An Owner-Independent Investigation of Diabetes Alert Dog Performance

Abstract

Objective: To quantify Diabetes Alert Dog (DAD) performance by using owner-independent measures. Research Design and Methods: Eight owners of accredited DADs used a FreeStyle Libre Flash Glucose Monitoring System (FGMS). Concurrent Closed Circuit Television (CCTV) footage was collected for between 5 and 14 days in each owner's home or workplace. The footage was blind-coded for dogs' alerting behaviors. The sensitivity, False Positive Rate and Positive Predictive Values (PPV) of dogs' alerts to out-of-range (OOR) episodes were calculated. Ratings for 11 attributes describing participant's lifestyle and compliance (taken from each dog's instructor) and the percentage of DAD alerts responded to by the owner as per training protocol (taken from CCTV footage) were assessed for association with dog performance. Results: Dogs alerted more often when their owners' glucose levels were outside vs . inside target range (hypoglycaemic 2.80-fold, p = 0.001; hyperglycaemic 2.29-fold, p = 0.005). Sensitivity to hypoglycaemic episodes ranged from 33.3 to 91.7%, the mean was 55.9%. Mean PPV for OOR episodes was 69.7%. Sensitivity and PPV were associated with aspects of the dog and owner's behavior, and the owner's adherence to training protocol. Conclusions: Owner-independent methods support that some dogs alert to hypo- and hyperglycaemic events accurately, but performance varies between dogs. We find that DAD performance is affected by traits and behaviors of both the dog and owner. Combined with existing research showing the perceived psychosocial value and reduced critical health care needs of DAD users, this study supports the value of a DAD as part of a diabetes care plan. It also highlights the importance of ongoing training and continued monitoring to ensure optimal performance.

Detection dogs as a help in the detection of COVID-19 Can the dog alert on COVID-19 positive persons by sniffing axillary sweat samples ? Proof-of-concept study

“…The dog's nose is also now currently utilised in order to prevent the consequences of crisis (or even prevent them) for diabetic (30,31,32,33) and epileptic people (70).…”

Dog Owners’ Survey reveals Medical Alert Dogs can alert to multiple conditions and multiple people

“…Following such reports, charities and training organizations have begun to harness dogs’ ability to detect odour cues associated with physiological changes in humans. Medical Alert Dogs (MADs) are now trained and placed in homes to alert people to a range of health conditions, including diabetes (hypo- and hyperglycaemic episodes; [ 12 , 33 , 34 ], epileptic seizures [ 35 ], asthma attacks [ 36 ], allergic reactions [ 37 , 38 ], Addison’s disease [ 39 , 40 ] and Postural Orthostatic Tachycardia Syndrome (POTS) episodes [ 41 ]. Specific training protocols vary across charities, training establishments and owners who train their dogs themselves.…”

“…Despite this, the basic protocol is usually a version of teaching the dog their ‘target odour’ (e.g., breath or sweat samples collected when that person experiences the medical condition that the dog is intended to alert to) followed by the shaping of ‘alerting’ behaviours appropriate to communicate to the owner the presence of the target odour. It is important to note, however, that dogs may employ a range of behaviours to communicate an alert, even if they have undergone the same training protocols [ 34 ]. Some owners may prefer specific ‘alert’ behaviours such as picking up a bringsel (a short item suspended from the collar of a detection dog that the dog takes in its mouth as an alert behaviour) or fetching a medical bag, whereas others may utilise behaviours such as the dog staring, nuzzling, or pawing.…”

“…Some owners may prefer specific ‘alert’ behaviours such as picking up a bringsel (a short item suspended from the collar of a detection dog that the dog takes in its mouth as an alert behaviour) or fetching a medical bag, whereas others may utilise behaviours such as the dog staring, nuzzling, or pawing. Some MADs receive no formal training and the dog seemingly spontaneously begins to ‘alert’ during, or immediately prior to, episodes of their owner’s medical condition (e.g., [ 34 ]). In this instance, owners may establish these behaviours, through reinforcement, over repeated exposures.…”

“…A noteworthy phenomenon is emerging whereby MAD owners report that their dog alerts to health conditions outside of what they were originally trained to alert, or first began alerting. For example, many dogs trained to alert to hypoglycaemia begin spontaneously alerting their owner to hyperglycaemia [ 34 , 42 ]. Furthermore, dogs trained to alert to hypoglycaemia have been reported to alert both their owner and/or other people to other health conditions such as anxiety or asthma attacks (Olivia Rockaway, February 2020).…”