Therapy Dogs Give Relief to Fibromyalgia Patients

By Pat Anson, PNN Editor

It’s well-known that having a pet or support animal can provide significant psychological benefits to people suffering from stress, anxiety or loneliness. A new study at the Mayo Clinic suggests that pet therapy can also help people with fibromyalgia.

To gain a better understanding of the physiological and emotional benefits of pet therapy, researchers monitored the hormones, heart rate, temperature and pain levels of 221 patients enrolled in the Mayo Clinic Fibromyalgia Treatment Program. Half of the participants spent 20 minutes interacting with a therapy dog and its handler, while the other half served as a control group, spending the same amount of time with the handler only.

The research findings, recently published in Mayo Clinic Proceedings, are striking. People who interacted with a therapy dog had a statistically significant increase in levels of salivary oxytocin – a hormone released by the pituitary gland that is known as the “cuddle hormone” or “love hormone.”

They were also more relaxed, their heart rates decreased, and they reported more positive feelings and fewer negative ones compared to the control group. Over 80% agreed or strongly agreed that animal therapy was helpful to them.  

Pain levels declined in both groups, but there was a larger decrease in those who interacted with the therapy dogs. On average, severe pain scores in that group dropped to more moderate levels.

“Given that individuals with FM (fibromyalgia) suffer pain chronically, this reduction, even if numerically minimal, could help to provide symptomatic relief and quality of life improvement,” researchers concluded. “Overall, the study showed that a 20-minute human-animal interaction (treatment group) as well as a human-human interaction (control group) could improve the emotional and physiological state of patients with FM; however, those who interacted with a therapy dog showed a more robust improvement.”

Fibromyalgia is a poorly understood disorder characterized by widespread body pain, fatigue, poor sleep, anxiety and depression. Its cause is unknown and many treatments prove ineffective. 

Therapy Dogs Calmer

The Mayo Clinic study was unique in another way – because researchers monitored and collected saliva from the dogs to see how they responded to the therapy sessions. Although therapy dogs are used in a wide variety of clinical settings, little is known about the impact of therapy sessions on the emotional state of the dogs.

Researchers say the 19 dogs involved in the fibromyalgia study -- all members of the Mayo Clinic Caring Canines program – did not show signs of stress, appeared to be more relaxed, and had significantly lower heart rates at the end of the sessions, a sign that they enjoyed interacting with patients.

"We need to expand our understanding of how animal-assisted activity impacts therapy dog's well-being, and this sizeable study with 19 dogs of various breeds provided solid evidence that animal-assisted activity done in the right condition does not have negative impacts on well-trained therapy dogs," said François Martin, PhD, a researcher for Purina, which sponsored the study.

"This only encourages us to do more research to continue to demonstrate the power of the human-animal bond on people while ensuring assistance animals also experience positive wellness as a result of their work."

You don’t need a trained therapy dog to enjoy the benefits of having a pet. A recent survey of older adults found that dogs, cats and other pets help their owners enjoy life, reduce stress, keep them physically active, and take their minds off pain.

Bunny Boy and Me: A True Story About Chronic Pain and Unconditional Love

By Pat Anson, PNN Editor

When most people think of therapy and support animals, a dog or cat immediately come to mind. But after years of struggle with chronic pain from lupus and fibromyalgia, Nancy Laracy needed a different kind of animal.

“Our family had been through so much that I felt we all needed a family pet other than our lizard. And because my husband was allergic to dogs and cats, we settled on a rabbit,” Nancy explained.

She adopted a baby red satin rabbit, a breed known for its calmness and sociability. “Bunny Boy” quickly became part of the Laracy family and would have a profound effect on Nancy’s life. She wound up writing a book about her furry friend, “Bunny Boy and Me: My Triumph over Chronic Pain with the Help of the World’s Unluckiest, Luckiest Rabbit.”    

“Little did I know that Bunny Boy would become my third child in so many ways and that he would be the perfect therapy for my pain,” Nancy told PNN. 

“I had tried acupuncture, massage therapy, chiropractic, mainstream medicine, slept on a magnetic mattress — just about anything. But it was Bunny Boy who took me away from my pain as he slept with me, snuggled with me, and grew to know when I needed him the most. When I had his warm body on mine, I could feel the muscle pain lessen and of course the stress as well.”

Nancy started taking Bunny Boy to her doctors’ appointments, where he had a similar effect on other patients.

“I would see the positive reaction of the patients in pain, sitting in the lobby while we were there. If only for a short time, Bunny Boy would run around, jump on their laps when they allowed him to, knock the magazines all over, and make the patients laugh and smile,” she said. 

In a cruel irony, Bunny Boy got sick and was diagnosed with a similar autoimmune disease, and needed multiple surgeries for a severe jaw abscess. Most rabbits don’t respond well to painful invasive medical procedures, but Bunny Boy was a plucky hare with a strong will to live.

“I provided that same comfort to Bunny Boy as he underwent numerous surgeries and treatments that normal rabbits don’t survive, but he survived due to the strength and love he received from me and my family,” Nancy said.

