A requiem for Pixie the therapy dog

In 2017 Pixie was an 8-year-old, well-padded, disciplined, loving therapy dog; a Shih Tzu Cairn Terrier mix who would visit us each week for about an hour. It became a ritual: my wife’s caregivers and I would arrange chairs so Pixie and her master could sit next to Bess, my wife, who was then in the haze of her dementia. It took her a few minutes to recognize her pet visitor. We were all excited to rub Pixie’s tummy and she usually responded by putting her head on Bess’s arm or in her lap. Bess smiled and gently stroked Pixie’s back, but then she would drift off to who knows where, eyes closed, but with her hands still on the dog. We talked to Pixie, who responded with little yelps that brought Bess back to the present, and again she would rub Pixie’s back. That seemed to make Pixie happy, and she would snuggle closer to Bess. We also had treats for Pixie, which she chewed with excitement, followed by licks for Bess’s arm as if to thank her. Bess passed in and out of being here while we chattered amongst ourselves, stroked the little dog’s back, and applauded when Bess opened her eyes and ran her hand through Pixie’s soft hair.

Pixie was a member of the St. John Ambulance Therapy Dog program, trained to interact with a variety of people. This is distinct from assistance dogs, which are trained to assist a specific person with physical needs. 

The use of dogs for therapeutic purposes goes back to the late 1800s. Florence Nightingale used pets to reduce anxiety in children who were in psychiatric institutions. Sigmund Freud used his pet dog in the 1930s to improve communication with his patients. In 1976 Elaine Smith, a registered nurse working in a hospital, established the first formal therapy dog organization. In recent years several universities have established a therapy dog presence to help students with exam-related stress.

Most studies have been inadequate to clearly demonstrate what specific psychological or physiological benefits are provided to those suffering from dementia or mental health issues by regularly visiting with pets. Petting animals does tend to lower blood pressure, and the release of mood-elevating serotonin, prolactin, and oxytocin have been detected. Bedside clinical evidence suggests that interactions with animals benefit patients with anxiety or depression, and contribute to socialization with staff. 

In November 2021, the then 12-year-old Pixie, long suffering from complications of severe congestive heart failure, passed away. She was mercifully euthanized and her body was donated to a local veterinary college. During her life she brought joy to her clients; in her afterlife she will contribute to research and teaching veterinary students.  

My wife passed away in November 2021 as well. It took 9 years for her relentless and deep dementia to run its course. The end was merciful; she simply didn’t wake up. It would be wonderful if, like in a fairy tale, she and Pixie met again wherever the two of them are now. 
—George Szasz, CM, MD

Suggested reading
Deaf Dogs Rock. 10 colleges with successful pet therapy programs. Accessed 15 December 2021. https://deafdogsrock.com/10-colleges-with-successful-pet-therapy-programs.

Ernst L. Animal-assisted therapy: An exploration of its history, healing benefits, and how skilled nursing facilities can set up programs. Accessed 15 December 2021. www.researchgate.net/publication/305467700_Animal-assisted_therapy_An_exploration_of_its_history_healing_benefits_and_how_skilled_nursing_facilities_can_set_up_programs

Richeson NE. Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia. Am J Alzheimers Dis Other Demen 2003;18:353-358. 

UCLA Health. Animal-assisted therapy research. Accessed 15 December 2021. www.uclahealth.org/pac/animal-assisted-therapy.

This post has not been peer reviewed by the BCMJ Editorial Board.

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