Service Dogs Lead to Fewer Seizures in Resistant Epilepsy

Thursday, March 14, 2024 Medscape Medical News by Eve Bender  March 12, 2024

Working with medically trained service dogs is associated with a 31% reduction in seizures compared with usual care in treatment-resistant epilepsy, a new study showed.

Investigators speculate that the dogs may ease participants’ stress, leading to a decrease in seizure frequency, although they note this relationship warrants more study.

“Despite the development of numerous antiseizure medications over the past 15 years, up to 30% of people with epilepsy experience persistent seizures,” study author Valérie van Hezik-Wester, MSc, of Erasmus University Rotterdam in Rotterdam, the Netherlands, said in a press release.

The unpredictable nature of seizures is one of the most disabling aspects of epilepsy, Hezik-Wester added. Seizure dogs are trained to recognize seizures and respond when they occur.

“The tasks that these dogs perform along with their companionship may reduce seizure-related anxiety, also potentially reducing seizures caused by stress, the most common trigger for seizures,” she said.

The findings were published online on February 28 in Neurology.

Improve Quality of Life

The study included 25 individuals with medically refractory epilepsy who had an average of two or more seizures per week, with seizure characteristics associated with a high risk for injuries or dysfunction. They also had to be able to care for a service dog.

All were observed under usual care, which included antiseizure medications, neurostimulation devices, and other supportive therapies. Participants could then choose to work with a service dog that had completed socialization and obedience training or be assigned a puppy they would train at home.

The median follow-up was 19 months with usual care and 12 months with the intervention. Participants recorded seizure activity in diaries and completed surveys on seizure severity, quality of life, and well-being every 3 months. Daily seizure counts were converted to obtain cumulative seizure frequencies over 28-day periods.

Of the 25 original participants, six discontinued trial participation before the end of follow-up, four of whom left the study due to difficulty with dog care and training.

Participants receiving usual care reported an average of 115 seizures per 28-day period, while those with trained service dogs recorded 73 seizures in the same period, or a 37% difference between groups.

Researchers found that participants had an average of 31% fewer seizures during the past 3 months when they had seizure dogs, with seven participants achieving a 50%-100% reduction in seizures.

The number of seizure-free days increased from an average of 11 days per 28-day period before receiving a service dog to 15 days after working with a dog.

Scores on the EQ-5D-5L, which measures perceived health problems, decreased on average by 2.5% per consecutive 28-day period with the intervention, reflecting an increase in generic health-related quality of life (0.975; 95% CI, 0.954-0.997).

“These findings show that seizure dogs can help people with epilepsy,” said van Hezik-Wester. “However, we also found that this partnership with seizure dogs might not be the right fit for everyone, as some people discontinued their participation in this program. More research is needed to better understand which people can benefit from working with seizure dogs.”

Enhanced Quality of Life

In an accompanying editorial, Amir Mbonde, MB, and Amy Crepeau, MD, of Mayo Clinic in Phoenix, Arizona, noted the findings add to a growing body of work on the effectiveness of service dogs in reducing seizure frequency.

“In addition to improved seizure control, the EPISODE study demonstrated the benefit of seizure dogs in enhancing the quality of life for patients, a crucial component of comprehensive epilepsy care,” they wrote.

In prior studies, seizure dogs have identified an odor that a person emits before a seizure in up to 97% of people, they noted, adding that this ability “offers immense clinical benefits to people with epilepsy, enhancing their independence, social engagement, employment opportunities, self-confidence, and thus quality of life.”

Study limitations include its small sample size and high attrition rate.

The study was funded by the Netherlands Organization for Health Research and Development and Innovatiefonds Zorgverzekeraars. Smith and Jones reported no relevant financial relationships. The authors reported no disclosures.

Lead image: Audrey Butterfuss/Dreamstime

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How to Optomize Your Home for a Service Dog

Written By Holland Webb April 25, 2023

Article compliments of Today’s Homeowner – https://todayshomeowner.com/blog/guides/how-to-optimize-your-home-for-a-service-dog/

Why You Can Trust Us

Service dogs lead their owners into more functional and fulfilling lives. These loving, highly trained animals bear a lot of responsibility as they help perform a variety of day-to-day tasks for people with disabilities.

Most people know about guide dogs, but did you know that service dogs can also watch for signs of seizures, listen for sounds that people with hearing impairments may miss, or help open doors and carry objects for their handlers?

Service dogs are valued working partners and companions to over 500,000 Americans. Welcoming a new service dog is an exciting opportunity for you and your family. 

It’s important to optimize your home for your service dog’s comfort, ease, and security. In this article, we’ll explore how to do that along with how to connect with organizations that provide service dogs and considerations for training your own service dog.

What is a Service Dog?

In addition to being great companions, working dogs perform a variety of jobs. They may aid in search-and-rescue operations, sniff out illegal substances, detect cancer, or provide therapy for people living in institutional settings.

Not every working dog is a service dog, though. The Americans with Disabilities Act specifically defines a service dog as one individually trained to do work or perform tasks for people with disabilities. 

These disabilities may be physical, intellectual, psychiatric, or sensory. To qualify for a service dog, you typically need to work with an organization that serves people who live with your specific disability.

Common Service Dogs

The kind of disability you have partly determines which breed of dog you’ll get. The tiny Pomeranian, for example, lacks the physical strength to pull a wheelchair, but it has sharp hearing, a keen sense of smell, and enough dexterity to open cupboards and doors.

Labradors, Golden Retrievers, German Shepherds, and Great Danes may be employed for jobs that require physical strength and agility. Poodles are often used for tasks that require keen vision and problem-solving skills. A Pomeranian can work in tight, confined spaces due to its small size. Whatever the breed, a service dog must have qualities like intelligence, friendliness, a calm demeanor, and a love for work. 

It takes about 18 months and can cost anywhere from $10,000 to $20,000 to train just one service dog. More than half of service dog candidates do not complete their training. Fortunately, these dogs can find homes as companions for loving families, while service dogs who complete their training programs go on to find work.

Optimizing Your Home for a Service Dog

When your new service dog arrives at your home, you’ll want it to feel welcome. That means optimizing your home and garden to make them accessible, navigable, and easy to work in.

Interior of the Home

Your dog needs clear, wide spaces that are simple to navigate and memorize. If you’ve had a disability for a long time, your home is probably already well-suited to your needs — and probably in good shape for your new dog, too. On the other hand, if your disability is recent, you may need to make some prompt modifications to your home.

Bathroom

The bathroom is probably the most hazardous room in your house. Every year about 235,000 people go to the emergency room because of an injury sustained in the bathroom. Small, slippery when wet, and filled with small objects in out-of-the-way cupboards, the bathroom can be tricky to manage

Help your dog out by storing anything it needs to retrieve in a low storage container. If you use non-slip coverings on your floor, make sure they’re well-positioned to avoid either you or your dog getting tripped up.

Living Room

The clearer your floor is, the easier your dog will find it to navigate. Store remotes, magazines, throws, pillows, and other small items in baskets or bins that open from the top. 

Keep personal belongings put away and debris picked up. In case of emergency, your dog will have a much easier time helping you get to safety. 

You’ll also want to keep your living room well lit. If your dog will be turning lights on and off for you, be sure that switches are within easy reach of his nose or paw.

Bedroom

Most likely, your service dog will share your bedroom so it can respond to any nighttime emergencies. If your dog is a seizure detection specialist, it may need to sleep in the bed with you. If it will remain on the floor, however, make sure it has a designated sleeping spot.

You’ll also want to keep cords secured to the wall, slippers put in the closet, and pajamas picked up off the floor. Nothing should be scattered around that could distract the dog from its important job.

Kitchen

The kitchen is the primary workplace for many service dogs. Here, they may put away groceries, operate appliances, or alert their humans to alarms or smoke detectors. You’ll want to talk with your trainer about what your dog needs to do his specific jobs well. 

