diabetenhulphond

Een studie, die werd gepubliceerd in het British Medical Journal, geeft aan dat honden diabeten kunnen waarschuwen bij een te laag bloedsuikergehalte, iets waarvan deze mensen zichzelf helemaal niet bewust zijn.

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Sit! Roll Over! Diagnose Hypoglycemia! Good Dog!

Is the Pooch Pal the Best Glucose Alarm Clock We Have?

Daniel Trecroci

1 March 2001

In a report published in the December 23, 2000 issue of British Medical Journal (BMJ), researchers at the University of Liverpool in the United Kingdom write that hypoglycemia is one of the complications of diabetes most feared by patients. They point out, "Intensive research has been devoted to the development of hypoglycemia alarms [Cygnus's GlucoWatch monitor]."

However, one thing we in the diabetes community might be overlooking is good ol' reliable Rover.

In addition to being used by law-enforcement officials for sniffing out drugs and explosives, dogs are capable of guiding visually impaired people, as well as recognizing fits in people with epilepsy. The U.K. researchers feel canine companions could also very well be the solution we have been looking for to detect low blood sugars, describing them as both "non-invasive" and a "fully bio-compatible and patient-friendly alarm system."

"Hypoglycemia alarm dogs could provide an important aid to patients with poor awareness of symptoms, particularly those prone to [nighttime] episodes or who live alone," the BMJ paper stated.

The BMJ paper is not the first to address this phenomenon. In a 1992 issue of Diabetic Medicine (volume 9; supplement 2; S3-S4), researchers at the Bristol and Berkley Health Centre in Gloucestershire studied 50 people with diabetes who had owned pets since starting insulin. Thirty-eight percent of the people who owned dogs said their pooch responded to their hypoglycemic episode, by either barking or fetching a neighbor. This lead the researchers to conclude, "Pets may help patients with type 1 diabetes through aiding them when hypoglycemic."

Three Case Studies

In the paper prepared for BMJ, three diabetic women (whose reports were volunteered spontaneously and independently) and their faithful canine companions were evaluated.

Hiding Under the Chair When You Go Low

The first case study involves a 66-year-old woman who developed type 2 diabetes in 1971. According to the BMJ paper, the woman was transferred to insulin in 1979 and currently takes injections of Regular and NPH, twice daily, for a total of 38 units per day.

Despite having no significant diabetic complications or other illness, and drinking very little alcohol, the woman reportedly has experienced "increasingly frequent hypoglycemic episodes the past two years," commonly characterized by excessive sweating, generalized weakness, anxiety and irritability. Most attacks occur in the evening and some occur at night.

The 66-year-old woman during the past year has noticed, "unusual stereotyped behavior" by her nine-year old female mutt, Candy, prior to her having a low-blood-sugar episode. Candy's behavior includes jumping up and down, running out of the room, and hiding under a chair in the hallway. Candy then re-emerges when the woman has taken a carbohydrate. The woman notes her BGs during such episodes are around 27 mg/dl.

'Wake up' says Little Susie

The second case study involves a 47-year-old type 2 woman who takes insulin each day. Her insulin usage totals 28 units per day. The woman has about two low-blood-sugar episodes per week, commonly characterized by sweating and sometime confusion. Her lows tend to occur during the afternoon and sometimes at night.

Within the past year, the woman's seven-year-old female mutt, Susie, has shown, "peculiar behavior during the patient's hypoglycemic attacks." The woman reports Susie has nudged her awake. After awaking, the woman has tested to find herself having low blood sugar-usually around 36 mg/dl. Susie goes back to sleep only after the woman has taken a carbohydrate and her symptoms have settled.

Scratching the Bedroom Door

The third case study involves a 34-year-old type 1 woman who has suffered from retinopathy and kidney complications. She currently takes NPH and lispro, totaling 41 units per day. On average, she has two hypoglycemic episodes per week, characterized by sweating and light-headedness. The BMJ paper reports the woman has, "reduced awareness of hypoglycemia and does not wake up during nocturnal episodes."

The woman's three-year-old male golden retriever, Natt, becomes very distressed whenever she is hypoglycemic. During episodes of nighttime hypoglycemia, he barks and scrabbles against the bedroom door and stops only after the woman's hypoglycemia has been corrected. For the BMJ paper, the woman notes her BGs, on two such occasions, were 29 and 34 mg/dl.

Taking Glucose Sensing to New Level

The BMJ authors say the three dogs reported here "take canine glucose sensing to a new level of sophistication."

"All were clearly able to sense hypoglycemia accurately under circumstances when the patients themselves were initially unaware of falling glucose levels," the paper states. "Formal calculations of sensitivity and specificity are not possible, but each dog showed [his or her] specific behaviors only when the patient had documented hypoglycemia."

