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Training the combat and operational stress control dog: an innovative modality for behavioral health.

For many thousands of years, dogs and humans have been companions. Although there is debate about when wolves became domesticated, (1) based on osteoarcheologic and genetic research, examples of this domestication have been traced to the Upper Paleolithic era (approximately 40,000 to 10,000 years ago). (2)

Regardless of when and how this partnership developed, canines have performed vital jobs for man throughout the ages. Historically, war dogs have been used by armies, including Egyptian, Greek, Persian, and Roman. (3) As fighting dogs, they were trained to attack the enemy or, when used defensively, to protect caravans or forts. In more recent times, dogs have been used as couriers to carry messages in battle or pull carts of wounded Soldiers. (4)

Dogs were used in an unofficial capacity during the Revolutionary War. The first recorded use of dogs by the US Army was during the second Seminole War (1835-1842), (3(p138)) but it was not until World War II that this relationship was formalized. Patriotic dog owners formed "Dogs for Defense," a civilian group that reached out, with the aid of the American Kennel Association, to other dog owners across the country to donate quality canines to the US Army Quartermaster Corps. (5) In 1942, the Secretary of War approved the creation of the first K-9 corps. (5,6) Since then, dogs have served with their handlers in conflicts around the world in a variety of roles, including sentries, scouts, messengers, and mine detectors.

A New Role for Military Dogs

America's VetDogs began as a project of the Guide Dog Foundation for the Blind, a not-for-profit agency, which has trained guide dogs for blinded Veterans since the end of World War II. VetDogs was created to provide an overall assistance dog program to enhance and increase the services the organization offered to disabled Veterans of all eras. Beginning in 2003 with a presentation at the National Disabled Veterans Winter Sports Clinic, America's VetDogs has built a solid reputation of providing guide and service dogs to disabled Veterans.

VetDogs was invited to train a balance dog to work at the Walter Reed Army Medical Center with vestibular patients as they adjusted to their new prostheses. However, it was realized that wounded Soldiers were also using the golden retriever (named George) for emotional support during their rehabilitation. Indeed, after George's original handler was reassigned, the dog became a "good will" ambassador-at-large for recovering service members.

Based on observations of how these men and women responded to George's presence, a new role was envisioned for therapy dogs as an innovative "tool" that combat and operational stress control (COSC) teams could use in theater to help break down the stigma attached to mental health care. They would allow members of the COSC team to reach out and help Soldiers who might be experiencing combat stress or home-front issues during their deployments as part of Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF). America's VetDogs was approached to train dogs to serve in this pioneering capacity. VetDogs and Army personnel worked together for a year to refine the aspects of the program, including training and dog handling responsibilities. In December 2007, SFC Boe and SFC Budge, two black Labrador retrievers (Figure 1), assumed a historic role: the first-ever combat and operational stress control dogs to be deployed in theater as specially trained skilled therapy dogs.

America's VetDogs worked in collaboration with the Army Public Affairs Office in New York, NY, to generate media coverage of the handover ceremony as America's VetDogs donated the dogs to the Army. Local New York and national media covered the story before the dogs' deployment, and updates appeared on CNN, Fox News Channel, and National Public Radio. Stories appeared in newspapers, websites, and blogs, including press releases generated by the different units that were visited by the COSC dogs.


Training the Cose Dog

To ensure that America's VetDogs provides only the highest quality, fully trained dogs to the Army, training and acclimating a COSC dog team and preparing it for deployment (including the training of handlers) is a 4to 6-month process. The search for a COSC dog begins with a review of the medical records of available dogs currently residing in the Guide Dog Foundation kennels (America's VetDogs obtains its dogs from its parent, the Guide Dog Foundation for the Blind) and includes Labrador retrievers, golden retrievers, and Labrador/ golden retriever crosses. Trainers evaluate dogs that come only from the Foundation's stock because of the detailed medical histories kept for each dog. All dogs chosen for the COSC training program must have clean bills of health because the availability of veterinarians and the conditions the dogs may face once deployed are not predictable. The dogs are reviewed for temperament, health issues, and adaptability. Trainers look for a "sound" dog, one that is confident and comfortable with new experiences. It must not react adversely to unpleasant experiences nor have residual effects when it does encounter such conditions. A pool of approximately 20 dogs will eventually be narrowed down to 12 dogs, and then 6 dogs.


