Seizure-alerting behavior in dogs owned by people experiencing seizures

The role of trained and untrained dogs in the detection and warning of seizures

Seizure unpredictability plays a major role in disability and decreased quality of life in people with epilepsy. Dogs have been used to assist people with disabilities and have shown promise in detecting seizures. There have been reports of trained seizure-alerting dogs (SADs) successfully detecting when a seizure is occurring or indicating imminent seizures, allowing patients to take preventative measures. Untrained pet dogs have also shown the ability to detect seizures and provide comfort and protection during and after seizures. Dogs' exceptional olfactory abilities and sensitivity to human cues could contribute to their seizure-detection capabilities. This has been supported by studies in which dogs have distinguished between epileptic seizure and non-seizure sweat samples, probably though the detection of volatile organic compounds (VOCs). However, the existing literature has limitations, with a lack of well-controlled, prospective studies and inconsistencies in reported timings of alerting behaviours. More research is needed to standardize reporting and validate the results. Advances in VOC profiling could aid in distinguishing seizure types and developing rapid and unbiased seizure detection methods. In conclusion, using dogs in epilepsy management shows considerable promise, but further research is needed to fully validate their effectiveness and potential as valuable companions for people with epilepsy.

Service Dogs and Persons with Disabilities: When COVID-19 Lockdown Changes Their Relationship

Persons with disabilities, who own service dogs, develop strong relationships with them. Since the COVID-19 pandemic decreased the possibility of social contact and modified human relationships, we hypothesized that the COVID-19 lockdown would influence people with disabilities-service dog relationships. An online survey was conducted during the first COVID-19 lockdown in France and included information (e.g., MONASH score) both in the general context prior to and during the COVID-19 lockdown. Seventy owners participated. Compared to the general context, scores for the Perceived Emotional Closeness and Perceived Costs subscales were significantly higher during the COVID-19 lockdown, while scores for the Dog-Owner Interaction subscale were significantly lower during the COVID-19 lockdown. Our study confirmed that service dogs, like other pets, were a source of emotional support for their owners during the COVID-19 lockdown. However, people with disabilities found their relationship with their service dog costlier (e.g., my dog makes too much mess). Our study highlights that, in extreme situations, characteristics of a human-animal relationship can be exacerbated in both positive and negative ways.

Canine olfactory detection and its relevance to medical detection

The extraordinary olfactory sense of canines combined with the possibility to learn by operant conditioning enables dogs for their use in medical detection in a wide range of applications. Research on the ability of medical detection dogs for the identification of individuals with infectious or non-infectious diseases has been promising, but compared to the well-established and-accepted use of sniffer dogs by the police, army and customs for substances such as money, explosives or drugs, the deployment of medical detection dogs is still in its infancy. There are several factors to be considered for standardisation prior to deployment of canine scent detection dogs. Individual odours in disease consist of different volatile organic molecules that differ in magnitude, volatility and concentration. Olfaction can be influenced by various parameters like genetics, environmental conditions, age, hydration, nutrition, microbiome, conditioning, training, management factors, diseases and pharmaceuticals. This review discusses current knowledge on the function and importance of canines' olfaction and evaluates its limitations and the potential role of the dog as a biomedical detector for infectious and non-infectious diseases.

The "olfactory fingerprint": can diagnostics be improved by combining canine and digital noses?

A sniffer (detecting) dog is conventionally defined as an animal trained to use its olfactory perceptions for detecting a vast array of substances, mostly volatile organic compounds (VOCs), including those exceptionally or exclusively generated in humans bearing specific pathologies. Such an extraordinary sniffing performance translates into the capability of detecting compounds close to the femtomolar level, with performance comparable to that of current mass spectrometry-based laboratory applications. Not only can dogs accurately detect "abnormal volatilomes" reflecting something wrong happening to their owners, but they can also perceive visual, vocal and behavioral signals, which altogether would contribute to raise their alertness. Although it seems reasonable to conclude that sniffer dogs could never be considered absolutely "diagnostic" for a given disorder, several lines of evidence attest that they may serve as efficient screening aids for many pathological conditions affecting their human companions. Favorable results have been obtained in trials on cancers, diabetes, seizures, narcolepsy and migraine, whilst interesting evidence is also emerging on the capability of early and accurately identifying patients with infectious diseases. This would lead the way to proposing an "olfactory fingerprint" loop, where evidence that dogs can identify the presence of human pathologies provides implicit proof of the existence of disease-specific volatilomes, which can be studied for developing laboratory techniques. Contextually, the evidence that specific pathologies are associated with abnormal VOC generation may serve as reliable basis for training dogs to detect these compounds, even (or especially) in patients at an asymptomatic phase.

The Untrained Response of Pet Dogs to Human Epileptic Seizures

Epilepsy is a debilitating and potentially life-threatening neurological condition which affects approximately 65 million people worldwide. There is currently no reliable and simple early warning seizure-onset device available, which means many people with unstable epilepsy live in fear of injury or sudden death and the negative impact of social stigmatization. If anecdotal claims that untrained dogs anticipate seizures are found to be true, they could offer a simple and readily available early warning system. We hypothesized that, given the extraordinary olfactory ability of dogs, a volatile organic compound exhaled by the dog's epileptic owner may constitute an early warning trigger mechanism to which make dogs react by owner-directed affiliative responses in the pre-seizure period. Using 19 pet dogs with no experience of epilepsy, we exposed them to odours that were deemed to be characteristic of three seizure phases, by using sweat harvested from people with epilepsy. The odours were delivered to a point immediately under a non-epileptic and seated pet dog owner's thighs. By altering the alternating odours emerging from sweat samples, captured before seizure, during a seizure and after a seizure, and two nonseizure controls, we were able to record the response of the 19 pet dogs. Our findings suggest that seizures are associated with an odour and that dogs detect this odour and demonstrate a marked increase in affiliative behaviour directed at their owners. A characteristic response of all 19 dogs to seizure odour presentation was an intense stare which was statistically significant, (p < 0.0029), across the pre-seizure, seizure and post-seizure phases when compared to control odours of nonseizure origin.

