Rapid Responses to:

PRACTICE AND RESEARCH: Mimi Chen, Mark Daly, Natt Williams, Susie Williams, Candy Williams, and Gareth Williams Non-invasive detection of hypoglycaemia using a novel, fully biocompatible and patient friendly alarm system BMJ 2000; 321: 1565-1566 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Canine hypoglycemic episode detection

Ray Markus   (23 December 2000)

"Sixth Sense" Information

John Sack   (1 January 2001)

Oranges, apples, hypoglycemia and dogs : the British plum pudding' hypothesis

Frédéric Pochard   (22 January 2001)

Training hypoglycaemia alarm dogs

Val Strong   (24 February 2001)

Canine hypoglycemic episode detection 23 December 2000
Ray Markus, Editor, Homepage World Small Animal Veterinary Association Send response to journal: Re: Canine hypoglycemic episode detection	Dr.Williams As you indicated in your article there has been much anecdotal and documented evidence as to the value of the human/animal bond in many aspects of our lives and now more than ever in the medical field. Your article on canine hypoglycemic episode detection was written somewhat as "tongue-in-cheek" but I as a veterinary practitioner hear more and more similar descriptions from my clients of such unexplained animal communications under a variety of circumstances.I feel that we are missing something by not furthering research into this potentially valuable field. As the website editor of the World Small Animal Veterinary Association (www.wsava.org) and INNO-VET (www.inno-vet.com) I intend to include reference to your BMJ article in the January updates and invite comment from our professional and other viewers on this subject. Sincerely Ray Markus D.V.M.
"Sixth Sense" Information 1 January 2001
John Sack, Director, HighWire Press Stanford University Send response to journal: Re: "Sixth Sense" Information	The authors mention they "are attracted by the notion of the 'sixth sense' with which dogs are commonly credited, but acknowledge that this will need to be substantiated by further research." Dr. Ann Squire(1) writes: "Both cats and dogs possess a unique sense organ that people lack. It is called the vomeronasal organ and is located in the roof of the mouth. Two small openings just behind the front teeth connect the vomeronasal organ to the outside air. To activate this sense, the animal sucks air into its mouth. Scientists know that the vomeronasal system is related to the sense of smell. They think that cats and dogs may use this system in mating to get special chemical information about animals of the opposite sex." My dog(2), Stanley, has a vet who regularly sniffs Stanley's ears to identify signs of problems. I would think that dogs could likewise identify health characteristics through odors pretty well. Competing interests: Stanley (1) Squires, A. Why Do Pets Do That? (Boca Raton, FL, American Media Mini Mags, 2000) (2) http://highwire.stanford.edu/icons/team/stanley.jpg
Oranges, apples, hypoglycemia and dogs : the British plum pudding' hypothesis 22 January 2001
Frédéric Pochard Send response to journal: Re: Oranges, apples, hypoglycemia and dogs : the British plum pudding' hypothesis	Sir - We strongly support research presented by Chen et al [1] regarding the notion of the "sixth sense" with which dogs are commonly credited, and acknowledge that this will need to be substantiated by further research. However, a serious bias should be unveiled: if dogs presented in this paper were nourished by remainders of British plum- pudding (BPP) (given to them after the dinner of their masters), they could be considered at higher risk of suffering from the secondary effects of this regimen (commonly described by foreigners visiting England) such as important variation of glycemia that may seriously impair their five common senses. An international study is needed, using German shepherd, American poodle, Irish setter and French mongrel to confirm that the hypothetical "sixth sense" of English dogs is not a symptom such as nocturnal hypoglycemia caused by the ingestion of BPP by the patient and the dog. Another study should confirm this result by including in a double blind fashion English cats (most of them would never want to eat BPP) to determine whether the hypothetical sixth sense is specific to dogs, but the methodology to describe the nutrition of these cats would unfortunately never be accepted by an ethical committee. The article by JE Barone [2] had the ambition to demonstrate that apples and oranges are quite similar. This assertion is probably pertinent in most English speaking countries, where either apples' BPP or oranges' BPP nutrition is a cultural phenomenon, and, in fact, does not modify taste of the BPP. We deeply regret to open controversy, but in France, confounding apples with oranges in cooking preparations would be considered a crime by most housewives (assertion validated by a double blind study performed using apple-pie and orange-pie respectively cooked by our mothers, and a special questionnaire available on request). 1. Chen M, Daly M, Williams N, Williams S, Williams C, Williams G. Non-invasive detection of hypoglycaemia using a novel, fully biocompatible and patient friendly alarm system. BMJ 2000; 321: 1565-1566 2. Barone JE. Comparing apples and oranges: a randomised prospective study BMJ 2000; 321: 1569-1570 Frédéric Pochard, MD, PhD Vincent Levy, MD, PhD Elie azoulay, MD Sylvie Chevret, MD, PhD Biostatistics department, Saint-Louis University Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France
Training hypoglycaemia alarm dogs 24 February 2001
Val Strong, Training Manager Support Dogs Send response to journal: Re: Training hypoglycaemia alarm dogs	EDITOR-Training hypoglycaemia alarm dogs We have recently trained a hypoglycaemia alarm dog who is successfully alerting his owner to hypoglycaemic episodes. However, our experience in training this dog and other dogs trained to provide warnings of epileptic seizures suggests that caution must be exercised in promoting the use of dogs in this way. In the absence of specialised training a dog is likely to respond unpredictably and may even behave aggressively towards its owner, resulting in potentially disastrous consequences for both dog and owner. The British charity, SUPPORT DOGS, trains dogs to assist people with a variety of disabilities. Our experience suggests that dogs must be carefully selected and then specifically trained for the work they do. In training dogs in these specialised roles, we must initially condition the dog to overcome his/her instinctive survival strategy towards a hypoglycaemic episode or epileptic seizure and teach the dog to provide an appropriate warning to his/her owner. It typically takes six months of training to ensure that a dog can perform this specialised role. A specially trained dog can offer people who experience unpredictable hypoglycaemic episodes or epileptic seizures the chance to live a relatively independent life. However, careful selection and specialised training are essential for the dog to assist the owner in achieving this goal. Val Strong, MSc Training Manager Support Dogs The John Fisher Centre Trianco House Thorncliffe Park Estate Chapeltown Sheffield S35 2PH Email: valstrong@aol.com Peggy Newton, PhD Psychologist Institute of General Practice and Primary Care University of Sheffield Email: p.newton@shef.ac.uk