After a certain number of dogs have been identified as potential COSC dogs, a trainer works with a local volunteer fire department to expose them to different types of vehicles and equipment, sights, sounds, and smells. During a typical visit, firefighters will sound the horns and flash the lights so the trainer can evaluate the dog's reaction. If it bolts or otherwise shows that it is afraid, the dog will not be used for the COSC program. However, minor anxiety exhibited by the dog can be overcome.

The dogs are loaded and unloaded onto different vehicles so they are comfortable with a variety of equipment. There is also a mechanic's "pit" that was previously used to make repairs on trucks. The VetDogs trainer leads the dog into the pit because it simulates a dark cave with many different smells, including burn smells. If the dog balks, the trainer gently encourages the dog without forcing it; the dog must be able to trust its handler.

The dogs are also acclimated to the sounds of gunfire and helicopters. VetDogs works cooperatively with the aviation division of a local police department and the Air National Guard for access to working helicopters and other military aircraft. Trainers have also worked at the Intrepid Sea, Air, and Space Museum (New York, NY), teaching the dogs to jump in and out of the helicopters (Figure 2) on display on the Intrepid's flight deck. Until they are deployed, the dogs' helicopter training is static.

Thanks to the relationship between VetDogs and a local firing range, the dogs are exposed to the sounds of gunfire, from automatic weapons to pistols (Figure 3). The trainers want to ensure that the dogs maintain a calm attitude and demeanor when exposed to these sounds. The dogs are also conditioned to wear special goggles, vests or backpacks, and ear muffs.

Additional sensory exposures include different types of surfaces (sand, stone, gravel, etc) and busy streets and highways so the dogs are comfortable around moving trucks and other loud noises.

VetDogs trainers also work on obedience training, basic commands, and controllability. They will use a motivational object (MO) or "drive toy" to enhance a dog's obedience skills. An MO can be used as a distraction if the dog is in a stressful experience--the dog focuses on the toy, not the situation, thereby alleviating its stress. Obedience is vital because eventually the dog will be in situations with equipment to which it has not previously been exposed.

The most important function of a COSC dog is its adaptability to different environments, noises, and crowds so that the dog enhances the work of the COSC team, without being a distraction. The dog must have excellent house manners and behave impeccably in a myriad of situations.

Dogs must not scavenge for food, so trainers work on teaching the dog to ignore "food distractions." For example, a handful of kibble is tossed on the floor, and the dog maneuvers around it without stopping to eat.

During its mission, the dog may be called upon to have enough energy to engage in morning physical training exercises, while later in the afternoon it may be required to lie quietly in a clinical setting, where Soldiers can interact with it. The dogs can provide emotional comfort through physical interactions such as playing fetch or simple petting.

The dog must also adapt to a number of different handlers depending on the current mission or future deployments. The presence of the dogs allows their COSC team handlers to concentrate on their duties.

Integrated Training

The first COSC team training took place in December 2007 on the campus of America's VetDogs in Smithtown, NY. Two occupational therapy assistants from the 85th Medical Detachment were temporarily assigned to Smithtown for 5 days to learn basic handling techniques for SFC Boe and SFC Budge.

When the 85th Medical Detachment returned to the United States, the dogs were assigned to the 528th Medical Detachment. Prior to their deployment, handlers from this unit also trained at VetDogs headquarters with "demo" dogs to familiarize themselves with obedience training and handling techniques.


Because the VetDogs campus does not offer the unique training facilities an Army base provides, VetDogs trainers currently travel to a unit's home base to train the dogs' primary and secondary handlers. The VetDogs trainer spends half of the first day working with the whole unit. Team members who are not the dogs' handlers will have the opportunity to understand the roles the canines will play as members of the COSC team. The trainer will also discuss proper handling techniques.

After the initial session, the trainers focus on the primary and secondary dog handlers. The primary handler is an occupational therapy assistant with an interest in the mission, and there are 8 to 14 potential handlers for every 2 dogs in theater.

