Seizures

Subway stairs

With seizures, service dogs can help in three ways:

  • The dogs are trained to respond to seizures; when their handler has a seizure, the dogs can alert others, protect the person, and help them as they recover from the seizure. 
  • In many cases, seizure response dogs have then developed the ability to alert to seizures before the seizure actually occur. Some scientists think the change in the physiology of their handler prior to the onset of a seizure may cause the handler to smell differently to the dog. 
  • In addition to the added safety of having the dogs alert and/or respond to seizures, new studies show that the quality of life of the handler is greatly improved by the presence of the dog. 

While science knows that some dogs can predict seizures (see quotes below), they don't know how. One theory is that the dog's sense of smell tells them that a seizure is coming on, and thus the dog knows up to twenty minutes ahead of time.

Because a dog's primary form of communication is body language and facial expressions, it is plausible that a seizure-alerting dog is cued by the patient's most minute gestures or posturing. However, with report of dogs being out of sight of their handler and then suddenly approaching them and alerting, one has to consider the possibility of a scent, auditory cue, or some other signal independent of visual cues. It seems possible that any one or combination of these senses play an important part in alerting behavior. 
"Seizure-Alert Dogs: A Review and Preliminary Study", Seizure - Volume 12, Issue 2, March 2003, Pages 115-120, Dalzierl, Uthman, McGorray, & Reep, 2003.

Epilepsy service dog pouchIf the dog is bonded to the person, they may indicate that a seizure is coming on by acting distressed. By encouraging this behavior, the dog can reliably alert the handler or their family of the upcoming seizure.

"59% of dogs trained to respond to seizures subsequently developed the skill to recognize seizures in advance" 
"Seizure Response Dogs: Evaluation of a Formal Training Program", October 2008. A. Kirton, A. Winter, E. Wirrell, and O.C. Snead.

A Service Dog would improve the quality of life, as the unpredictable nature of the seizures would be lessened.
"Neurology" magazine, Kirton A, Wirrell E, Zhang J, et al., Alberta Children’s Hospital's Division of Pediatric Neurology, 2004 and 2005.

Boy getting an EEG with his service dogAt Pawsitivity, we believe that most, if not all, dogs can smell the seizures coming on, but because they know so far in advance, it can be difficult to reliably reward any behavior indicating that the seizure is coming on. There are a few Service Dog organizations who require handlers to go off their medication for months in order to have multiple seizures, and then train the dog to alert to a cue (by using cotton balls infused with the saliva of the handler, which had been taken immediately after their seizure). We believe that the problems with this approach outweigh the benefits because every time someone has a seizure, they get permanent damage to their brain. While that approach certainly works in other organizations, for us, though, we believe that it is not worth it to ask handlers to go off their medication in an attempt to train the dog to alert. We believe that the best approach for our organization is to have a highly-trained (seizure response) Service Dog, make sure they're bonded with the handler, and then in the future, the handler can be watchful for unusual behavior indicating an upcoming seizure (and then reward that behavior). Even if the dog and family never get on the same page about the alerting, though, meanwhile, the Service Dog can be helpful in the other ways noted below. 

Quotes from participants about their service dogs who helped them with seizures, from a 2008 study

  • ‘‘I am no longer afraid of going out and being taken advantage of.”

  • ‘‘He is my security blanket.”

  • "He brought me out of my shell.”

  • Service dog at the office‘I didn’t have any quality of life before my Seizure Response Dog. I was  locked up in my  apartment for more than 2 years, too  afraid and embarrassed to interact with other people, but I have overcome this thanks to her.”

  • ‘‘I didn’t care about life before my Seizure Response Dog, I just went through the motions. But it was like a light turning on and that she cared for me while I had the responsibility to care for her changed my life.”

  • ‘‘I am a much happier person and no longer take medication for depression.” 

  • ‘I used to rely on others to help me but now I go anywhere with my Seizure Response Dog and feel safe and confident.”

  • ‘‘I was always told not to go out alone because I had many accidents with my  wheelchair but now my Seizure Response Dog helps me  and I don’t hesitate to go anywhere.”

  • ‘‘My Seizure Response Dog has empowered me; I am motivated to do more and feel like  I can do anything.”

  • ‘‘Having a Seizure Response Dog has changed people’s perception of me. It has legitimized my condition (and) helped people understand epilepsy.”

  • ‘‘My Seizure Response Dog allows me to trust more in myself and I am less afraid to leave my apartment.”

  • "My Service Response Dog has improved my relationship and communication with my partner who always worried about me.”  

  • ‘‘My family shares the confidence and security I do with my Service Response Dog and they worry about me less.”

 

Service dog on the subwayOther results of this 2008 study:

  • All participants in the study reported quality of life improvements (82% said major improvement, 19% said moderate improvement) as a direct result of their service dog. These benefits included: Spontaneous alerting behavior developed in 59% of the service dogs, evolving over months of ownership. Intense staring was most common reaction, and other alerting behaviors were close attachment, sniffing, barking/whimpering,  jumping, licking, or even physically prevented their owners from leaving the house prior to seizures. The average alert time 31 minutes before the seizure. The handlers reported:

    • Better mood
    • Decreased feelings of anxiety
    • Better interpersonal relationships, both with family and friends and with strangers
    • Improvements at work/education
    • More self-confidence
    • More independence
    • More safety and security
  • Even in the other 41% of service dogs who didn't develop alerting behavior, however, the handler's quality of life still greatly improved.

  • Added benefit: 45% of handlers of the service dogs reported decreased frequency,  intensity/severity, or duration of the seizures.

    tired.jpg

Seizure Response Dogs: Evaluation of a Formal Training Program. Kirton A, Winter A, Wirrell E, Snead OC.

Note: Another study examined whether people with epilepsy could simply rely on pet dogs to alert before or during seizures instead of specially trained therapy dogs. The report concluded not only that pets are not equipped to do the job of a service response dog, but also that the demands of the task might actually be harmful for the pet dog:
  • Most of the pet dogs suffered significant adverse health effects as a result of spontaneously reacting to, or anticipating, epileptic seizures in their human owners. These included three cases in which the dog died.

  • However, when (non-pet) dogs have been specially trained as Seizure Alert Dogs, these adverse effects have not been seen.

epilepsy.jpg

Should People With Epilepsy Have Untrained Dogs As Pets? V Strong, S W Brown, Chapeltown, Sheffield, UK.


How do we select and train the service dogs to work with people with seizures?
All our dogs undergo behavioral analysis and training to determine their suitability for seizure assistance work. Again - we don't ask handlers to stop taking their medication in order for us to train the dogs to alert to seizures (the hope is that with our training they will become intensely focused on the handler and then they develop that ability on their own), thus we train them to be very attentive to their handler and to respond to seizures. Our standardized selection criteria used to select dogs include a calm disposition, responsiveness to humans, initiative, chase instinct, sensitivity to handler, confidence, ability to tolerate distractions, lack of hyperactivity, good attitude adaptability, crate/kennel livability, plus a complete veterinary evaluation. For more information, see our page on standards.


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