For example, you might need to install tugs on the refrigerator doors or even remodel your kitchen so that countertops and cabinets are easy for your dog to access. Sometimes installing a lazy susan or pull-down shelf can be a great way to make your kitchen canine accessible without major renovations. 

Doorways

Modern doorways are generally 32 inches wide or more to allow space for wheelchairs to get through. In an older home, however, you may be facing doors that are too small for you and your dog to pass through easily. Check with your dog’s trainer to see if your doors will be feasible for your animal to use. If not, you could have a remodeling project on your hands.

Some doorways are easy for an avid DIYer to enlarge on their own. If a door is part of a load-bearing wall, though, you need a licensed contractor to do the job.

Hallways

Narrow by nature, hallways can be a real challenge for your dog to navigate. Help your dog out by keeping them clean and clutter-free. You’ll also want to relocate furniture or decor that’s currently obscuring any part of the space. 

Finally, keep this space well-lit. Maximize any natural light the space gets, and make sure overhead lights are clean and bright. If you haven’t already painted your hall a light color, now’s a good time to do that, too.

Exterior of the Home

Your dog will spend time outdoors. It’s important to keep your yard, sidewalk, and garage in good shape.

Garage and Driveway

If your dog will assist you in getting into and out of your car, it will need plenty of space to work. Trim any bushes or shrubs that extend into your driveway. You can also keep your space clear by moving other vehicles to another area outside your home. Most importantly, if your driveway is less than 12 feet wide, consider having it enlarged before your dog comes home.

Sidewalks and Pathways

Will your dog walk with you on the paths around your home or garden? If so, your sidewalk needs to be at least 36 inches wide if you use a wheelchair or 24 inches wide if you walk. Here again, you’ll want to trim any shrubs or other growth that may obscure the path or trip up your dog.

Yard

If your home has a yard, your dog needs a fence. A six-foot high barrier that discourages digging is enough for most dogs. You’ll want to check into the policies governing what kind of fence you can have in your area, and consult with the service dog trainer about the right kind of fencing for your dog’s breed and build.

General Accessibility Tips and Emergencies for Service Dogs

As you plan to welcome your service dog, look at your home as a whole space, not just a collection of individual rooms. What could you reorganize or remodel to help your dog live and work comfortably? 

Avoid The Following For Your Service Dog

  • Tight Spaces: Like people, dogs can’t work well in confined quarters. Find out your dog’s size, and then look for places that might feel like a tight squeeze.
  • Obstructions: Your dog is probably much smaller and closer to the floor than you are. What might seem like a small obstruction to you could be a big impediment to it.
  • Situations Your Dog Is Not Accustomed To: Dogs work best in predictable environments. Although service dogs are trained not to react to their surroundings, they will appreciate fewer distractions when working.
  • Overstimulating Settings: While service dogs are chosen and trained to be gentle and quiet, they do experience a lot of work-related stress. Build in time for relaxation and exercise, and keep your dog out of intense environments as much as you can.
  • Highly crowded Areas: Your service dog may be trained to lead you through a crowd or to provide crowd control if you have PTSD. You’ll probably want to keep your dog away from rowdy, crowded areas whenever possible, though.

Emergency Plan Tips

  • Establish a safe spot for earthquakes. Make sure the area includes ample space for yourself, your dog, and any supplies both of you will need.
  • Create a flood evacuation plan that your dog can follow.
  • Designate an area with access to communication services during tornadoes or storms.
  • Plan for power outages with an emergency kit that includes battery packs, medications, and first aid kits that the dog can reach.

Organizations that Help Find and Train Service Dogs

  • The Seeing Eye
    • Located in New Jersey, the Seeing Eye breeds and trains dogs to assist blind and visually impaired people. They also instruct dog owners in the proper use of handling service dogs.
    • Good Fit For: People who are blind or visually impaired
    • https://www.seeingeye.org/
  • Assistance Dogs International
    • Assistance Dogs International is a clearinghouse of programs that provide guide dogs, hearing dogs, and service dogs. The organization also accredits individual programs around the world. 
    • Good Fit For: Anyone looking for a service dog
    • https://assistancedogsinternational.org/ 
  • Leader Dogs for the Blind
    • Fully funded by individuals and nonprofit donors, Leader Dogs for the Blind helps people who are blind or visually impaired live with independence and mobility.
    • Good Fit For: People who are blind or visually impaired
    • https://www.leaderdog.org/ 
  • Epilepsy Foundation
    • The Epilepsy Foundation provides resources for people interested in learning more about seizure dogs and their work. The foundation can connect you with an appropriate organization near your home.
    • Good Fit For: People with epilepsy or a seizure disorder
    • https://www.epilepsy.com/ 
  • Canine Partners for Life
    • Canine Partners for Life helps match people with disabilities with partner dogs. The organization provides canine partners for people with a wide variety of disabilities as well as people with diabetes and those who need a home companion.
    • Good Fit For: Anyone with a qualifying disability
    • https://k94life.org/ 
  • Fidos for Freedom
    • Fidos for Freedom provides trained service dogs, hearing dogs, therapy dogs, and combat-related PTSD dogs for people with disabilities, patients in health care facilities, and children with reading difficulties.
    • Good Fit For: People living in the Baltimore-Washington, D.C. metropolitan community
    • https://fidosforfreedom.org/ 
  • Guide Dogs of America
    • Based in Los Angeles, Guide Dogs of America breeds, raises, and trains service dogs for veterans, children with autism, and people with visual impairments. The organization also provides highly skilled dogs for jobs in hospitals, courtrooms, or classrooms.
    • Good Fit For: Veterans, individuals with autism, or people with visual impairments
    • https://www.guidedogsofamerica.org/ 
  • Warrior Canine Connection
    • Using a Mission Based Trauma Recovery (MBTR) model, Warrior Canine Connection helps warriors reconnect with their lives, families, friends, communities, and each other. Warriors both train and use the dogs as service partners.
    • Good Fit For: Veterans, military families
    • https://warriorcanineconnection.org/ 
  • Puppies Behind Bars
    • Founded in 1997, Puppies Behind Bars partners with incarcerated men and women to train service dogs and places the animals with qualifying applicants. 
    • Good Fit For: Veterans
    • https://puppiesbehindbars.com/ 
  • Canines for Disabled Kids
    • Headquartered in Worcester, MA, Canines for Disabled Kids provides scholarships for children who need service animals. The organization also offers public education and training for families interested in acquiring a dog.
    • Good Fit For: Children and families
    • https://caninesforkids.org/ 

Tips on How to Train Your Own Service Dog

Service dogs do not have to be professionally trained. Anyone has the right to train a service dog. 

However, before you begin training your own dog, make sure that he or she would make a good service dog. To be trained as a service dog the animal should meet the following criteria:

  • Younger than six months old
  • Spayed/neutered
  • Properly sized for your needs
  • Calm personality
  • Long attention span

If you would like to train your own dog, consider the following best practices: 

House Training

Like other house-dwelling animals, service dogs must be trained to do their business in a designated place outside. Crate-training is an effective approach since most dogs want to keep their crates clean. In the early days of training, reward the dog for going to the bathroom outside so it associates outdoor bathroom behavior with positive reinforcement.

Teaching Focus and Attentiveness Towards Handler

Your dog should focus on you — and only you — while it is working. Start this habit by encouraging the animal to make eye contact with you. Give the dog a treat for staying focused.

Off-leash Training

A service dog must respond to you whether it is on or off a leash. In a safe and controlled environment, you can take off the dog’s leash and give it simple commands. Reward or praise it for obeying those commands. Over time, you can move the activity to more-public situations.

Task-Oriented Training

Your dog is more than a companion. He or she has a job to do, and it’s up to you to train them how to do it. What do you need the animal to do?

