You may be surprised to learn that migraines affect more than one billion people worldwide each year, making it one of the most common neurological disorders. Migraines are characterized by high prevalence and significant morbidity, particularly among females and young adults.
It’s important to clarify that for many people, migraines are not just headaches, but events that can derail an entire day and make them hard to function properly. While treatments and medications help many manage their symptoms, some individuals look for complementary aids and sources of support, namely, migraine alert dogs.
Today, we’ll explore types of migraine, what migraine alert dogs do, how they are trained, and why they’re becoming an increasingly important part of migraine management for those affected.
Types of Migraine
Migraines come in several forms, each with distinct features and symptoms.
The two most common types are:
- Migraine with aura;
- Migraine without aura.
A migraine with aura is characterized by disturbances in your sight like flashing lights, blind spots, or zigzag lines that show up before the headache even begins.
On the other hand, migraines without aura, strike without warning and are typically characterized by throbbing pain, nausea, and sensitivity to light or sound. They typically start on one side of the head.
Other types of migraine can include:
- Chronic migraine;
- Hemiplegic migraine.
Individuals with chronic migraine experience headaches on 15 or more days per month, while hemiplegic migraine is a rare form. It can cause temporary paralysis or weakness on one side of the body.
Understanding the specific type of migraine a person experiences is key to tailoring both medical treatment and the tasks a migraine alert dog may need to assist with.
What Is a Migraine Alert Dog?
Migraine alert dogs are specially trained service dogs that can sense and alert their handlers to the early warning signs of a migraine attack.
While migraines can strike suddenly, many people experience subtle pre-attack changes known as the "prodrome phase"—which might include mood swings, fatigue, sensitivity to smells or sounds, and other hard-to-spot symptoms.
According to Independent Pharmacy, “The premonitory (prodrome) phase of a migraine is the warning stage. It’s the start of a migraine and gives you an opportunity to take steps to hopefully avoid an attack. The prodrome migraine stage can last from hours to days and is experienced by most migraine sufferers”.
Receiving this early warning can be vital, as it allows individuals to take medication, find a safe place, or prepare before the attack worsens.
Migraine Alert Dogs detect these changes earlier than the person experiencing them and exhibit a trained alerting behavior to notify their handler. Examples of such trained behaviors can include pawing, nudging, licking (giving a kiss), etc., based on the person’s needs and preferences.
An important question arises here: how do medical alert dogs actually detect migraines?
How Do You Train a Migraine Alert Dog?
Training a migraine alert dog is a complex and highly individualized process. However, service/assistance dog training always start with:
Basic Obedience Training
Before a dog can begin learning specific service dog tasks, it’s essential that they first master foundational obedience skills.
This foundational training involves training the dog basic commands such as “sit,” “come,” “heel,” and walking calmly on a leash. Clicker training, and focus training (especially the latter) are also included in obedience training.
Basic obedience is essential for developing good manners, impulse control, and promoting calm behavior. All these are especially important for a dog to become a reliable service dog in the next training stage.
Most dogs, especially those driven by food rewards, pick up these basic cues pretty quickly. Trainers commonly use one of two techniques:
-Luring, which involves guiding the dog into a position using a treat; and
-Capturing, which rewards a behavior the dog shows naturally.
Initial obedience training should take place in a quiet, low-distraction environment. As the dog gains confidence and consistency, trainers (owners if they self-train their dogs) add distractions gradually.
That way, dogs learn to remain focused and respond to commands in all types of situations and environments.
Recognizing the Onset of Migraines
Training a migraine alert dog starts with one critical element: helping the dog learn to recognize what a migraine looks, smells, or feels like before the pain hits.
This is typically focused on the prodrome phase — the early stage of a migraine that can occur hours or even days before the full episode. During this time, the body begins to change in subtle but consistent ways.
1. Association with the Episodes
The key to successful alert training is building a strong association between early migraine symptoms and a positive outcome for the dog. That’s why positive reinforcement training plays a crucial role!
When the handler starts noticing early migraine symptoms, they should calmly bring their dog close by. The canine should be encouraged to remain close and observe, and any behaviors they naturally exhibit, such as sitting nearby, staring, licking, or pawing, should be rewarded.
Rewards may include treats (high-value treats are preferred for teaching dogs new behaviors), praise, petting, or play, depending on what motivates the dog.
Simply put, this teaches the dog that when their beloved human feels in a certain way, they get something good if they stay near or respond. The dog also starts associating this specific state with something significant happening, which, in this case, is the onset of a migraine.
Over time, the canine begins to notice subtle cues, whether behavioral, physiological, or emotional, and is motivated to respond to them because they have been positively reinforced.
2. Responding to Tells
Many migraine alert dogs start by picking up on behavioral tells, which might include:
- Subtle changes in the handler’s posture, breathing, or facial expression;
- Repetitive motions or vocal patterns;
- Variations in how the person moves, talks, or reacts to their environment.
As you can see, 'tells' can include anything from changes in breathing, movement, facial expressions, and more.
Dogs are naturally observant, and some begin alerting spontaneously once they notice a consistent pattern of these tells preceding a migraine.
These alerts might include pawing, licking, staring intently, or nudging the handler. Handlers then reward these alerts consistently, strengthening the behavior.
For migraines, behavior-based alerting is often the most reliable starting point because chemical changes aren’t always as obvious as with blood sugar or cardiac events.
3. Scent Training
Although not all migraine alert dogs rely on scent, some do — especially if the handler has consistent, noticeable physiological changes during the prodrome phase. These can include:
- Changes in sweat composition;
- Altered breath chemistry;
- Hormonal fluctuations.
Scent imprinting, when used, follows a method similar to that used in training diabetic/seizure/cardiac alert dogs:
Collect scent samples:
The handler uses sterile gauze or cotton to collect sweat or saliva during a confirmed prodrome phase.
Label and store samples:
The samples are dated and stored properly to avoid contamination.
Use the samples in training sessions:
The dog is introduced to the “migraine scent” and rewarded for identifying it among neutral samples (from times when no migraine is present).
Alerting Types of Behavior
Dogs are trained in specific ways to alert their handler when they detect a migraine coming on.
Common alert behaviors include pawing, persistent nose nudging, licking at the arm/leg (many handlers don’t like having their face licked), or fetching medication.
Once the dog consistently identifies the scent, the alert behavior is reinforced.
With that being said, migraine scent cues can be highly individualized and inconsistent from person to person, or even from episode to episode. That’s why scent-based training for migraine dogs doesn’t work in every case, and most successful migraine alert dogs combine scent cues with behavioral tells to form a more reliable alerting system.
Public Access Training
Since migraine alert dogs are a type of service dog, they must have excellent manners in public and be able to remain calm in busy environments, ignore distractions, and perform their tasks reliably.
This includes staying focused on their handler in crowded places like shopping centers, restaurants, or public transportation, even when unexpected noises or people are nearby. They must also be non-reactive around other animals, walk politely on a leash, and remain calm at their handler’s side unless performing a specific alert or task.
Public access training helps ensure the dog can support their handler safely and effectively in any setting.
Breeds Commonly Used for Migraine Alert Work
While many dog breeds have the potential to be trained for migraine alert, the most common breeds include:
- Labrador Retrievers;
- Golden Retrievers;
- Poodles;
- Border Collies;
- German Shepherds
- Australian Shepherds.
With that being said, a dog's personality, temperament, eagerness to learn, and, of course, their strong bond with the handler are far more important than their breed.
