RALEIGH — As a 7-year-old Sheltie, Ruger brings a novel approach to caring for cancer patients at Rex Hospital: roll over on back, wait for ear scratches, sneak a quick lick on the chin.

Among Rex's three therapy dogs, he's easily the most laid-back, so cool under pressure that he once fell asleep on the chest of a 4-year-old boy recuperating in intensive care. The boy fell asleep, too.

On Wednesday, visiting in the oncology ward, Ruger crawled into Tammy Godwin's lap.

"Ain't you special?" she told him, brightening up after a week at Rex. "I wish my little dog could be up here. She'd be jealous."

In January, Ruger, a terrier named Ziti and a mutt called Ruby Sue officially begin work as Fur Friends at Rex, a program aimed at bringing non-medical cheer to some of the sickest patients.

A pilot program since July, Fur Friends mirrors similar pet therapy work at Duke University Hospital, UNC Health Care and WakeMed.

Studies have shown that regular contact with animals can reduce anxiety and despair among cancer patients, reduce blood pressure in recuperating children and improve morale among people suffering from terminal illness, according to DukeHealth.org.

Over the last six months, Ruger and his colleagues have worked mainly with cancer patients, who tend to stay hospitalized longer and sink more easily into depression, said Sherry Raymond, volunteer coordinator at Rex.

But the program has worked well enough to spread hospital-wide, and to add another three dogs in January.

"Even ICU wants us," Raymond said.

Before a dog can join, one of three agencies that certify therapy dogs must sign off, which requires intensive training and behavior testing.

"They'll take a wheelchair and come flying at them with it," said Bob Gelinas, Ruger's owner. "They'll take a walker and slam it on the floor. They'll put a treat down."

Before each visit, dogs get their eyes, teeth and nails checked, their respiratory and musculoskeletal functions examined to make sure they're healthy and not carrying anything that would make the patients sick. Both the doctors and the patients must agree to a visit in advance.

A fresh sheet covers every patient's bed and lap when Ruger comes in, and everybody who pets them gets a squirt of hand sanitizer. Licking isn't allowed, but it's hard to prevent.

"No faces!" scolded volunteer Marilyn Willis when Ruger kissed Tammy Godwin. "I don't want to put hand sanitizer on your face."

Godwin, from McGee's Crossroads, has spent a week on the oncology floor, and she needed help putting sanitizer on her hands. But she stroked Ruger affectionately enough that he rolled over on his side, exposing his belly.

"It's a treat to have a visitor," she said with a smile.

Only one patient felt up for a dog visit on Wednesday. But Ruger has managed as many as 19 in a week. All the dogs can.

Raymond recalled the time he visited a cancer patient known for being sullen and seeing him grin when he patted Ruby Sue.

"His daughter started crying," she said. "She hadn't seen him smile in so long."

You don't have to be sick for Ruger's magic to work. Some mornings, Gelinas his owner confesses, he doesn't feel like doing much. But he finds his motivation when his Sheltie hops in the car alongside him.

It's like getting a shot.

Shaffer: 919-829-4818