Friday, September 24, 2004

An epilepsy patient's best friend


Golden retriever trained to alert owner that a seizure is coming and to help her through it

By Peggy O'Farrell
/ Enquirer staff writer

epilepsy
Katie Kemper 26, with her service dog, Cooper.
(The Enquirer/Brandi Stafford)
Cooper, a 2-year-old golden retriever, does all the usual dog tricks: He plays fetch and tug-of-war. He chases squirrels.

But his best trick is telling owner Katie Kemper to "sit" and "stay" - 15 minutes to half an hour before an epileptic seizure hits.

I don't know how he does it, but he does it," says Kemper, 26, of Forest Park.

Epilepsy FAQ
What is epilepsy?

Epilepsy is a neurological disorder in which a person has repeated seizures - abnormal electrical discharges of the brain's cells that result in temporary disruption of movement, sensory or mental function.

What causes it?

Epilepsy can have several causes, including chemical imbalances, tumors, stroke or other brain injury, toxic chemicals or drugs, alcohol withdrawal, birth injuries or abnormal brain development. In many people, the cause is idiopathic, or unknown.

How many people have epilepsy?

More than 2.5 million Americans have epilepsy, and more than 180,000 Americans develop epilepsy and seizures for the first time every year. The condition develops most often during early childhood and old age.

How is epilepsy treated?

Most people who have epilepsy respond well to anticonvulsant medications. Surgery is also an option. Some children have success with a complex high-fat, low-carbohydrate diet requiring medical supervision.

Sources: The Epilepsy Foundation of America; The National Institute of Neurological Disorders and Stroke; www.emedicinehealth.com

About 2.5 million American children and adults have epilepsy. Children often outgrow the recurring seizures. But for some adults, the disease can be disabling and isolating. And that's where Cooper comes in.

Man's best friend could be the best thing to happen to some people with epilepsy. Seizure alert dogs like Cooper don't prevent seizures, but they do give people with epilepsy the confidence to lead more normal lives, some experts and dog owners say.

No one keeps track of how many such dogs are used nationally, but several service dog providers train them. Kemper is one of a handful of Cincinnatians to have a seizure alert dog. Cooper's job is to warn Kemper that a seizure is on its way, keep her safe during the seizure and help her recover afterward.

When Cooper senses that Kemper is going to have a seizure, he starts whining and pawing at the ground. He barks.

If she tells him to be quiet, he will for a minute or two. "Then he gets right back up and starts again," Kemper says. "It's called intelligent disobedience."

If she keeps ignoring him, Cooper will jump up on her and try to make her sit or lie down, she says.

Kemper has learned to pay attention. Now when Cooper tells her she's about to have a seizure, she says, "I listen and I sit down."

During a seizure, Cooper stays by her side. If she moves violently during the episode, he'll lie on top of her to keep her from hurting herself.

After a seizure, Kemper is often weak and disoriented. Cooper wears a "hold harness" with a sturdy plastic handle so he can help support Kemper while she walks. He's also been trained to open doors for her. He wears a kind of pack that includes information for first responders about Kemper's condition, a pillow that she can use during a seizure and his "service dog" ID.

"If I hold Katie's hand and pet him with it, she'll recognize him when the seizure's over," says Debbie Kemper, Katie Kemper's mother. "If not, when she wakes up, she's like, 'Who's the dog?' "

Kemper began having seizures when she was 22. Doctors don't know why they started. Her mother also has epilepsy, but her seizures are controlled by medication.

When Kemper was first diagnosed, she was having five or six seizures a day.

"I was having so many seizures, and I was really anxious about not knowing when I was going to have the next one because I was having so many," Kemper says.

She read an article about seizure alert dogs in an Epilepsy Foundation newsletter and thought getting one might ease her anxiety.

Kemper found the right mix of medication - Dilantin and Zonegran - to cut her seizures back to one to three a week.

But having Cooper does make her feel safer, she says.

"He's very calm, except when he plays," Kemper says. "Then he's one hyper dog."

Training lasts five months

Kemper found Cooper through Amazing Tails, a service dog provider in Oxford, Pa. Cooper underwent five months of training to learn how to do his job, and Kemper went to Pennsylvania for a week to train with him before she brought him home in May.

Not all dogs can become seizure alert dogs, says Siobhan Fromm, Cooper's trainer.

The dogs have to have the ability to predict seizures plus the ability to alert their owner that something is about to happen, along with the intelligence and willingness to be trained as service dogs.

"We get most of our alerting dogs from shelters," Fromm says. "They are the dogs most likely to be turned into shelters. They are annoying to live with. They are hyperactive and hyper vigilant. They do not sleep. They make everyone crazy until they have something to do. Monitoring someone 24/7 for seizure activity gives the dog something to do. They are bright and very energetic. They like to be very, very busy."

When she found Cooper, Fromm says, "he had the right look in his eye. He came out of the cage and looked me straight in the eye and introduced himself."

No one is quite sure how seizure alert dogs sense a seizure is on its way.

Dr. Roger Reep, an anatomist and physiologist with the University of Florida's College of Veterinary Medicine, believes the dogs can smell changes in a person's body chemistry when seizure activity starts. The electrical activity in the brain that prompts the seizure starts up to 90 minutes before the physical signs of a seizure are apparent, Reep points out.

Dogs smell onset

Seizures most often occur in the part of the brain that controls involuntary functions like respiration, heartbeat and perspiration - a tie-in for the smell theory, he points out.

"We think alerting dogs can not only detect the odor but they can hook it up with some idea the person is in danger, and we think that's tied to having a close bond between the dog and the owner so the dog is motivated to protect the person's well-being," Reep says. He did a small study on seizure alert dogs in 1998 and concluded the dogs could be useful for some people with epilepsy.

There's been little research on seizure alert dogs, and the information that is available is based on what the dogs' owners report, says Dr. Anthony Murro, a neurologist and epilepsy specialist at the Medical College of Georgia in Augusta. Two of Murro's patients use seizure alert dogs, but he has never seen the dogs in action, so he doesn't recommend them. "I don't know how well they work," he says.

Murro also wonders if the dogs can alert their owners of an impending seizure early enough for the person to take action to protect themselves.

Dr. Tracy Glauser, a pediatric neurologist and epilepsy researcher at Cincinnati Children's Hospital Medical Center, says seizure alert dogs can provide "a sense of empowerment" for people with epilepsy who might be too afraid of having a seizure to go out to the supermarket or other public places.

"We're always looking for ways to help patients be empowered to lead as normal a life as possible," Glauser says. He doesn't recommend alert dogs for all of his patients, he says, but for some "it makes sense to at least discuss it."

Margie Frommeyer, executive director of the Epilepsy Foundation of Greater Cincinnati, calls the alert dogs "wonderful. It's fascinating to think that an animal could do that."

Unfortunately, she says, many of the foundation's clients can't afford service dogs. Cooper cost $5,000. Kemper is accepting donations through the Cooper Kemper Fund at any U.S. Bank to help defray the cost.

Despite the expense, Kemper says, Cooper is the love of her life - pretty impressive for a woman who used to be afraid of dogs.

"We're made for each other," she says. "He's stubborn. I'm stubborn. He talks back. I talk back. We're the perfect couple."

E-mail pofarrell@enquirer.com



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