It gives the 22-year-old Kiama resident time to find a safe space to lie down and put her feet up – and may avert the fainting episode altogether.

The cardiac alert dog also gives the young woman the confidence to get out and about, and to better cope with the heart condition she’s lived with for over a decade.

“I have a genetic connective tissue disorder called Ehlers-Danlos syndrome,” Ms Wall said.

“Everyone’s body has collagen which is their body’s glue and holds everything together – but while most people’s collagen is like superglue, mine is like the glue stick you get in Kindy.

“It affects multiple parts of my body – my stomach and intestine are paralysed so I’m fed through tubes. And it’s also led to another condition called postural orthostatic tachycardia syndrome which causes my heart to race after sitting up or standing and my blood pressure to drop which makes me faint.

“I had started to get scared to go out in public because I was passing out a lot, and I was becoming withdrawn. But Betsy has given me that confidence back, has given me my independence back, because I know she’s there – she’s my shadow, she’s just amazing.”

Amazing indeed, with such a fine sense of smell that she can detect subtle changes in Ms Wall’s sweat and saliva that forewarn of a fainting episode.

“She can give me 10 minutes warning so I can be prepared and not hurt myself,” she said. “It’s helped reduce the fainting episodes as I’m able to lie down and get my heart rate under control.”

The four-year-old Australian kelpie can also detect changes in her owner’s blood sugar levels – although she has a different warning system for when that happens.

“If my blood sugar level drops, which can be quite dangerous as I have gastroparesis, then she spins in a circle and give out a low bark,” Ms Wall said.

“And if I do get a bit dizzy and lean over a little to one side, she’ll work to counter balance that by pulling the other way on her harness to bring me back to the proper position.”

Ms Wall initially got Betsy as a therapy dog, but soon realised her four-legged friend had a knack for predicting her fainting episodes.

“As a puppy she would get agitated and run round in circles before I had fainted so we realised that she was picking up the signals in advance.”

Ms Wall received assistance to train Betsy, who has since passed the Public Access test as an assistance dog accessing public spaces.

“Betsy’s changed my life,” she said.