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As doctors hovered over a 7-year-old girl undergoing kidney surgery Wednesday morning, her beloved furry companion was right there, carefully watching along with the humans and machines monitoring her condition.
JJ, a dog that can sense when Kaelyn Krawczyk — known as KK — is about to have a life-threatening reaction, is believed to be the first canine allowed into the procedure room at the Children's Health Center at Duke University Medical Center.
“It struck us that JJ is really just an additional monitor that provides information about what’s going on with KK,” Dr. Brad Taicher, assistant professor of pediatric anesthesia at Duke, told NBC affiliate WNCN in Raleigh, N.C.
“We’re very excited for the fact that JJ can join us for this. We’re excited to see what she can do and what information she can provide us.”
KK, who lives in Apex, N.C., was born with mast cell activation disorder, a rare condition that can cause reactions when the girl is too hot, too cold, or gets stressed. One of her biggest triggers is fatigue.
The reactions can range from mild, where she just feels a bit uncomfortable, to life-threatening, where her blood pressure drops and she experiences abdominal pain and vomiting, and has trouble breathing, said Michelle Krawczyk, KK’s mom.
“Everyday things that every 7-year-old wants to do, like run around and play or to go to the park or anything like that, I mean any of those can be a potential trigger,” Krawczyk said.
Knowing dogs can be trained to detect impending seizures in people, KK’s parents started looking around for a canine that could help warn them KK was about to experience a problem, but the Krawczyks kept being told that dogs aren’t trained for her condition or that they’re not trained for a child that young.
Finally, the family connected with Deb Cunningham, program director of Eyes, Ears, Nose and Paws, a nonprofit in Chapel Hill, N.C. Employing a similar process used to train diabetic-alert dogs, the center provided the family with JJ. Krawczyk says the 2-year-old rescue dog can sense when KK is about to have a reaction, giving her family precious advance notice.
JJ is now the girl’s little monitor and they are inseparable. When the dog senses something is wrong, she will jump up Krawczyk’s leg, tug at her clothes and bark.
Most scientists believe the dog is actually alerting to small, subtle changes in behavior on the part of the individual, said Dr. Lawrence Myers, associate professor of animal behavior at Auburn University.
“Dogs really, really, really are very interested in humans and pay a lot of attention to us,” Myers said. “Especially the behavior of humans that they’re bonded to.”
Dogs are used to detect some types of cancers, high and low blood sugar in diabetics, and seizures in people with epilepsy. Some researchers are convinced the animals respond to a change in the odor of the person, though Myers finds that unlikely.
Whatever the dog is reacting to, KK’s mom is thankful JJ is there.
“She is the reason why we can sleep at night, she is the reason why KK can have a more normal life, and that might not seem like a lot, but when you have to restrict your child from normal every day activities, the ability to do anything more is just phenomenal,” Krawczyk said.
KK calls the dog “very beautiful and smart” and says she’s her best friend.
“She’s the top of my love list,” KK said.
KK has been having a lot of kidney infections so on Wednesday, she underwent surgery at Duke University Hospital to try to treat the problem. Her doctors wanted JJ to do what she always does – alert them to any problems.
The 45-minute procedure "went perfectly," Taicher said. The doctors knew going to sleep and emerging from the anesthesia were times of higher stress for KK, and the dog did react in a very mild, controlled way, to indicate something was going on, but nothing too important, he added. Otherwise, JJ stayed calm throughout the procedure and sat underneath her trainer's chair.
Taicher admitted some people at first thought he was crazy for suggesting the dog should be present, but his decision ultimately received global support. JJ didn't wear any special garments or undergo any extra cleaning before entering the room, he said.
"Our concerns for infections were pretty low and we thought that the benefit of having JJ as an extra anesthesia monitor would be of greater benefit than the risk of infection," Taicher said.
It’s very unusual to have a dog present in a hospital procedure room, said Dr. Timothy E. Smith, an associate professor of pediatric anesthesiology at Wake Forest Baptist Medical Center. In fact, both Smith and Myers have never heard of any other such cases.
Smith said he would be open to considering such an option if he had a strong reason to believe it would help, but noted many things happen to the human body under anesthesia that may change any interpretation that a dog is responding to. In general, he would also be worried about how an animal would impact what’s normally a “sacred sterile environment.”
“My main concern is entering some potential infection or bacteria into the operating room where you have a patient having surgery and an open wound,” Smith said.
Myers added much more research needs to be done on the ability of dogs to detect seizures and diseases humans so scientists can understand how they do it and how reliable they are.
But KK’s mom is just thankful JJ was there for her daughter.
“(She’s) her little angel,” she said.