University Times

Dog owners need no scientific proof as to the value of a wet-nosed nuzzle. For those who’d like a little evidence with their anecdotes, neurologist Dawn A. Marcus, a faculty member in anesthesiology, combines both in her book, “The Power of Wagging Tails: A Doctor’s Guide to Dog Therapy and Healing,” to make the case for the many ways therapy dogs can contribute to physical and mental health and well-being.

Marcus, an internationally known expert on migraines and chronic pain, is no stranger to non-drug treatments and non-traditional therapies. Through her work at UPMC’s Pain Evaluation and Treatment Institute, she’s found that sometimes the most effective treatments aren’t found in a prescription bottle.

“As a neurologist, you have the sense that pain practice is very much a ‘take a pill’ approach,” Marcus said, adding that she found it eye opening to discover through experience that non-drug treatments seemed to surpass drug treatment in helping patients manage chronic pain.

Marcus authored a study that was published in the January issue of the journal Pain Medicine that evaluated the benefits of a brief therapy dog visit as part of patients’ visits to the outpatient pain clinic.

The study found that patients who spent their clinic waiting time with a therapy dog reported significant improvements in pain, mood and other measures of distress compared to patients who did not. Clinic staff and family or friends who accompanied the patients also benefited from the canine visits, the study found.

Similar research is in the works to study the benefit for fibromyalgia patients, Marcus said.

Other studies have shown the benefits associated with companion dogs. As pets, dogs can boost immunity, provide their owners with comfort and support, foster interactions with others and even keep their owners in better shape by giving them reason to stick to a regular exercise plan. (Marcus’s 2008 book, “Fit as Fido: Follow Your Dog to Better Health,” and her web site www.fitasfido.com detail how dogs can promote better health and well-being.)

“The Power of Wagging Tails” cites research on the impact of dogs on such factors as pain, blood pressure, stress, mental health and immune system function.

It also details how animals can be used to detect illness such as cancer, or alert their owners to problems such as low blood sugar.

“If we are attuned to our dog’s behavior, they can alert us when something is wrong,” said Marcus, who noted she hopes to conduct a prospective study of how dogs may be able to sense the onset of migraine in their owners.

An initial survey showed that about half of 1,000 people who responded reported that their dog’s behavior changed when they had a migraine. Of those, half reported the dog’s behavior changed in advance of their migraine symptoms, providing potential for intervention before the migraine becomes painful. “Presumably they’re noticing some changes people aren’t attuned to,” she said.

In preparing to write the book, Marcus immersed herself in scholarly literature on animal-assisted therapy and sought out personal stories from therapy dog handlers, patients and health care providers to back up the research that demonstrates the healing powers of dogs.

Marcus said as a doctor she enjoys hearing patients’ own stories. “It’s more convincing when it’s personal,” she explained. “Research studies can be convincing, but it’s very compelling when a patient of mine has that same experience.”

Some of the tales in “The Power of Wagging Tails” are Marcus’s own: She is a trained therapy dog handler who volunteers with her soft-coated wheaten terriers, 6-year-old Wheatie and his 3-year-old nephew Toby. They have made the rounds in hospitals and nursing homes and visited with students. She and Wheatie also make regular stops at a North Hills convent, where the sisters dote on him.

The book also serves as a practical resource for people who may be considering embarking on therapy dog training.

People may mistake therapy dogs — whose role is to interact — for service animals, which shouldn’t be distracted when they are working. Service dogs, such as seeing-eye dogs or those trained to perform tasks for people who have disabilities, are paired with an individual and are permitted to accompany their owner at all times.

In contrast, therapy dogs typically are pets that are trained and evaluated for their temperament and obedience, then certified to visit in places such as hospitals, nursing homes and schools.

“Most dogs could be a therapy dog,” Marcus maintains. “It takes training, though.” Regardless of breed, the dog must be well behaved, outgoing and not fearful of strangers.

In Marcus’s case, it was a veterinarian who recognized Wheatie’s potential. She and Wheatie took a therapy dog training course and enjoyed it. As a new volunteer, she was skeptical when she heard an orientation session leader’s uber-enthusiastic description of what it would be like.

“I thought she was over the top, telling how amazing it would all be and what a difference it would make,” Marcus said.

Despite her extensive experience with alternative medicine, “I wasn’t expecting a whole lot” from becoming a therapy dog handler, she admitted.

That all changed when she and Wheatie began visiting patients together. After seeing how his presence brightened patients’ mood and brought smiles to hospital visitors and staff, she was convinced. “It was amazing the impact he’d have, the difference he’d make,” she said. “Something important happens when we connect with another living thing.”

Marcus said she doesn’t want to minimize the value of human visitors to hospital patients, but therapy dogs — who visit as completely non-judgmental, accepting friends — can provide certain comforts that people can’t.

“Wheatie doesn’t care what they look like, or what they smell like or what they want to talk about,” she said. Unlike human visitors, dogs don’t ask patients how they’re doing, relieving them of the obligation to put on a cheery face or stiff upper lip for the benefit of visitors.

With a canine visitor, “Patients can be honest. Face it — they’re in the hospital. Things aren’t typically great,” Marcus said.

Where human visitors may feel obliged to try to cheer up a patient, a therapy dog visit can give patients a chance simply to forget about themselves and their illness for a short while. “It takes them out of themselves,” she said.

Marcus recounted the story of a friend who underwent cancer surgery and chemotherapy. “People would get upset and try to comfort her,” Marcus said. Visitors would try to “make it all better” or make promises, when all she wanted was to sit and cry, she told Marcus. “She could share her fears and thoughts with the dog.

“We as humans feel we can do so much more than we can,” Marcus said. “We offer hugs and platitudes. It’s hard to be the person who just listens and accepts.” Dogs simply listen and don’t say anything back.

“For a lot of people who are struggling, they can unburden themselves on a dog when they don’t want to unload on people,” Marcus said. She related an encounter in a surgical waiting room between Toby and a woman whose husband was in surgery and wasn’t expected to do well. The woman began talking to the dog, then sobbing, before gathering herself emotionally. “You don’t know what that did for me,” she told Marcus.

Therapy dogs also can foster better relationships between hospital staff and patients by creating a non-medical topic of conversation and an opportunity for human connection. “It makes a more friendly relationship that’s warmer than a staff-patient relationship,” she said.

Hospitals and doctor’s offices aren’t the only venues for therapy dog visits. Marcus and Wheatie’s first volunteer efforts were as part of a “Reading With Rover” program in which school children would improve their skills by reading aloud to a therapy dog.

She and Toby volunteer at LaRoche College in a program similar to Pitt’s college canines program. Visits to college students relieve stress and offer a sense of home for students who have left their pets behind to come to college. The dogs ease homesickness and provide opportunities for students to interact around the common experience of visiting with the dog, fostering social connections, Marcus said.

Nursing homes also are amenable to therapy dog visits, Marcus said.

Sharing her pet in a place where people may feel lonely, isolated or forgotten speaks volumes, especially to those who loved their own pets, Marcus said. Patients value that she’s offering her prized pet to them to play with. “It says to them: ‘You’re really important.’”

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Marcus, who juggles her Pitt research with freelance medical writing and therapy dog handling, has two new books. “The Woman’s Fibromyalgia Toolkit: Manage Your Symptoms and Take Control of Your Life” follows Marcus’s “The Woman’s Migraine Toolkit: Managing Your Headaches From Puberty to Menopause.”

The other, “Therapy Dogs in Cancer Care,” aims to encourage health care providers to integrate therapy dog activities into cancer management plans. It is scheduled for release in May.

—Kimberly K. Barlow