What is a Medical Alert Service Dog?
A Medical Alert Dog is a service dog who has been trained to alert its owner to a medical episode before it happens. Medical Alert Service Dogs also learn extensive obedience and public access skills. They may also be called Medical Assistance Dogs.
A Dual-Purpose Service Dog might perform a Medical Alert and other types of tasks like mobility assistance.
The Americans with Disabilities Act (ADA) says that a service dog is…
It also describes what “work” and “tasks” mean:
Medical Alert Dogs may also be trained to perform other tasks such as:
- Retrieving items
- Using an emergency button or phone
- Deep pressure therapy
- Carry medication and emergency contact information in a vest or backpack
- Interrupt repetitive, anxious or harmful behaviors
- Turn on lights
- Open and close doors
- And more!
The purpose of a therapy dog is to go along with its owner and visit people in the community to show them love and compassion.
Therapy dogs should have a friendly temperament and complete basic and intermediate obedience training so that they can behave well in public.
However, since therapy dogs do not perform tasks or work that helps an individual person with a disability, they are not service dogs.
This means they are still considered pets and all the pet laws of each city, county, state and country apply to therapy dogs.
The purpose of an emotional support dog is to simply provide companionship to an individual with a mental/emotional disability.
Emotional support dogs are not required to have a friendly temperament or any training. They do not perform any tasks or work the help an individual with a disability.
Emotional support dogs (ESA’s) may be allowed to live in homes where pets generally aren’t allowed. ESA’s must now travel like all other pets on flights. They also do not have public access rights.
Paw alerts are where the dog is taught to gently paw at your leg. This kind of alert is popular because the pawing behavior is quite natural to dogs and is easy to train. It is also quiet and can be used to get your attention or the attention of a caregiver. Some instances where a paw alert wouldn’t be a good idea include if the dog isn’t gentle with his paws, if you have frail skin, chronic pain, or if being pawed would put you off balance.
Nudge alerts are when the dog uses his nose to nudge your hand, arm or leg. Nudge alerts may be gentler than paw alerts, especially for larger dogs. Nudge alerts can be confusing though if the dog uses nudging for other purposes (getting the owner to play, feed, etc.).
The dog should learn to keep his mouth closed when performing a nudge alert so his teeth don’t contact any skin. A hard nose nudge is hard to ignore! And most times that’s just what we need in an alert behavior.
Bringsel alerts are the least common alert, but are quite useful. A bringsel is a tab, like a short length of leather or nylon. It attaches to the dog’s collar or vest. Some other options for the bringsel include a medical badge or stuffed toy attached to the dog’s collar or vest, or to your belt.
To use it for an alert, the dog grabs it in his mouth and shows it to you (or another person if necessary). The behavior is very quiet and can prevent problems such as rough pawing, slobbery licking, and barking.
A bringsel alert can be taught like a retrieve where the dog brings the object to you, or like a tug where the dog tugs on a bringsel attached
to you.
Jumping alerts are sometimes used because of how obvious the behavior is. Jumping is usually easy to teach the dog, but has some drawbacks. Jumping can potentially cause falls, may not look professional and give the appearance that your dog is not well trained, and dogs easily generalize jumping to other people which may not be a welcome or safe greeting.
Barking alerts are usually a natural behavior dogs use to get attention, not something we train. It’s almost rarely suitable for use in public because it draws attention and can interrupt whatever is going on. However, barking can have one practical use. Some dogs are trained to get the attention of another person when the owner is unconscious or unresponsive. The dog can stay by his owner and bark to draw attention to get help from someone nearby.
Licking alerts can be useful because they are quiet, noticeable to the owner, and can be either calming or stimulating. A dog who licks his owner to alert him can seem loving and caring, providing emotional support. Also, licking can stimulate the nervous system which can be beneficial for helping a return to consciousness or coming out of a seizure. If you don’t care to be licked or if the dog drools excessively, consider picking another behavior to train.
Button alerts are a newer idea. For this alert the dog uses an electronic dog button with a programed sound, phrase, or response such as dialing an emergency contact or 911. This can work well at home as a response task for falling, seizures, unconsciousness/unresponsiveness.
What is the best choice for an alert?
“Guessing as to whether or not the dog gave an alert or was just trying to prompt you to play is not a sign of a well-trained DAD.” – Training Your Diabetic Alert Dog (Rita Martinez and Sue Barns)
The best choice depends on what alert works best for you.
For example, if you are distracted, asleep, busy, or mentally foggy, a bringsel or gentle paw on your leg won’t be enough to get your attention. In this case, a hard nose nudge repeated several times, barking, or climbing in your lap may be more effective.
Ideally, the alert is a behavior that is easy for you to recognize. Your dog should use the alert behavior only for alerting and never to ask for attention, play, food, or anything else. The behavior should also be something your dog can repeat for however long it takes to get your attention.
Escalating Alerts
It’s nice to have an alert that doesn’t always draw attention in public. However, sometimes a quiet behavior won’t get your attention. A medical alert service dog can learn to start with a quiet alert behavior such as pawing, and to add a more noticeable behavior such as nudging you repeatedly, jumping on you, climbing in your lap, or barking if necessary.
Many dogs will naturally escalate an alert if it isn’t getting them the attention and reward they want. You may need to teach your dog what behavior to escalate to so that he doesn’t do something undesirable out of frustration. You may want the dog to bark to get someone else’s attention, but jumping on you might be dangerous. A nose nudge might turn into a nip out of frustration if the dog doesn’t know that he should go seek help instead.
Can dogs alert to multiple medical conditions?
Yes. It is not uncommon for service dogs to learn multiple alerts. Some medical conditions are often seen together, so two alerts may be needed.
In fact, many scent-trained alert dogs take on extra medical alerts on their own. After training to recognize and alert to one medical condition, the dogs are more in-tune to significant changes in their people and may choose to alert to an extra condition without training.
Sometimes it makes sense to teach the dog to perform two alerts. When one condition triggers or makes a second diagnosis worse, it makes sense to have an alert to both conditions. This allows you better control because both conditions can be treated early.
Migraines often occur in combination with other medical conditions, such as POTS. So the dog might learn to alert to migraines and POTS with separate alerts.
In the U.S. there is no legal requirement for testing, certification or registration for service animals.
State or county pet registration also applies to service dogs, however the fee may be waived in some cases.
Voluntary testing (example: a public access test or Canine Good Citizen test) is recommended as a standard for acceptable service dog behavior in public. However, passing any voluntary test does not grant any person with a disability the right to bring a dog into public places. The team must meet the legal qualifications of the ADA which does not require any testing, registration or certification.
Beware of false online registries and companies selling fake IDs, vests, badges, or papers. These are only scams and they are not legal or required! There are many reputable service dog suppliers that should be supported instead.
The PDF below will give you a quick overview of basics service dog laws in the U.S. Included are links to all sources for your research.
Please also read the ADA ‘s Service Animal Requirements: https://www.ada.gov/resources/service-animals-2010-requirements/
And research your State’s Service Dog Laws: https://www.animallaw.info/…/table-state-assistance…
Still Have Questions?
If you have questions about service dogs, alert dogs, therapy dogs, or emotional support animals, checkout these service dog communities!