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Dogs to the Rescue

How Clayton’s Mark Ruefenacht is training man’s best friend to save lives.


Yellow Neener Photography

Dennis McGrath-Wagner started his car after a doctor’s appointment in Martinez, eager to head home. But before he pulled out, his black lab, Yancey, pushed his nose between the two front seats, nudging McGrath-Wagner’s shoulder.

This gesture was more than a sign of affection.

Yancey had detected a subtle scent that indicated that McGrath-Wagner’s blood sugar level was dropping—fast. McGrath-Wagner, who has type 1 diabetes, pricked his finger to check. As always, Yancey was right about his owner: His blood sugar had dropped to a dangerously low level, and he needed to stabilize it.

“I was only three minutes from the highway, and I could have passed out behind the wheel,” McGrath-Wagner says. “Yancey saved my life and potentially the lives of others I could have hit that day.”

While that lifesaving moment was brief, it was the product of years of research conducted by Clayton native and diabetic Mark Ruefenacht, founder of Dogs for Diabetics (D4D).

The Concord-based organization, which launched in 2004, was the first in the world to train dogs to alert diabetics of rapid changes in blood sugar levels. Ruefenacht’s first dog, Armstrong, is recognized in Guinness World Records 2015 as the world’s first diabetic-alert dog.

Many people who have type 1 diabetes test their blood sugar levels throughout the day and depend on programmed insulin pumps or injections. Despite this regimen, factors such as exercise, heat, or travel can unexpectedly alter blood sugar levels—and that’s when a diabetic-alert dog can mean the difference between life and death.


Forensic expert Mark Ruefenacht discovered that dogs can detect drops in blood sugar. / Yellow Neener Photography

A Fortuitous Trip

Ruefenacht, a forensic technical expert who trained pups for Guide Dogs for the Blind, had his first inkling that dogs might be capable of detecting hypo-glycemia while on a trip to New York in 2000.

“I did the one thing I should never do: I went to bed without checking my blood sugar,” he says. “Sometime during the night, I was conscious enough to know that my blood sugar was low, but I was having trouble waking up. A low feels a lot like being intoxicated because your judgment is impaired, and it was difficult to think and move.”

Although the puppy he was traveling with had not been trained to detect sugar lows, the pup woke up and nudged Ruefenacht, who summoned the strength to sit up to take glucose tablets. “After that night, I started to wonder if there was something I could do to train dogs to detect lows,” he says.

Eager to test his hypothesis, Ruefenacht delved into self-funded research for the next five years. Guide Dogs for the Blind in San Rafael donated a yellow Labrador retriever named Armstrong, and Ruefenacht spent weekends and evenings collecting his own sweat and breath during lows, and then rewarding Armstrong when the canine recognized this smell.

Once Ruefenacht successfully trained Armstrong, the next question was whether this scent was common to all diabetics. One day in 2004, a diabetes specialist—and fellow diabetic—who was interested in Ruefenacht’s work came to his office and asked to try an experiment. She had collected her sweat on a brown paper towel during a low blood sugar episode earlier in the day and hid the towel in a trash can in the bathroom. Ruefenacht brought Armstrong into the office and asked him to find the scent. Within 30 seconds, he returned with the correct paper towel.

“We were ecstatic,” Ruefenacht says. “Armstrong had been trained with my scent, yet he was able to detect the same scent in a different diabetic, which meant the smell was universal. We had discovered something that would profoundly impact the diabetes community.”


Gallagher demonstrates an alert bychomping down on his bringsel. / Yellow Neener Photography

Launching D4D

Although Ruefenacht was pioneering potentially lifesaving science, he faced a very practical hurdle: funding his venture. He contacted Guide Dogs for the Blind to ask if the organization would consider donating service dogs.

“They were very supportive of the idea,” Ruefenacht says. “About 40 percent of people with diabetes experience blindness or retinal disease, and the folks at Guide Dogs for the Blind understood that our program would actually prevent blindness and other complications by helping diabetics manage their disease.”

Ruefenacht also sought out donations from local businesses, foundations, and donors to cover the $20,000 cost of extensive scent training for each dog, which can take up to six months.

“Mark [Ruefenacht] always insisted on reliability,” says D4D’s Executive Director, Ralph Hendrix. “The dogs have to be at least 80 percent accurate, and it takes months to achieve this. Most service dogs are trained to do something on command, but we do not cue the dogs. They have to learn to initiate this activity on their own, even when their owners are sleeping.”

In some cases, the dogs have helped individuals other than their owners. One yellow Lab alerted his owner—a local doctor—that a recently delivered baby was hypoglycemic.

The dogs wear a bringsel, or flat strip of canvas, that hangs from their collar, and grab it by the mouth to alert a diabetic. The demand for diabetic-alert dogs is high, with roughly 100 inquiries for every dog, and those who qualify must attend 130 hours of training. In the past decade, D4D has placed more than 100 dogs with diabetics ages 12 to 75. Similar organizations that use Ruefenacht’s scent-driven technique have been formed around the world.

“The training was incredibly thorough, and I know more about dogs now than I ever have,” McGrath-Wagner says. “I learned how to teach Yancey to avoid distractions, calm him down if he gets spooked, and train him on giving me a warning if my blood sugar drops.”

Before finding D4D, McGrath-Wagner looked into several other organizations around the country that offered diabetic-alert dogs, but most charged $15,000 to $20,000 per dog, he says. D4D charges only $150, thanks to fundraising and more than 100 volunteers who help with everything from fostering the dogs to assisting with outreach events.

“We are essentially giving these dogs to diabetics as gifts, with nothing in return,” Ruefenacht says. “It is part of our culture and message.”


A Future in Disease Detection  

Now, Ruefenacht is looking to double the number of dogs trained each year, and is also researching the possibility of training dogs for people who are both diabetic and blind. His dreams for the future of scent science extend far beyond diabetes.  

“My belief is that we have only scratched the surface of what a dog can do in disease detection and management,” Ruefenacht says. “I believe each disease has a unique scent, and if we can isolate those scents and train a dog on them, this could have incredible implications with early detection of illnesses such as TB and MS throughout the world.”

As for diabetes, he believes dogs are one of the best ways to manage this tricky disease in addition to current medical technology.

“When people get low, they can become ornery, and they may not be compliant when a mom, dad, or other loved one is telling them to check their blood sugar,” he says. “But when you have a nonjudgmental, hairy, four-footed friend tell you, there is no ulterior motive, and it feels very different.”

Dogs for Diabetics will host its annual Dogtoberfest in October at Lagunitas Brewing Company in Petaluma. For details, go to dogs4diabetics.com.

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