News for Relatives of Type 1 Diabetics

Mo is a type 1 diabetic and a research information volunteer with JDRF. She participates in monthly research updates in the world of juvenile diabetes. She shares this:

Trial net is the name of a study that tests all 1st and 2nd degree relatives (45 years old and under) of type 1 diabetics.  I have my children tested annually for auto-antibodies. This is a way that moms can have their children who are siblings of a type 1 (or a parent) tested annually, for free, to see if they are at high risk for developing the disease. If a person is found to be auto-antibody positive, they can be put in studies that may forestall or delay the onset of the disease.

Almondine Multitasks

Editor's note: Type 1 diabetics are at risk for a myriad of long-term health issues. That's assuming they have a "long-term" life, since 1 in 20 diabetics will die as a result of their disease. Marcia, 56, was diagnosed with diabetes at 27. She has had surgery for diabetic retinopathy in both eyes. The best preventative of long-term health issues for a diabetic is stable blood sugar levels. Toward that end, Marcia has a 7-month-old Diabetic Alert Dog (DAD), Almondine. What follows was observed and written about by Marcia's husband, Mark. These are three days in the life of a DAD. 

These events occurred October 15 - 17, 2011: 

Friday night we went to spend the weekend in Illinois with Marcia's sister and her family. Upon arrival, we began to unload the car. Marcia's brother and sister-in-law arrived at the same time. We went into the house and gathered in the kitchen to say "Hi" to each other. Well, during this greeting time Almondine was so excited she began to howl. She has never behaved like that before so Marcia tested her BG level. It was in a good place so we thought it was just puppy behavior. Within 20 minutes Marcia's eye hemorrhaged. Editor's note: This is another health risk associated with diabetes and will require a surgical procedure called a Vitrectomy. Almondine's unusual behavior before the hemorrhage indicated she knew something bad was about to happen and she alerted (howled) to communicate to her Mom.

The next day, Saturday, there were a bunch of people that came over to the house including four little girls age 4 and under. Almondine is normally very sociable and loves kids and their toys, but she was disinterested and would not even take a treat from them (she NEVER turns down food!) she just wanted to stay on the job and seemed to be especially sensitive to Marcia the whole time.  We decided to head back home early on Saturday afternoon. Editor's note: Almondine was sensitive to Marcia's additional health issue and stayed close to take care of her.

This morning, Sunday, I got up w/Almondine so Marcia could sleep in a little. I got her fed and all that stuff, she usually will then get up on the loveseat (which is now hers by the way) for a little nap which she did, but then she stood up on the loveseat and started whining and just staring at me from where I was in the kitchen. When I started to walk towards her she jumped down and went to the gate that leads to the bedroom and stood there looking down the hall. I took her back to the bedroom and let her wake up Marcia - bg was 74! Good puppy Almondine! Editor's note: Almondine on the job - alerting Mark that Marcia was going low.

www.deethedogtrainer.com

www.diabetesalertdogs.com

Calming Music for Your Dog

Through a Dog's Ear is an incredible set of CDs. This from the mother of a diabetic and a 6-month-old diabetic alert dog (DAD): 

"Through A Dog's Ear is the most amazing CD for calming our DAD. Blossom becomes anxious when blood sugars are off at our house and can become difficult to settle. The science-based music on the CD gradually progresses to create a calming effect for your dog (and other members of the household!). The beautiful piano pieces are peaceful to listen to and pleasing to the human and canine ear. 

"Our first experience with the CD brought noticeable results within 5-10 minutes, but now calms Blossom almost instantly when she hears the first few notes. Blossom loves the CD and will sprawl out by the speaker and slip into a deep slumber. 

"I cannot live without this CD and have uploaded it to my phone and I-Pod so that it is available whenever I see the need. Highly recommended!" 

Thanks to pianist, Lisa Spector, and everyone she collaborates with - for a truly amazing music experience! 

Diet and the T1D

Thanks to Trish, the mother of a T1D, for writing this book review and sharing her personal experiences. Dee

_______

Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies: The Groundbreaking Program for the 4-A Disorders 

By Kenneth Bock

Most T1 parents recognize the rising numbers of T1 diagnoses, but none of us know why. Varying ideas exist from environmental factors, vaccines, and our food system. This book explores those ideas and connects the epidemics of the 4-As to one primary source - food sensitivities. Bock pinpoints food sensitivities (which are reactions to foods that can take anywhere from 1-3 days) and the body's reaction in the brain for autism/ADHD, lungs (asthma), skin and various systems (allergies). Although food sensitivities are not a cause of diabetes, some of the other issues our kids deal with may be.  

