Evaluating the Effectiveness and Cost-Effectiveness of Seizure Dogs in Persons With Medically Refractory Epilepsy in the Netherlands

__Background:__ Epilepsy is associated with a high disease burden, impacting the lives of people with epilepsy and their caregivers and family. Persons with medically refractory epilepsy experience the greatest burden, suffering from profound physical, psychological, and social consequences. Anecdotal evidence suggests these persons may benefit from a seizure dog. As the training of a seizure dog is a substantial investment, their accessibility is limited in the absence of collective reimbursement as is seen in the Netherlands. Despite sustained interest in seizure dogs, scientific knowledge on their benefits and costs remains scarce. To substantiate reimbursement decisions stronger evidence is required. The EPISODE study aims to provide this evidence by evaluating the effectiveness and cost-effectiveness of seizure dogs in adults with medically refractory epilepsy. __Methods:__ The study is designed as a stepped wedge randomized controlled trial that compares the use of seizure dogs in addition to usual care, with usual care alone. The study includes adults with epilepsy for whom current treatment options failed to achieve seizure freedom. Seizure frequency of participants should be at least two seizures per week, and the seizures should be associated with a high risk of injury or dysfunction. During the 3 year follow-up period, participants receive a seizure dog in a randomized order. Outcome measures are taken at multiple time points both before and after receiving the seizure dog. Seizure frequency is the primary outcome of the study and will be recorded continuously using a seizure diary. Questionnaires measuring seizure severity, quality of life, well-being, resource use, productivity, social participation, and caregiver burden will be completed at baseline and every 3 months thereafter. The study is designed to include a minimum of 25 participants. __Discussion:__ This protocol describes the first randomized controlled trial on seizure dogs. The study will provide comprehensive data on the effectiveness and cost effectiveness of seizure dogs in adults with medically refractory epilepsy. Broader benefits of seizure dogs for persons with epilepsy and their caregivers are taken into account, as well as the welfare of the dogs. The findings of the study can be used to inform decision-makers on the reimbursement of seizure dogs

Pets and their owners during the first COVID-19 lockdown period:Perceived changes in routines and emotions – An exploratory study

An international online questionnaire Pets in Lockdown was conducted during the first COVID-19 lockdown during the months of April and May 2020 to assess how pet owners perceived some aspects of their relationship with their pets, including time spent together and how much they enjoyed it, difficulties taking care of their pets, the amount of comfort they obtained from interacting with their pets, and whether they had observed any changes in their pets’ resting time and behavior. Most pet owners did not describe any changes in the relationship with their pets or in their pets’ behaviour. Horse owners expressed more difficulties taking care of their animals than owners of other species. Approximately 20% of the animals had less time available to rest undisturbed. Of the animals that displayed behavioral changes, remaining closer to the owner was the most frequently described change followed by descriptions of higher arousal and increased negative affective states

Pets and their owners during the first COVID-19 lockdown period: Perceived changes in routines and emotions – An exploratory study

An international online questionnaire Pets in Lockdown was conducted during the first COVID-19 lockdown during the months of April and May 2020 to assess how pet owners perceived some aspects of their relationship with their pets, including time spent together and how much they enjoyed it, difficulties taking care of their pets, the amount of comfort they obtained from interacting with their pets, and whether they had observed any changes in their pets’ resting time and behavior. Most pet owners did not describe any changes in the relationship with their pets or in their pets’ behaviour. Horse owners expressed more difficulties taking care of their animals than owners of other species. Approximately 20% of the animals had less time available to rest undisturbed. Of the animals that displayed behavioral changes, remaining closer to the owner was the most frequently described change followed by descriptions of higher arousal and increased negative affective states