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People with certain health conditions can be subject to low blood sugar episodes, that if not caught and addressed, can result in impaired cognition, making it difficult or impossible for the person affected to treat themselves. This can be very dangerous if the person is alone or asleep and is unaware they are having a low blood sugar episode.
While many diabetics have good control over their condition, with a routine of blood sugar monitoring, insulin injections, and careful diet, some people have a great deal of difficulty controlling their diabetes and are frequently subject to low blood sugar episodes that can be life-threatening. Service dogs that are trained to detect low blood sugar episodes almost as soon as they begin and alert their owners to take action to counteract the condition, can be lifesavers. These dogs allow diabetics the ability to be independent, working and living on their own, and provide safety for diabetics when asleep by detecting low blood sugar episodes that could go unnoticed and alerting the diabetic themself and/or another family member.
Diabetic service dogs detect low blood sugar by recognizing the scent of low blood sugar on a human's breath or emitted through their pores. Because dogs have such an incredibly sensitive sense of smell, they are able to detect this scent, which is not perceivable to us. Diabetic dogs are then taught several behaviors to help the person with low blood sugar. They alert the person with a nudge, paw or other predetermine signal, they can go get help by alerting another person if the diabetic does not respond, and they can be trained to assist a low blood sugar episode by going to fetch testing materials, a phone, and/or glucose tablets. When out in public or in an environment such as school or work, the dog wears a harness identifying him as a service dog and carries diabetic supplies for their owner. Because of the complexity of the behaviors and situations required of a low blood sugar detection dog, the training is extensive and takes a major investment of time; many hours over several months.
Any dog breed can be taught, what is important is the temperament of the dog. Detection dogs require the ability to work in public, around other people and distractions, they need to be non-aggressive, friendly, confident and motivated to work for a reward. Dogs trained to detect low blood sugar are started by being taught to recognize the scent of low blood sugar from puppyhood; serious training begins at 1-3 years of age. Low blood sugar dogs are extremely successful at detecting episodes and can detect the onset of an epsiode 15-30 minutes before it would be detected by symptoms or even blood glucose meters.
In order to train a low blood sugar detection dog, you will need to use positive reinforcement, never negative. Dogs are rewarded for providing the correct behavior and ignored when they do not respond appropriately. Lots of treats, attention, toys, and play can be used for rewards.
You will need to provide samples of low blood sugar scent in the absence of a person actually having a low blood sugar episode in order to provide the volume of training experience required to teach the dog to detect. Samples can be obtained by taking saliva samples with a cotton ball whenever a diabetic is having a low blood sugar episode, or swabs from sweat glands, such as in the underarms or feet. These samples are then put in a zipper baggie and frozen for future use. These scent samples can be used in porous containers to teach the dog to respond to the scent. Initially, teaching a puppy to respond to low blood sugar scent may involve using a bowl and a colander to teach the puppy to put their nose up to the scent for a treat.
Service dogs used for detecting low blood sugar need to be certified and regular yearly recertification checks are performed to ensure the dog and handler are working effectively together. Investigate the certification requirements and assistance in your area prior to training.
The Associate with Reward Method
Most Recommended
19 Votes
Most Recommended
19 Votes
Prepare scent
Start by putting a low blood sugar scent sample in a bowl with a mesh colander overtop to protect the sample but allow scent to pass through.
Present
Present the bowl to the young dog or puppy.
Reward with the scent
When the puppy puts his nose in the colander and smells the scent, provide the puppy with a food treat in the colander. The puppy begins to associate the scent with reward.
Move
Move the bowl around to different location so the puppy has to go to the scent, this begins to teach locating.
Hide
As the puppy gets older, start providing the scent in smaller containers and hiding containers in various locations throughout the house. When the puppy locates the scent, reward.
Add signal
Later, you will need to teach your dog how to signal or alert you when he detects the scent of low blood sugar. Teach the signal on command, associate the signal with location of a low blood sugar sample, then remove the command so the alert is performed in response to the scent of low blood sugar sample.
The Shape Signal Method
Effective
5 Votes
Effective
5 Votes
Teach signal
Teach your dog a signal, such nudge a hand, that will be used to alert for low blood sugar. Use a hand signal to command the behavior and capture the behavior with a clicker.