The BMJ authors say Susie and Natt's case is unique because they detected low blood sugars even before their owners noticed the symptoms. Possible clues may include:

• Olfactory changes (possibly related to sweating)
• Muscle tremor
• Behavioral alterations, such as the patient's failure to respond to his or her dog in the usual way.

The BMJ authors suggest an extended healthcare role should now be considered for man and woman's best friend.

"Research is urgently needed to determine whether dogs can be trained to recognize and react to early signs of hypoglycemia."

Who's a Good Doggie?

Several Diabetes Health readers were not surprised with the article published in BMJ, saying their faithful companions have always been there when lows blood sugars have come around.

Courtney Newton of Erie, Pennsylvania, says her step daughter, Becka, was diagnosed with type 1 diabetes in February 2000. Their dog is a Sheltie/Jack Russell mix named Dexter.

"Dexter is my baby and [has never sat] on the couch with anyone but me," says Newton. "If I am not in the room, he sits on the floor."

Shortly after Becka was diagnosed, however, Newton noticed Dexter sitting quietly on Becka's lap, trying to lick her face. At first, Newton thought this odd and ignored it. She then realized it was Becka's snack time, so she tested her blood sugar.

"She was only 48 mg/dl," says Newton. "She was not aware of her low blood sugar. As soon as I fed her and got her blood sugars to come back up, Dexter was back on the floor laying in his usual spot."

A couple of weeks later, Newton recalls Dexter was again sitting on Becka's lap around dinnertime, trying to lick her face. Newton asked Becka if she felt low and Becka said no. When Newton took Becka's BG reading, sure enough, it was 52 mg/dl.

"I thought maybe it was just a coincidence, but the next time I saw [Dexter] sitting with [Becka] and licking her face, I immediately grabbed the meter even though it was not testing time," says Newton. "She was 54 mg/dl that time. She had not felt any of these lows herself, but the dog had."

Newton says it has been almost a year since these episodes. Every time Dexter is nearby and Becka is low, the dog licks some part of her body.

"Becka knows that if Dexter licks her incessantly to test her sugar and tell me or her dad," says Newton. "Every time he has licked her, she has been low. He seems to be able to pick up anything below 60 mg/dl."

Gregor Randall of Grants, New Mexico, has had type 1 diabetes for 26 years. Randall's dog, Maty, whom he has had almost four years, has awoken Randall for the last three years during times in which his BGs have dropped low in the night.

"At first I thought it was just coincidence, however, it has happened too many times over the last three years," says Randall. "I don't know if I thrash, mumble, snore or breathe differently when my blood-sugar levels drop, but regardless, she is always pushing me with her paws."

Randall says when he does not quickly respond, Maty, who is 40 pounds, becomes aggressive. "[She takes] a running start and hits me with both her front paws."

Mona Vicente is a type 1 from Odessa, Florida, who has been on an insulin pump for seven years. She says she experiences about five hypos per week, typically brought on by administering too much insulin. Vicente says her half Chow/Sheepdog, Frosty, detects her bouts of oncoming hypoglycemia.

"Frosty was a lifesaver in waking me up when I was sleeping and incurring a low blood sugar," says Vicente.

Ann Thelemann, a type 2 from Burnsville, Minnesota, raises Dobermans. A few months back, she noticed that her smallest dog, Hannah, would begin to cry and whine for no apparent reason.

"After a few weeks, I realized that just before I did my finger sticks, she began to whine and cry," says Thelemann. After each stick, Thelemann noticed she would be low. She says Hannah would lay at her feet and wait for her to say it's okay. "On days when I would tell her, 'It's not good today,' she would bring me her rawhide chew."

Thelemann says Hannah never lets her oversleep or miss her next testing session.

Chet Woj, a 75-year-old type 2 from Alto, Texas, has five untrained dogs of various ages. Woj says they stay with him when he is working on the ranch. Sometimes, he goes a little low and begins to get dizzy.

"When I have a hypo and head for the truck, the young and middle-aged dogs follow and jump in excitement," says Woj.

Feline Friends Have Protective Instincts Too

Deana Przybylski of East Lansing, Michigan, has had type 1 diabetes for 30 years. She says dogs are not the only animals that have protective instincts for their diabetic owners.

"My cat, Angora, whom I've had for about 15 years, woke me up on one occasion by pawing at me and meowing to get my attention," says Przybylski. "It was a time in my life before I was married and before I was in tight control, so I didn't have very many lows."

Przybylski says that after her cat awoke her, she discovered she was low. Przybylski got herself out of bed to get some juice.

Christine Moye of Detroit, Michigan, has both a dog and cat. Moye, who has had type 2 diabetes for 13 years, says her animals wake her up when her BGs go low at night.

