Welfare considerations: Salivary cortisol concentrations on frequency of therapy dog visits in an outpatient hospital setting: A pilot study
Open accessAbstract
The animal-assisted therapy field is exponentially growing under the lack of science-based evidence of potential risks to the animals involved. Even though to become a therapy dog, the dog must pass an evaluation, most evaluations do not take into account disposition. Thus, a dog could become certified as a therapy dog but still become uncomfortable in stressful situations. Therefore, it is important to understand the magnitude of stress therapy dogs may experience during visits and if the amount of visits per month affects the level of stress. In this 4 × 4 Latin square-designed pilot study, four therapy dog teams were randomly assigned to an outpatient nursing unit at Mayo Clinic, Rochester, MN. The therapy dog teams were then randomly assigned to the order of the four treatments. The treatments include: treatment A, two visits a week over the course of four weeks; treatment B, one visit a week over the course of four weeks; treatment C, two visits over the course of four weeks; treatment D, one visit over the course of four weeks. Interestingly, this study noted a dog × time effect. Dog 3, the youngest in the study, had the highest postsalivary cortisol for treatment A, C, and D. When comparing pre and postsalivary cortisol concentrations, only treatment A was significantly different ( P = 0.04). This novel study was the first to assess the frequency of therapy dog visits’ effect on therapy dog salivary cortisol. In comparing baseline to postvisit salivary cortisol concentration, treatment A had a significant reduction in cortisol postvisit. These data suggest that the more frequently, two visits a week, the therapy dog visits, the lower the cortisol concentrations will be. To further evaluate the welfare and potential state of stress in therapy dogs, researchers need to collect additional biological, objective parameters and have visits uniformed and recorded for behavioral analysis.
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Dogs participating in AAT may be positively affected in carefully designed interventions when comparing their state before and after the session.
“Regarding animal welfare, dogs participating in AAT may be even positively affected in interventions that are carefully designed when comparing their state before and after the session [65,66].”
From Effects of dog-assisted therapy in adolescents with eating disorders: A study protocol for a pilot controlled trial (2021) · cites this paper as [66]
The Results and Conclusion (pages unavailable) report lower postvisit cortisol than baseline for dogs visiting twice weekly, consistent with a possible benefit under that visit schedule. But the Conclusion cautions that cortisol alone cannot establish good welfare, and the study does not show that carefully designed interventions generally affect dogs positively. (LLM, conf=0.84)
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Cites
The cortisol awakening response (CAR): Facts and future directions
Fries, E., Dettenborn, L., & Kirschbaum, C. (2009) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2008.03.014 · Cited by 1,188 · see citing works
Animal-Assisted Therapy: A Meta-Analysis
Nimer, J., & Lundahl, B. (2007) · Anthrozoös · doi:10.2752/089279307x224773 · Cited by 712 · see citing works
The effects of animal-assisted therapy on anxiety ratings of hospitalized psychiatric patients
Barker, S. B., & Dawson, K. S. (1998) · Psychiatric Services · doi:10.1176/ps.49.6.797 · Cited by 415 · see citing works
Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions
Glenk, L. (2017) · Animals · doi:10.3390/ani7020007 · Cited by 239 · see citing works
Berget, B., Ekeberg, Ø., & Braastad, B. O. (2008) · Clinical Practice and Epidemiology in Mental Health · doi:10.1186/1745-0179-4-9 · Cited by 184 · see citing works
Patient benefit of dog-assisted interventions in health care: a systematic review
