By Dr Matthew Doré, palliative care consultant at Northern Ireland Hospice & Royal Victoria Hospital in Belfast. 

Sometimes I wonder if we limit our prescriptions to ‘medications’ rather than ‘treatments’ and that prevents a more creative approach to being a doctor. Compassionate communities (1) is prescribing ‘compassion’ with amazing success and we were (pre covid) prescribing fans for breathlessness. So as I sat talking to my patient Gladys* today who’s main diagnosis is being lonely and isolated, I was struck by a realization this lady needed a dog.

 

“People with dogs are more healthy,” I said, shouting slightly, pretending to know more than I did.

“Really?” Gladys looked curiously at me. I was unsure if she had heard me properly or she was enquiring further.

“Well a dog is often a good companion and friend,” I said raising my eyebrows in an agreeable way.

“How do I get one?”

 

Has anyone looked at this? The benefits our canine friends bring? I know that some hospices do have a dog to pet, which is often for the dying and in one hospice I know of a llama. I wonder if we should be making this a bigger thing earlier in peoples journey.

Well, kids in bed, I made a coffee, sat at my desk, looked out to the full moon and howled at the internet.

And Yes! There is a surprising amount. It helps maintain physical activity in winter (In Norfolk anyway) (2). They make you happy as every PhD in psychology will tell you (3), they support the elderly (4), act as companions (5), catalysts for social interaction (6), make you have something to talk about (7), makes you more likable (8), and best of all make you have better health (9,10).

And they make you live longer! A systematic review and meta-analysis in the journal ‘Circulation: Cardiovascular Quality and Outcomes’ (11) outlined dog ownership was associated with a 33% lower risk of death for heart attack survivors living alone and 27% reduced risk of death for stroke survivors living alone, both compared to people who did not own a dog.

Dog ownership was also associated with a 24% reduced risk of all-cause mortality and a 31% lower risk of death by heart attack or stroke compared to dog negative people.

I love the hand-held fan, but there is more evidence here than most of palliative care practice alone! However, in the search for palliative research and dogs all I got was a comparative kinematic gait analysis of beagle dogs (12).

 

Are there any negatives to such an overwhelming body of evidence? Well, interestingly if your dog is diabetic you have an increased risk of also becoming a type 2 diabetic (13). And, if you were wondering, cats I reluctantly admit also have some health benefits in reducing your cardiovascular mortality (14).

Would prescribing dogs help QoL scores? Could they act as holistic symptom control bundles of fur? I propose at diagnosis of cancer, a RCT of Labrador or not, (maybe a 3^rd arm of a hamster) and measure.

 

German Shepherd PRN

*Gladys is not her real name

 

1. https://www.compassionate-communitiesuk.co.uk
2. Wu Y, Luben R, Jones A Dog ownership supports the maintenance of physical activity during poor weather in older English adults: cross-sectional results from the EPIC Norfolk cohort J Epidemiol Community Health  Published Online First: 24 July 2017. doi:10.1136/jech-2017-208987 – https://jech.bmj.com/content/71/9/905
3. Friedmann, E. (1995). The role of pets in enhancing human well-being: Physiological effects. In I. Robinson (Ed.), The Waltham book of human-animal interactions: Benefits and responsibilities (pp. 33-53). Oxford, UK: Pergamon
4. Garrity, T.F., Stallones, L., Marx, M.B., & Johnson, T.P. (1989). Pet ownership and attachment as supportive factors in the health of the elderly. Anthrozoos, 3, 35-44
5. Hart, L.A. (1995). Dogs as human companions: A review of the relationship . In J. A. Serpell (Ed.), The domestic dog: Its evolution, behavior and interactions with people (pp. 162-178). Cambridge, UK: Cambridge University press.
6. McNicholas, J., & Collis, G.M. (2000). Dogs as catalysts for social interactions: Robustness of the effect. British Journal of Psychology, 91, 61-70.
7. Rogers, J., Hart, L.A., & Boltz, R.P. (1993). The role of pet dogs in casual conversations of elderly adults. Journal of Social Psychology, 133, 265-278.
8. Rossbach, K.A., & Wilson, J.P. (1992). Does a dog’s presence make a person appear more likeable? Anthrozoos, 5, 40-51.
9. Headey, B. (1998, November). Do pet owners enjoy better health? Results from the German Soci-Economic Panel. Paper presented at the Animals, Community Health and Public Policy Symposium, Sydney.
10. Wells, D.L. (2007). Domestic dogs and human health: An overview. British Journal of Health Psychology, 12, 145-156.
11. Kramer, C. K., Mehmood, S., & Suen, R. S. (2019). Dog ownership and survival: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes, 12(10), e005554.
12. Comparative kinematic gait analysis in young and old Beagle dogs. Author(s) Lorke M; Willen M; Lucas K; Beyerbach M; Wefstaedt P; Murua Escobar H; Nolte Source Journal of veterinary science;
13. Delicano, R. A., Hammar, U., Egenvall, A., Westgarth, C., Mubanga, M., Byberg, L., … & Kennedy, B. (2020). The shared risk of diabetes between dog and cat owners and their pets: register based cohort study.bmj, 371. https://www.bmj.com/content/371/bmj.m4337.short
14. Qureshi, A. I., Memon, M. Z., Vazquez, G., & Suri, M. F. K. (2009). Cat ownership and the Risk of Fatal Cardiovascular Diseases. Results from the Second National Health and Nutrition Examination Study Mortality Follow-up Study.Journal of vascular and interventional neurology,2(1), 132.