Animal-assisted therapy and the severely disabled child: a quantitative study - Graduate Literary Award Winner - Abstract

Journal of Rehabilitation, Oct-Dec, 2001 by Kathryn Heimlich

As his health was not improving, further testing was conducted. It was then determined that Cody was suffering from Cushing's Syndrome, also known as canine hyperadrenocorticism (HAC). Cushing's Syndrome is a hormonal disorder that results in chronic elevation in circulating blood cortisol (a form of cortisone) concentrations (Tilley and Smith, 1997). This cortisol toxicity is the result of excessive production of hormones by the adrenal glands and is often the result of chronic stress. Cody was placed on the oral medication, mitotane (Lysodren) and because of the chronic nature of this syndrome, will receive this medication for life.

Although there is no conclusive evidence that Cody's illness was the result of the strain placed on him by the intense therapy regiment, one must question its impact. Cushing's Syndrome in the dog may be caused by an adrenal cortex tumor growth (15% of cases), excessive or prolonged administration of cortisone drugs (< 1%) and most commonly (85% of cases)because of an abnormality of the pituitary gland (Nelson and Couto, 1992). It is widely recognized however, that chronic stress can cause destructive physical symptoms and behaviors in both humans and animals.

Coe, Lubach and Ershler (1989) determined that psychological distress (in primates) can alter the immune system with potentially long-lasting effects. During periods of stress, cortisol levels in the blood stream become elevated. This response is necessary to increase energy levels in response to the stressor. Excessive elevation of cortisol levels may overwhelm the immune system, increasing susceptibility to illness (Huebner & Thomas, 1995). The development of ear and urinary tract infections in Cody and subsequent development of Cushing's Syndrome, may be result of his high, chronic stress level.

Regardless of the underlying cause, Dr. Eurell believes that environmental factors as well as heredity may be responsible for the onset of Cushing's Syndrome. She stated that the enormous stress placed on Cody might have overwhelmed his immune system resulting in illness. These stress factors included, but were not limited to:

1. Fourteen therapy sessions (seven students seen for 30 minutes, two times per week) were conducted in a three-day period of time. This was too many sessions, too close together for one animal. Although an effort was made to pair Cody with the more active children during the early sessions, he clearly showed signs of exhaustion as the day progressed.

2. This investigator was both the dog handler and therapist. Consequently, as the unexpected needs of the students were being attended to, Cody was required to accompany his handler. This extra movement may have further contributed to his exhaustion.

3. Fifteen minutes was scheduled between therapy sessions to return the student to his classroom, travel back to the therapy room to restore it to its original condition and escort Cody outside to relieve himself. An administrator expressed concern with this lapse in time and requested that it be eliminated or considerably shortened. The time span was reduced to ten minutes, again placing undue strain on the animal.