Jenn’s life changed dramatically when she was diagnosed with Sheehan’s Syndrome (postpartum hypopituitarism) when her son was just 13 days old. Suddenly living with secondary adrenal insufficiency as a new mum, Jenn repeatedly went into a life-threatening adrenal crisis. Determined to find a positive way through, Jenn discovered Medical Detection Dogs (MDD) and now Joy is her cortisol alert dog. Here Jenn shares her journey, the impact Joy has had on her life and her work as the co-founder of Maternal Pituitary Support.

Want to know more? At the end of this blog, Endocrine Specialist Nurse Helen Loo from the Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM) shares her research on the ability of alert dogs to be successfully trained to detect low cortisol levels in patients with Addison's disease.

Jenn's diagnosis

I’m diagnosed with acute Sheehan’s Syndrome, which is when the pituitary gland is damaged in pregnancy or childbirth. My pituitary gland doesn’t release enough ACTH which means I have secondary adrenal insufficiency.

When my son was 13 days old, I was rushed into hospital in adrenal crisis and into critical care. This is how my pituitary damage was detected. 

How long has Joy been your Medical Detection Dog?

We are an own-dog partnership, which means Joy belongs to me, rather than being a dog that is owned by Medical Detection Dogs (MDD). I’ve had Joy since she was 8 weeks old and we started her scent training under the guidance of Medical Detection Dogs at 9 weeks old. We believe Joy first alerted at 11 weeks old! In September 2017 she was accepted by Medical Detection Dogs into their training programme and was accredited in April 2018.

I loved training Joy and all the obedience work has been so much fun. It has been challenging at times and having a puppy is certainly not an easy route, but it has been so very worth the effort. I never imagined having such an amazing bond with Joy. She is my best buddy and my constant companion. I trust her completely. She will wake me up at night to alert me if necessary.

She’s now 8 years old and has kept me out of A&E since 2018! 

What does an average day for you and Joy look like?

Our days are usually busy, as I recently started home-educating my son. We live in a beautiful area so we’re usually at the beach, local waterfall, visiting home education groups, museums or learning at home. Joy loves exploring and making new human and dog friends too! 

In 2022, I co-founded Maternal Pituitary Support, a non-profit organisation with Claire Barlow who also has Sheehan’s Syndrome. Last year Joy accompanied us to an important event at the Palace of Westminster and enjoyed having her own personal water bowl attendant and exclusive patch of grass! 

At home, Joy is very good at chilling out and snoozing whilst keeping a close nose on me. She likes to go out running every day with my husband too which is a lovely break for her.

How has having Joy helped you?

Joy has given me my independence and confidence back. It is so frightening to experience adrenal crisis and critical illness. Suddenly I couldn’t trust my body any more. I experience lack of awareness of my symptoms, so without Joy I can suddenly become very unwell.

"Having Joy with me means that I can trust her to alert me early on so that I can check in with myself and make small changes to my steroid replacement, rather than getting very unwell. I feel confident going out on my own and that Joy is there for me to keep me safe."

She is a comfort and reassuring presence if I’m reminded of my traumatic medical experiences. I can’t imagine life without her now, she is my best buddy and so in tune with me. I love spending time with her having cuddles, walks, playing or training together.

What would be your advice for someone looking for a medical detection dog?

Medical Detection Dogs (MDD) is an amazing charity and they were so supportive and kind when I first enquired and applied. I would suggest getting in touch with them to find out more. Having a medical alert assistance dog does come with many responsibilities in terms of daily exercise, training, data collection and finances so it may not be right for everyone.

We ask Jenn our most asked "Addison's Admin" questions here at ADSHG!

How do you remember to take your steroid replacement medication? 

I use a pump for my steroid replacement to deliver subcutaneous hydrocortisone infusion and this is programmed over 24 hours. Joy alerts me early on when my pump is set too low or too high, meaning I can manage my condition so much better.

Some of my other hormone replacements are tablets, and I keep these in a daily tablet organiser, which I keep where I will definitely see it! 

How do you carry your injection kit?  

I have an injection box from the ADSHG shop in my handbag and another two in the car. Joy carries information in her working jacket too.

What type of medical alert identification do you have? 

I have a medic alert bracelet, lock screen alert on my phone and a medical alert seatbelt slip with information inside. I also carry my NHS steroid card and a small folder from the ADSHG shop with my information in case of emergency.

I have a t-shirt in the car which I had printed during the pandemic. It says: “patient is steroid dependent for life” and I wear it if admitted to hospital. Joy also serves as a clear medical alert when she’s in her working jacket and lead slip! 

	Author: Jenn (and Joy)
	Maternal Pituitary Support  Website | Instagram | Facebook | X (Twitter)
	Medical Detection Dogs (MDD)  Website | Instagram | Facebook | X (Twitter)

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The Research - Cortisol Alert Dogs

At the 2019 Society For Endocrinology BES Conference, the ADSHG was delighted to present Endocrine Specialist Nurse Helen Loo with our Annette Louis Seal Award for her work on the ability of alert dogs to be successfully trained to detect low cortisol levels in patients with Addison's disease.

Endocrine Specialist Nurse Helen Loo explains: "Often hailed as a human’s best friend, dogs have been the topic of many scientific studies exploring how they might boost our well-being. The phenomenon of medical alert assistance dogs came to my attention while I was caring for a patient experiencing repeated adrenal crises.

The charity Medical Detection Dogs defines medical alert assistance dogs as trained companions that detect biochemical changes in individuals and alert them to impending health episodes. These dogs can identify distinct odour changes, enabling individuals to take preventative measures to manage their condition. Evidence suggests that medical alert assistance dogs reduce the severity of health episodes, decrease hospitalisation, and improve quality of life.

In the case of the patient under my care, they and their dog had embarked on a training program using Pavlovian conditioning, teaching the dog to detect low cortisol levels based on scent changes. During the study, we gathered data through patient interview and compared their hydrocortisone day curve results from before and after incorporating the medical alert dog in their life. The key findings were that since having the dog she was able to reduce her Hydrocortisone to 25mg per day, indicating better self-regulation; the dog reliably alerted the patient when their cortisol levels dropped below 180nmol/L;

The patient reported feeling safer, more independent, and less anxious about the risk of adrenal crises. In the patient’s words, ‘the increased confidence I felt in not missing low cortisol levels made me feel less scared to be on my own and that I’m not taking too much cortisol’. This shows the patient’s ability to manage steroid requirements was optimised and her quality of life demonstrated significant improvement."

This case along with emerging research, suggests that medical alert dogs could be a support for people with adrenal insufficiency. The ability to detect and pre-emptively respond to low cortisol could significantly reduce adrenal crises." 

Cortisol Alert Dogs

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