  • Be alert to seizures?
  • Answer the door?
  • Be alert to alarms?
  • Carry groceries?
  • Close doors?
  • Guide you through a crowd?
  • Be alert to allergens in food?
  • Pull a wheelchair?
  • Retrieve medication?
  • Find help?

Socialization and Task-Focused Training

A successful service dog can stay focused on specific tasks even when it is out in social settings where there are distractions. Puppies should be acclimated to different sounds and people as much as possible and as early as possible. Also, be sure the dog is comfortable staying alone to minimize separation anxiety.

Disability Specific Training

Some service dogs work in disability-specific roles. For example, a hearing dog’s job is to listen for certain sounds and respond to them. A mobility assistance dog helps a human partner with limited mobility. You may want to work with a coach who can help you focus on building your dog’s unique skill set. 

Emergency and Medication Focused Training

Medical alert dogs are trained to get help for those who need it. Some dogs also help manage their human’s medication. These dogs need to be individually trained to meet their job’s requirements.

Offer Relaxation Periods Between Training 

Don’t forget to let your dog have fun. Off-duty time to relax, chew on a toy, get some exercise, or play with other pets is a critical part of training — and enjoying — your service dog.

12 Games for Dogs to Keep Your Pup Entertained and Healthy

  • From ApartmentGuide
  • We have 12 games you can try playing with your dog
  • Stuck indoors? Try out the indoor games and puzzles
  • Looking to get some exercise in the yard? We’ve included outdoor activities as well

Similar to humans, dogs need their exercise to stay healthy. While walking your dog can be a good way to release energy, sometimes you don’t have the time or space to go on a long walk. In these situations, use these games for dogs to tire your pup out.

Whether it’s a sunny day and you can spend time in the yard or you’re confined to your small apartment, we have a variety of games for your pup. When playing, be sure to consider your dog’s size and age. Bigger dogs tend to have more energy and might need longer games. Small dogs may tire more easily. When considering age, older dogs are more prone to hurting themselves. This means you may want to choose games that are easier on their joints.

No matter your dog’s breed, size or age, we have twelve games for dogs to keep them healthy and happy.

DIY puzzles for dogs

You’ve found the perfect pet-friendly apartment and now you need games to entertain your dog throughout the day. Luckily there are plenty of indoor puzzles for dogs that you can try out in the comfort of your home.

graphic showing dog doing a scent experiment

1. Scent experiment

Try out a scent experiment with your dog to test its snout. This can be played in a variety of ways. In the most basic version, you’ll hide a treat somewhere and have them find it.

Muffin tray tennis ball game

For this activity, you’ll need a muffin tray, four tennis balls and treats.

  • Step 1: Start by having your dog sit. Place a few treats in different cups of the muffin tray as they wait patiently.
  • Step 2: Instruct them to find the treats.
  • Step 3: Now that they are familiar with the game, repeat step one but this time put tennis balls over the treats.
  • Step 4: Instruct your dog to find the treats. See if they can sniff them out and figure out how to move the tennis balls out of the way to retrieve them.
  • Step 5: As your dog gets better at sniffing out the treats, set up some decoy tennis balls with no treats under them.

This game can last as long as you’d like it to. For variety, try changing which treats you are using or use a more difficult treat to gobble up like peanut butter.

graphic showing dog with treat dispenser

2. Treat dispenser fun

Give your dog a treat puzzle to figure out. You can either buy a treat dispenser like the popular Kong toys or make your own.

How to DIY a dog treat dispenser

For this project, you’ll need a water bottle, dog treats and a drill.

  • Step 1: Wash the bottle so that it’s clean and remove any labels.
  • Step 2: Drill a hole in the side of the bottle. The size of the hole will depend on the size of your treats. The hole should be a little smaller than your treats so they don’t easily fall out.
  • Step 3: Put the treats in the bottle and screw on the top.
  • Step 4: Give the treat dispenser to your dog and see how long it takes them to solve the puzzle.

Be sure you are supervising your pup when they play with this toy. If they manage to chew off the lid or tear through the plastic, you’ll want to take it away.

Active indoor games for dogs

Just because you are confined to your apartment, doesn’t mean your dog can’t release some energy. Try out one of these active indoor games to keep from going stir crazy.

graphic of dog playing hide and seek

3. Hide and seek

A fun indoor game to play with your dog is hide and seek. Have your pup sit and stay. Then go hide somewhere in the house. When you are hidden, tell them to come. When they find you, reward them with a treat.

graphic of dog racing up the stairs

4. Stairway race

Release some energy by having an indoor race with your dog. This is best for homes that have carpeted stairways to prevent any injuries. Have someone say, “On your marks, get set, go!” Race up the stairs and see who can make it to the top first. Have everyone in the family race in different heats to determine who is the champion.

Training challenges to try with your dog

While you might have taken a training class when your dog was a puppy, you may not have kept up with teaching them as they grew. Test their mental strength by practicing new skills and learning agility.

graphic showing hand signals for training dogs

5. Practice skills

Test your dog’s memory and obedience by teaching them some basic skills. These can include sit, stay, shake and roll over. Skills are good for a dog of any age to practice. Use their favorite treat as an incentive. Be sure to only reward them if they are successful in completing the action.

If your canine has already mastered these basics, try some more advanced skills. Some advanced dog skills include:

  • Play dead
  • Crawl
  • Kiss
  • Hug
  • Spin
  • Sit pretty
  • Bow
  • Leash

Practicing these skills will create a deeper bond between you and your pup as well as lead to them being more obedient.

graphic showing an indoor agility course

6. Create an indoor agility course

If you are practicing agility with your dog, you can make an agility course with basic home furniture. Learning agility can help solve dog behavior problems, improve their off-leash reliability, build your bond and gain some skills you can show off.

Make a scorecard and see how your pup would fare in a real competition. To learn more about agility, check out the American Kennel Club scoring guide.

Homemade dog agility course

Create your own agility course at home to learn these skills.

  • Weave: Set up laundry baskets in a row. Have your dog practice weaving in and out of them.
  • Jump up: Have them jump up on a chair or your bed. Practice with different heights.
  • Jump through: Hold up a hula hoop and have them jump through.
  • Under: Practice going under a few chairs that are lined up in a row.
  • Crawl: Get a box and open the ends. Have your dog practice crawling through.
  • Over: Rest a pole or broom over two stools. Work on their ability to jump over the pole.

infographic of games for dogs

Additional classic games for dogs

These are the games that your dog knows and loves. When you’re at a loss for what to play, try one of these classic games for dogs.

7. Clean up

If you have toys scattered throughout your apartment, clean up is the game for you. A game of clean up will entertain your pup as well as get rid of some of the clutter in your home.

Have them pick up one of their toys and lead them to the toy bin. When their head is over the bin, instruct them to “drop it.” Praise them with words or treats. This process may take a little longer for them to understand so be patient as they are learning. In the end, you’ll be rewarded with a tidy space.

8. Fetch

Fetch is a classic for a reason. This game may seem repetitive to you, but to your dog, it’s endless entertainment. To play, throw a ball of some sort. Typically tennis balls work best because they fit in your dog’s mouth, can be thrown far distances and their color is easy to spot. Your dog will chase after it and return the ball, panting and ready for more.

Many play fetch with sticks they find in the backyard, but this can be dangerous. The stick can easily break down when chewed and the splinters can be harmful to your dog’s mouth or stomach. Be sure you are using soft, pet-safe toys when playing fetch.

photo showing dog with frisbee

9. Frisbee

Another crowd favorite is a frisbee. Frisbee is similar to fetch, but oftentimes your dog is content playing with it alone for hours. Since frisbees have rounded sides, they often roll away. This turns into a game of chase and then a wild battle until your pup comes out of it victorious.

There are two types of frisbees you can purchase. The classic plastic kind is durable, but be sure to keep an eye on how it’s holding up. Sharp teeth can cause the plastic to crack, making it dangerous for dogs to play with and humans to throw. Another option is to get a softer, cloth frisbee. These are good for dogs with more sensitive gums like puppies who are teething.