I have personal experience with my son that was diagnosed in 1st grade with high functioning Aspergers/ADHD. With the elimination of gluten (wheat) and casein (the dairy protein), I saw immediate results with the disappearance of his chronic nasal congestion, daily stomach aches, bowel issues, and headaches. Four months later, we had a blood test done that found other food sensitivities to eggs, peanuts, citrus fruit, soy, and oysters. With the elimination of these foods, I witnessed extreme changes in his behaviors: increased concentration, decreased hyperactivity, improved social awareness, and balanced emotions.  We have been following this strict diet for 3 1/2 years with fantastic results (no meds, no problems at school). Any accidental exposure sets off the behaviors for a day and often sends him to the bathroom that night, so you need to be strict with total elimination. 

It's hard to start, but gets easier. This book will get you thinking and open your eyes to how your body may react to foods that you never even considered. If you choose to change the way you eat, it will get you started. At a minimum you will be enlightened.

No service dogs allowed?

Service dogs. The Americans with Disabilities Act. McDonalds et al.

You have a service dog. Your dog is permitted to accompany you to pretty much any public place in the U.S., right? You know the law. Does the American public know the law? Too often the answer is no. The Today Show recently ran the story of the mother of autistic twins, their service dog, and a confrontation at McDonalds. Is this unusual? Unfortunately, no. Similar scenarios play themselves out daily in this country.

Sue Kindred, President of Service Dog 411, noted examples of noncompliance with service dog laws in a recent white paper:

• In Denver, Colorado a blind woman tried to hail a cab. The cab driver insisted that she put her service dog in the trunk of his cab. 
• In South Carolina, a woman entered a restaurant, and the owner asked her to sit far away from the other patrons in the back of the restaurant at a less desirable table.
• In New York, a man entered a bus with his service dog and he was ridiculed and harassed by the bus driver because his dog “didn’t have a handle” and she knew it couldn’t be a real service dog.
• In Florida, a young man was denied entrance to a “big box” warehouse store because they “require papers on all service dogs and we keep records”.

According to Kindred "In each of these instances, the service dogs were wearing a vest. The owners were humiliated and so uncomfortable with the harassment they received, that THEY complied with the business owners demands to put the dog in the trunk, sit away from other patrons, get off the bus, and leave the store. Sadly, this is all too often the case and it perpetuates the criminality of not abiding by the law."

What should you do if you and your service dog are denied access? The Delta Society recommends:

"If you are illegally denied access to or otherwise discriminated against in a place of public accommodation because of your service animal, stay calm. Explain that the ADA (or state law if it provides greater protection) protects your right to be accompanied by your service animal in places of public accommodation. If that does not get you admitted, ask to speak to the manager or supervisor. Repeat the explanation. If you are still not admitted, you can politely offer to call the police to have them explain the law."

Going somewhere with your service dog? Carry with you at all times a card that explains your service dog's rights under the Americans with Disabilities Act. Sharing these cards with anyone who questions your rights will, hopefully, continue the process of educating employees and owners of businesses: 

There are many kinds of service dogs - not just service dogs for the blind - and they are ALL permitted in your place of business.

Madrid

Late August 2011.
Virginia. Earthquakes. Hurricanes.
Madrid, Spain. Warm. Sunny.

It was an amazing journey when Sue Kindred, Siete (a 4-1/2 month old Labrador Retriever ), and I flew from Virginia to Siete's new home in Madrid, Spain. 

We made it through check-in and security at Dulles International Airport fairly quickly with Siete. She was a perfect lady, taking the hustle and bustle of a busy metropolitan airport in stride. When we boarded, our assigned seats were part of a four-seat configuration that we had to ourselves. That meant that Siete had a seat of her own, with Sue on one side and me on the other. She slept curled up throughout the 8+ hour flight without a whimper or whine or potty break. What a traveler! After landing in Madrid, we sailed through customs and met Blanca (Siete's new Mom and T1 diabetic) for the very first time.

What a privilege it was for Sue and me to deliver this life-saving puppy. The video below was taken a couple of days into our visit. In it, Blanca teaches Siete the training protocol for visiting the ATM.