“The vets who cared for him eventually called him ‘Iron Bunny’ and said to me over and over again that he was only surviving so many things due to our bond which formed in sickness and in health.”

Bunny Boy not only survived, he helped pioneer a new medical treatment that Nancy credits with saving her life, which she discusses in her book.

Bunny Boy lived a long life for a rabbit – nine years – and Nancy went on to adopt a new rabbit that she named Muffin, who also became a therapy animal.

“I started first by visiting nursing homes to see if she had the right temperament. Not only did I visit the patients in their rooms, but they wanted me to visit the patients in physical therapy and it was amazing how Muffin could help the patients increase their physical therapy programs, simply by sitting on their laps during some of their exercises,” Nancy said.

“For arthritis and fibro patients it is important to keep moving at some level and having pets helps us do that. For me a bunny was perfect because I believe it would have been too difficult for me to walk a dog that dragged me or walk a dog regularly period. A bunny is litter trained, doesn’t have to be walked, and they are equally as endearing and social as a dog or cat.”

Bunny Boy and Me is featured in PNN’s Suggested Reading section, along with other informative books on chronic pain and pain management. Nancy is donating all proceeds from her book to charity.

Pets Help Take Our Minds Off Pain

By Pat Anson, PNN Editor

Pets make good companions, keep their owners physically active and help us enjoy life. But did you know that pets can also help take our minds off pain?

That’s one of the findings from a new National Poll on Healthy Aging conducted by AARP and the University of Michigan Institute for Healthcare Policy. Researchers surveyed over 2,000 American adults aged 50 to 80, who answered a wide range of questions online about the health benefits of pet ownership.

Companionship, social connection and physical activity were positive side effects of pet ownership for many poll respondents.

People said their pets helped them enjoy life (88%), make them feel loved (86%), help reduce stress (79%), keep them physically active (64%) and help them cope with physical and emotional symptoms (60%), including taking their mind off pain (34%).

For those who said their health was fair or poor, pet ownership offers the most benefits. More than 70 percent of those older adults said their pet helps them cope with physical or emotional symptoms, and nearly half (46%) said their pets help distract them from pain.

"Relationships with pets tend to be less complicated than those with humans, and pets are often a source of great enjoyment," says Mary Janevic, PhD, an assistant research scientist at the U-M School of Public Health. "They also provide older adults with a sense of being needed and loved."

More than half of those who owned pets said they did so specifically to have a companion and nearly two-thirds said having a pet helps connect them to other people.

"We have long known that pets are a common and naturally occurring source of support," says Cathleen Connell, PhD, a professor at the U-M School of Public Health. “Although the benefits of pets are significant, social connections and activities with friends and family are also key to quality of life across the lifespan. Helping older adults find low cost ways to support pet ownership while not sacrificing other important relationships and priorities is an investment in overall mental and physical health."

While pets come with benefits, they can also bring concerns. Nearly one in five older adults (18%) said having a pet puts a strain on their budget. Some owners even put their animals' needs ahead of their own health.

"For people living on a fixed income, expenses related to health care for pets, and especially pets that have chronic health issues, can be a struggle. Older adults can also develop health problems or disabilities that make pet care difficult," said Janevic.

"More activity, through dog walking or other aspects of pet care, is almost always a good thing for older adults. But the risk of falls is real for many, and six percent of those in our poll said they had fallen or injured themselves due to a pet," said poll director Preeti Malani, MD. “At the same time, given the importance of pets to many people, the loss of a pet can deal a very real psychological blow that providers, family and friends should be attuned to."

More than half of older adults (55%) reported having a pet. Among pet owners, the majority (68%) had dogs, 48% had cats, and 16% had a small pet such as a bird, fish, or hamster.

Over half of pet owners (53%) reported that their pets sleep in their bed. Dog lovers are often told that’s a bad idea, but a recent study found an "overwhelmingly positive" response from owners who say they slept better with their dogs.

Are Opioid Prescriptions for Pets Diverted to Humans?

By Pat Anson, PNN Editor

Opioid prescriptions for pets have soared over the past decade and may have helped fuel the opioid epidemic in humans, according to a small and speculative study published in JAMA Network Open.

Researchers at the University of Pennsylvania's Perelman School of Medicine say there was a 41 percent increase in opioid MMEs (morphine milligram equivalents) prescribed to dogs, cats and other pets at an acute care veterinary hospital at Penn’s School of Veterinary Medicine from 2007 to 2017.  Some of the increase was attributed to more complex procedures performed in veterinary medicine, as well as a greater awareness of the importance of pain management in animals.

But the authors took their analysis a step further by suggesting -- without offering any evidence -- that some of the opioids were diverted for human use.

"As we are seeing the opioid epidemic press on, we are identifying other avenues of possible human consumption and misuse," said senior author Jeanmarie Perrone, MD, a professor of Emergency Medicine and the director of Medical Toxicology at Penn Medicine.

