• Seizure alert dogs and seizure response dogs

At the Assistance Dog Trainer Center T.A.R.S.Q.® we only train epilepsy alert dogs who can actually warn of focal seizures.

Alert dogs react BEFORE the focal seizure occurs and warn the epileptic in good time!

Dogs who help people with epilepsy are trained assistance dogs. They are usually trained for between 18 and 24 months, adhere to the same standards as, for example, an assistance dog who accompanies someone in a wheelchair, and have all the rights of an assistance dog.

Assistance dogs for epileptics help the epileptic achieve more security and independence. Epilepsy alert dogs can save lives and prevent injuries. Dogs for epileptics are trained for both children and adults, predominantly through owner trained dogs with the help of an assistance dog trainer.

Dogs who could recognize epileptic seizures before they occurred were already being reported on in 1985. Assistance dogs for epileptics have been trained by assistance dog trainers in the USA since 1996, and since 2004 in Germany.

There are two types of assistance dogs who can help epileptics:

• Epilepsy alert dogs
• Epilepsy response dogs

• Seizure alert dogs

Seizure alert dogs react before an emergency situation occurs. The ability to provide a warning before a life-threatening event becomes severe can't be taught to a dog. Either it has the sensitivity to pick up on an oncoming event, or it doesn't. It is therefore of paramount importance to choose the right dog who possess this innate ability. In the case of epileptics this means that the seizure alert dog can notice and warn of seizures before they occur. The epileptic can then sit or lie down and avoid becoming injured.

An alert dog notices a few minutes before a seizure that one is oncoming and lets the epileptic know by, for example, prodding them or laying down its paw. Many epileptics can enjoy a halfway normal life thanks to an alert dog. Many epileptics report that, since having an alert dog, they suddenly feel confident doing activities which they would not have done beforehand, due to the fear that they could have a seizure.

An alert dog can however generally not completely prevent a seizure if the epileptic doesn't take the emergency medication which could prevent a seizure. But a dog can give its partner the chance to place themselves in a safe position in a safe location so that they can survive the seizure without succumbing to injury.

A   dog has to be born a seizure alert dog - you can't make a seizure alert dog!

The biggest difficulty with training alert dogs is that only very few dogs possess this warning ability - an ability which can't be taught. Alert dogs are born with this ability. Puppies who have this ability start to notice partial seizures a few minutes before they occur when they're just 3 weeks old and have just started walking, without any training whatsoever!

A seizure alert dog has to want to notice an oncoming seizure a few minutes beforehand, and to make their partner aware of it. A seizure alert dog has to act on its own initiative and not just give a warning when commanded to. This illustrates the specialness and difficulty of alert dogs. If an seizure alert dog doesn't want to alert an epileptic to an oncoming seizure, he won't do it. If a dog doesn't have the ability to recognize seizures beforehand, it will never gain the ability. Neither trainer nor epileptic can really influence the ability to reliably give a warning beforehand. This depends on several factors, such as the ability of the dog, the bond it has, and the type of seizure.

During training at the International Assistance Dog Center T.A.R.S.Q.®, a qualified assistance dog trainer will help the team to encourage reliable warnings and avoid mistakes, so that the epileptic can really rely on their seizure alert dog.

Seizure alert dogs who have all the necessary qualities and have gone through all the training, and who alerts and support their partner for the rest of their life, will give a warning for oncoming seizures 90-100% of the time.

• A seizure alert dog's tasks

The main tasks a seizure alert dog has to carry out is noticing focal seizures a few minutes before they occur and warning the epileptic. By doing this, and by providing additional support, the dog prevents injures caused by falls, and by climbing stairs just before seizures. If needed, a seizure alert dog can be taught additional duties, such as reminding the epileptic to take medication, bringing the epileptic a cell phone to call for support following a seizure and pressing an emergency telephone to call for help.

• Scientific studies on seizure alert dogs

Between 1997 and 1998 the University of Florida carried out a study on dogs who lived with epileptics. 185 adult epileptics took part in the study; 29 of them owned a dog. They reported that three of these dogs had already given a warning of a seizure before it happened. The study revealed that age, breed, type of medication, length of the illness and gender did not have any effect on the ability to detect epileptic seizures.