10. Water games

On a hot summer day, there’s nothing better than cooling off with some water games. Get sprinklers and attach them to the hose in your yard. Be sure you’re using a garden hose that is lead-free. If it’s been sitting out in the sun, run it for a little bit to clear out any bacteria that may have formed.

Set up the sprinkler in an area of your yard that needs some hydration. Turn it on and encourage your dog to jump over it with you. For more dynamic entertainment, get an oscillating sprinkler so your dog can chase it back and forth.

11. Soccer

A game for the whole family, soccer can be an excellent way to release some energy. Get a soccer ball and be sure it’s fully inflated. If a dog’s sharp teeth puncture it, your match will be over.

Familiarize your dog with the ball. Reward them with treats when they push it with their nose. Once they are comfortable with the new toy, try playing pass. Lightly kick the ball towards them and see if they can return it to you. Another option is to set up a goal (could be two sticks that serve as goal markers) and have your dog play defense.

photo showing tug of war

12. Tug of war

Your dog may naturally try to play tug of war with you with something you’re holding. To be sure they don’t destroy your couch pillow or shoelaces it’s important to give them an item they are allowed to play with. Create a tug of war toy with some natural cotton rope. Tie knots in the rope so your pet has something to grab onto.

Many pet parents are worried that this type of game will bring out aggression in their dog. To avoid this, be sure you are playing on your terms. Keep the toy stored out of reach and bring it out when you want to play. When playing, be sure that your dog never touches you. If they do, the game is temporarily over. This will teach them boundaries. In addition to learning these boundaries, they should know how to “drop it” when instructed to. If they haven’t learned this command, it’s a skill you should work on.

Spending quality time with your dog

Partaking in these games for dogs will create a stronger bond between you and your four-legged friend. Be sure to add these skills to your dog’s pet resume when moving to a new apartment.

Sources:

New 4-Legged Hope for Veterans With PTSD

Analysis by Dr. Karen Shaw Becker, February 13, 2020

From healthypets.mercola.com

STORY AT-A-GLANCE

  • Between 11% and 30% of veterans who served in Operation Iraqi Freedom, the Gulf War or the Vietnam War suffer from post-traumatic stress disorder (PTSD)
  • The Puppies Assisting Wounded Servicemembers, or PAWS, Act would establish a grant program to provide service dogs for veterans with PTSD
  • The U.S. Department of Veterans Affairs (VA) would provide eligible veterans with a $25,000 voucher for a service dog
  • Service dogs decrease nightmares in veterans with PTSD while also lessening symptoms like social isolation and intra/interpersonal difficulties associated with psychological trauma

It’s estimated that between 11% and 30% of veterans who served in Operation Iraqi Freedom, the Gulf War or the Vietnam War suffer from post-traumatic stress disorder (PTSD).1 This mental health condition may occur in those who have experienced or witnessed a traumatic event, leading to symptoms that are often debilitating.

People with PTSD may struggle with recurrent memories of the traumatic event, nightmares and feelings of irritability or hopelessness. The condition often causes a person to always feel on guard, have difficulty concentrating and engage in self-destructive behavior, such as speeding while driving or drinking alcohol in excess.

PTSD often causes problems with relationships along with feelings of detachment from family and friends, and a loss of interest in activities that were once enjoyed.2

Service dogs can prove to be invaluable for people with PTSD, but the U.S. Department of Veterans Affairs (VA) does not support service dogs for veterans with mental health conditions — only for those with mobility issues. A new bill, however, could change that.

The Puppies Assisting Wounded Servicemembers (PAWS) Act

The Puppies Assisting Wounded Servicemembers, or PAWS, Act would direct the VA to carry out a grant program to provide service dogs for veterans with PTSD.

The VA would provide eligible veterans with a $25,000 voucher for a service dog from a service dog organization that meets national standards set by the Association of Service Dog Providers for Military Veterans (ASDPMV).3 According to K9s for Warriors, the largest provider of service dogs for disabled U.S. veterans:

“The intent of the bill is to make service dogs more accessible to all veterans wanting an alternative PTSD treatment option, to help reduce the veteran suicide rate of 20 per day and enable them to reintegrate successfully into society.

Currently, the VA does not fund service dogs or recognize the use of service dogs as a viable method to treat PTSD. Nonprofit organizations like K9s For Warriors train and supply service dogs for qualifying veterans.”4

The PAWS Act was first introduced in 2017 by Sen. Deb Fischer, R-Nebraska, who said in a 2017 news release, “Veterans with PTSD may have left the battlefield, but they are still in a tough fight. Service dogs can provide support, peace, and joy to these Americans as they confront the invisible scars of war. Through the PAWS Act, we can bring our veterans relief by offering them hope.”5

VA Study Looking Into Service Dogs for PTSD

In 2010, Congress mandated VA researchers to study whether service dogs could help veterans with PTSD. A pilot study began a year later but was was halted in 2012 due to health and training issues with some of the dogs.6

The study was launched again in 2015 but results aren’t expected until 2020. In summer 2020, the results should show whether service dogs or emotional support dogs helped veterans with PTSD, while a second part of the study, slated for release in late 2020, will look into whether the type of dog affected factors such as hospital stays and medication use.7

While the results of the VA study are still pending, other research has found favorable results for service dogs in PTSD treatment. Service dogs have been found to diminish the effects of nightmares in PTSD patients, for instance. Up to 70% of those with PTSD suffer from nightmares, and the dog acts by immediately awakening the person and also providing comfort. According to the journal Sleep Review:8

“Dogs are also used to mitigate anxiety, which is often associated with insomnia, and to modify hyperarousal and hypervigilance, which in turn creates a more amenable mood state for sleep initiation, as well as a greater sense of safety in those who are uneasy in the dark and/or night and who tend to phase-reverse to dodge nighttime sleep.”


How do Dogs Help Veterans With PTSD?

Part of service dogs’ ability to help people with PTSD lies in providing a sense of purpose — a reason to get up and keep going. Rory Diamond of K9 for Warriors told Military.com, “People are always asking me what is it the dogs actually do. The genius of the dog, or the magic, is it gets the warrior out the front door. You have a reason to get up in the morning because the dog needs to be fed and walked.”9

In more objective measures, one study found higher levels of salivary cortisol awakening response (CAR) among veterans with PTSD with a service dog, which could be indicative of better health and well-being compared to those without a service dog.10

A number of other beneficial outcomes have also been suggested, including that service dogs decrease social isolation, increase physical activity and exposure to green space and possibly even favorably alter humans’ microbiomes.11

In a pilot study of 30 veterans with PTSD, those who completed a service dog training program had significant decreases in PTSD symptoms as well as fewer intra/interpersonal difficulties associated with psychological trauma.

The results were so promising that researchers noted, “Social work practitioners may want to consider referring their veteran clients with PTSD to qualified service dog programs for adjunctive support when they are having difficulty engaging with or benefiting from office-based traditional therapy approaches.”12

K9s for Warriors welcomes up to 12 veterans to their headquarters every month, where they stay for three weeks, getting to know their service dog and learning how to work together.

While it costs about $27,000 to train and place a service dog, the program is free to veterans. If the PAWS Act becomes law, it could open up access further, allowing many more veterans with PTSD to benefit from having a service dog by their side.

