US researcher, Dr Adam Kirton, outlines his work in the area of seizure alert and response dogs – and gives us the scientific perspective
When did interest in seizure alert/response dogs begin?
I suspect the interest goes back many decades. I became interested as a result of the repeated observations of seizure-related behaviours in dogs living with people with epilepsy. However, valid research is limited, with only a handful of papers published in the last 10 years or so. There are likely many additional – less reputable – organisations and individuals who have promoted the idea of seizure alert and response dog programmes. But their programmes and stated results must be interpreted with caution.
What is the difference between a seizure response dog and a seizure alert dog?
The available literature generally agrees with the following definitions.
- A seizure response dog demonstrates unique and specific seizure-related behaviours that begin only once a seizure has already started clinically. This is judged either by the person's own awareness or as observed by a witness.
- A seizure alert dog demonstrates unique and specific seizure-related behaviours that begin before the clinical beginning of seizure activity. This implies an ability to anticipate the seizure.
What are the potential benefits of having a seizure alert/response dog?
There are many potential benefits, though most remain unproven (there have been no good studies yet).
Seizure response dogs can activate emergency response systems (such as calling 999) with special devices, or notify family members or other care-givers. They can be trained in additional assistance skills.
Seizure alert dogs may have these same benefits, plus the potentially huge advantage of seizure prediction. Knowing when a seizure is going to occur could allow people much greater control of their lives. They could take measures to avoid injury [simply sitting or lying down, for instance], seek help, or even take medicine to abort the seizure. Much more study is required before any of these abilities and potential benefits can be proven.
What effect do these dogs have on the independence of a person with epilepsy?
We recently completed a study of graduates from one of the only [US] seizure response dog training programmes. The study was done after these people had been through the programme – and was potentially biased, so the results must be interpreted with caution. However, there was a strong consensus of all graduates that their quality of life was greatly improved by owning a seizure dog. This included improved independence, but also many other effects on quality of life.
Is everyone suitable for a seizure alert/response dog?
Criteria still have to be established. I think the first studies need to include carefully selected individuals according to numerous criteria. These should include age, lifestyle and home environment, school/occupational factors, personal abilities and motivation, and probably many others.
Is it really possible to train dogs to detect seizures? Exactly what are they sensing?
The truth is,we do not know. The limited evidence available certainly suggests it is possible and worthy of proper study. Limited studies suggest these abilities can be trained by an operant-conditioning method [using consequences to change behaviour – for instance, rewarding a dog when he does what you want]. Until these studies are repeated and the results proved, we will not know if these abilities can be trained. Only once this is accomplished can we conduct the necessary studies to determine what the dogs are sensing.
What should people with epilepsy bear in mind when getting pet dogs? Haven't there been cases of untrained dogs attacking their owners during a seizure?
Until further studies are conducted, people with epilepsy should not be purchasing a dog with any expectation that it can assist them with their seizures. The only published studies looking at the behaviours of dogs living with people with epilepsy suggest no increased risk of negative events. It is likely very safe for people with epilepsy to own dogs.
Is there much research available on the topic?
Minimal. All current research, including our work, is only of the most preliminary nature. To date, research has proven nothing about the use of seizure dogs in epilepsy. Future research needs to carefully prove the dogs' abilities using properly designed methodology. We are currently beginning such work – but it will be several years before the results are available.
Adam Kirton MD MSc FRCPC
Pediatrics and clinical neuroscience
Faculty of Medicine
University of Calgary
Alberta Children's Hospital