Dillon: Seizure Alert Dog

Lisa, a few questions:

1. Does Dillon alert BEFORE a seizure event?

2. How? Does Dillon alert you? Does Dillon alert to Ava? Does Dillon have a universal alert behavior that you all recognize?

3. What does Dillon do DURING the seizure?

4. Does Dillon have post-seizure behavior?

5. Does Dillon alert to all types of seizure? The same way? (IOW, if the answer is yes, that would imply that the odor is the same or similar for all types of seizures)

Thanks.

Hi Lynn,

Yes, she does alert before seizures. Last night was a good example. Ava seemed fine after school, but Dillon began aggressively licking her palms, turning them over with her paw to get to them. This is her signal. So we watched very carefully, and sure enough, Ava began to have seizures in the early evening. This was about an hour after the alert behavior. Ava ended up having a cluster of at least four seizures. Since Ava is always with one of us, we always see the universal alert behavior, which is using her paws to turn over Ava’s hand, and then licking it. 

Here is her pre-seizure alert, just as she’s beginning to flip Ava’s hand.

 

While in a seizure, Dillon lies by Ava‘s side, and if it is a tonic clonic seizure, she will lick her face and keep her airway clear. This is particularly helpful when I am using all my strength to turn Ava onto her side and don’t have a hand to keep her head turned. Dillon also is a comfort for her as she’s coming out of the seizure, and her licking of the palm often seems to help Ava return to baseline more quickly. Post seizure, she continues to lie down next to Ava, or on her legs. The licking stops once the seizure stops, but she will not leave her side. So her presence is the greatest assistance after a seizure, simply giving Ava comfort. She does alert to all seizures the same way, but I will say that these clusters and tonic clonic seizures seem to spark her interest a bit more. She is more assertive with her licking, actually quite insistent when she’s licking the palms, when Ava has her larger seizures, or her big clusters- such as last night.

As seizure is beginning.

So, to answer your question about whether or not she alerts the same to all seizures, I think the answer is yes. So the scent is likely the same. But I will say that the scent is stronger on the bigger seizures, or on the clusters. And she responds proportionately in terms of the assertiveness of the lick. Bigger licks mean bigger seizures, almost all the time. I also see her use her paws more assertively to hold Ava‘s hand in the turned over position to lick it, when she has a big seizure or these large clusters. It’s really quite some thing to see. This is the only time that she flips Ava‘s palm over to lick it. Even though she is a bit of a licky dog, this is the only time that she will use her paws to flip Ava’s hand over, and access the palm. So it’s a very very clear signal.Also, with last night’s cluster seizures, Dillon kept flipping Ava‘s hand over and licking the palm in between the seizures. We thought Ava was done each time, but Dillon was telling us otherwise. This was invaluable, because she was telling us, “Nope, she is not done seizing!” While Ava is in a seizure, at least when she is beginning to come out of it, she gets a bit agitated as Dillon is licking her palm. Ava doesn’t seem to like the licking, but it is very helpful because it seems to bring her back to baseline more quickly.

Immediately after seizure; still in post ictal confused state—but Dillon won’t leave her.

This is so very helpful, Lisa. And am I assuming correctly that Dillon's seizure behavior is not a trained behavior but rather something that Dillon does on her own? And did you ever attempt training an alert behavior?

You are correct that this particular seizure behavior was led by Dillon herself; however we definitely reinforced it once she chose it, because it was SO clear and consistent early on. In fact, any bright ideas we had to train a different seizure behavior were scrapped right away, because Dillon chose the palm flip/lick immediately. It's really something to see when she uses both of her paws (like hands!) to flip Ava's hand over. Again, it's the only time she does this--before or during seizures. Yesterday's first alert was at least an hour before the seizures started.

We did recently find out from Ava's RNS device representative that she is having 5600 episodes per day, which her RNS device detects. This is mind blowing to us, as she is having these small episodes as often as she blinks if not more frequently. This means that her body is nearly always in a state of near seizure, so Dillon is detecting only the higher levels of actual clinical seizures, large and small. She seems to be able to distinguish between those sub clinical episodes and the real deal.

Happy 4th Birthday, Dillon!

2021

What is RNS?