Add scent
Now use the hand signal and provide a low blood sugar scent in a small porous container. When the dog performs the signal in response to the presence of the scent, and hand signal, click, and reward with food or toy play. Practice several times a day for a few weeks.
Remove command
Gradually remove the hand signal, continue to present the scent and use the clicker and reward the dog for performing the signal HIDE - Now hide the scent in a small container, let your dog find the scented object, and perform the signal, click and reward.
Add multiple samples
Use multiple containers, some using low blood sugar scent, some using other scents, present to the dog. If the dog signals to the wrong scent, ignore, but if they signal the correct scent reward.
Remove clicker
Gradually remove clicker so that dog alerts and receives a reward to the presence of low blood sugar scent alone.
The Match to Sample Method
Least Recommended
1 Vote
Least Recommended
1 Vote
Establish signal
Teach your dog a signal to be used to alert for low blood sugar, such as nudge.
Plant scent
Provide two articles, one that is scented with low blood sugar scent and one that is not, in two different spots on floor of the room.
Provide scent
Provide your dog with the low blood sugar scent on a separate object.
Shape and reward match
Let your dog loose in the room and when your dog approaches the unscented object, ignore. When he approaches the scented object, click and reward. Gradually click and reward as your dog gets closer and closer to the scented target object. Repeat exercise multiple times a day for several weeks.
Add signal
Now give your dog the command for his nudge signal, or another predetermined signal you have chosen, when your dog locates and matches the scented object. Continue to click and reward when your dog successfully matches the scent and signals you appropriately.
Remove command and click
Gradually remove the verbal command. Gradually remove the click.
Reward match
When the dog matches the scent and alerts, provide a food or play reward.
Written by Amy Caldwell
Veterinary reviewed by:
Published: 11/27/2017, edited: 01/08/2021
More articles by Amy Caldwell
Training Questions and Answers
I am a Type 1 diabetic and I am just learning about service dogs I dont know why but MoAna is a mix of German and America Rott that is not socialized with her brother Oceano however, she is very sweet not aggressive but Oceano can be at times only when he feels the need to protect. My question is...is she to old to train to service for helping me with my low blood sugars?
Dec. 6, 2023
MoAna Chavez's Owner
My dog will be 1 year old in May 1st. Is it too late to start teaching him to signal hypoglycaemia?
April 22, 2023
Koda's Owner
Caitlin Crittenden - Dog Trainer
1128 Dog owners recommended
Hello, In most cases it is not too late. Often service dog puppies are trained on basic manners, socialization, how to adapt to new situations and interactions, and task specific training doesn't begin until 6-12 months anyway. A lot of your future success with service dog training starting at this age depends more on pup's level of adaptability, general manners, and specifically socialization. An aggressive fearful dog who lacked socialization during key developmental periods as a puppy can't always recover from that to the level needed for service work. A dog who is good socially can often learn obedience commands and tasks like alerting and scent detection at a later age if they have the genetic temperament to succeed at service dog work, like a good sense of smell and a desire to work with you and ability to adapt to new environments for public access once trained. Best of luck training, Caitlin Crittenden
April 25, 2023
i was wondering if it would be a similar process to teach my kitten to sense my low blood sugar/
April 16, 2023
i am getting a kitten next week's Owner
Caitlin Crittenden - Dog Trainer
1128 Dog owners recommended
Hello, Cats do not have the same natural desire to please as dogs so they are not commonly used for service work. They also do not qualify legally as service animals so are not given the same public access rights as a service dog to be able to accompany you places. With that said, you could certainly try and see. I have never personally attempted this with a cat. Cats tend to respond best to clicker training and rewards, since they work mostly off of whatever is in it for them rather than pleasing you, so rewards based training is really important when training cats. Best of luck training, Caitlin Crittenden
April 17, 2023
I would like to be reminded to take my meds. and would like to be able to take her to my appointments. I have been a shut-in off and on for the past seven years. I have PTSD, and high anxiety, compounded with depression. I have a therapist and my doctor who is willing to write the required information needed in a letter to help facilitate the proper letters needed to help.
