Multi-ability alert dogs for people with diabetes and visual impairment

Lee Stanway

Guide Dogs in the UK was Working with a guide dog requires the In 2003, Guide Dogs initiated a number established in Wallasey, near owner to be able to recognize the move- of projects in partnership with other ments of the dog through a harness, not-for-profit organizations, such as Liverpool, in 1931. Since then, and use tactile clues and sound clues Canine Partners, Support Dogs, Dogs many thousands of blind people to complement their knowledge and for the Disabled and Hearing Dogs. The have benefited from having a experience of a certain route. The dog success of these projects has confirmed guide dog. Recent research into then responds to commands to turn that dogs can perform more than one the training of people who are left or right or carry straight on. The role. The evidence suggests that far from dog is trained to stop at kerbs, allowing being overburdened, the dogs actually visually impaired has shown the owner to assess the traffic before enjoy the additional work. that around 30% of people who proceeding, and avoid any obstacles train with a dog have some along the way. Medical Detection Dogs is a recently form of additional disability. For established UK-based charity with a Guide dog owners with diabetes can face small number of committed staff and many, this can be a co-morbid specific challenges. The loss of sensitiv- dedicated volunteers. For the last few condition like diabetes. Lee ity in feet or fingers, for instance, can years, they have been working with dogs Stanway reports on progress make following a guide dog more diffi- that provide medical alerts – including towards the provision of multi- cult; a drop in blood sugar during a walk for people with diabetes. can present a whole range of problems. ability alert dogs to protect These issues affect a person’s ability to Dogs can detect smells many thousands the health and wellbeing concentrate and follow the dog properly. of times more effectively than humans, of people with diabetes. Guide Dogs and diabetes an ability that has been harnessed by

October 2012 • Volume 57 • Special Issue 1 DiabetesVoice 39 humans for many years – to search alert to important glycaemic changes. The success of the Medical Detection for food, drugs, explosives and many The dogs develop the ability to detect Dogs programme has been life-changing other things. Medical Detection Dogs changes in advance. for Julie (not her real name) a school- employs a number of dog trainers with girl whose brittle diabetes had resulted The dogs develop diabetes. Using material impregnated in frequent calls to paramedics. Her with the trainers’ sweat and breath, the ability to detect blood glucose on those occasions had the dogs become familiarized with the important glycaemic dropped to dangerously low levels. The unique chemical markers associated changes in advance. introduction of a trained diabetes alert with human diabetes. dog changed all that. The dog stays with The dogs progress to performing a fol- her in the classroom, under the supervi- As the dogs progress through training, low-up task, which in this situation is to sion of the teacher, and provides vital they are encouraged to sit alongside fetch the case containing the trainers’ alerts that make the attendance of the the trainer while he or she carries out blood testing kit. The bag also contains paramedics no longer necessary. self-monitoring of blood glucose. If the some kind of food reward, reinforcing trainer’s glucose levels are within normal each dog’s motivation to detect changes Davey, Sue and Graeme too – parameters, the dog is given a small food in blood glucose and alert its owner. a pilot project ‘reward’; if the trainer’s blood glucose The alert can take several forms – the A collaborative pilot project was dis- have dropped, the dog gets a ‘jackpot dog licking the owner’s hand, nudging cussed between Guide Dogs and reward’ – encouraging the animal to be with its nose or using a paw. Medical Detection Dogs two years ago. The possibility that a dog could perform These dogs often perform a guiding role and alert a person with exceptionally, and diabetes to changes in blood glucose was at times surpris- potentially ground breaking. ingly, well. The CEO of Medical Sue fit the criteria for the project. She is Detection Dogs, an experienced guide dog owner with Claire Guest, described type 1 diabetes. Sue lives in the north west to me how a dog stopped of England with her husband Graeme, suddenly during on a visit who is highly supportive, helping Sue to a restaurant during train- to keep daily records of her blood glu- ing with a potential new cose levels and ensuring that the cor- owner. It sat and stared at rect amounts of insulin are administered one of the diners, a person several times a day. Like many people completely unknown to who live with a partner or relative with the dog or its trainer. It diabetes, Graeme is aware when Sue’s turned out that the per- blood glucose is too high or too low. son having a meal A person’s body language, slurred speech had diabetes or sense of confusion can offer vital clues. and the dog had detect- A major concern for Sue, however, and ed her high other visually impaired people with blood glu- diabetes, is being unaware of falling or cose levels. rising glucose levels when alone. Sue had experienced fairly regular drops in blood glucose that she was unable to detect. Undetected hypoglycaemia dur- ing the night is particularly threatening for many people with diabetes.

40 DiabetesVoice October 2012 • Volume 57 • Special Issue 1 The dog provides vital alerts, eliminating the need for paramedics to be present at all times.

OctoberOctober 2012 • Volume 57 • SpecialSpecial IssueIssue 1 DiabetesVoice 41 Sue had an established working dog Sue needed to test her blood glucose. At the moment, Medical Detection Dogs called Davey. They had a close bond and It was low. A drink and something to is working hard with limited resources Davey was happy to be in fairly constant eat brought Sue’s levels back to normal. and Guide Dogs continues to provide proximity to her. This was important, as more than 820 guide dogs each year to Graeme was unsure a less sociable dog would be more likely visually impaired people throughout to enjoy time alone and not necessarily why Davey had woken the UK. Hopefully, the pilot will help be with Sue when needed. him but quickly realized us to identify new and more effective that this was an alert. methods of training that will continue to Davey was trained to sit next to Sue impact positively on the lives of people whenever she tested her blood glucose Hope for the future who could benefit from the extraordi- levels, and given an appropriate re- Many people with diabetes could benefit nary intelligence and abilities of a dog. ward depending on the reading from from the life-changing, and potentially Sue’s monitor. This continued for some life-saving, alert that a dog can pro- months. Visits were made by a guide dog vide. Guide Dogs and Medical Detection mobility instructor from the local Guide Dogs are committed to exploring the Dogs mobility team and trainers from potential to support people who are Medical Detection Dogs, who offered visually impaired and have diabetes. further advice and checked progress. It may be that the most effective way forward is to identify a dog before it Over a period of several months, it be- undergoes any mobility training (to came evident that Davey was detect- support visual impairment) in order ing changes in Sue’s blood glucose. One that the diabetes-related training can night, Graeme felt a wet nose nudging be carried out in advance. This follows Lee Stanway him awake. At first Graeme was un- the model of other dual-purpose dog Lee Stanway is Additional Needs sure why Davey had woken him but training in the UK and there is no reason Manager at Guide Dogs UK. quickly realized that this was an alert: to believe that it will not be successful.

42 DiabetesVoice October 2012 • Volume 57 • Special Issue 1