On a Tuesday morning in May of 2008, Kathy Allbright, a 38-year-old insulin-treated diabetic, was in the bathroom at her Berkeley home when she suddenly felt dizzy and collapsed on the floor. Perspiring profusely, cold and shivering, she was barely conscious when her housemate, Marcy, arrived home.
“Who are you?” she mumbled in a slurred voice. A short time later, with Marcy’s help, Kathy tested her blood glucose level on her meter. It was very low, only 18 mg/dl. The normal range is from 70 to 135.
Kathy is one of more than 5 million Americans who take insulin to treat their diabetes. Despite significant medical advances and use of battery-powered devices like insulin pumps and continuous glucose monitors, type 1 diabetics still face formidable and at times life-threatening challenges when their blood sugars drop precariously low like Kathy’s did. If untreated, the brain, which secrets glucose directly from the bloodstream, begins to shut down, leading to seizures, comas, brain damage, or death.
The promise of a new journey in coping with this incurable disease began in 2009, when Kathy acquired Odetta, a small, shy black Lab from Dogs 4 Diabetics (D4D). Based in Concord, California, this nonprofit is one of only a handful of certified dog-training programs of its kind across the country.
D4D provides the dogs, training, and all follow-up services throughout the working dog’s life at no cost to its clients, except for training materials and a $50 application fee. It trains only Labradors and Golden Retrievers donated by the Guide Dogs for the Blind and Canine Companions for Independence.
The dogs trained by D4D have more than 200 million sensory receptors used for scent detection, compared to about six million in human beings. They are trained to identify and discriminate different chemical scents released through a diabetic’s breath or skin when their blood sugars change rapidly. Gradually changing blood sugar levels are more difficult for the dogs to detect.
The focus is on training the dogs to identify not only the chemical scents from low blood sugars (>70 mg/dl), but also those from normal borderline blood sugars that are dropping (>100 mg/dl). This gives the person enough time to check their blood sugar and, if necessary, eat a high-glucose snack.
According to Ralph Hendrix, D4D’s executive director, “The dogs identify the correct scent at least 80 percent of the time.” No glucose meter or CGM on the market can match what they do with their noses. And unlike these devices, there is no delay or lag time in the dog’s response. It’s immediate.
The dogs work with different handlers at D4D’s training facility until a compatible match is found in terms of the client’s personality and handling capability. The training takes from six months to a year to complete before the dog is certified and placed with an appropriate client.
The bottom line is that diabetic service dogs ease the fear of hypoglycemia and save lives.
“Rowan’s accuracy is incredible,” says an excited Abby Sheats, a 30-year old type 1 diabetic, referring to her 80-pound black Labrador, whom she got from D4D in 2013. “He alerts me when my blood sugar is in the 90s, but beginning to drop, and this gives me enough time to check it.”
Since graduating from D4D with Odetta, a small, shy black Labrador, in November 2010, Kathy has not had any insulin reactions and rarely experiences low blood sugars now. “Odetta alerts me well before I ever get to that point,” she says. “With her by my side, I walk an even line [in terms of normal blood sugars]. She stops me when I’m hiking, alerts me when I’m driving, and wakes me when I’m sleeping.”
Until Fred Bertsch, a 43-year-old Google programmer, got Picabo, a three-year old Labrador-Golden Retriever, in 2013, he had difficulty controlling his blood sugars. “They’d go low frequently, sometimes dropping as low as 40, and I could no longer program,” he explains. “But since I’ve had Picabo, my blood sugars are not only better controlled, but more consistent and more predictable. I still have lows, but no 911 calls.”
Managing glucose levels among insulin-dependent children and teens is especially difficult because of their changing physical and emotional development. Parents with children enrolled in D4D’s program are comforted by the support that a medical alert dog provides in numerous situations, but especially when their children are away from home.
This became apparent to me when I met Dylan Calamoneri, a 17-year old high school student, and Celeste, his yellow Labrador. Dylan completed his training with D4D in 2010, making him its youngest graduate. A diabetic since age six, Dylan is well aware of his need to adhere to a complex medical regimen. “I don’t have any memory of not being a diabetic,” he tells me. Diabetes makes him “different” from his peers, and school and other activities can be challenging. “My blood glucose is not always going to be 110,” he explains, “and sometimes it drops quickly and I’m not able to think clearly.”
Before he got Celeste, Dylan was reserved and sometimes embarrassed in public by his condition. “When I’d go out with my friends to a restaurant, they would watch me test my blood sugar or take insulin.” The irony is that Celeste, who goes everywhere with Dylan, has helped alleviate much of his discomfort about being a diabetic. “Once people see Celeste with her service-dog vest, they come over to talk to me,” he remarks. “Her presence initiates conversations. I’m much more relaxed and my social life has really changed a lot.”
Managing diabetes, especially rapidly changing and unpredictable blood glucose levels, is a formidable, never-ending challenge. Today, despite major advances in technology and treatment, diabetes is the leading cause of kidney failure, lower-limb amputations not caused by injury, and new cases of blindness in the United States.
Diabetic service dogs are not for everyone, but for people who like or love dogs and are open to a new lifestyle and routine, they will enhance their diabetes management and well-being because they offer something that no medical device can: A relationship forged out of mutual trust and interdependence.
Monitors and meters beep, they vibrant, but they cannot alert before the onset of hypoglycemia, because their responses are programmed, not instinctual in comprehending the danger or persistent like the those of a trained service dog.
What interests me is what D4D clients have observed or learned from these relationships. People told me that they learned something about themselves as well as the character of their dogs. “Imagine moving through the world with someone literally by your side all the time,” says Abby Sheats. “If I am angry or frustrated or worried, it affects Rowan. His presence has taught me to be more kind, more sensitive, more positive, and more accountable.”
The dogs are “both healers and teachers” according to Kathy Allbright. “They ask so very little from us, but give us so much. Odetta has taught me the importance of living in the moment and the healing affects of sharing hope with others.”
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