At the request of the Army, VetDogs trainers traveled to Landstuhl, Germany, to train 2 COSC dogs that would be deployed with the 254th Medical Detachment to Afghanistan. These were the first COSC dogs to be deployed as part of OEF. VetDogs trainers have also trained personnel of the 212th Medical Detachment at Fort Campbell, KY, and the 98th Medical Detachment at Joint Base Fort Lewis-McChord, WA.

In Theater

When deployed, the dogs accompany their handlers wherever they go. The dogs serve as an icebreaker and communications link between troops and care providers, and, whether in a one-on-one or group setting, members of COSC teams have reported that service members would talk to them for longer periods of time than if they were alone.

As part of its commitment to the Army, America's VetDogs trainers are constantly in touch with COSC dog handlers throughout their deployment so they remain confident that VetDogs will resolve any issues that might arise with the dogs.

As of this writing, a total of 8 dogs have served as part of OIF, OEF, and Operation New Dawn. The dogs have interacted with thousands of service members, both in theater and in new assignments once they return home. SFC Budge and SFC Boe served 2 consecutive tours of duty, first with the 85th Medical Detachment and then with the 528th Medical Detachment. SFC Zeke and SFC Albert were attached to the 212th Medical Detachment, and then the 85th Medical Detachment. SFC Butch and SFC Zack served with the 98th Medical Detachment in Iraq, and SFC Apollo and SFC Timmy were assigned to the 254th Medical Detachment in Afghanistan. Apollo and Timmy were reassigned to the 528th when the 254th rotated home. For both the 85th and 528th Medical Detachments, the assignments represented the second time the units had requested COSC dogs to be members of the combat stress control team. Zeke is currently with the 113th Medical Detachment, stationed in Afghanistan.

New Duty Assignments

When Boe and Budge returned to the United States in 2009, they had not been reassigned. However, a civilian physical therapist at Eisenhower Army Medical Center (EAMC) on Fort Gordon, GA, had requested a dog to work with her patients. The dogs were available and residing at America's VetDogs, so the next phase in the careers of the COSC dogs had begun.

It is now standard procedure for America's VetDogs to meet a COSC unit upon its return and transport the dogs back to the VetDogs campus in Smithtown. There, VetDogs trainers reevaluate the COSC dogs for behavior and temperament. When they perform a "temperament test," the trainers compare a dog's behavior from before deployment to its behavior after deployment. Dogs are retrained to correct behaviors that might have been acceptable in theater but would not be in a hospital or other medical setting.

Once the Army Medical Command has determined a dog's next mission, the dog may be trained to perform specific tasks. Such tasks include providing balance and stability with the use of a special balance harness or by "bracing," opening doors, picking up dropped items, pressing buttons, turning on light switches, creating a safe "personal space zone" or leading someone to a door to go outside. Depending on the task, task training involves constant repetition of the task and positive reinforcement when the dog performs it successfully. Each step forward builds on the success of previous steps.

Trainers from America's VetDogs reevaluated and retrained Boe and Budge to serve at EAMC, along with a third dog trained especially for the medical center. Just one example of their effectiveness and value: a Soldier recovering at EAMC was encouraged by her occupational therapist to interact with Budge. She began to realize that the dog was not only helping with her vestibular problems, he was helping to improve her mental state. With the dog by her side, she felt comfortable going out by herself, and later trained with her own service dog from America's VetDogs. She credits her service dog with giving her the freedom to reclaim her life. Further, when her tire blew out during a wheelchair basketball game and she reacted to the noise, her service dog came running to her side as it had been trained to do. This so impressed a fellow Veteran in the stands that he applied for his own service dog in April 2011.

America's VetDogs-the Veteran's K-9 Corps

In addition to COSC dogs, America's VetDogs also provides individual assistance dogs and training for disabled Veterans of all eras. To date, over 200 disabled Veterans have received assistance dogs to help them with daily life activities. These dogs range from guide dogs for Veterans who are blind or visually impaired to service dogs that provide balance and stability for amputees or those with traumatic brain injuries, seizure alert response dogs for those with seizure disorders, and dogs to alert diabetics when they have low blood sugar.