The Runaway Concept of an Emotional Support Animal

From:  https://healthypets.mercola.com/sites/healthypets/archive/2019/12/15/emotional-support-animal-certification.aspx

Analysis by Dr. Karen Shaw Becker               December 15, 2019

STORY AT-A-GLANCE

  • Emotional support animals (ESAs) seem to be everywhere these days, but the issue is not without controversy
  • Researchers at the University of New Mexico have developed a standard assessment for therapists asked to provide patients with ESA certificates
  • The proposal answers the need for ethical guidelines around ESAs
  • If the proposal is adopted as an industry standard, it will become more difficult for individuals to receive ESA certifications, but will benefit society as a whole from the standpoint of safety

By now almost everyone is familiar with the concept of an emotional support animal (ESA), and chances are, many of you have already encountered an ESA in a formerly “animal-free zone.” Or perhaps you or someone in your family or circle of friends has a dog, cat, bird, or other animal companion who serves as an ESA.

How ESAs Differ From Service Animals

Emotional support animals, according to the Fair Housing Act and Air Carrier Access Act (ACAA), can be any species of animal, who must fulfill a disability-related need and whose use is supported by a physician, psychiatrist or mental health professional.

ESAs don’t qualify as service animals under the Americans with Disabilities Act (ADA). Service animals are highly trained and can receive certifications as psychiatric service dogs to help people who suffer from depression, bipolar disorder, anxiety, panic attacks, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), schizophrenia and other mental conditions.

Emotional support animals, on the other hand, don’t require specific training to provide assistance to someone with a psychological disability. However, they may be permitted in housing facilities that would otherwise prohibit animals, and the ACAA allows some ESAs to travel on airlines at no extra cost, often with supportive documentation required.

As you might expect, there’s growing controversy surrounding the appearance of ESAs in ever-increasing numbers in locations that have traditionally been off-limits to animals. Sadly, the backlash isn’t surprising given that more than a few people have taken advantage of the special access granted to ESAs, falsely claiming their pet is necessary for emotional support.

Researchers Propose a Standard Assessment to Certify ESAs

Recently, researchers at the University of New Mexico published an article in the journal Professional Psychology: Research and Practice, outlining the ethical challenges therapists face when asked to certify emotional support animals for their patients, and offering possible solutions to better serve both people who feel they need ESAs and those who must comply with the animals, such as landlords and airlines.1

The research team developed and is proposing a four-prong standard assessment for therapists when asked by patients to provide an ESA certificate:

  1. Understanding, recognizing and applying the laws regulating ESAs.
  2. A thorough valid assessment of the individual requesting an ESA certification.
  3. An assessment of the animal in question to ensure it actually performs the valid functions of an ESA.
  4. An assessment of the interaction between the animal and the individual to determine whether the animal’s presence has a demonstrably beneficial effect on that individual.

Assessment Will Address Whether the ESA Is Able to Do What It’s Being Asked to Do

The proposed assessment involves not just the patient, but the animal as well.

“Somebody has to certify that the animal is able to do what you’re asking it to do,” says lead article author Jeffrey Younggren, a forensic psychologist and clinical professor at the University of New Mexico’s Department of Psychiatry and Behavioral Sciences. “And there are avenues by which animals can be evaluated regarding their capacity for these kinds of experiences.”2

There’s no shortage of horror stories of encounters with emotional support animals, especially during air travel, and Younggren and his colleagues believe that implementing standardized guidelines and practices will reduce the number of incidents.

“Our research has nothing to do with service animals,” Younggren clarifies. “Seeing eye dogs and therapy dogs are animals that help individuals manage their disabilities in certain situations — but that’s not what an ESA is. An ESA is an example of a well-intended idea that has metastasized and developed into a world of nonsense.”

Proposal Answers the Need for Ethical Guidelines Around ESAs

Paper co-author Cassandra Boness, a University of Missouri Ph.D. candidate, says the proposed assessment will better align ESA certifications with professional and legal practices, while also providing guidelines for mental health therapists.

“One of our biggest goals is to disseminate this information in order to better educate mental health providers, as well as policy writers, about the need for ethical guidelines around ESAs,” Boness said.3

Importantly, mental health practitioners who aren’t knowledgeable about the law may not realize that when they write an ESA certification letter for a patient, legally it constitutes a disability determination that becomes part of the patient’s permanent medical record. Per the UNM Newsroom publication:

“Currently, in order to receive waivers for housing or travel purposes where animals are banned, the law requires patients must have a mental or emotional condition diagnosable by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

If patients are given certifications for an ESA, it means they, and the therapist signing the certification, are declaring the patient to be psychologically disabled with significant impairment in functioning.”4

The proposed assessment will require ESA certifiers to perform a comprehensive evaluation of the person requesting the certification to determine if they have a disability under the DSM-5, according to Younggren.

“That disability has to substantially interfere with the patient’s ability to function, which is what the ADA requires,” he explains. “And the presence of the animal has to ameliorate the condition, which means you have to see the person with the animal.”

If the proposal is adopted as an industry standard, it will become more difficult for individuals to receive ESA certifications, but will benefit society as a whole from a safety perspective.

Moving Forward

The researchers are hopeful their work will spur more research on the impact of emotional support animals on patients in order to build a larger body of scientific evidence.

The important takeaway here is that no one is arguing that pets provide both physical and mental health benefits to humans — those facts are well-estab­lished and backed up with an ever-growing library of scientific studies.

The human-animal bond is real and describes the powerful, positive interaction that exists between people and animals. It’s not just about companionship — it’s about a deep connection that enhances the quality of life of both humans and animals.

The issue is that in a civilized society, it’s necessary to develop and enforce guidelines and standards that benefit the many rather than the few. It’s also important to evaluate current trends, in this case the growing use of ESAs, for potential short and long-term consequences to the animals and humans involved in these pairings, as well as society as a whole.

What You Likely Don’t Know About Service Animals, but Should

Analysis by Dr. Karen Shaw Becker

Story at-a-glance

  • A service dog is “Any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability”
  • Any breed of dog can be a service animal, as can miniature horses
  • Service dogs do not require professional training and there are no required ADA certifications for service animals
  • People with disabilities are allowed to bring their service animals to all public facilities and private businesses, without providing any type of “proof” of their disability or dog’s “service animal” status
  • A service animal may also be denied access if its presence interferes with “legitimate safety requirements,” such as a hospital unit that must maintain a sterile environment
  • Service dogs should not be approached, talked to or touched, unless permission is asked for and granted by the dog’s handler

Service dogs provide invaluable support to their owners, alerting them to potentially life-threatening medical problems or offering psychiatric or visual support. While most people will never experience the close bond that exists between service dogs and their owners, most everyone will cross paths with a service dog at some point in their lives.

Despite their prevalence — you’re likely to spot one sooner or later, since service dogs are allowed to accompany their owners virtually everywhere — many misconceptions persist about these generous animals. This is partly because service dogs look like any other dog, which leads some to believe they should be treated like any other dog — which isn’t the case if the dog is “working.”

Also problematic, the U.S. has no centralized process that allows people with disabilities to register service dogs,1 which means, even though service dogs are afforded special rights, there’s a lot of grey area when it comes to how those rights are protected, for both the dogs and their owners.

Clearing up common misconceptions is an important part of ensuring that service dogs and their owners get the respect and protections they deserve.

Service Dogs Are Not the Same as Emotional Support Animals

The Americans with Disabilities Act 1990 (ADA) defines a service animal as, “Any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability. Other species of animals, whether wild or domestic, trained or untrained, are not service animals for the purposes of this definition.”2

Miniature horses have been added as an exception, however, provided they are housebroken, under the handler’s control, can be accommodated by the facility and will not compromise safety regulations.

On the other hand, emotional support animals (ESAs), according to the Fair Housing Act and Air Carrier Access Act (ACAA), can be any species of animal, who must fulfill a disability-related need and whose use is supported by a physician, psychiatrist or mental health professional. ESAs do not have to be trained to perform a particular task and do not qualify as service animals under the ADA.

Service Dogs Are Not Only for the Visually Impaired

Guide dogs for the visually impaired are just one type of service dog. Service dogs can be trained to help people with physical or mental difficulties, including post-traumatic stress disorder (PTSD). If a veteran is experiencing anxiety or stress due to PTSD, for instance, a service dog can be trained to notice the signs and step in to provide calm and comfort.

