently academic study to evaluate how well dogs detect hypoglyce- mia is being done by Deborah Wells, MD, at Queens Uni- versity in Belfast, Northern Ireland. If she verifies that dogs can alert to blood glu- cose drops, her next project 42 DIABETES FORECAST | MARCH 2008 “ This dog is incredible. She’ll come running to us in the middle of the night with the test kit in her mouth.” —Donna Cope Hunter Cope AND GERMAN DivaSHEPHERD PHOTOGRAPH BY BRIAN SMITH DIABETES FORECAST | MARCH 2008 43 A Mark Ruefenacht AND LAABRrmstrongADOR RETRIEVER PHOTOGRAPH BY ROBERT HOUSER 44 DIABETES FORECAST | MARCH 2008 ANIMALS WHO NEED HELP, TOO Does the famously rotund cartoon cat Garfield need a shot of insulin? have an amazing ability, much We may never know, but the fact of the matter is that many household remains to be learned about how pets have diabetes, and fat cats are at higher risk for diabetes than sensitive they are in detecting leaner ones. “Type 2 diabetes is associated with obesity in people, and hypoglycemia,” he adds. it’s the same story in cats,” says Margarethe Hoenig, DVM, PhD, profes- sor in the College of Veterinary Medicine at the University of Georgia in A FORENSIC SCIENTIST who has Athens. She says that 45 percent of cats are overweight or obese, and as type 1, Mark Ruefenacht had they have gotten bigger, feline diabetes has increased three- to fivefold trained dogs for law enforcement, over the past 30 years. and worked as a volunteer “puppy Canine diabetes, on the other hand, appears to be closely related raiser” and supervisor for Guide to human type 1 diabetes. Pancreatic antibodies, the hallmark of Dogs for the Blind in Northern human type 1 diabetes, are found in diabetic dogs, indicating that an California. While on a business trip autoimmune war is being waged on the pancreatic cells that secrete to New York, Ruefenacht ate a insulin. Diabetic cats, meanwhile, maintain these cells, but produce chocolate doughnut one night be- less insulin and have reduced insulin sensitivity. fore bedtime, and took extra insulin Overall, 0.5–1 percent of cats and 0.2 percent of dogs are diabetic. to compensate. But he didn’t check Certain breeds—including Burmese cats and Golden Retrievers— his blood glucose. He happened to are more prone to diabetes than others. This indicates that there may have brought along Benton, a dog be genetic factors that predispose certain animals to the disease. Ahe was training to be a guide dog, The signs that a pet may have diabetes are the same as in people: and that night Benton recognized They drink more, they urinate more, they want to eat more, and that Ruefenacht’s blood glucose they may become weak. If you suspect diabetes in your pet, make a had plunged, and frantically tried to veterinarian appointment as soon as possible. Diabetic wake him. “He had difficulty get- dogs will need to be administered insulin indefinitely. ting me up, and getting me going. For cats, insulin may be required, but a high-protein diet But he stayed with me until I got up and exercise are also good ways to help keep blood and ate something to raise my glucose levels in check. Oral medications blood sugar,” Ruefenacht says. may also be included in care regimens. “This was not a dog that knew me, There’s another way their human or my diabetes. I started thinking, companions can help cats, by the ‘Can I train a dog to do this?’ ” way. It’s believed that one problem Ruefenacht was given Arm- contributing to the increase in feline diabetes strong, a yellow Labrador Re- may be the cuteness factor: As Hoenig says, triever, from Guide Dogs for the “Cat owners like their cats obese.” Of course, fans of Blind. The organization felt Arm- a certain lasagna-loving feline already know that. strong had a great nose for scents, —Erika Gebel, PhD but his penchant for walking she had experienced low blood symptoms. “But what we found is around puddles made him inappro- glucose.