Dee The Dog Trainer
Sue Kindred, Service Dog 411

Protect Those Paws

Extreme weather conditions mean that you need to protect the pads on your service dog's paws. You can teach your pup to wear booties or you can use Musher's Secret. One of our DAD families used Musher's Secret this summer in 100 degree weather - walking on both pavement and sand - and it worked beautifully. Whether it's blazing hot or freezing cold, you have two terrific alternatives to protect those pads.

Traveling with a young service dog

These questions were posed by one of our DAD families. Their puppy is 12 weeks old and will soon be traveling with the family.

When we make a hotel reservation, do we mention we are traveling with a service dog?

Yes. Always give the hotel a heads up that you will be checking in with your service dog. The same rule applies if you are flying with your service dog. Call the airline when making your reservation and ask their guidance about the best seat, based on the kind of aircraft, for you and your dog.

What if we stay in a downtown hotel and there are no grassy areas for potty breaks?

Ask hotel staff for suggestions about where to take her. Service dogs need to be comfortable going potty on any surface, since there may not always be grass available. To practice, take your puppy out on your street or sidewalk for her first potty of the morning (do this a few times before your trip to make sure she okay with it). Praise and reward for going potty on pavement. And, of course, always bag and properly dispose of puppy poo.

What if we're on the 33rd floor and it's 2:00 in the morning and the puppy needs to potty? 

When you make your reservation, tell them you are traveling with a service dog and ask for a room on a low floor near an exit. A dog past 4 months old, if pottied before bedtime, will not need a potty break in the middle of the night unless there is a tummy ache involved.

How many hours can we drive before we need to stop for our puppy to get out and stretch and stuff? 

Depends on the age of the dog. Under six months, maybe every four hours or when the dog indicates she needs a break. Over six months, whenever the humans need a break or the dog indicates the need for one.

Where do you recommend we stop for these breaks, i.e., gas station or rest area or something else? 

After a dog has all of her shots, rest areas are fine. They are usually kept pretty clean. Be careful of areas around fast food restaurants, gas stations, and such. There can be a lot of litter, even broken glass - things you don't want your dog to be around. Parks with hiking trails are a wonderful place to take a break, too.

When you start traveling with your service dog, remind yourself that she IS a service dog and can go anywhere you go. Sounds silly ... but we all have those "family dog" rules so ingrained in us (mostly where they cannot go) and it takes some adjustment in thinking to plan our lives around our service dogs' rights to full public access.

http://diabetesalertdogs.com/

http://www.deethedogtrainer.com/

What a good puppy

When I fly a puppy who is part to his or her new home, I inevitably hear from airline and airport employees, as well as the flying public, “what a good puppy that is.”

The puppies are usually 10-12 weeks old, tucked into a small soft carrier that fits under the seat in front of me during flight. Airline regulations say that the puppy cannot come out of the carrier until we reach our destination. The goal is to get from Place A to Place B without incident and with a happy puppy when we de-plane. The puppy usually starts to settle in when we are in the boarding area. By the time we take off, the puppy is napping. How can such a young dog be calm in an environment like an airport? It’s all about great temperament and training. These puppies are bred for a temperament that will allow them to go anywhere and do anything with self-confidence. Their formal training starts at 7 weeks. Breed them right, start their training early. It's magic.

http://www.deethedogtrainer.com/

I wrote this while flying with Blossom (above). This picture was taken while we waited to board. Throughout the flight there was a crying baby, a noisy toddler, and a quiet puppy.

Jacob & Shalom

Shalom is a 13-week-old Lab. I spoke with Mom, Jessica, this afternoon about the third week of life with Shalom and Jessica's son, 7-year-old T1 diabetic, Jacob. Here's a highlight:

June 25th, 9:56 p.m.

Shalom seemed very interested in Jacob (she smelled him, licked him and gave him a little nip). We checked. He was at 109. She wouldn't leave him. At 10:33 he said he was feeling low. I checked again and he was at 66. She wouldn't leave Jacob and she seems to come to get me when he's low.

In this example, I believe Shalom knew her boy was dropping. Based on this and numerous other things that happened during the week, it is pretty clear that Shalom is recognizing Jacob's fluctuating blood sugar levels. Her response is to stay close, "taking care" of her boy. If Mom isn't around, the puppy is understanding that Jacob needs something and is in the early stages of "getting help".

Bravo to Jacob's parents for recognizing and noting Shalom's behaviors, then sharing their notes with their trainer. Great job everyone!