Monitoring the frequency and duration of epileptic seizures: "A journey through time"

Seizure monitoring plays an undeniably important role in diagnosing and managing epileptic seizures. Establishing the frequency and duration of seizures is crucial for assessing the burden of this chronic neurological disease, selecting treatment methods, determining how frequently these methods are applied, and informing short and long-term therapeutic decisions. Over the years, seizure monitoring tools and methods have evolved and become increasingly sophisticated; from home seizure diaries to EEG monitoring to cutting-edge responsive neurostimulation systems. In this article, the various methods of seizure monitoring are reviewed.

Dog Owners' Survey reveals Medical Alert Dogs can alert to multiple conditions and multiple people

Medical Alert Dogs (MADs) are a promising support system for a variety of medical conditions. Emerging anecdotal reports suggest that dogs may alert to additional health conditions and different people other than those that they were trained for or initially began alerting. As the use of medical alert dogs increases, it is imperative that such claims are documented empirically. The overall aims of this study were to record the proportion of MAD owners who have a dog that alerts to multiple health conditions or to people other than the target person and to determine whether any sociodemographic variables were associated with dogs alerting to multiple conditions, multiple people, or both. MAD owners completed an online survey that contained a series of forced choice questions. Sixty-one participants reported a total of 33 different conditions to which dogs alerted. Eighty-four percent of participants reported that their dog alerted to multiple conditions and 54% reported that their dog alerted to multiple people. This is the first study to document that a large percentage of people report that their MAD alerts to multiple conditions and/or to multiple people. We present a discussion of how these alerting abilities could develop, but questions about the underlying mechanisms remain.

The Value of Companion Dogs as a Source of Social Support for Their Owners: Findings From a Pre-pandemic Representative Sample and a Convenience Sample Obtained During the COVID-19 Lockdown in Spain

Dogs are a source of companionship and comfort for their owners, but the degree to which this might translate into real emotional and social support has not been quantified. Emotional and social support are essential to help people to get through personal crises such as bereavement. In this study we characterize the social support owners obtain from their dogs, provide evidence of how widespread this social support is amongst dog-owners, and show how social support from dogs can increase during a crisis (using the COVID-19 pandemic as an example). We collected data from a representative population-based sample of Spanish dog-owners and found that most respondents said that their dogs helped them to get through tough times. They got comfort from physical contact with their dogs, shared activities with them and treated them as confidants in a similar way to friends and family. These are all key aspects of social support, and dogs offer the advantage of being more available than human sources of support. It would be expected that the support that dogs provide would be increased during a time of personal crisis and when we looked at data collected from a convenience sample of Spanish dog-owners during the COVID-19 confinement that is what we found; during the confinement owners engaged in more shared activities with their dogs, hugged them more often and turned to them more as a source of companionship and comfort (p < 0.0001 in all cases). However, although owners did confide more in their dogs (p < 0.0001), the effect was not as great as for other aspects of social support. We suspect that this is because people were able to use telecommunications such as video conferencing to maintain their human confidant relationships. Our findings indicate that dogs can substitute for humans as sources of some kinds of social support when conventional sources are unavailable. Our conclusion is that where a dog is present in a household, it should be regarded as an important resource for social support. This should be considered when designing clinical interventions and when public health decisions are being made.

Is there a Profile of Spontaneous Seizure-Alert Pet Dogs? A Survey of French People with Epilepsy

Simple Summary

Very little is known about dogs that could alert their owner of an impending epileptic seizure. Here, we explored the profiles of untrained dogs that spontaneously show seizure-related behaviors. Using a self-reporting questionnaire, we found that these dogs do not have a particular profile (e.g., sex, breed, age, epilepsy of the owner), but bonding is perceived as better when the dog alerts compared to a dog who does not alert. Personality traits helped discriminate between these two types of dogs; seizure-alert dogs were scored higher for Motivation, Training Focus and lower in Neuroticism than non-alerting dogs. In addition, we reported alert-related behavior characteristics (e.g., the dogs that alerted the more frequently stayed close and stared at their owner when he/she had a seizure). Our results are in line with the existing literature and help further the understanding of seizure-alert dogs. In particular, we suggest that some personality traits could be a basis for the selection of future assistance dogs.

Abstract

Despite controversies and the lack of research, dogs are empirically selected and trained to perform as service dogs, in relation to the dogs’ and future owners’ characteristics. We assessed the characteristics of both humans and dogs in an unbiased population (not selected or trained) of spontaneous seizure-alert by pet dogs and investigated whether we could replicate previous findings. We addressed a self-reporting questionnaire to French people with epilepsy. We analyzed the general characteristics of the humans and pet dogs and their behaviors that could alert their owner before a seizure. In addition, we used the Monash Canine Personality Questionnaire refined to evaluate pet dogs’ personality through five different traits, and the Monash Dog-Owner Relationship scale to assess human–dog relationships. In line with previous reports, we found no particular factor, either pet-, people- or epilepsy-related that could be associated with the presence or absence of alert behaviors. Alert behaviors and circumstances were explored and three different alert patterns emerged. In terms of personality, seizure-alert pet dogs scored significantly higher than non-alerting dogs for the traits “Motivation” and “Training Focus” and lower for “Neuroticism”. The owner–dog bond score was significantly higher for seizure-alert dogs than for non-alerting dogs.