by Robert Schmitt.
Dylan Verron, 15, of West Covina suffered from three seizures last year, all in the middle of the night. When she was 3, Verron was diagnosed with Type I Diabetes and she was now a cheerleader at South Hills High School with aspirations for college. These new developments could make that much more difficult. Her night time seizures occurred while she was asleep and unaware of the dangerous change in her blood sugar.
Throughout Verron’s life there has been new technology introduced to her that has helped keep her safe. According to Verron’s mother, Erin Villarreal, 33, the newest technology isn’t enough.
“Technology isn’t going to wake her up and tell her to correct her blood sugar,” Villarreal said. “A dog would be more persistent.”
The use of Diabetic Alert Dogs that can alert owners is growing in the Diabetes community. Debby Kay, Executive Director of the Diabetes Alert Dog Alliance (DADA), said that she sold a dog to someone in the ‘70s who would nudge him to remind him to eat. But recently, dogs have begun to be trained to detect changes in blood sugar levels.
“For about 15 years now, people have been training dogs to do this,” Kay said. “Dogs that have been devoted to their people have found out how to do that on their own a log time ago.”
Right now, DADA has the only national standard for Diabetic Alert Dogs, or DADs. For a dog to become certified, it must go through rigorous training and meet DADA’s minimum standards. These standards include two tests: The Public Access Test where the dog is to show appropriate behavior in public and The Scent Test where the dog denmonstrates alerting at the scent of high or low glucose. The DADs scent mastery doesn’t only apply to a single owner.
One day Verron was with a family friend who is also a Type I Diabetic and who has a DAD. Without knowing why, the dog went up to Verron and began to nudge at her.
“They told me to check my blood sugar and sure enough, I was high,” Verron said.
According to Kay there are three types of alerts used by trainers. Dogs are taught to paw at the owner, nose nudge the owner or use a tug toy as a sign to check blood sugar.
Felicia Tejakusuma, founder of Pawsible Independence Assistance Dog, a DADA certified dog training company, says the most efficient alert is the nose nudge. She said they have found at PIAD that some people have skin sensitive to pawing, and that the tug toy is ineffective at night.
“That is when it’s the most dangerous for diabetics,” Tejakusuma said. “With the nose nudge, the dog can wake the person up.”
Luke Van Ginkel, 18, introduced Verron to DADs. His own dog, Astro, has saved his life multiple times by waking up his mom when Van Ginkel’s blood sugar is low. Van Ginkel once suffered from the same seizures Verron experienced this year.
This is why Villarreal has began to take the necessary steps to make sure her daughter gets a DAD. One could save her life.
Villarreal has already run into problems typical of someone looking into getting a DAD. “We were talking to a company back east that trains Diabetic Alert Dogs,” Villarreal said, “but we found out they weren’t very reputable.” Because there are no agencies to regulate companies that sell DADs, people are at risk of buying an unreliable dog that could leave them in danger.
Companies like PIAD who follow DADA standards are required to monitor new owners of dogs every month for six months after placement. Then, once a year after the initial six-month period, both the dog and owner are required to pass a test to show the dog continues to meet standards, according to DADA’s website.
“Just like an athlete, if you don’t practice, you will lose your skill,” Tejakusuma said. “Yearly re-testing is covered in the initial fee for the dog.”
Cost of a DAD is another obstacle. PIAD charges between $15,000-$16,000 which is a lifetime fee that covers an application fee, group camp fee, home materials, the dog, the training, and the lifetime support.
Kay, Tejakusuma, and Villarreal say there is no insurance that covers the cost of a DAD. Villarreal said they will, however, help fundraise. Companies like PIAD will work with clients on fundraising as well.
DADA, itself, does its own type of fundraising, but for different reasons. Since the alliance doesn’t get much research funding, the board of directors has to decide where to invest the grant money they do get.
Kay said that knowledge typically comes from the trial and error between trainers. She’s been training dogs for so long that she has found what she thinks is the most effective way to train the dogs.
“Classical conditioning,” Kay said. “The dog is conditioned to a particular odor and the response related to the specific odor is positively reinforced.”
Tejakusuma echoes the same sentiment. She said that at PIAD they use positive reinforcements with clickers and verbal commands.
“Whatever the dog is doing at the second we use the clicker, is the behavior we are looking for,” Tejakusuma said. “Then we pair it with the food to make sure they understand that is the right behavior.”
Certain breeds of dogs are genetically more apt to be DADs, but Kay and Tejakusuma insist their training regimen can work on any breed of dog. Kay said that as long as the dog can respond appropriately while its owner does daily tasks in public, it can be a DAD.
“Going into restrooms, to school, into stores, and things like that, you need a dog that’s reliable, that likes to work, and is well mannered while doing their job,” Kay said.
However, there are certain breeds that are naturally better at being DADs. According to Kay, most DADA certified trainers use labradors or golden retrievers because of their knack of working with people and their easy going temperament.
Tejakasuma likes the combination of the two the most.
“Labs are hardy dogs, less sensitive than golden retrievers and retrievers are too sensitive,” Tejakasuma said. “When you mix them together they are a better combination.”
Research into why dogs can smell the high or low glucose levels in humans is minimal. Kay, who has been a pioneer in research of Diabetic Alert Dogs for the last 40 years, still doesn’t have answers she needs for training to be most efficient.
According to Kay, most trainers use saliva samples to train dogs to alert dangerous levels of glucose. Some are using breath samples and some sweat.
“Saliva is the easiest to store and deal with,” Kay said. “I’ve proposed to a group that does breath samples that it would be interesting to do some research to see if there is some difference between results.”
Kay continues to be a leader in research on the topic. The most important research happening at the moment, according to Kay, is finding out what it is specifically that the dogs detect by scent. It is unknown what the dogs are reacting to, the trainers just work with the fact that the training can produce positive results for patiets with a serious need for the dog.
“Research being done is to determine what the factor x is,” Kay said. “That’s what we call it — that unknown factor x — is what we want to identify.”
Once the dogs are trained, it is time to find them someone to work with. The way they are matched with an owner is much like the way one would find a dating partner. The trainers know each dog’s personality and look to match the lifestyle of the Diabetic.
For someone like Verron, an active dog who can navigate social situations while staying on task would be ideal. Verron is a cheerleader with lots of friends. She will need to take the dog with her to football and basketball games while she cheers. Villarreal said that compared to a three-year old who isn’t very active, Dylan will need a dog with a lot of personality and discipline.
“I hope it’s really playful and loving because I love cuddling with dogs,” Verron said.
For Van Ginkel, his dog Astro is just as rambunctious as he. For someone who puts himself in a lot of high pressure situations as a kicker for his high school football team, he creates a lot of work for Astro.
Van Ginkel said that during games, when his blood sugar is at its highest, his mom has to stay with Astro on the sidelines to keep him tamed.
“He saves my life and goes everywhere with me,” Van Ginkel said. “He’s pretty much my best friend.”
As for Verron, she is going through the process of landing a dog for herself. Because of the standards set by DADA on the applicants who want a dog, the process is a long one. Her application is currently being processed after getting extensive proof of her Type I Diabetes from her physicians at Kaiser Permanente.
Verron said she is looking forward to the day she gets a dog like Astro. For her, the biggest relief is that her brother will no longer have to sleep next to her with part of his mind on saving her life.
“I have a really close knit family,” Verron said, “so what happens to me, affects my whole family.”