Dee Bogetti, Service Dog Trainer/Consultant

The Muffin Pan Game

Interactive games and toys engage dogs in appropriate play. In this case, all it takes is a muffin pan, tennis balls, and treats. Your dog will have fun while learning to problem-solve. In this version of the game, there is a treat under each ball. Put a treat under only one tennis ball and it becomes a real scent game. Murphy demonstrates.

Service Dogs in School

The role of service dogs is changing dramatically. With the rights afforded people with disabilities through the Americans with Disabilities Act, more and more children are able to take their service dogs to school. Read the story of two kids and their service dogs on NPR's website. Even though these are not Diabetic Alert Dogs, the same rights - because of the Americans with Disabilities Act - apply to DADs and a multitude of other kinds of service dogs. 

A New Beginning

May 5, 2011

Today 11-week-old BG, a handsome yellow Lab, met his new family in Florida. BG will grow up to be 15-year-old Blake's Diabetic Alert Dog. That's Blake, below, holding his puppy.

Kids with Diabetes. The Classroom.

Managing diabetes is a 24-hour-a-day job ... including when your child is in school. The American Diabetes Association created the Safe at School program to ensure that:

• All children with diabetes are medically safe at school and
• All children with diabetes have the same educational opportunities as their classmates.

Take advantage of this program that helps families overcome barriers at school by providing solutions to challenges their child may encounter.

Learn more about diabetic alert dogs here.

Sugar - One great dog!

Beverly T. shared this story about her medical alert dog in training. Sugar is a 5-1/2 month old chocolate Lab.

Yesterday Sugar was pretty amazing. We had gone to our favorite little lunch spot, ordered and sat down. Sugar went under the table as always and went to sleep. This is his habit, his proper behavior in a restaurant for months. Mom was with us and we both ate our lunch and started talking. At a point Sugar started looking at me and making whimpering noises. I thought he had to go out, so we slipped out the back door and I gave him a chance to "go", he did not and I knew he had taken care of that before we entered the coffee shop. So we went back in, again he went back under the table and laid down. A little bit later he looked at me and whimpered again. Mom and I started talking about him possibly being in some pain, as he acted really distressed, but just whimpered low a few times. It really was a pitiful little noise.

I needed to go to the bank, and since Sugar was acting "different" we decided mom would leave her car and ride with me, then Sugar wouldn't have to go in with me. When I finished at the bank and got back in the car, Sugar was acting distressed, pulling hard on his harness and trying to get to me in the front seat. He was able to stretch his zip line far enough to come up and push on my shoulder, pretty hard. Mom asked me had my sugar been dropping this morning, it had not, and since I had just eaten lunch, I really wasn't concerned that it was the problem. At that point I looked down at my CGM and it read 144, but with 2 arrows pointing down (the alarm was off?), which means my blood glucose was falling fast. Since the numbers on the monitor can lag behind actual BG, I pulled my meter out to check BG. It was then 111.

I started correcting the drop, waited about 5 minutes, and rechecked. My BG was 90. So I was on a quick drop down, and because of Sugar's behavior I didn't have to wait for it to go into the really low numbers to start correcting the problem. It was behavior I believe that showed he was aware I was "headed" for a quick drop, before it became low, and this is just what I need, and had wondered how to relay that to him in training. Well no need, he knows his business!

Sugar was 5 months old a few days ago, and has not officially started any scent training. I had started involving him in BG checks, and he had been watching me intently each time. We had started checking BG together as a team on Monday (Feb. 28th, 2011, 4 days ago) when I had 5 glucose drops (one to 33) in one day. Until that time I had been unusually stable for a few months. I attributed this to Sugar's presence and had found some information that oxytocin hormone (see below) is released in people who are in contact with a dog. I thought maybe that hormone was overriding the catecholamine hormones (flight-or-fight hormones) that we believe were reducing the glucose that I had circulating. (Oxytocin has a role in social behaviors in many species, and so it seems likely that it also does in humans. In 2003, a study showed that in both humans and dogs, oxytocin levels in the blood rose after five to twenty four minutes of a petting session. It is possible that this plays a role in the emotional bonding between humans and dogs). He also the same behavior last night and again caught a drop before it was low.

Sugar also lost one of his baby teeth. He deserves the tooth fairy to visit him tonight!!!

Bravo, Sugar!

Healthy Lifestyle Expo

Two of the finest dog handlers I know are 14-year-old Christian Hall with his Diabetic Alert Dog, LuLu (in the orange vest) and 11-year-old Cassidy McAdams with her Diabetic Alert Dog, Pepper (green vest). The Healthy Lifestyle Expo was a wonderful opportunity to train the pups. LuLu is 10 months old and Pepper is 6 months old.

