An assistance dog at home can prevent an epileptic seizure

An assistance dog at home can prevent an epileptic seizure

At first glance, the training center of Stichting Hulphond Nederland in the idyllic North Brabant village of Herpen is an ordinary office building. A bright entrance, neat meeting rooms and cozy coffee corners. But if you look closely, you will notice something. The strings on the doorposts, for example. The lost dog basket. At the secretary’s feet lies a black dog recovering from its day of training.

Here dogs learn to open the door for their owner. They can put socks in the washing machine and pull the blanket off the bed. They learn to press the alarm button when necessary. The dogs are trained to help people with a physical disability, post-traumatic stress disorder or epilepsy.

Health economist Valérie van Hezik-Wester obtained her PhD from the Erasmus School of Health Policy & Management for research into the epilepsy assistance dog. Two training centers trained the epilesia assistance dogs for her research.

She is surprised by all the positive outcomes of her studies. “The presence of the epilepsy assistance dog not only significantly reduces the number of seizures among participants, the dog also appears to be a very good intervention from an economic point of view!”

Epilepsy has many forms and degrees. Most patients can quickly suppress their seizures with medication, but for a small group the seizures still occur regularly despite pills, operations and all kinds of diets.

Many of these patients build their lives around their seizures. An attack can also occur during exercise or in the supermarket. They are very dependent on informal caregivers, because these patients regularly hurt themselves during a seizure in such a way that they end up in hospital.

An epilepsy dog ​​can help. What the dogs learn depends on how the disease presents itself to their owners. They learn to recognize the insult and then, for example, press an alarm button that is linked to an informal caregiver’s telephone. The dogs can bring a bag of medicine to the patient or maneuver the owner into a stable side position.

One third fewer attacks

Such an assistance dog is expensive, think of 20,000 to 40,000 euros per dog. “At the moment, patients pay for this out of their own pocket or from donations,” says Van Hezik-Wester. “The intervention is not reimbursed, because there was some anecdotal evidence about the benefits, but the health effects were never properly investigated. There was also no information about the cost-effectiveness of epilepsy assistance dogs.”

Van Hezik-Wester is the first in the world to thoroughly investigate both. This was possible thanks to a one-off subsidy from the government. “I therefore felt a lot of pressure to do this well and finish it. I don’t think another study like this will be set up anywhere in the world anytime soon.” Her results were published in the renowned American magazine Neurology.

“The most striking outcome is that the number of seizures in our participants decreased by 30 percent within one year,” says Van Hezik-Wester. “That’s a lot, especially when you consider that these patients had already tried everything.” How is that possible? “We suspect it has to do with stress. For many patients, this is an important triggering factor for epileptic seizures.”

The diaries that the twenty-five participants kept showed that they suffered less from stress and anxiety. Their social life got a boost because they dared to go out with the dog again. “We also saw that these participants needed less informal care and ended up in hospital less often.” According to the PhD candidate, this could be because these patients had fewer accidents as a result of their attacks or because bystanders unnecessarily call an ambulance less often.

For a health economist like Van Hezik-Wester, it was quite awkward to also investigate medical effects. If only because she is not trained to talk to patients about their illness. She saw for the first time how much impact epilepsy can have on daily life. “While I am in the prime of my life, starting a family, getting my PhD, all those things were not an option at all for many of the patients.”

The dog must continue to train

She realized even more how much was at stake for these patients. “They have actually finished their treatment. That is why this study was so special: we were able to offer our participants a service dog for free for ten years.”

For a quarter of the participants, a dog turned out not to be a solution. “A dog like this is not only a helper, you also have a pet that you have to take intensive care of,” says Van Hezik-Wester. This goes beyond feeding and walking, you must continue to train for assistance dogs. Some patients have many attacks at night and wake up exhausted in the morning. Then it can be very stressful to be ready for the dog again immediately.”

The study demanded a lot from the two participating dog centers, Van Hezik-Wester soon noticed. An enormous number of dogs had to be trained in a period of three years and at exactly the pace that the study dictated. “And don’t forget the participants! They had to wait a long time for their dog, kept seizure diaries every day for three years and completed a large set of questionnaires every four months, in addition to all the new responsibilities of the dog. I find it heart-warming to see that all parties have worked so hard to make this happen.”




SCIENCE