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Dogs Can Detect Low Blood Sugar Tri Valley Herald (Bay Area, CA) Ruefenacht was traveling in New York City five years ago with Benton, a guide dog in training, when the normally well-behaved dog roused his traveling companion from a deep sleep. "He was pawing at me," Ruefenacht said. "He had his paws on the bed and was barking. It was activity that was unlike the normal personality of this dog." Ruefenacht has diabetes that he manages with insulin shots. That evening, he had given himself extra insulin so he could have dessert. He then made the mistake of going to bed without checking his blood. The extra insulin caused Ruefenacht's blood sugar to plunge to a dangerously low level. "I knew I had a problem, but I was having a hard time bringing myself up to consciousness," Ruefenacht said. "Benton persisted in waking me up until I was able to get out of bed to help myself." Ruefenacht has no idea how low his blood sugar dropped that night. He shudders at the thought of what might have happened if Benton hadn't been so relentless. "That dog may very well have saved my life that night," he marveled. "I on't know far my blood sugars would have fallen. Why or how he alerted on me, I do not know." The uncanny events of the evening made Ruefenacht realize that something had alerted Benton to his handler's low blood sugar. Ruefenacht saw in Benton's actions the possibility of service dogs for diabetics. "I did some research," he said. "I found there are a number of cases in the United States where people's dogs have alerted them to low blood sugar. It's a natural instinct within some dogs." That fateful evening in New York led Ruefenacht on a five-year journey that ended with the successful training of Armstrong, a friendly yellow Labrador who can detect the scent of low blood sugar -- a scent so faint that humans cannot smell it. "As far as I know, we're the only program that is actually training a dog from point zero," Ruefenacht boasted. "It's very similar to the way a dog is trained for narcotics or explosives detection." Ruefenacht is in a unique position to train a service dog to detect the scent of low blood sugar and alert its owner. The Pittsburg resident works with his family's Concord company in quality assurance for pharmaceutical and forensics laboratories. In addition, he's a volunteer puppy trainer and East Contra Costa County group leader for San Rafael-based Guide Dogs for the Blind. "I started talking to people in the crime labs about breathalyzers that are used to check for drunk driving," Ruefenacht said. "I heard stories of diabetics who were pulled over, given a sobriety test and put into a (jail) cell. They died because their blood sugar was too low." The symptoms of low blood sugar can be similar to symptoms of intoxication. Old-fashioned breathalyzers could not distinguish between low blood sugar and intoxication, he learned. Newer models can make that fine distinction. "I talked to a breathalyzer manufacturer and asked what the breath is picking up," he said. "The breathalyzer can pick up whether you're hypoglycemic (low blood sugar), intoxicated or a combination of the two. It's all done through acetones." Ruefenacht had told his colleagues at Guide Dogs for the Blind that he was in the market for a dog that had been through the group's extensive training program but didn't make the cut to be placed with a blind person. "I waited for the right dog to come along," he said. As luck would have it, a puppy Ruefenacht had helped train was simply too rambunctious to be a guide dog. "He was just too playful, but they thought he would make a good medical alert dog," he said. "He was also very sniffy. He's always sniffing. He could find toys that other dogs had lost a couple of years ago. He has an incredible nose." That puppy was Armstrong, who would become Ruefenacht's constant companion. Ruefenacht dubbed the years-long experiment "The Armstrong Project" in honor of his loyal, hard-working pooch. To train Armstrong, Ruefenacht was closely monitored as he injected himself with too much insulin to force his blood sugar to plunge dangerously low. With constant medical assistance, he kept his blood sugar far below normal to get multiple samples of his breath and, with gauze pads, draw off sweat from his body. Ruefenacht also worked with dog-training experts at Guide Dogs for the Blind, search-and-rescue groups and the San Francisco SPCA Hearing Dog Program. Armstrong not only had to recognize the scent of low blood sugar but also had to alert Ruefenacht and keep at him until he remedied the situation. "This was all an experiment," Ruefenacht said. "What I had to figure out was if there's a common scent to the low blood sugar. Can a dog be trained to do this? And, No. 2, is the scent common among diabetics? He's alerted on nine other diabetics, so we know that this works." Ruefenacht is so confident in Armstrong's skills and the innate skills of other dogs that he's setting up a nonprofit group to train other dogs in diabetes detection work. The start-up group, Dogs4Diabetics, has an advisory board and two new canine recruits in the beginning stages of training. "I'd like to take those dogs, train them and provide them first to juvenile diabetics and then to adult Type 1 diabetics," Ruefenacht said. "They (those with Type 1) are insulin dependent. Type 2 diabetics normally are on oral medications. They do have the possibility of going low, but it's not as serious as it can be when you're using insulin." Jeannie Hickey, a registered nurse and an adult with Type 1 diabetes, has supported Ruefenacht during his quest to train Armstrong and expand the program to include other dogs. "This is so exciting," Hickey said from her office at Kaiser Permanente medical center in Martinez. "There are so many young people who (have diabetes that) it's almost risky that they live alone. There are parents who are up several times at night to check their child's blood sugar because of the fear of lows. I even have adults (with diabetes) who get up once a night to check their blood sugar so that they sleep better." The dogs could be true life-savers at night, waking people whose blood sugar drops so low that they cannot rouse themselves to seek treatment, said Hickey, who also serves on the Dogs4Diabetics board. "If you go low and there's nobody there to know that you're restless or there's nobody there to wake you up, then you could die," she said. The problem is so common that there's even an emergency response term for it: Diabetic dead in bed. "If you had a dog that alerted you when your blood sugar was low, then you could use that dog at night to build your trust so that you could sleep," she said. "It would be useful for a kid going away to college or for someone who's moving out on their own." Armstrong, the official spokesdog for Dogs4Diabetics, makes celebrity appearances at camps for kids with diabetes. At a recent visit to a Diabetic Youth Foundation camp at Camp Arroyo in Livermore, Armstrong was an instant hit. Families were excited to meet a dog that understands diabetes. "It's wonderful," mom Saroj Wadhwa said as her daughter, 9-year-old Meena, played with Armstrong. "My husband's up at least three times a night to check her (blood). A dog (like Armstrong) would give us peace of mind." Camp counselor Kyle Eisenberg, of San Ramon, first met Armstrong in March when the dog was at a weekend diabetes camp. Eisenberg was awakened in the middle of the night by a cold, wet nose gently nudging him. "At first, I thought he was just moseying around at 3 o'clock," Eisenberg explained. "But he kept nudging me with his nose. I thought maybe I should test (my blood)." Sure enough, Eisenberg's blood sugar had dropped low after a full day of camp activities. "I was intrigued," the 18-year-old said of the dog's uncanny abilities. "It was peculiar that he sensed my low blood sugar. Ever since then, I've wanted to take him home." Mom Joan Sheehan, whose 13-year-old daughter, Noel, has Type 1 diabetes, sees the gentle Lab and his owner as pioneers. "Armstrong is groundbreaking," she said. "He's pioneering a whole new world for people with diabetes. To be able to sense somebody's low (blood sugar) is lifesaving." |
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