In 2001 the organization Support Dogs in England carried out a study together with the University of Plymouth. The study showed that the number of seizures was reduced by a seizure dog.

In 2004 the Alberta Children's Hospital in Canada carried out a study, which looked at whether dogs could notice epileptic seizures before they happened. 45 families with epileptic children and family dogs were questioned for the study. Nine families reported that that their dog had at least once noticed an epileptic seizure before it happened. None of the dogs were trained to recognize seizures. 80% of the dogs who were already aware of a seizure some minutes beforehand were large dogs of the following breeds: crossbreed, German shepherd, Collie, Poodle, Shetland Sheepdog, Akita, Rottweiler, Golden Retriever and Great Pyrenees. The researchers concluded that dogs could not be trained to recognize seizures, but that some dogs have an innate ability while others do not.

In 2007 a further study was carried out at the Alberta Children's Hospital in Canada, in which epileptics, who had received a seizure dog from one of the Canadian assistance dog organizations between 2001 and 2006, were surveyed. 45% of the epileptics reported that the dog had reduced the frequency, length and intensity of their seizures. 69% of those who had a seizure alert dog, who also warned of seizures before they happened, reported an improvement in their seizures. 82% reported a substantial improvement in quality of life in the following areas: relationships with family and strangers, increase in self-confidence, improvement of work-place situation and improvement in depression and feelings of anxiety. The greatest improvement, with 87%, was reported by the participants in the study as being the increase in security and independence.

In 2010 the University of Bologna in Italy carried out a study on a dog who alerted of seizures without having been trained to do so. The dog gave warnings of all the seizures in the study consistently. The researchers are certain that the untrained dog had drastically improved the quality of life of a woman suffering from epilepsy, and had greatly reduced the number of seizures she had.

A study from 2013, "Frontal hemodynamic changes precede EEG onset of temporal lobe seizures", which was carried out by Seydal, found out that both oxygen partial pressure and oxygen saturation change shortly before a focal seizure. Although this study is not directly linked to seizure alert dogs, it lead to the insight into what dogs notice when they warn epileptics of a seizure.

In 2014 the research team at the German Assistance Dog Center T.A.R.S.Q. succeeded in finding out what dogs notice when they warn of partial seizures. The results show that dogs give a warning, because they perceive reduced oxygen saturation.

In a seven year long behavioral study, the researchers found out that dogs don't just react in the same way to hypoglycemia and hyperglycemia., but also to focal epileptic seizures, migraine attacks and life-threatening asthma attacks. Dogs between the ages of three weeks and seven years took part in the study. They all had the innate ability to give a warning without having received any training, which they did by prodding at the hand, ear, leg and mouth, licking the hand and laying out their paw. They gave the same identical warning with all illnesses. Dogs who warned of hypoglycemia gave the same type of warnings for migraine attacks and focal seizures. This observation suggested that dogs notice the same thing with all these illnesses.

