Whether dogs are able to sense seizures before they happen has been a topic of heated debate for some time. While many say it is impossible, the loving owners of seizure alert dogs insist that it’s not. In the first of a two-part feature, Peter Fox explores how these dogs are trained – and how one Epilepsy Action member found herself in need of one
I’m sure there will be many dog-lovers among our readers. Many of us have a soft spot for 'man's best friend', reminiscing fondly about our childhood pets and their unconditional companionship. Even that time Fido ate the Sunday roast has become one of our favourite stories.
But what if dogs could be much more than simply companions? Research on the topic is very scarce. But there are epilepsy researchers, charitable organisations and people living with the condition who all insist that they can be much more than just pets.
Dogs can be trained to respond to seizure activity. If a trained dog sees you fall to the ground in a tonic-clonic seizure, for example, he can bring the telephone, pull an alarm chord, or perform a number of other useful tasks. These dogs are called seizure response dogs.
Arguably more useful than seizure response dogs are seizure alert dogs. These are dogs that many think have learned to recognise the early signs of a seizure in their owners. According to British charity Support Dogs, the dogs can be trained to warn their owners up to 45 minutes before the seizure begins.
Exactly what the dogs are sensing, and whether this can be relied upon in predicting a seizure, no one really knows. A great deal of research still needs to be done in proving whether or not dogs can really do this, and in figuring out what they can sense that humans can't. For the people who are living with seizure alert dogs, however, it seems they have all the proof they need.
Lynne Radcliffe is an Epilepsy Action Accredited Volunteer. She has been through the long process of applying for a seizure alert dog and through the necessary training for both dog and owner. Lynne's dog Dougal has had a significant impact on her life – bringing back much of the independence she lost after being diagnosed with epilepsy.
Lynne says: “I was diagnosed with epilepsy in 1998.I'd had a head injury at a fun fair. That evening I had a seizure, although I didn't know it was a seizure at the time. We never thought any more about it after my 'funny turn'. But then they started happening more frequently. When my GP suggested it might be epilepsy, I went immediately into denial.”
Lynne found – as some people do – that a diagnosis of epilepsy is difficult to accept. It was particularly difficult for Lynne, since she highly valued her own independence. The impact of seizures on her usual routine was significant.
Lynne continues: “It affected my life quite dramatically. Immediately I lost my driving licence. I had to start epilepsy medication and I did have side-effects. I've never had complete control. Ultimately, I lost my job because of my epilepsy – which I found quite devastating.
“As far as my independence goes, every day tasks that I used to take for granted suddenly became hazardous to me. Things like having a bath, cooking, ironing and going out and about. I was wary of going out on my own. My confidence was knocked quite severely. Your relationships with people are affected. My mum became extremely protective of me. I wasn't comfortable with people's protective impulses – I'm very independent.”
In struggling with her diagnosis, Lynne managed to find out about Epilepsy Action. It was through a local branch meeting that she became aware of seizure alert dogs – when she met one.
“I went to the Epilepsy Action branch in Stockport. There was a young man who had a support dog. When I asked him about the dog, he replied: 'She's a seizure alert dog.' She could warn him of an impending seizure.”
Lynne then got in touch with the only charity in Britain that currently trains seizure alert dogs – an organisation based in Sheffield called Support Dogs. Despite a lack of research on the effectiveness of seizure alert dogs, the organisation has been successfully training dogs and their owners for quite some time.
Rita Howson is the director of operations at Support Dogs. She explains: “The charity was founded in 1992.Initially,it was set up to train people's own pet dogs for disability assistance for wheelchair users. Picking things up, for instance, or opening and closing doors. In 1993 we trained our first seizure alert dog.
“We were working with a young girl with epilepsy. She was getting a disability assistance dog, basically a seizure response dog. But the girl had read some articles about dogs that could sense epilepsy and wondered if we could train her dog to tell her when she was going to have a seizure. It was very successful. We knew then that we had to stop and research exactly how we could train dogs to do this.”
The processes that Support Dogs staff members go through in training seizure alert dogs are very specific. They have been honed over the 16 years that the seizure alert programme has been running. Although the charity began life training people's pet dogs, these dogs are not suitable as seizure alert dogs. In fact, Rita insists that people with epilepsy ought to take care when bringing a dog into their homes.