"My dog uses his nose to wake me up, and the cat bites me," she says. "They do this until I get up."

http://www.diabeteshealth.com/read/2001/03/01/2153.html

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Tiere und Diabetes

Forscher untersuchen in verschiedenen Studien, wie und warum Tiere so einiges aufspüren können, ohne dass es sichtbar ist: Erdbeben, Lawinenopfer, Postbote – noch ums Eck -, Angst, Unterzucker, Drogen etc.

Auch Papageien sind sehr sensibel

Marion Rudolph glaubt, dass es ihr verändertes Verhalten bei Hypoglykämie ist, auf das Vogel Coco mit Zwickattacken von Nase und Ohren anspringt. „Ich werde dann fahrig oder schläfrig, bekomme das aber selber nicht mit“, so die 53-Jährige.

Marion Rudolph hat seit 33 Jahren Diabetes. Ihre Blutzuckerwerte versucht sie im unteren Normbereich zu halten. „Das hat den Nachteil, dass mein Körper kaum auf Zeichen einer beginnenden Unterzuckerung reagiert. Es kann sein, dass ich einen Wert von 30 mg/dl (1,7 mmol/l) habe und nichts merke. Mitunter bin ich dann schlagartig weg.“

Coco hat auch das Erdbeben bemerkt

Graupapagei Coco hat indes ausreichend Möglichkeit, sein Feingefühl fürs Frauchen zu trainieren. Tag für Tag beschäftigt sich die Teilzeit-Buchhalterin zwischen drei und sieben Stunden mit ihm. Gut möglich, dass noch mehr dahinter steckt. „Gestern hatten wir ein Erdbeben hier in Baden-Württemberg“, erzählt Marion Rudolph, von dem sie erst aus dem Radio erfahren habe. „Aber die Vögel hatten es wahrgenommen.“

Deutsche Forscher untersuchen tierisches Frühwarnsystem

Wie das tierische Frühwarnsystem genau funktioniert, soll jetzt eine Studie klären, die das Deutsche Diabetes-Forschungsinstitut zusammen mit einer Tierarztpraxis durchführt. Professor Werner Scherbaum, Leiter der Studie, hat entsprechende Fälle von Hundebesitzern gesammelt.

Australier legten bereits Studie vor

Während das Ergebnis noch aussteht, ist man am anderen Ende der Welt schon weiter. „Können Hunde Patienten mit Hypoglykämie helfen?“, fragte sich Alan E. Stocks, Ex-Präsident der Australischen Diabetes Gesellschaft und Arzt an der Brisbane-Klinik. Der Mediziner hat die Erfahrungen von 462 Patienten ausgewertet und das Resultat auf einer Fachtagung in Budapest im September vorgestellt. Gut zwei Drittel aller Hundebesitzer behaupten, dass ihr Tier auf Unterzuckerung reagiere. Die meisten Patienten meinen, ihr Hund verhielte sich dann aufmerksamer und verharre so lange in ihrer Nähe, bis sie die Unterzuckerung behandelten. Einige der Vierbeiner registrierten fatale Zuckerwerte angeblich sogar dann, wenn sie nicht bei Frauchen oder Herrchen im Haus weilten – erstaunlich.

Tiere spüren auch Lawinenopfer oder Drogen auf

Andererseits: Manche Tiere spüren ein Erdbeben, noch bevor dieses ausbricht, Hofhunde wittern die Angst des Postboten, kaum dass der an der Gartenpforte auftaucht, Bernhardiner spüren Lawinenopfer unter Schneemassen auf, und der Beagle am Chicago Airport weiß im Vorbeigehen, ob der Tourist Lebensmittel in seinem Rucksack hat, deren Einfuhr verboten ist. Von Drogen ganz zu schweigen. Vor rund 100 000 Jahren wurden Bellos Vorfahren vom Menschen domestiziert. Genug Zeit also, sich auf das neue „Alpha-Tier“ einzustellen.

Briten fordern „Diabetikerbegleithund“

Die in der Medizinerbranche hoch geschätzte Fachzeitschrift „British Medicial Journal“ schlägt sogar vor, nach dem Blindenhund nun eine weitere Berufsgruppe auszubilden: den Diabetikerbegleithund.
Diabetiker, deren Haustier im Ernstfall nicht anschlägt, sollten ihm die mangelnde Sensibilität nachsehen: Zumindest Hunde haben einen weiteren medizinischen Nutzen – ausnahmslos: Das Zusammenleben mit ihnen baut Stress ab und senkt auf Dauer den Blutdruck. Von den wohltuenden Auswirkungen des Gassigehens ganz zu schweigen.

Aus dem Diabetiker Ratgeber – jeden Monat kostenfrei in Ihrer Apotheke

DiabetesPro.de; 21.10.2003

© 2003 W&B und Lizenzgeber. Alle Rechte vorbehalten.