They may wake a veteran up from nightmares and are also taught specific commands, including “block,” in which the dog stands in front of the veteran to provide for more personal space, and “cover,” in which the dog goes behind the veteran to “watch their back.”3 Other examples of tasks that service animals may perform include:4

Assisting individuals who are blind or have low vision with navigation and other tasks Alerting individuals who are deaf or hard of hearing to the presence of people or sounds Providing non-violent protection or rescue work
Pulling a wheelchair Assisting an individual during a seizure Alerting individuals to the presence of allergens
Retrieving items such as medicine or the telephone Providing physical support and assistance with balance and stability to individuals with mobility disabilities Helping people with psychiatric and neurological disabilities by preventing or interrupting impulsive or destructive behaviors

Not All Service Dogs Are Professionally Trained

Service dogs do not require professional training and there are no required ADA certifications for service animals. While most service dogs come from reputable trainers or organizations that specialize in training service dogs, according to the ADA, “People with disabilities have the right to train the dog themselves and are not required to use a professional service dog training program.”5

That being said, many service dogs undergo about two years of training before they’re ready and will continue to learn and adapt to their owner’s changing needs over time.6 There are also misconceptions about what type of dog can be a service dog; according to the ADA, any dog breed can be a service animal.

In choosing a service dog, personality is often more important than breed; dogs who are fearful or aggressive are not well suited to be service dogs.

Can Service Dogs Ever Be Denied Access?

People with disabilities are allowed to bring their service animals to all public facilities and private businesses. The owners of a business may ask two questions to determine if the animal is a service animal — and only if the need for the service animal isn’t obvious (such as a dog guiding someone who is blind. Those questions are:7

  • Is this animal required because of a disability?
  • What work or task has this animal been trained to perform?

Beyond this, no further questioning or “proof” is needed. As noted by the ADA, “A public entity or private business may not ask about the nature or extent of an individual’s disability or require documentation, such as proof that the animal has been certified, trained or licensed as a service animal, or require the animal to wear an identifying vest.”8

Generally, service animals are allowed to go where their owners go, but there are a few exceptions in which a business can ask for a service animal to be removed, including if the animal is out of control or not housebroken. A service animal may also be denied access if its presence interferes with “legitimate safety requirements,” such as a hospital unit that must maintain a sterile environment.9

Should You Pet a Service Dog?

One important point to remember is that certain rules of etiquette apply when it comes to interacting with service dogs and their handlers. Generally speaking, don’t interact with them at all; let the dog and the owner go about their business uninterrupted.

Service dogs should not be approached, talked to or touched unless permission is asked for and granted by the dog’s handler, but take no offense if the handler asks you not to interact with the dog — doing so could distract him from his important role, which is to look out for the health and safety of his owner.

Why Fake Service Dogs Do More Harm Than You Might Think

From www.fearfreehappyhomes.com and Award-winning journalist Jen Reeder 

A service dog named Elmer has made a wonderful difference for a 7-year-old boy named Gavin Swearingen. As a toddler, Gavin fell off a swing and suffered a traumatic brain injury that led to complex medical issues, from strokes and epilepsy to cerebral palsy marked by weakness on his right side.

Elmer, a Labrador-Golden Retriever mix raised and trained by the nonprofit Canine Companions for Independence, teamed up with Gavin in November of 2018. The attentive dog assists Gavin in numerous ways: acting as a buffer in public places since Gavin has no peripheral vision on his right side, engaging Gavin with physical therapy tasks (that seem more like a game with a dog) such as throwing a ball or holding his leash, and supporting him through his tenth cranial surgery.

Having a service dog has given Gavin “an independence and a strength,” according to his mom, Amanda Swearingen.

“We’re just grateful,” she says.

The Trouble With Fake Service Dogs

While Swearingen has witnessed the positive effect a trained service dog can have for people with disabilities, she has also learned firsthand that fake service dogs have a negative effect.

For starters, after fraudulent service dogs misbehave in businesses, staff, owners, and other patrons can grow leery of legitimate ones. One woman got “really angry” at the Swearingens for having a dog in a restaurant soon after they brought Elmer home; in another instance, a man asked, “Is your son disabled enough to need a dog?”

Safety is another huge issue. Recently when Amanda, Gavin, and Elmer were trying to enter a hospital, they crossed paths with a woman walking a small dog – clearly not a true service dog – who started barking and snapping at them.

“We couldn’t go in,” she recalls. “And for me it’s scary because I had a child attached to a dog and he’s not a robot. He’s still a dog. He has been through years and years of training, but he’s still a dog.”

Dogs Outside the Law

Service dog fraud has become so widespread that one in five Canine Companions graduates feel their quality of life and independence has been moderately or severely impacted by fraudulent service dogs, according to a 2018 survey by the organization.

“We are committed to the safety and access rate of our graduate teams, which is impacted by the presence of out-of-control dogs, whether they are wearing a vest and purporting to be a service dog, or a pet dog that is in a public place where they are not permitted under the law,” says Wallis Brozman, outreach program specialist for Canine Companions.

It’s a professional as well as a personal issue for Brozman, who is a three-time graduate of Canine Companions.

“I actually had to retire my second service dog after two and a half years because he was attacked so many times that he was completely uncomfortable going into public places and didn’t want to work because he was constantly looking for other dogs to make sure he was safe,” she says. “At that point, if your dog doesn’t feel safe, that’s a safety issue for you as a person with a disability.”

Canine Companions for Independence®Canine Companions dogs undergo around two years of socialization and training, and the nonprofit invests about $50,000 in each service dog (and provides them free of charge to people with disabilities). A service dog’s early retirement is a significant loss to both the handler and the organization.

Even without an attack, a phony service dog can distract a legitimate, task-trained service dog from his or her job. Fake service dogs can also create a bias against actual service dogs if they have an accident or incident in a grocery store or other business that allows only service dogs, says Brozman.

“I think a lot of people see fraudulent service dogs as not really hurting anyone,” she says. “The reality is that people are actually getting hurt. We have someone like me, who has had to start over and lost a service dog because of this very issue.”

Brozman says it’s important to note that while people might want their pets to go everywhere with them, their pets might prefer to be left at home. When a dog reacts negatively to other dogs or strangers, it’s often a sign of fear or stress.

“I think a lot of dogs love their life of leisure where they’re at home,” she says. “That’s something to keep in mind with any animal in your life: ‘Am I doing what’s best for my animal?’”

For more information or to take a stand against service dog fraud, visit: CCI.org/StopFraud

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Cover photo courtesy Liz Kaye Photography; inset photo courtesy Canine Companions for Independence®

Award-winning journalist Jen Reeder is former president of the Dog Writers Association of America.

Bogus ‘Service Animal Certifications’ Increasingly Being Sold Online

Mercola Healthy PetsBy Dr. Karen Shaw Becker

Story at-a-glance

  • Service dogs or animals who provide mental, emotional or physical support have made it possible for people with disabilities to live independently, but now, there are websites advertising bogus certification for support animals
  • The Americans with Disabilities Act (ADA) says support animals don’t have the same federal protections as service animals, and business owners may ask someone with a disability only two questions regarding their service animal
  • Some people purchase vests or certification to identify their animals as needed support without their animal having actual qualifications behind their label — in some cases simply to bring their favorite animal with them into public places
  • It’s often obvious when an animal is a bona fide service dog, such as when they’re guiding someone who is unable to see, is in a wheelchair or has trouble with stability or balance, but other times, disabilities aren’t evident
  • According to the ADA, there are regulations in place regarding service dogs, such as what to do if someone is afraid of or allergic to service animals, whether restaurants or theaters are exempt, and whether extra fees are allowed

Service dogs or animals who provide mental, emotional or physical support have transformed the lives of scores of people, as they make it possible for people with disabilities to live independently. Since new laws have sanctioned the public appearance of service animals, the lives of their humans are far easier and less stressful, as Katherine Moore, who is legally blind, can attest.