Rita explains: “If a dog is left to develop this himself, there is a 99 per cent chance that the dog will develop a fearful response to seizures. So if a pet dog has already experienced seizures, we wouldn't consider him for a seizure alert dog – because those negative associations are already in his memory.”
Dogs act instinctively – which is why a pet dog may not always be suitable for a person with epilepsy. Seizures scare people if they aren't used to them – and, by the same token, they can scare a pet dog. Dogs may deal with their fear in several ways – and there is a risk that a frightened dog will lash out.
Rita explains: “Dogs may respond differently to a stressful event. Some will run away, some will stand and fight and some will roll onto their backs as if to say: 'Don't hurt me'. There have been cases where pet dogs have attacked their owners during a seizure.”
Support Dogs use very specific criteria in selecting both a potential seizure alert dog, and their potential owner. It is their skill in choosing the right partnership that makes that partnership a useful and successful one. But what makes a good seizure alert dog?
Rita explains: “I believe that all dogs could predict seizures. It's hard to say, because very little research has been done. What we do is use our skills to pick the right dog in the first place.
“A seizure alert dog must comply with all the general assistance dog criteria. He must be very friendly and very obedient – what we call a 'bomb-proof' dog. That way, when he's out working in public he's happy. On top of those qualities, a seizure alert dog must have that extra personality trait. A good seizure dog is nothing to do with a dog's breed or sex – it's the personality and the temperament that matter.”
A dog is selected – often from a rescue centre – based on their personality. He or she is then placed with a foster home until old enough to begin training. This process begins with basic training that applies to all assistance dogs – whether they will help people with epilepsy, autism or physical disabilities.
“A lot of that training is basic socialisation,” Rita continues. “That's getting the dogs out and about in shopping centres and supermarkets, hotels… Basically, anywhere that pet dogs wouldn't be allowed to go. A seizure alert dog will then come into our seizure preparation work, if he's right for that career. Meanwhile, we're always interviewing people for the seizure alert programme.”
The applications process for a person with epilepsy can be lengthy. Due to funding, Support Dogs are only able to train a certain number of dogs every year. On top of that, there are strict criteria designed to make sure that any applicant is right for a seizure dog.
Lynne explains: “There's a long list of criteria for eligibility. They don't want you to have changes in your medication, for instance, and you must be keeping a seizure diary. You should also be having enough seizures to make it worthwhile having
A minimum number of seizures is not simply so that the owner will get as much as possible out of their new-found friend. The criteria a person must follow to qualify for a dog are as much practical concerns for the training staff.
Rita explains: “The person must have a minimum number of major seizures – sometimes, but not always, tonic-clonics. That's 10 each month (on average).That's because we can't let a dog go home until we're happy that he's alerting – and we can't do that unless the person is having seizures during the training period. Also,it's very hard to train a dog to alert to only one or two seizures a year. If you only asked your dog to sit twice a year, how reliable would it be? We need that reliability.”
Selecting a person with epilepsy and potentially matching them with a seizure alert dog is only the first step. Next, both the dog and owner come to the Support Dogs training centre for a three-week residential training course. This course is designed
to build a bond between them, while giving the dog a chance to begin sensing the person's seizures and, hopefully, alerting to them.
Lynne says: “There's a lot involved in the process before you eventually come home with your dog. I met Dougal in February 2008.The trainer was pleased, so I went for my intensive training. The three-week residential training is when you are getting used to each other. Fortunately for me, Dougal was a quick learner. By the time he came home with me, he was already alerting me to seizures.
“Dougal gives me a 10-minute alert. If I'm at home watching TV he'll come and sit right in front of me, blocking the telly. If I ask him what's the matter, he'll whine if it's a seizure alert. If I'm not sure I'll get one of his toys and try playing with him. If he's
trying to alert me, he just won't play. He'll just carry on looking at me.”
If you would like any further information on the Support Dogs seizure alert programme, contact Support Dogs direct on 0870 609 3476 or visit www.support-dogs.org.uk
[This article originally appeared in Epilepsy Action's membership magazine Epilepsy Today]