Of those service members who were still on active duty when they trained with their service dogs, 20% have chosen to remain active.

VetDogs also trains facility and physical and occupational therapy dogs that are placed at various military and Veterans Administration (VA) medical centers. In addition to the Walter Reed National Military Medical Center and the Eisenhower Army Medical Center, VetDogs has placed dogs at VA facilities in Northport, NY, Dublin, GA, and Lake City, FL. Recently, Boe was transferred to Fort Benning, GA.

In June 2009, America's VetDogs received the Secretary of the Army's Public Service Award, which recognizes "exceptional service that makes a substantial contribution to the accomplishment of the Army's missions."

The timeline of the development of the COSC dog program, beginning in 2006, is shown in the inset.


(1.) Burying man's best friend. interview with Darcy Morey. Archaeology [serial online]. November 8, 2006. Accessed November 22, 2011.

(2.) Pionnier-Capitan M, Bemilli C, Bodu P, et al. New evidence for Upper Palaeolithic small domestic dogs in south-western Europe. J Archaeol Sci. 2011;38(9):2123-2140.

(3.) Karunanithy D. Dogs of War: Canine Use in Warfare from Ancient Egypt to the 19th Century. London, UK: Yarak Publishing. 2008.

(4.) Dogs of war in European conflict. New York Times. February 21, 1915. F20A13FF395B17738DDDA80A94DA405B858DF1D3. Accessed November 22, 2011.

(5.) Waller AM. Dogs and National Defense: Study on the history of War Dog training and utilization during and after World War II. Fort Lee, VA: Office of the Quartermaster General, US Dept of the Army; 1958. Accessed November 22, 2011.

(6.) Quartermaster War Dog Program. US Army Quartermaster Foundation website. Accessed November 28, 2011.


A new role for therapy dogs in theater is envisioned after it is observed how wounded service members interact with George, a therapy dog at Walter Reed Army Medical Center.


Occupational therapy assistants with the 85th Medical Detachment are temporarily assigned to VetDogs headquarters to train with SFC Boe and SFC Budge, who are deployed to Iraq in December.


Members of the 528th Medical Detachment travel to VetDogs headquarters to learn dog-handling techniques before they deploy to Iraq and assume responsibilities for Boe and Budge.


SFC Zeke and SFC Albert are trained to replace Boe and Budge. VetDogs instructors travel to Fort Campbell, KY, to facilitate training with members of the 212th Medical Detachment.

Boe and Budge return and spend several months at VetDogs headquarters while they are reevaluated and retrained for service at Eisenhower Army Medical Center. MSG Maverick is trained and will join them for the traumatic brain injury clinic, and inpatient and outpatient behavioral health.

America's VetDogs receives the Secretary of the Army's Public Service Award.


SFC Apollo and SFC Timmy are trained in Landstuhl, Germany, to accompany the 254th Medical Detachment to Afghanistan. They are stationed at Bagram Airfield.

SFC Budge is diagnosed with lymphoma, one of the most common cancers in dogs, and passes away. He touched the lives of many Soldiers, Veterans, and their families and is remembered during a memorial service at Fort Gordon.


Zeke and Albert return home and are reevaluated and retrained for their next duty assignment. Albert joins Maverick at Eisenhower. Zeke redeploys with the 113th Medical Detachment, and is currently in Afghanistan.

SFC Boe is reassigned to Fort Benning, Ga.

SFC Butch and SFC Zack are trained at Joint Base Fort Lewis-McChord with the 98th Medical Detachment for deployment to Iraq as part of Operation New Dawn. After a 9-month deployment, the unit rotates home. Butch and Zack are currently in residence with America's VetDogs for evaluation and retraining.

Author and Acknowledgement

Mr Krol is the communications manager for America's VetDogs-the Veteran's K-9 Corps. The author thanks Valerie Cramer, a service dog instructor for America's VetDogs, who provided background and details on the training of COSC dogs.
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Author:Krol, William
Publication:U.S. Army Medical Department Journal
Article Type:Report
Geographic Code:1USA
Date:Apr 1, 2012
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