Diabetes Forecast

Diabetes Alert Dogs: Buyer Beware

By Jennifer Cattet, PhD, and Dana S. Hardin, MD , , ,
black labrador dog


With their superior sense of smell, diabetes alert dogs seem to have the ability to sniff out low blood glucose. These service dogs are trained to smell chemical changes the human body produces when blood glucose is dropping or is low, although for now there’s no clinicial-trial evidence that shows how this works or whether the dogs’ sensing and alerting abilities are reliable and effective. The animals provide a signal to alert their owner to check blood glucose and treat hypoglycemia, if necessary.

Alert dogs have become more and more popular over the past few years, especially with people who have hypoglycemia unawareness, the inability to sense that a low is happening. A dog won’t replace a blood glucose meter and continuous glucose monitor, but it provides another layer of security as well as a friendly and watchful presence for better peace of mind.

The downside: Finding an alert dog can be a long, expensive process. As with any other valuable purchase, it’s necessary for buyers to beware. Not all alert animals are equal, so a little up-front investigation is important before you make a commitment to a service dog provider.

Many companies across the United States and around the world provide highly trained dogs with proven abilities to detect blood glucose changes. Because hypoglycemia alert dogs are also service dogs, they wear service-dog vests when working and accompany their owners during all activities and in all locations—classrooms, workplaces, medical offices, malls, airports, and more. No matter the situation, the dog should be capable of performing the job while staying as inconspicuous as possible. To get to that level, dogs undergo months, if not years, of full-time training. The time commitment required for training, as well as the price of food and veterinary care, drives the cost of alert dogs. The average fully trained alert dog comes with a price tag in the $20,000s.

There are two types of alert dog providers: not-for-profit organizations and for-profit organizations. Not-for-profit organizations provide dogs at a very low cost, sometimes for free. They are able to do this by offsetting the cost of training through their own fund-raising efforts. The waiting lists for a dog at most not-for-profits are generally long: two to five years. For-profit companies price dogs based on the hours of training required and generally have much shorter wait times. Some for-profits provide fund-raising help and guidance, but for the most part, raising the funds to purchase a dog is the client’s responsibility.

There’s always a risk that some providers will cut corners to maximize profit. That may include hiring inexperienced trainers who may not have previously trained dogs for scent detection in particular. Currently, there are no standardized training methods, so success depends on many factors that are unique to both scent-based work and diabetes. What’s more, without a full understanding of Americans With Disabilities Act laws and requirements for service dog public etiquette, organizations may underestimate the standards of behavior required.

Here are a few guidelines about alert dogs to help you become an informed consumer:

A dog’s age matters.

Puppies may be able to learn the basics of scent-based alerting, but becoming a service dog takes months of full-time training, socialization, and exposure to a variety of situations. Like humans, puppies go through adolescence, during which they may develop behaviors that can be problematic or even dangerous for public access.

Reputable organizations remove from their program dogs whose temperaments are inappropriate for public access and, instead, place them as pets. Some unscrupulous trainers, however, place animals as young as 6 months—or even younger—as service dogs. But as dogs mature, their behavior requires expert monitoring, and their training may need adjustments.

Even if an organization says it will continue training at a client’s home, trainers can’t predict a puppy’s behavior; there are no reliable tests to determine which puppies will develop service-quality behavior and which ones won’t. Beware of any organization offering a service dog younger than 1 1/2 years.

The type of alert is crucial.

Most organizations train dogs to nudge, scratch, or bring an object as a clear indicator that a critical change in blood glucose has occurred. The dogs should not be trained to perform a behavior that can be problematic when out in public (barking, for example) or an action easily confused with normal dog behavior, such as rubbing against a leg. An even bigger problem is when an organization untruthfully claims that a dog’s physiology will naturally change as an indicator. A dog’s nose, for instance, will not become either warmer or colder depending on a person’s blood glucose levels.

Ongoing assessment is essential.

No matter how well trained, a dog is a living creature that experiences changes in emotions and motivations during its life. For the training to transfer to home placement, most organizations spend a few days to a few weeks teaching the client how to communicate with the dog and how to reinforce the training. In addition, any reputable organization will provide follow-up for at least the first six months to a year after the placement as part of the initial cost and will be available for any retraining throughout the dog’s life. A reputable organization also will provide references from past clients.

When all goes well, living and working with an alert dog can be a life-changing experience. Dogs provide early alert, but they also offer emotional support. Most service dog organizations are run by caring professionals and are dedicated to providing quality dogs. Just like in any other industry, however, there are individuals who—for lack of knowledge, experience, or ethics—are willing to take shortcuts. Educating yourself so you know what to look for and what to avoid will help you find and have a successful placement with a hard-working diabetes alert dog.

Dogged Search

Diabetes Forecast suggests searching online to find out more about these and other diabetes alert dog–training organizations. Consider the principles from this article and apply common sense before making a purchase.

Jennifer Cattet, PhD, a dog behaviorist and trainer, is the founder of Medical Mutts, a service dog–training company. Dana S. Hardin, MD, is a clinical research physician at Eli Lilly and a clinical professor at Marian University College of Osteopathic Medicine.

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