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PHILADELPHIA: Bob Maher's diabetes was shutting his body down. He no longer got the shakes or the sweats to warn him that his blood sugar was plummeting. Instead, he would just pass out. It made him scared to drive, to be alone, even to sleep. Chewie's going to change all that. The 2-year-old dog, an auburn Labrador mix named after the "Star Wars" character Chewbacca, has the ability to detect changes in Maher's blood sugar that are unrecognizable to Maher himself. Chewie then alerts Maher to correct it. To see the phenomenon "just makes the hair on the back of your neck stand up," said Jennifer Kriesel, director of development at Canine Partners for Life, a Chester County, Pa., organization that trains service dogs for people with impaired mobility and medical conditions.

In June 2004, Bob's wife, Jean, found him in front of the television in his recliner, unconscious. By the time the paramedics arrived, he had no pulse or heartbeat. After that, Jean Maher would wake up several times a night to check Bob's blood sugar, and when he was home she would not leave his side. Then Maher, 64, a project manager who lives in Plano, Texas, was paired with his new best friend by Canine Partners for Life. Having a 24-hour canine companion, said Maher, "will give both of us greater independence." In the long run, Chewie may also improve Maher's health. Tighter blood-sugar control lowers the chance of long-term diabetes-related complications, such as blindness or amputations.

Service dogs assist recipients by helping them balance or walk, opening doors, retrieving objects - even phones - and flipping light switches. Some, like Chewie, have the additional, innate ability to sense medical episodes before they have occurred. Alert dogs were first recognized for detecting seizures, but increasing evidence suggests they can also detect other medical conditions, such as low blood sugar. Maher and Chewie are the first diabetes-alert team Canine Partners has paired up. Chewie's obedience is broken only when he wants to alert Maher to check his blood sugar. Each dog's alert is different, and one challenge for recipients is to recognize when their dogs are trying to warn them. Chewie stops in front of Maher and refuses to move.

Since meeting, Chewie has alerted Maher seven times. Originally skeptical of Chewie's alerts because they would sometimes come right after he had eaten - when low blood sugar should not be a problem - Maher checked his level and realized Chewie was right. Every time.

At Canine Partners, about three out of every 10 service dogs appear to have this ability, according to Kriesel. It's unclear exactly how the dogs sense blood-sugar problems or impending seizures. It may be changes in a person's scent or electrical activity in the body or brain, Kriesel said.

Research from the University of Florida finds that some dogs indeed have the ability to alert, but how they do it is unknown. Now in its 16th year, Canine Partners is only one of about 15 organizations that train medical-alert dogs, according to Assistance Dogs International, the coalition that sets the training standards. In order to be considered for a service dog, an applicant's main motivation must be to be more independent, said Darlene Sullivan, executive director of Canine Partners. "The type of disability is not important." The service dogs are carefully selected and go through a two-year training process, yielding at most 28 trained dogs each year. Canine Partners also requires extensive follow-up and recertification training on the part of the recipient. Each dog costs about $20,000 to train, although the nonprofit agency asks for a $900 donation from recipients. Its waiting list for dogs is currently eight to 18 months. For Maher, who used to be reluctant to talk about his diabetes, Chewie is not only helping him get his life back; he is ushering Maher out of the diabetes closet. Chewie, Maher said, "will set me free."

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PALM COAST: The mammoth dog plops herself on the couch. With Lacey's basketball-sized head leaning over the armrest, she'll occasionally plunk it down or scratch a spot on her shiny black fur -- as little movement as needed to find a comfortable position.

Coming face to face with the slobbery giant, the average person might not recognize Lacey as a hero. In fact, this bull mastiff is on a mission every night.

Her owner, 56-year old Sandi Montagna suffers from brittle diabetes, a condition in which the blood-glucose level fluctuates from high to low. When it elevates, she gets sleepy. And that's when it can get dangerous. If she's sleeping, she doesn't know when to pump more insulin into her system.

That's when Lacey dutifully plants herself in front of her sleeping owner's face and barks until Montagna gets up and takes in more insulin. Without the alert, Montagna could fall into a coma.

"I don't know why, but it happens," Montagna said. "I'm glad."

Although Montagna insists Lacey can smell the change in her system, some experts contend Lacey's reaction could be associated with their emotional connection. It happened randomly five years ago, without any kind of training. Lacey, who sleeps on the bed near Montagna, jumped off the bed and walked over to the other side of the bed, the closest access to Montagna's face.

"I thought it was a freak thing the first time it happened," Montagna said. But Lacey has done it ever since.

The 130-pound bull mastiff that stands waistline-high saves her owner from slipping into a precarious condition about three times a month.

"When I go to bed at night, she's on duty," Montagna said.

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