– It’s actually a bit scary to think about. Most of the times he has alerted me, I have been asleep, says Anne-Line O’Donnell (40). She has type 1 diabetes. The disease means that she does not produce insulin – the substance that regulates the body’s blood sugar. She is therefore dependent on receiving insulin through a pump attached to her body. Low blood sugar can make her faint, a condition that can be fatal in the worst case scenario. – If I get a sensation at night, I am completely dependent on waking up myself, or for someone to wake me up. They don’t have to be in the same room. Anton can sleep in the hallway, while Anne-Line is in the bedroom. If her blood sugar level drops to the exact level of 3.8, Anton wakes up. He can smell that. Then the Labrador goes into the bedroom and claws at Anne-Line with its paws. He won’t stop until he wakes her up. How is it possible? The answer is mainly about dogs’ improbably good sense of smell. And a lot of targeted training. The razor-sharp muzzle The dog’s muzzle is specially designed to capture odors from the surroundings. In addition, dogs use around a third of their brain to process information about smells. Among other things, the nose consists of specialized olfactory cells. Dogs have 70 to 220 million such olfactory cells, while we humans have to make do with 5 to 20 million. Thus, a dog’s nose is 100,000 to a million times more sensitive than ours. Such numbers may not tell you much. In the book “Dogs’ adventurous sense of smell” it is explained as follows: On a 500-metre-long sandy beach, which is 50 meters wide and 50 cm deep, a trained dog can manage to find two grains of sand. It therefore makes sense that dogs have become man’s invaluable helpers when hunting, during search operations for people taken by avalanches or in the search for clues that can solve criminal cases. Photo: Marius Christensen/news Family dog with an extra job The three-year-old Labrador Anton is first and foremost a family dog. When Anne-Line had Anton, she lived alone with her son. She wanted to give the new addition to the family a task in addition to “just” being a family dog. She came across an article about a diabetic dog on Lundqvist dog school’s website. The dog school is located in Rælingen, not far from where Anne-Line lives. It said how dogs can be trained to smell different blood sugar levels and alert the owner. Photo: Marius Christensen/news – The article made me sign up for a puppy course with them. On the first day of the course, I mentioned to the instructor that I was interested in training Anton to become a diabetes dog. A short time later, she was put in contact with dog trainer Kjersti Østlund at Lundqvist dog school. Østlund had previously trained a diabetic dog and has several years’ experience working as an instructor on search courses. The smell of 3.8 Anton was about half a year old when he gradually began what was to become an extensive training program. In addition to the usual everyday obedience at puppy and basic courses, Anton was introduced to search training early on. It is training where dogs are trained to use their sense of smell to recognize a particular smell. The aim of the search training was for Anton to learn to recognize the smell of Anne-Line’s saliva every time she had a blood sugar level of 3.8. Anne-Line chose the blood sugar level of 3.8 because it is a level where she is still able to help herself. – At that level, I can still butter a slice of bread and think clearly. If I’m driving, I can stop, she says. MEASURES CONTINUOUSLY: This insulin pump with sensor measures Anne-Line’s blood sugar at all times. Anton also had to learn that that smell means he must notify Anne-Line, no matter what. – Now I have a dog I trust to help me. And he chooses to do that above all other things, says Anne-Line. Getting there has required a lot of training, patience, willpower and money. Q-tips with saliva in the freezer In order for the Labrador to learn to recognize the smell, Anne-Line had to make hundreds of saliva samples. She did this by pushing her own blood sugar down to 3.8 and taking samples of her saliva with a q-tip. The saliva samples were placed in sealed bags and frozen. That way, they can be stored for a long time without the smell disappearing. The saliva samples were used in the training with Anton. HUNDREDS OF Q-TIPS: Saliva samples like these are stored cold in the freezer and used to train Anton. Photo: Marius Christensen/news Dogs have such sensitive noses that they can smell the difference between saliva that has a blood sugar level of 3.6 and 3.8. Dogs can also distinguish the smell of different people’s saliva. – It is really only our imagination that sets limits to what we can teach a dog to search for, says dog trainer Kjersti Østlund. It is she who, together with Anne-Line, has trained Anton. Had to pay myself Østlund explains that there is no public scheme or support for training diabetic dogs in Norway. – Guide dogs and service dogs are acquired and trained by various organisations. Support from NAV is not given to acquire or train dogs to warn of diabetes. Training a diabetic dog is something you have to do yourself and pay for yourself, says Østlund. The dog trainer explains that dogs will always try to do what is profitable for them. – If they understand that a behavior means a treat, they will try to do it again. In that sense, it is easy to get dogs to search for what you want, she says. – But it is important that we humans pick up the signals the dog gives us, and reward the behavior correctly, she points out. – Nothing can replace a dog’s nose During Anton’s training, they put a lot of emphasis on him experiencing the training as fun. – We raised the mood every time he smelled the right smell. We created a great expectation of reward. This is how we built up his motivation to do it every single day, she explains. After a year and a half of weekly training, Anne-Line felt confident that Anton would notify when he was supposed to. – A dog can never take over for the medical aids. A dog can contribute, says dog trainer Østlund. – But on the other hand: There is also no aid today that can replace a dog’s nose. Must be maintained Dog training is a fresh commodity. Therefore, Anne-Line must regularly train with Anton in various situations to maintain his skills. She often does this outdoors by placing q-tips around the terrain, but also at home and when they are visiting friends. Anne-Line hides saliva samples in random places. After searching the area, Anton approaches the q-tip. Then he finds the saliva sample and marks it by scratching with his paws. – Anton does not notify me at level 4.1 or 3.6. He speaks at 3.8, explains Anne-Line. She has good aids attached to her body. Among other things, an insulin pump with a sensor that measures her blood sugar at all times. It beeps if blood sugar becomes critically low. But it happens that she calculates doses incorrectly or does not hear the pump beep. When she was recently sitting around the dinner table on a cabin trip with friends, she didn’t hear the pump beeping. Then Anton was quick with his paws. – At the cabin with a lot of walking and movement, I also sometimes find it difficult to distinguish between the fact that I am tired after physical exertion or that my blood sugar is low. Then Anton is very useful, says the 40-year-old. Photo: Marius Christensen/news – Has made me safer Anne-Line was diagnosed with diabetes as an 11-year-old and has learned to cope with a life with a chronic illness. But the four-legged companion has changed something important in her everyday life: He has given her increased security and freedom. – I am no longer as dependent on having people around me, who, whether I want to or not, look after me. If I’m in the forest alone or lying down sleeping, I have Anton looking after me. He has made me safer. She has no doubt that the process there is worth all the time and money. – Training Anton to become a diabetes dog is one of the smartest things I’ve done in my life, says Anne-Line. Sources: The book “A nose for everything – The dog – man’s most useful friend” – by author Frank Rosell (2014) The book “Dogs’ adventurous sense of smell – step by step from treat search to trace search” – by author Anne Lill Kvam (2020) Hi! 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