“When you have a service animal it’s like you are one. When I put my hand on his harness it’s like an extension of my arm … That’s like putting a value on your freedom. How do you do that? How do you say what your freedom is worth? It’s worth everything.”1

Training for service animals is wide-ranging and extensive, which is why Moore says she’s able to live a full life, including working and commuting, just as she did before she lost her ability to see. One of the few organizations in Tennessee that specializes in service dog training, Smoky Mountain Service Dogs (SMSD),2 focuses on training dogs that will be used by wounded veterans. Mike Kitchens, chairman of SMSD, explains:

“Every dog that we have we will take to Harley Davidson and have them start up the motorcycles. We will take them to the baggage area at the airport. Revolving doors. They have to be so environmentally stable because the intent is for that dog to be able to accompany that veteran wherever he goes.”3

Other animals may provide emotional comfort, but they don’t necessarily fall under the same federal protections as service animals. In fact, Dr. Zenithson Ng from the University of Tennessee Knoxville’s College of Veterinary Medicine contends that emotional support animals are pets. They may alleviate symptoms of conditions their humans have, and even be designated by mental health professionals, but still, they’re not considered service animals. According to the Americans with Disabilities Act (ADA):

“While Emotional Support Animals or Comfort Animals are often used as part of a medical treatment plan as therapy animals, they are not considered service animals under the ADA. These support animals provide companionship, relieve loneliness, and sometimes help with depression, anxiety, and certain phobias, but do not have special training to perform tasks that assist people with disabilities.”4

Bogus Service Dog Certifications: ‘There’s No Such Thing’

Where there’s a service, privilege or right, especially when it comes to animals, it seems there’s always people willing to bend the rules. It usually involves money, and selling so-called “service dog certification” to designate animals with qualifications they don’t actually have are no exception. Needless to say, the types of service and support animals are vast and can be confusing. Here’s a chart that summarizes all of the categories.

“It’s major issue for us because we see it all. We really do,” Kitchens says. “You can Google ‘service dog access’ and you will come up with multiple organizations that for $69.95 we will send you a service dog certification. Well, there is no such thing.”5 There’s also no national registry for animals who are designated helpers for humans, Ng says.

For a fee, there are dozens of websites that offer vests for dogs to wear that “certify” them as certified service, emotional support or therapy animals. There’s another reason why some people are willing to purchase vests without their animal having actual qualifications behind their label. WATE.com notes that for some, it’s also a way to bring their favorite animal with them into public places.

Ng, who’s a member of the steering committee on human-animal interaction with the American Veterinary Medical Association (AVMA), says the problem is a hot topic among personnel responsible for governing the situation due to what he terms as an “onslaught” of problems the AVMA has run into recently. He also notes:

“We are so lucky in this society to have this term of emotional support animal and … we really should designate that for the people who need them and the animals that are well behaved in public settings. So when people are taking advantage of the system that’s really hard, it’s disappointing.”6

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Service Animals: Training to Perform Their True Function

The ADA acknowledges that it’s often fairly obvious when an animal is merely accompanying someone in a public place as a pet, or if it’s a bona fide service animal; you’ll know the latter is the case if a dog is guiding someone who is either blind or unable to see clearly, or helping someone who has trouble with stability or balance or is in a wheelchair. However, sometimes disabilities are not always visible to bystanders. The ADA, a division of the U.S. Department of Justice, states:

“When it is not obvious what service an animal provides, only limited inquiries are allowed. Staff may ask two questions: (1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. Staff cannot ask about the person’s disability, require medical documentation, require a special identification card or training documentation for the dog, or ask that the dog demonstrate its ability to perform the work or task.”7

Further, service animals are limited to dogs under Title II and III of the ADA, as of March 15, 2011.8 Local laws prohibiting specific breeds of dogs do not apply to service animals.

The ADA states that a “service animal” refers to any dog individually trained to do what is necessary to help someone with a disability, whether it’s physical, sensory, psychiatric, intellectual or mental. It makes clear, however, that emotional support animals, comfort animals and therapy dogs are not in the same category: They’re not service animals. Similarly, the work service animals perform must be related directly to their human’s disability. In addition:

“It does not matter if a person has a note from a doctor that states that the person has a disability and needs to have the animal for emotional support. A doctor’s letter does not turn an animal into a service animal.”9

ADA Facts Regarding Service Animals

An animal may or may not be wearing a special collar or harness. Some, but not all, are certified, licensed and/or have identification papers stating as such; however, they may not be carrying those papers with them. Most service dogs perform jobs most are familiar with, such as Seeing Eye dogs, seizure response dogs and those who alert people with hearing impairments.10

It’s important to note, though, that some local and state governments have special rules for people entering businesses or public places with support animals aside from service dogs, such as emotional support animals, so it’s best to check with these agencies to find out if such ordinances exist. From a page on the ADA’s website, facts regarding service dogs in businesses include:11

A service animal must be permitted to accompany an individual with a disability to all areas of the facility where customers are normally allowed to go and must not be segregated from other customers.

Even if an establishment has “no pets” signs posted, service animals, again, are not pets. Further, the ADA requires proprietors of “restaurants, hotels, retail stores, taxicabs, theaters, concert halls, and sports facilities” to change the wording in such postings to accommodate service animals needed by people with disabilities.

ADA rules supersede local and state laws stating that only guide dogs are admitted to enter a business to assist individuals with disabilities — so refusing to allow other types of service animals violates the ADA. That said, service animals must be under control, and they must be housebroken.

Businesses are not allowed to charge customers with service animals any maintenance, deposits or cleaning fees, even if such charges are in place for pets. However, if a service dog does damage in, say, a hotel, proprietors can charge the customer with the disability, but only if the hotel’s policy is to charge non-disabled guests for similar damage.

Taxi companies may object to a service dog accompanying a disabled person getting into their cabs, but refusing to pick someone up for this reason is also a violation, even if the taxi company is privately owned, and they can’t raise the fare.

Service Animals: Sometimes Other Rules Apply

There are dozens of situations regarding service animals in public places, and probably just as many exceptions. For instance, the care and conduct of service animals is the responsibility of the disabled person they’re with — the animal’s owner. Business owners aren’t required to provide food, care or a special location for the animal.

Arguably one of the greatest concerns people have about service animals relates to fear of the animal becoming a threat to themselves or their customers. But fear of animals, dogs included, or allergies to animals are not good enough reasons to refuse service. The business or government entity is expected to find solutions if employees, other customers or travelers are afraid of or allergic to dogs, such as allowing more or even a separated space.12

As for air travel, the rules are different. The Air Carrier Access Act (ACAA) says airlines must allow both service and emotional support animals to travel in the cabin with the people they’re helping. True, the rules for the latter are getting more strict in light of a number of unfortunate animal incidents on flights.

For that reason, WATE News notes, people who want to travel with emotional support animals or psychiatric service animals may be required to supply specific documentation, including proof of their disability and why their animal is necessary, well before their trip.

People with disabilities who want more information regarding special circumstances, including air travel, may also want to check the provisions made under the Fair Housing Act, which can be found on the U.S. Department of Housing and Urban Development site,13 as it includes specifications for service and emotional support animals.