Dogs just gotta have fun!

Yes, even, service dogs need to have fun. And here's beautiful LuLu and her T1D, Christian, hanging out in the snow in Northern Virginia! Once LuLu is fully trained and certified, she will be perfectly able to interrupt a play session (or agility or retrieving or anything else they are involved in) to alert on their diabetic. Dogs are the ultimate multi-taskers!

Pepper goes to school

My clients' diabetic children attend public, private or home school. When the time is right, based on the child, the dog, and the kind of school, we begin the dog's introduction to a classroom setting. Pepper's handler, 11-year-old Cassidy, is home schooled. One day a week she attends a home schoolers' co-op, which is similar to a standard day in a public school. Yesterday, Cassidy attended her first day of the new session at co-op. Her mother was there, assisting in the classrooms. I joined them to evaluate 5-1/2 month old Pepper's ability to handle a full day of school. Following are some of my observations.

Pepper:

• was well mannered for six straight hours. 
• moved comfortably from classroom to classroom, through crowded halls, up and down the stairs, in the ladies' room, and in the elevator
• had no toileting issues - going potty outdoors on cue each time we took a break between classes
• did not try to interact with anyone but observed everything (gold star for that one!)
• never vocalized (no whining, barking, etc.)
• showed no anxiety when not in direct contact with Cassidy (they are bonded to the nth degree)
• Note: I handled Pepper most of the day so I could closely observe even the most nuanced behaviors. This meant we were sometimes seated next to Cassidy in the classroom, sometimes across the room. It also meant I took the pup on potty breaks without Cassidy. Separation anxiety can be an issue with service dogs and their handlers. I'm thrilled this is not an issue for Pepper.

• handled the chaos of an unexpected evacuation of the building (very much like a fire drill) beautifully
• was extremely cooperative in a tight space when I took her collar and vest off to crate her briefly during lunch

Pepper's family and I will sit down and talk about the next step: when and how Cassidy starts the process of taking Pepper to school.

This was a stellar performance by a young dog. Bravo to everyone involved!

Service Dogs in Schools

Should a child be allowed to take his or her service dog to school? This question arises from time to time when a child's service dog is refused entry to the classroom. This time the story revolves around a 12-year-old in Fairfax County, VA and his seizure alert dog.

When questions concerning service dogs arise, I turn first to Federal law. The Americans with Disabilities Act does not specifically address service animals in the classroom. In general terms, access under the ADA applies to public areas of schools like the gymnasium during sporting events or the auditorium during a public fund raiser. Classrooms are usually not considered public areas. As with many laws, the intent of this one is murky - leaving it open for interpretation.

Virginia's Department of Education recommendations are more specific:

... the Code of Virginia, § 51.5-44 affords each student a near absolute right to be accompanied by a service dog in a Virginia public school; however, this right must be qualified, carefully weighed against the rights of other students who are equally entitled to receive educational benefits at the school. Furthermore, the right of the student to be accompanied by a service dog must also be weighed against the school division’s ongoing legal responsibility to operate, maintain, and supervise Virginia’s public schools.

From my perspective as a trainer, I believe each case should be considered on its own merit. Children who are very young, emotionally immature, or severely handicapped may simply be unable to handle a service dog in the classroom without assistance from a third party. Following are a few things to ponder.

Will the child be able to do these kinds of things with a dog in tow:

• ride a school bus with his service dog plus a backpack and whatever else he's toting to school on a given day
• change classrooms quickly and efficiently
• eat lunch (dog + human food can = disaster)
• participate in PE class
• attend after-school programs
• go on field trips
• participate in fire drills
  

Also ask these questions:

• If the child becomes ill or is injured at school and has to be taken to the hospital, what happens to the service dog?
• Is the service dog able to lay quietly for long periods without get antsy, needing potty breaks or being disruptive?
• Does the service dog have fear or anxiety issues of any kind like noise phobias (fear of thunderstorms, for example) or separation anxiety?
• Has the service dog passed a public access test?
• Has the dog been certified by a service dog trainer or organization

As service dogs become more visible, handicapped individual's rights will inevitably be challenged. It is the responsibility of everyone involved to ensure that each case be judged fairly and on its own merit.

And what has happened with the 12-year-old in Fairfax County and his service dog? According to change.org "Andrew Stevens can now bring his service dog Alaya to school with him".