Abstracts

Rationale: Evidence supporting seizure-related behaviours in dog companions of epileptic humans is emerging. Potential benefits include assistance abilities, anticipation of seizures, and enhanced quality of life (QOL). Seizure response dog (SRD) behaviours follow clinical seizure onset and may include trained assistance skills. SRD organizations are increasing but their methods and outcomes are unstudied.Methods: All graduates of a large North American SRD training program (Lions Club Foundation) were approached for enrollment (2001-2006). A standardized survey was developed and applied by the same investigator via in-person and telephone interview. Data was captured on patient medical history, animals, training methods, SRD behaviours and effectiveness, spontaneous alerting ability, and effects on seizure frequency and QOL. Likert-scaled scoring of qualitative variables was performed and changes in QOL recorded. Program methods were evaluated including patient satisfaction and accuracy of epilepsy diagnosis.Results: Twenty-two of 27 potential patients (81%) participated (median age 34 (12-66) years, 73% female). Most had childhood onset (87%), long-standing (22 years), intractable (36 seizures/month) and refractory (4.8 meds failed) epilepsy. Patients tended to be unmarried (81%), rural (73%), and unemployed (59%) with high school education or less (73%). All had neurologist-confirmed epilepsy diagnoses with symptomatic partial being most common (64%). SRD were large, pure bred animals living with their companions for a median of 4 years. While event-related animal anxiety was described, no adverse events or harm were reported. SRD behaviours (beginning after seizure onset) were consistent and reliable, including activation of emergency response systems in 27%. Spontaneous development of alerting behaviour (prior to clinical seizure onset) was described in 67%, usually within weeks of pairing after >20 seizures were witnessed. Anticipation behaviours were reliable and occurred a mean of 31 (range 0.5-180) minutes prior to seizure onset with this interval increasing over time in 42%. Alerting abilities were reported to directly influence patient management of their own epilepsy in 89%. After obtaining their SRD, decreased duration or frequency of seizures was commonly reported (45%), particularly by those with alerting dogs (86%). All patients reported improvement in QOL since obtaining their SRD (major 82%, moderate 18%). QOL benefits were distributed evenly across mood, anxiety, interpersonal relationships, and self-confidence issues. Most (73%) described direct social benefits with SRD facilitating new interpersonal relationships. Patients were very satisfied with the SRD program (89%) and all strongly recommended SRDs for others with epilepsy.Conclusions: SRD programs can select genuine epilepsy patients, instill valuable assistance skills, and generate meaningful improvements in QOL. Untrained alerting abilities commonly develop and may confer additional benefit. The consistency and magnitude of effect, coupled with possible effects on seizure frequency, support the need for additional seizure dog research.