Bogus ‘Service Animal Certifications’ Increasingly Being Sold Online

  • Service dogs or animals who provide mental, emotional or physical support have made it possible for people with disabilities to live independently, but now, there are websites advertising bogus certification for support animals
  • The Americans with Disabilities Act (ADA) says support animals don’t have the same federal protections as service animals, and business owners may ask someone with a disability only two questions regarding their service animal
  • Some people purchase vests or certification to identify their animals as needed support without their animal having actual qualifications behind their label — in some cases simply to bring their favorite animal with them into public places
  • It’s often obvious when an animal is a bona fide service dog, such as when they’re guiding someone who is unable to see, is in a wheelchair or has trouble with stability or balance, but other times, disabilities aren’t evident
  • According to the ADA, there are regulations in place regarding service dogs, such as what to do if someone is afraid of or allergic to service animals, whether restaurants or theaters are exempt, and whether extra fees are allowed

By Dr. Karen Shaw Becker

Service dogs or animals who provide mental, emotional or physical support have transformed the lives of scores of people, as they make it possible for people with disabilities to live independently. Since new laws have sanctioned the public appearance of service animals, the lives of their humans are far easier and less stressful, as Katherine Moore, who is legally blind, can attest.

“When you have a service animal it’s like you are one. When I put my hand on his harness it’s like an extension of my arm … That’s like putting a value on your freedom. How do you do that? How do you say what your freedom is worth? It’s worth everything.”1

Training for service animals is wide-ranging and extensive, which is why Moore says she’s able to live a full life, including working and commuting, just as she did before she lost her ability to see. One of the few organizations in Tennessee that specializes in service dog training, Smoky Mountain Service Dogs (SMSD),2 focuses on training dogs that will be used by wounded veterans. Mike Kitchens, chairman of SMSD, explains:

“Every dog that we have we will take to Harley Davidson and have them start up the motorcycles. We will take them to the baggage area at the airport. Revolving doors. They have to be so environmentally stable because the intent is for that dog to be able to accompany that veteran wherever he goes.”3

Other animals may provide emotional comfort, but they don’t necessarily fall under the same federal protections as service animals. In fact, Dr. Zenithson Ng from the University of Tennessee Knoxville’s College of Veterinary Medicine contends that emotional support animals are pets. They may alleviate symptoms of conditions their humans have, and even be designated by mental health professionals, but still, they’re not considered service animals. According to the Americans with Disabilities Act (ADA):

“While Emotional Support Animals or Comfort Animals are often used as part of a medical treatment plan as therapy animals, they are not considered service animals under the ADA. These support animals provide companionship, relieve loneliness, and sometimes help with depression, anxiety, and certain phobias, but do not have special training to perform tasks that assist people with disabilities.”4

Bogus Service Dog Certifications: ‘There’s No Such Thing’

Where there’s a service, privilege or right, especially when it comes to animals, it seems there’s always people willing to bend the rules. It usually involves money, and selling so-called “service dog certification” to designate animals with qualifications they don’t actually have are no exception. Needless to say, the types of service and support animals are vast and can be confusing. Here’s a chart that summarizes all of the categories.

“It’s major issue for us because we see it all. We really do,” Kitchens says. “You can Google ‘service dog access’ and you will come up with multiple organizations that for $69.95 we will send you a service dog certification. Well, there is no such thing.”5 There’s also no national registry for animals who are designated helpers for humans, Ng says.

For a fee, there are dozens of websites that offer vests for dogs to wear that “certify” them as certified service, emotional support or therapy animals. There’s another reason why some people are willing to purchase vests without their animal having actual qualifications behind their label. WATE.com notes that for some, it’s also a way to bring their favorite animal with them into public places.

Ng, who’s a member of the steering committee on human-animal interaction with the American Veterinary Medical Association (AVMA), says the problem is a hot topic among personnel responsible for governing the situation due to what he terms as an “onslaught” of problems the AVMA has run into recently. He also notes:

“We are so lucky in this society to have this term of emotional support animal and … we really should designate that for the people who need them and the animals that are well behaved in public settings. So when people are taking advantage of the system that’s really hard, it’s disappointing.”6

Service Animals: Training to Perform Their True Function

The ADA acknowledges that it’s often fairly obvious when an animal is merely accompanying someone in a public place as a pet, or if it’s a bona fide service animal; you’ll know the latter is the case if a dog is guiding someone who is either blind or unable to see clearly, or helping someone who has trouble with stability or balance or is in a wheelchair. However, sometimes disabilities are not always visible to bystanders. The ADA, a division of the U.S. Department of Justice, states:

“When it is not obvious what service an animal provides, only limited inquiries are allowed. Staff may ask two questions: (1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. Staff cannot ask about the person’s disability, require medical documentation, require a special identification card or training documentation for the dog, or ask that the dog demonstrate its ability to perform the work or task.”7

Further, service animals are limited to dogs under Title II and III of the ADA, as of March 15, 2011.8 Local laws prohibiting specific breeds of dogs do not apply to service animals.

The ADA states that a “service animal” refers to any dog individually trained to do what is necessary to help someone with a disability, whether it’s physical, sensory, psychiatric, intellectual or mental. It makes clear, however, that emotional support animals, comfort animals and therapy dogs are not in the same category: They’re not service animals. Similarly, the work service animals perform must be related directly to their human’s disability. In addition:

“It does not matter if a person has a note from a doctor that states that the person has a disability and needs to have the animal for emotional support. A doctor’s letter does not turn an animal into a service animal.”9

ADA Facts Regarding Service Animals

An animal may or may not be wearing a special collar or harness. Some, but not all, are certified, licensed and/or have identification papers stating as such; however, they may not be carrying those papers with them. Most service dogs perform jobs most are familiar with, such as Seeing Eye dogs, seizure response dogs and those who alert people with hearing impairments.10

It’s important to note, though, that some local and state governments have special rules for people entering businesses or public places with support animals aside from service dogs, such as emotional support animals, so it’s best to check with these agencies to find out if such ordinances exist. From a page on the ADA’s website, facts regarding service dogs in businesses include:11

A service animal must be permitted to accompany an individual with a disability to all areas of the facility where customers are normally allowed to go and must not be segregated from other customers.

Even if an establishment has “no pets” signs posted, service animals, again, are not pets. Further, the ADA requires proprietors of “restaurants, hotels, retail stores, taxicabs, theaters, concert halls, and sports facilities” to change the wording in such postings to accommodate service animals needed by people with disabilities.

ADA rules supersede local and state laws stating that only guide dogs are admitted to enter a business to assist individuals with disabilities — so refusing to allow other types of service animals violates the ADA. That said, service animals must be under control, and they must be housebroken.

Businesses are not allowed to charge customers with service animals any maintenance, deposits or cleaning fees, even if such charges are in place for pets. However, if a service dog does damage in, say, a hotel, proprietors can charge the customer with the disability, but only if the hotel’s policy is to charge non-disabled guests for similar damage.

Taxi companies may object to a service dog accompanying a disabled person getting into their cabs, but refusing to pick someone up for this reason is also a violation, even if the taxi company is privately owned, and they can’t raise the fare.

Service Animals: Sometimes Other Rules Apply

There are dozens of situations regarding service animals in public places, and probably just as many exceptions. For instance, the care and conduct of service animals is the responsibility of the disabled person they’re with — the animal’s owner. Business owners aren’t required to provide food, care or a special location for the animal.

Arguably one of the greatest concerns people have about service animals relates to fear of the animal becoming a threat to themselves or their customers. But fear of animals, dogs included, or allergies to animals are not good enough reasons to refuse service. The business or government entity is expected to find solutions if employees, other customers or travelers are afraid of or allergic to dogs, such as allowing more or even a separated space.12

As for air travel, the rules are different. The Air Carrier Access Act (ACAA) says airlines must allow both service and emotional support animals to travel in the cabin with the people they’re helping. True, the rules for the latter are getting more strict in light of a number of unfortunate animal incidents on flights.

For that reason, WATE News notes, people who want to travel with emotional support animals or psychiatric service animals may be required to supply specific documentation, including proof of their disability and why their animal is necessary, well before their trip.

People with disabilities who want more information regarding special circumstances, including air travel, may also want to check the provisions made under the Fair Housing Act, which can be found on the U.S. Department of Housing and Urban Development site,13 as it includes specifications for service and emotional support animals.