Between May 2013 and February 2014 the team at the German Assistance Dog Center T.A.R.S.Q. carried out a study with 24 participants and fourteen dogs. The participants consisted of seven type 1 diabetics, one type 2 diabetic, two epileptics with focal seizures, one asthmatic and one migraine sufferer, as well as twelve healthy people, all between ten and 63 years old. All dogs had been proven to have the innate ability to warn and showed this ability with those known to them, as well as study participants who were strangers to them. The dogs consisted of two crossbreeds , seven rough Collies, four Lollies and one Poodle. Each participant was observed over several days with different dogs, with only one dog being in the room at any one time. During this time each participant wore a pulse oximeter on their finger, which constantly measured the SpO2 level of the participant. The diabetics regularly measured their blood sugar. At the beginning of the study, it was determined that each participant had a normal SpO2 level, while the blood sugar levels of the diabetics were optimal and the epileptics, migraine sufferers and asthmatics were not in any danger of an imminent attack. The dogs did not give a warning with any of the healthy participants over the whole course of the study. The healthy participants' SpO2 level also did not change. The SpO2 levels of the diabetics sank by at least three units from the normal individual levels every time their blood sugar sank to the level of oncoming hypoglycemia or rose to the level of oncoming hyperglycemia. The SpO2 levels of the epileptics decreased significantly shortly before a focal seizure. The SpO2 levels of the asthmatic and the migraine sufferer also decreased shortly before an attack. Every time that the pulse oximeter showed a decrease of three to four units, the dog stood up, went to the test person and showed typical warning behavior by prodding, licking or laying down a paw. If a diabetic delayed snacking on a carbohydrate after a warning of hypoglycemia from the dog, the SpO2 level decreased further to SpO2 91. When a slow decrease of blood sugar levels into hypoglycemia occurred, reduced oxygen saturation sometimes continued. The SpO2 level also sank further during focal seizures and life-threatening asthma attacks, after having in some cases increased for a short time before decreasing again. The SpO2 levels normalized again only when blood sugar levels were stable or the attacks were over. The dogs continued giving warning signs until the SpO2 level returned to normal. None of the dogs gave a warning if the SpO2 level did not decrease by at least three units. The researchers came to the realization that the dogs noticed a decreasing oxygen saturation, and that this was responsible for the warnings the dogs gave. When oxygen saturation decreases, the breathing rate changes by an amount imperceptible to humans. The researchers conclude from this that the dogs hear smalls changes in breathing rate, as all warning dogs make clear ear movements to localize a noise, before they go to the person and give a warning.

Generalized seizures were not studied in the studies from 2013 and 2014, so we don't currently know whether dogs can be aware of generalized seizures before they happen. According to what we know at the moment, it can be assumed that something else happens in the body with generalized seizures than with focal seizures.

• Preconditions for having a seizure alert dog

You have focal seizures, which you still suffer from despite taking medication.

The epileptic is willing and capable of establishing and maintaining a close connection with the seizure alert dog.

The seizure alert dog has to have the strongest connection with the epileptic, so that it knows who it should be watching out for. All other family members must restrict their interactions with the seizure alert dog, so that they don't endanger the reliability of the dog as an alert dog.

The epileptic is with the seizure alert dog 24 hours a day.

The epileptic always stays close to the seizure alert dog, so that the dog can help them.

The seizure alert dog is the only dog in the household, so that other dogs do not distract it from its work. Other animals such as cats present no problem.

If the seizure alert dog is trained for a child, the child should want to have a seizure alert dog and do the extra daily work required. A seizure alert dog should not just be brought in on the wishes of the parents. Your child should be at least six years old, although a minimum age of four is possible in special cases, and upon discussion with the assistance dog trainer in your location.

• Seizure response dogs

Response dogs are dogs who react to a situation. With a seizure response dog, this means that the dog reacts to a seizure and lets others know what is happening while the seizure is still ongoing. A seizure response dog learns to react to a seizure and inform others. An seizure response dog is not aware of seizures before they happen, it simply reacts when the seizure is already happening.

• A seizure response dog's tasks

When the epileptic has a seizure, the dog informs the relevant people, either with an emergency button, a bell, an emergency telephone, or by barking. If this is successful, the dog brings the person medication on command, so that the person can remain with the epileptic. During a seizure, the dog can provide the epileptic with closeness and warmth, and calm them once the seizure has ended. After the seizure, the seizure response dog can bring a cell phone on command. If the epileptic has a seizure in a public space, a seizure response dog learns to stay near its partner so that it doesn't get into danger itself.

• Preconditions for having a seizure response dog

You have at least one primary generalized seizure per month, and continue to have seizures despite taking medication.

Or you have focal seizures, but don't fulfill the requirements for having a seizure response dog, or only want a dog to help when you have a seizure, not to warn you beforehand.

An epileptic stays with a seizure response dog 24 hours a day.

An epileptic always remains close to the dog, so that the dog will be close by when a seizure happens, and can be aware of it.