"Even where the increase in prescribed veterinary opioids is well intended by the veterinarian, it can mean an increased chance of leftover pills being misused later by household members, sold or diverted, or endangering young children through unintentional exposure. The results of this study suggest that by assessing the rate of veterinary opioid prescriptions, we can develop strategies to reduce both human and animal health risks associated with increasing use."

Perrone was one of three peer reviewers who helped the CDC develop its controversial 2016 opioid prescribing guideline. One of her co-authors is Lewis Nelson, MD, a longtime critic of opioid prescribing practices who belonged to the “Core Expert Group” that drafted the CDC guideline.

The researchers reviewed pharmacy records at Penn Vet's Ryan Hospital during the 10-year study window, analyzing trends in four opioids prescribed to animals: tramadol, hydrocodone, codeine and fentanyl. The vast majority of animal patients were dogs and cats, along with an assortment of rabbits, snakes and birds.

"We found that the increased quantity of opioids prescribed by our hospital was not due to increased patient volume alone. It is likely that our goal of ensuring our patients are pain-free post-operatively, particularly for those requiring complex and invasive procedures, has driven our increased prescribing practices during this period," said lead author Dana Clarke, VMD, a professor of Interventional Radiology at Penn’s School of Veterinary Medicine.

"At the national level, we don't know the potential or extent of prescription diversion from animals to humans, and what impact this could have on the human opioid crisis."

Although the evidence of veterinary opioids being diverted to humans is largely anecdotal, many states have adopted measures that require background checks on pet owners. Twenty states require veterinarians to report their opioid prescriptions to a drug database, just as medical doctors do.

Maine and Colorado require background checks on a pet owner’s drug use before a veterinarian can even write a opioid prescription; while Alaska, Connecticut and Virginia limit the amount of opioids any one veterinarian can prescribe to a single animal.

Last year the Food and Drug Administration warned veterinarians to be cautious when prescribing opioids and be alert for people who may be using their pets to gain access to the drugs.

“We recognize that opioids and other pain medications have a legitimate and important role in treating pain in animals,” said FDA commissioner Scott Gottlieb, MD. “But just like the opioid medications used in humans, these drugs have potentially serious risks, not just for the animal patients, but also because of their potential to lead to addiction, abuse and overdose in humans who may divert them for their own use.”

A small study published in the American Journal of Public Health suggested that some pet owners are purposely injuring their animals to gain access to opioids. In a survey of 189 Colorado veterinarians, 13 percent reported they suspected an animal owner of purposefully injuring a pet to obtain opioid medication.

FDA Warns Veterinarians of Pet Owners Abusing Opioids

By Pat Anson, Editor

Doctors and patients aren’t the only ones under scrutiny for prescribing and using opioid pain medication. Pet owners are also coming under suspicion for diverting and abusing opioids intended for their animals.

The Food and Drug Administration today warned veterinarians to be cautious when prescribing opioids and be on the alert for people who may be using their pets to gain access to the drugs.

“We recognize that opioids and other pain medications have a legitimate and important role in treating pain in animals – just as they do for people,” FDA commissioner Scott Gottlieb, MD, said in a statement.

“But just like the opioid medications used in humans, these drugs have potentially serious risks, not just for the animal patients, but also because of their potential to lead to addiction, abuse and overdose in humans who may divert them for their own use.”

Only one opioid is currently approved by the FDA for use in animals, a potent fentanyl medication for post-surgical pain that is sold under the brand name Recuvyra.  

The maker of another fentanyl based product -- carfentanil -- voluntarily surrendered approval for the drug in March because of growing signs it was being diverted. Carfentanil is so potent it was used by veterinarians as an anesthetic on elephants.   

With few options to choose from, some veterinarians are legally prescribing tramadol and others opioids intended for humans to relieve pain in pets. The FDA is recommending veterinarians use alternatives to opioids whenever possible and look for signs of opioid abuse by pet owners and their own employees.

“We’re advising veterinarians to develop a safety plan in the event they encounter a situation involving opioid diversion or clients seeking opioids under the guise of treating their pets; and taking steps to help veterinarians spot the signs of opioid abuse,” Gottlieb said.

Possible warning signs of opioid abuse are suspicious injuries to animals, a pet owner asking for specific medication by name, or asking for refills of lost or stolen medication.

Gottlieb’s statement was released one week after a small study published in the American Journal of Public Health suggested that some pet owners are purposely injuring their animals to gain access to opioids.

"Our results indicate that we should be paying more attention to how opioid abusers are seeking their drugs -- including through veterinary clinics," said Lili Tenney, deputy director of the Center for Health, Work & Environment at the Colorado School of Public Health.

In a survey of 189 Colorado veterinarians, 13 percent reported they had seen a client who they believed had purposefully injured a pet or made them ill. Nearly half the vets said they knew of a pet owner or employee who was abusing opioids; and 12 percent suspected a staff member of diverting opioids or abusing them.

Colorado and Maine require veterinarians to look at a pet owner’s medication history before dispensing opioids or writing a prescription.  Over a dozen states require veterinarians to report when they prescribe opioids to a prescription drug database.