Lundqvist, M., Carlsson, P., Sjödahl, R. I., Theodorsson, E., & Levin, L. (2017) · BMC Complementary and Alternative Medicine · doi:10.1186/s12906-017-1844-7 · Cited by 158 · see citing works
The Effect of Animal-Assisted Therapy on Stress Responses in Hospitalized Children
Tsai, C.-C., Friedmann, E., & Thomas, S. A. (2010) · Anthrozoös · doi:10.2752/175303710x12750451258977 · Cited by 142 · see citing works
McCullough, A. J., Jenkins, M. A., Ruehrdanz, A., Gilmer, M. J., Olson, J., Pawar, A., Holley, L., Sierra-Rivera, S., Linder, D. E., Pichette, D., et al. (2017) · Applied Animal Behaviour Science · doi:10.1016/j.applanim.2017.11.014 · Cited by 111 · see citing works
Welfare considerations in therapy and assistance animals
Serpell, J. A., Coppinger, R., Fine, A. H., & Peralta, J. M. (2010) · Elsevier eBooks · doi:10.1016/b978-0-12-381453-1.10023-6 · Cited by 100 · see citing works
Therapy dogs’ salivary cortisol levels vary during animal-assisted interventions
Glenk, L. M., Kothgassner, O. D., Stetina, B. U., Palme, R., Kepplinger, B., & Baran, H. (2013) · Animal Welfare · doi:10.7120/09627286.22.3.369 · Cited by 86 · see citing works
Animal-Assisted Intervention in Dementia
Nordgren, L., & Engström, G. (2013) · Clinical Nursing Research · doi:10.1177/1054773813492546 · Cited by 81 · see citing works
Stress level evaluation in a dog during animal-assisted therapy in pediatric surgery
Palestrini, C., Calcaterra, V., Cannas, S., Talamonti, Z., Papotti, F., Buttram, D., & Pelizzo, G. (2016) · Journal of Veterinary Behavior · doi:10.1016/j.jveb.2016.09.003 · Cited by 76 · see citing works
Handbook on Animal-Assisted Therapy
(2010) · Elsevier eBooks · doi:10.1016/c2009-0-01976-x · Cited by 73 · see citing works
Behavioral and cardiac responses by dogs to physical human–dog contact
Kühne, F., Hößler, J. C., & Struwe, R. (2014) · Journal of Veterinary Behavior · doi:10.1016/j.jveb.2014.02.006 · Cited by 65 · see citing works
Psychobiological Factors Affecting Cortisol Variability in Human-Dog Dyads
Schöberl, I., Wedl, M., Beetz, A., & Kotrschal, K. M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0170707 · Cited by 53 · see citing works
Humans with Mental Disorders Working with Farm Animals
Berget, B., Skarsaune, I., Ekeberg, Ø., & Braastad, B. O. (2007) · Occupational Therapy in Mental Health · doi:10.1300/j004v23n02_05 · Cited by 52 · see citing works
impact of therapy dog visits on outpatient nurse welfare and job satisfaction
Clark, S. D., Smidt, J. M., & Bauer, B. A. (2018) · Pet Behaviour Science · doi:10.21071/pbs.v0i6.11172 · Cited by 13 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- Venable, E.B., Bland, S.D., Holscher, H.D., Swanson, K.S., 2016. Effects of air travel on the canine microbiome: a pilot study. Int. J. Vet. Health Sci. Res. 4 (6), 132e139.
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- Authors
- Clark, S. D., Smidt, J. M., & Bauer, B. A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Clark, Stephanie D.
- Venue
- Journal of Veterinary Behavior
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 30
- Pages
- 88-91
- ISSN
- 1558-7878 (ISSN-L)
- OpenAlex
- W2904335245
- Cited by
- 49
- References
- 18
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 11 · 2023: 3 · 2022: 8 · 2021: 11 · 2020: 7 · 2019: 3
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Veterinary Behavior (publishedVersion, cc-by-nc-nd)
- Funders
- Georgia Clinical and Translational Science Alliance (UL1-TR002377)
- National Institutes of Health (UL1TR002377)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Human-Animal Interaction Studies
- Health Sciences › Veterinary › Small Animals › Animal Behavior and Welfare Studies
- Health Sciences › Health Professions › Speech and Hearing › Veterinary Practice and Education Studies
- Keywords
- therapy dogs, animal-assisted therapy, salivary cortisol, canine stress, visit frequency, dog welfare, stress biomarkers
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