Sept. 28, 2022
Ava's Owner
Caitlin Crittenden - Dog Trainer
1128 Dog owners recommended
Hello, For pup to remind you to take your meds, I would associate you taking your meds with something that happens to pup on a similar schedule - like if you take your meds in the morning and evening - it could be connected to your dog's eating schedule, so their internal clock would remind them to remind you when they got hungry. Dogs can't tell time, so a timeline schedule for when to take your meds would be hard to teach, unless your medication schedule can coordinate with something else you schedule into pup's day that they will come to associate with that, like a walk at the same time, eating schedule - more reliable, then have pup earn the thing they want by being required to remind you of your medication before giving them the walk or meal each time. For pup to be allowed at appointments, I would pursue service dog training with her. To qualify as a service dog, pup need to very well mannered in public around various types of distractions and not show aggression or reactivity to any of the other dogs or people or animals, noises, or objects in the area; this means working on pup’s general obedience, socialization, and manners, so that pup can go places, get along well with everyone, and be well mannered enough not to disturb others. Joining a Canine Good Citizen or Intermediate obedience class is a good way to work on those things. How is pup around kids, various ages, races, and personalities of people, new objects, noises, other animals? Since getting out is difficult, if you can hire someone to train pup for you, that would likely be easiest for you. Managers and owners of public places also have the right to ask someone to leave if the dog isn't trained well and is causing a disturbance. To qualify as a Service Dog a dog needs to be well mannered in public as mentioned above, and be able to perform at least one specialized task that directly assists with the medical or psychological condition they are trained to help with. The person also has to have a doctor approved medical or psychological condition that qualifies - anxiety attacks, depression, PTSD, ect.. which you already have from your doctor. Pup reminding to you take medication could be a task. There are also other tasks that can help with anxiety - like teaching pup to detect when you are nervous and apply pressure therapy - such as leaning against you, lying on a foot, or lying in your lap (without resource guarding). Pup can also help facilitate certain social interactions, be taught to lead to exits if needed, or get help. Some dogs are able to detect anxiety based on scent. This is done using saliva samples taken during times of high anxiety. The dog is taught an alert, such as Sit, paw, bark, or nose - like pup is already doing. You then practice having the dog sniff the sample, give their alert, and you reward with a treat. Practice this until you don't have to tell the dog to alert but they will simply alert when they smell the sample, then you reward. Once pup can alert really well on the sample, then Saliva samples taken during anxious times and saliva samples taken during normal times are practiced together - with the dog only being praised and rewarded for alerting to the anxious sample, and not the normal sample. Ignore incorrect alerts and don't reward them. Practice this until pup can reliably alert to the correct sample only. Once pup alerts consistently, you plant the sample on yourself and practice with the scent somewhere like your pocket - rewarding alerts. You then plant the scent on yourself at random times during your day and in different environments to help pup do the alert when they aren't in "training mode" to teach them to pay attention to you in various environments and be ready to alert at all times. You can also teach pup to alert to your anxious "cues", finding things you tend to do while anxious, like bite nails, rub arms, wiggle a leg, ect...Those cues will be unique to you and probably subtle. Pay attention to what yours are. Once you know them, teach pup to alert you whenever you do those things so that pup will also alert when you do them subconsciously while anxious. Typically that's the initial anxiety alert task trained to qualify pup. You can also teach additional things that benefit you. Social media, such as instagram and facebook is actually a good resource to connect and follow other owner-trainers who are teaching their own pups tasks too. It can be a good place to meet others in your city doing the same thing to connect for practicing things with people doing similar training with their dogs. There are trainers who offer remote and in person service dog training assistance - whose role is not to take the dog and train it entirely themselves (which is great but much pricier), but who can guide you in training your own dog as needed for a lower price. Youtube is also a resource to find service dog trainers who share some how to videos on teaching specific tasks to help you trouble shoot as you go. For now, I suggest starting with pup's public access - with socialization, manners, and obedience. You can work on task training at the same time if you have time, but obedience and socialization is often more time sensitive. While doing that, you can certainly reward pup's natural alerts right now to further encourage them. In the United States there is no official certification required for a dog to pass as a Service Dog. A qualifying medical or psychological condition, great behavior while in public, and at least one task that directly helps with your condition is all that is required. Carrying a copy of ADA law regarding service dogs, pup's vet papers, a note from your doctor simply stating your need for a service dog (you don't have to disclose what condition you need help with to anyone), and a vest for pup letting people know pup is a working service dog can help people allow pup into places more easily though. Best of luck training, Caitlin Crittenden
Oct. 3, 2022