Medical Alert Dog

What is a Medical Alert Dog?

A community that used to be primarily dominated by guide dogs has now grown to include almost more types of service dogs than there are breeds! Okay, maybe not quite that many, but the scope of what dogs can be trained to do has steadily increased since the first guide dog school opened in the USA in 1929. For almost 30 years, guide dogs were the only form of service dog. It wasn’t until the 1960s that other types of service dogs began to emerge.

The Introduction of Other Types of Service Dogs

Guide DogIn 1976 service dogs for the hard of hearing were officially recognized, and the role of service dogs continued to grow with autism service dogs and psychiatric service dogs being some of the more recently recognized types of service dogs. However, it was not until 1990 and the American’s with Disabilities Act (ADA) granting public access rights to handlers choosing to use a service dog for their disability that the use of service dogs began to increase exponentially.

Now the list of possible service dog types includes guide dogs, hearing dogs, psychiatric service dogs, autism service dogs, mobility assistance, medical alert, allergen detection, and more. Because service dogs are trained to perform specific tasks to address their handler’s disability, no two service dogs will have identical training even if they are both the same type of service dog just as no two disabilities are the same even with the same diagnosis. This is most commonly seen with medical alert dogs.

Medical Alert Dogs

The title of medical alert dog is probably the broadest category of service dog. It includes natural alerts to things such as seizures, blood pressure changes, heart rate changes, migraines, and more. It also includes trained alerts (often from scent samples) to things such as blood sugar changes and severe allergic reactions.

Natural Alerting Ability

For dogs that have a natural ability to alert, that ability does not automatically make them a medical alert dog.

For dogs that have a natural ability to alert, that ability does not automatically make them a medical alert dog. Before being actually considered a natural alert, the handler needs to document repeated behavior prior to the onset of specific symptoms. This may look like a dog becoming extra clingy and focused on its handler within 15-30 minutes of a seizure. It could also look like a dog lying across its handler’s lap and refusing to allow them to stand up in response to a spiking heart rate or dropping blood pressure. The behavior if often unique to the dog, but to be considered a natural alert must be consistent with specific symptoms.

Transitioning a Natural Alert to a Trained Alert

Once a handler has recognized natural alerting behaviors in their dog, there is still work to be done before it can be considered a medical alert dog. The natural detection of oncoming medical issues must be shaped into a consistent behavior to be considered a task per ADA. Even if the behavior the dog exhibits naturally is the same with each alert, it might not be appropriate for public access. Some dogs naturally alert to seizures by barking, whining, or otherwise becoming loud and antsy. This is not typically considered appropriate service dog behavior. The handler will need to choose a different behavior and teach the dog to perform that instead. These behaviors are often things such as single leg pawing, both paws being placed in the handler’s lap, or nosing the handler’s leg. Any behavior that would not be disrupting in a public setting can be appropriate for alerting.

Training a Medical Alert

Glucose MonitorFor trained alerts, the process is very similar to shaping a natural alert. Currently, trained alerts are only done with conditions that are known to have specific scents associated with chemical changes in the body. Diabetic alerts are the most commonly seen trained alerts. These are done by training dogs to perform a specific behavior in response to scent samples that represent low or high blood sugar. Again, the behaviors chosen can be anything that is appropriate in a public setting and are often things such as pawing, nosing, or retrieving a glucose meter.

Controversy in Medical Alerts

There is a lot of debate when it comes to scent training alerts other than blood sugar. High and low blood sugars have been well studied and the chemical changes that occur in the blood are known and documented. However, within the past 10 years or so, there have been a few other situations of successfully scent trained medical alert dogs for conditions other than diabetes.

Addison’s Disease occurs when the body is unable to produce the stress hormone cortisol and it has to be artificially supplemented. There have been a couple of success stories of dogs scent trained to alert to dropping cortisol and keeping their handlers out of an adrenal crisis. A few years ago, there was a news story about a young girl with mastocytosis whose medical alert dog was scent trained to her severe reactions that present as anaphylaxis. The dog was so consistent, he was brought into the OR during a procedure to alert the doctors to severe reactions that often occurred in response to surgery. Since that story was published, there have been other cases of dogs successfully scent trained to similar severe reactions.

New Frontiers

However, beyond diabetic alert, the concept of scent training for medical alerts is still relatively new and unresearched. Other debatable trained alerts include migraine, anxiety (in response to spiking cortisol not dropping as seen in Addison’s Disease), blood pressure changes, heart rate changes, and more. Currently is it not yet known whether there is truly the opportunity to train these alerts or whether those that claim to have scent trained some of these debatable alerts actually shaped natural alerts without knowing.

Regardless of whether an alert is natural or trained, though, there is no denying the life saving impact these alerts can have. Ultimately, a medical alert dog is one that performs a consistent, trained behavior in response to oncoming symptoms that can either be a medical emergency or lead to their handler being unable to function.


Kylene Boka
Kylene is a grad student living in Ohio with her husband and two dogs, Bonk and Leni. Leni is her service dog and is scent trained to alert to severe allergic reactions and hypoglycemia due to Kylene’s mast cell disease. To learn more about life with mast cell disease and a service dog, you can check out Kylene’s blog,