Brianna Bertrand huffs and puffs, blowing into her dog Cyrus face.
The scene playing out is not that of an 8-year-old playfully tormenting her pup.
Its of life and death.
Cyrus is a medic-alert service dog trained to detect when Briannas blood sugar levels are dangerously low or high. He does so by smelling her breath and skin.
Doctors diagnosed Brianna with Type 1 diabetes last year.
Juvenile diabetes is difficult for any child, with the constant finger pricks and insulin shots and the counting of every carbohydrate, but it is particularly so for Brianna.
Brianna is autistic and cant communicate when she doesnt feel well. She has never told her parents, Dana and Joe Bertrand, when her tummy hurt or her ear ached.
But on March 2, 2011, Dana Bertrand could tell from Briannas behavior that she wasnt feeling well. The doctor thought the girl had a virus. While at the appointment, Dana Bertrand also mentioned to the pediatrician, Elaine Harrington at Via Christi Clinic, that Brianna had been drinking a lot of water, waking her parents up at night for more.
Harrington ordered a urine test, and Brianna and her mother left afterward. They were down the road a ways when the doctors office called and asked them to come back to do a blood test. It revealed Briannas blood sugar levels were too high, and Brianna went straight to the hospital, where she spent the next four days.
That day just happened to be Dana Bertrands birthday.
Brianna now takes insulin injections at least four times a day. Her family checks her blood sugar levels day and night.
So does Cyrus.
If the yellow Labrador retriever senses Brianna's blood sugar level is low or high, he alerts her parents. Her parents then test Brianna.
If her blood sugar level is lower than 80 or higher than 200, Cyrus gets a treat for being right a 5-calorie mini Milk-Bone. Thats the only time he gets a treat.
On an average day, he gets four treats.
Dana Bertrand tears up when she talks about what Cyrus means to her family, which includes son Kenneth, 11, who also is autistic.
I am very thankful for him and how hes affected Brianna, she says of the dog, adding that not only does Cyrus help the family manage Briannas diabetes, he also helps calm Brianna.
And he provides companionship for a girl who says little to anyone except Are you OK?, a question she cant answer herself.
A 24/7 job
Brianna showed symptoms of autism when she was 2, her mother says. She flapped her hands, developed repetitive behaviors and didnt play with toys like other children.
She didnt speak at all until she was 4 or 5.
Doctors told the Bertrands that Brianna was autistic when she was 4.
Her brother is considered high-functioning in terms of autism, but Briannas autism is considered moderate to severe. She shows more classic symptoms of autism.
Kenneth will be in the sixth grade this fall at Andover Central Middle School. Brianna was enrolled in special-education classes, but her mother has home-schooled her the past year because of her diabetes.
Keeping Briannas diabetes in check is a 24-hour-a-day, seven-days-a-week job. Cyrus sleeps in Briannas room to monitor her.
Her blood sugar levels are checked before every meal and two hours after every meal and throughout the night. Nurses come to the Bertrands Andover home to help provide respite care.
Theres no sleeping through the night anymore, Dana Bertrand says. Thats been very tough.
But having Cyrus, who was trained at CARES (Canine Assistance, Rehabilitation, Education and Services) in Concordia, has helped, she says.
The Bertrands knew about and had seen service dogs for people who are blind. But they had never heard of a medic-alert service dog like Cyrus.
A speech therapist in Derby told the Bertrands about dogs trained to detect blood sugar levels. Harrington, Briannas doctor, thought such a dog would be helpful and wrote a recommendation.
Brianna is a child who cant communicate and cant communicate effectively, Harrington said. To have a dog who can pick up on whatever little slight change Brianna does just before she needs some attention is great before it becomes a catastrophe or a major issue.
She said Cyrus, because of his calm nature, also helps keep Brianna calm for blood checks and injections.
That family has been through a whole lot, Harrington says. He can ease some of that. Dogs just have a sixth sense that we cant explain.
'Such a good fit'
Childrens Miracle Network Hospitals at Via Christi Health and the Butler County Community Developmental Disability Organization helped the Bertrands pay the $2,500 fee to get a service dog.
Any opportunity we have to help a family out and ease their financial burden thats our whole mission to help sick and injured kids, said Jill Bosley, director of development for Childrens Miracle Network Hospitals at Via Christi Health.
This past March, the Bertrands got Cyrus, who will be 2 in September, after a weeklong training session for the whole family.
The first day was a really neat experience, Dana Bertrand recalls. Trainers brought out dogs to their new families one at a time. There were four people with diabetes who were matched to a service dog.
It was amazing the connection and how they were such a good fit, she says, fighting tears. It was a pretty emotional week.
Cyrus doesnt bark when he senses something is amiss with Brianna.
Instead, he comes to Briannas mother or father with his ears upright, staring. Sometimes, he whimpers.
If Cyrus comes into our room at night, my husband and I know we need to go check on her, Dana Bertrand says.
When Briannas blood sugar levels are off, hes on her and he doesnt let her out of his sight.
Cyrus, who wears a vest and badge identifying that he is a service dog, goes everywhere with Brianna. Most people have been supportive, Dana Bertrand says, but some have questioned whether Cyrus is just a regular pet. A fast food restaurant in New Mexico, where the family recently went on vacation, wouldnt allow Cyrus to come inside, even though service dogs are allowed in public places under the Americans with Disabilities Act. Bertrand says shes also had to explain to the grocery store where she shops that Cyrus is allowed to go wherever Brianna goes.
Cyrus recently saw Madagascar 3: Europes Most Wanted at the movie theater. The family joked about whether they should put 3-D glasses on him.
The Bertrands hope that Cyrus will help Brianna be as independent as possible as she grows older.
It is so important that he goes everywhere with her, Dana Bertrand says. There are times we think shes fine, and he has shown us that shes not fine and that is huge.