Service Dog Eases Patient's Anxiety
Do You Need a Service Dog for Crohn's Disease?
Service dogs have helped people with visible disabilities like blindness and “invisible” disabilities like diabetes. Learn how service dogs can help you with Crohn’s.
By Aisha Langford
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Carol Lea Benjamin, a dog trainer with Crohn’s, had been with Dexter since he was six weeks old. Over time, she noticed that the pitbull mix was helping her with the pain associated with the condition. For example, Dexter would lean against her as a way to provide comfort when her symptoms were acting up.
“It took a long time for me to realize that he was doing something intentional, that he knew when I was in pain, that he knew where the pain was, and that he knew when the pain went away,” says Benjamin, who also authors a blog about dogs. That’s when she decided to train Dexter to be her service dog. In addition to basic commands, like "sit down," she used the word “keppie” — which has personal significance to her — to let Dexter and subsequent service dogs know when she needed pressure applied to various parts of her body.
Since Dexter, Benjamin has trained three other service dogs to help her with Crohn’s. Today, she has less pain from the inflammatory bowel disease and the condition is less severe. She largely credits these improvements to the service dogs she’s had over the years, plus good self-care.
“I take no medication for Crohn’s disease. I only use a service dog,” Benjamin says. “I accept with gratitude what the dogs offer me. They have changed my life beyond what I could imagine.”
How Service Dogs Detect Health Problems
The Americans with Disabilities Act (ADA) defines service animals as “dogs that are individually trained to do work or perform tasks for people with disabilities.” In fact, guide dogs have been trained for more than 70 years to help the blind, but the idea of training service dogs to help people with other types of physical and mental health disabilities is a more recent concept.
Today, service dogs are trained to help people with a range of health problems, including diabetes, seizure conditions like epilepsy, post-traumatic stress disorder (PTSD), and Crohn’s disease.
“We know that part of a dog’s ability to detect health problems is connected to smell,” says Dana Sue Hardin, MD, senior medical advisor at Eli Lilly and a pediatric endocrinologist in Indianapolis, who has authored several articles on service dogs.
Dr. Hardin notes that when changes occur in a person’s physiology or body chemistry, certain hormones and other chemicals get released. These changes often create a different smell that service dogs can pick up. She adds that dogs are very good at paying attention to body language and other cues that you may be in trouble.
A small study published in December 2015 in the journalDiabetes Therapy found that diabetes alert dogs could accurately detect low blood sugar levels, or hypoglycemia, in their owners. In the study, dogs sniffed sweat samples collected from patients while they were experiencing low blood sugar levels. To compare these smells, dogs also sniffed samples collected when the patients' blood sugar levels were normal. This process helped the dogs know when the patients may be in a diabetic crisis.
Trainers are using the same concept to train dogs to help people with Crohn’s — except instead of sweat samples, they’re using saliva.
Because there aren’t many studies about service dogs, Hardin noted that more research is needed to better understand how service dogs do their job and the best ways to train them to detect other “invisible” disabilities.
Your Rights Under the ADA
There’s no way to officially “certify” a service dog, but some departments of health allow you to register a service dog and will give you tags for the dog to wear. You may also choose to register your service dog with a state or national organization, or undergo a Public Access Test to show that your dog is stable, well-behaved, and keeps a low profile in public.
“When you have a disease that’s exacerbated by stress, it’s great to show a tag or a letter and not have to talk at all,” says Benjamin.
If you have a service dog for Crohn’s, people are only allowed to ask you two questions:
- Is the dog a service animal required because of a disability?
- What work or task has the dog been trained to perform?
They can’t ask details about your disability, or for your medical records or documentation for your service dog.
“Sometimes people can’t wrap their head around the fact that a service dog is allowed in the store or restaurant,” says Michelle Krawczyk, NP, doctor of nursing practice and associate dean of faculty at Chamberlain College of Nursing headquartered in Downer's Grove, Illinois, who wrote an article published in January 2019 inThe Online Journal of Issues in Nursing.
Dr. Krawczyk is also a mom to a child who has a service dog for a disability, a rare disease called mastocytosis.
She suggests that people think about service dogs in the same way that they think about wheelchairs. If you wouldn’t question a person entering a restaurant in a wheelchair, you shouldn’t question someone entering a restaurant with a service dog. “Remember that service dogs are medical devices, not pets. If the public thinks about them as medical devices, it often clears up the confusion,” Krawczyk says.
How to Pick a Service Dog and Where to Find Them
Before selecting a dog, you’ll need to think about your daily activities and the places you’ll go. For example, if you live in New York City and ride the bus or navigate tight spaces, a small to mid-size dog may work better for your life. Large dogs are hard to put under a table in a restaurant or take on a plane. On the other hand, a small dog may have trouble performing physical tasks like opening doors.
A good service dog is people-oriented, friendly, and able to adapt quickly to different environments, such as the airport, grocery store, or church. While it’s good for a service dog to be confident, the dog shouldn’t be overly active, protective, or aggressive.
Benjamin notes that any breed can be a good service dog. If you don’t know where to start, she suggests considering dogs that have been bred to work with humans, such as herding, sporting, or working dogs.
Currently, there are no national standards for how service dogs are trained or who can sell them, but organizations like Assistance Dogs International and Medical Mutts are good places to start your search. It’s also important to know that service dogs don’t have to be professionally trained. If you select and train your own dog, you should explore trustworthy breeders and organizations like the American Society for the Prevention of Cruelty to Animals (ASPCA) and the .
Whichever path you take to get a service dog, you’ll need to play an active role in helping the dog learn your specific needs and situation.
“The more I’m with my dog, the more help I get,” says Benjamin.
Video: How Do I Get a Service Dog?
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