Attitudes and practices toward feral cats of male and female dog or cat owners and non-owners in Seoul, South Korea.

The number of pet cats in South Korea has sharply increased since 2010. Problems have arisen with feral or stray cats, creating conflict among residents, to such an extent that the government provides some sites for people to offer feeding stations for the stray cats. This study investigated hypotheses on people's attitudes toward feral cats in Seoul, South Korea: (i) dog and cat owners would show more positive attitudes than non-owners toward feral cats; (ii) females would have more positive attitudes toward feral cats than males; (iii) the number of Seoul-provided feeding stations by district would be correlated with people's positive attitudes toward feral cats. Responses from 7,394 participants were used for the final analyses with 3,179 males, 3,607 females, and 599 others (includes "decline to state"). Cat owners reported more extremely positive attitudes toward feral cats than people who had no cats. Females more often had cats than males, and they were more extremely positive toward pet and feral cats than males, and strongly opposed to culling as a management strategy. The attitudes toward feral cats of people with only dogs were intermediate between people with cats and people without pets, more resembling those of people without pets. There was a correlation between the number of city-provided feeding stations and people's attitudes toward feral cats, but only in the areas with at least 40 feeder stations; having many city-provided feeding stations was associated with very negative attitudes to feral cats. Whether the very large number of feeding stations were provided in the two neighborhoods due to a previously excessive number of feral cats in those neighborhoods, vs. those feeding stations attracting or provisioning an ever-growing number of feral cats, is unknown. These results show sharp differences in attitudes between cat owners and non-owners, and between males and females. Results resemble findings in other studies, perhaps with more extreme differences between sub-groups. The study revealed that attitudes toward pet and feral cats in Seoul were complex and varied with pet ownership, with sex, and with neighborhood context.

Development of Two Korean IACUC Guidance Documents to Foster Implementation of the Three Rs.

In Korea, Institutional Animal Care and Use Committees (IACUCs) have been legally required to apply the Three Rs principles (i.e. replacement, reduction and refinement) and undertake the ethical review of animal study protocols, since 2008. According to Korean law, each IACUC is required to appoint at least one lay member recommended by a non-governmental animal protection organisation, who participates in the ethical review process as part of this role. Despite the importance of the Three Rs and the ethical review process, limited information and practical resources are available for IACUC members in the Korean language, particularly for lay members who are inexperienced in animal experimentation. In January 2020, the Animal and Plant Quarantine Agency announced the funding for a six-month research project to develop guidance to assist IACUC members in carrying out effective and efficient protocol reviews in line with Korean legislative requirements. This funding was awarded for the production of two IACUC guidance documents - 'Guide for Animal Study Protocols' and 'Guide for the IACUC Lay Member' - which were published in December 2020. These guidance documents aim to foster the implementation of the Three Rs and provide practical resources for IACUC members, researchers and other relevant personnel. This paper describes the framework for animal use in Korea and the overall production of these two IACUC Guidance Documents.

Decision-Making on Recommended Age of Spay/Neuter for a Specific Dog: General Principles and Cultural Complexities.

Many dogs and cats were euthanized in US animal shelters through the 1940s, sharply declining in the 1980s. Early age neutering of young cats and dogs grew frequent in the 1990s; adoptions from shelters increased, leading to a decline in shelter euthanasia of dogs. Several publications, beginning in 2013, revealed heightened risks of joint disorders and some cancers for some dog breeds when neutered at young ages. These risks are breed-, gender-, and body-size specific and related to neutering age. Current guidelines suggest making a personalized decision for each dog's neutering age. Recommendations are presented for 40 breeds and mixed-breed weight classes.

Understanding Job Satisfaction and Occupational Stressors of Distinctive Roles in Zoos and Aquariums.

For professionals caring for humans or non-human animals, many joys are to be found in working towards what an individual believes to be their calling, especially as they contribute to purposeful, meaningful work consistent with and intrinsic to their own values and beliefs. However, there can be downfalls. Empathic strain, conflict between co-workers, dissatisfaction with upper management, lack of opportunities to make positive changes, limited or no access to level and experience-appropriate professional development, and other stressors are all risks carried by organisations concerned with animal welfare. In the present study, a survey on job satisfaction and workplace stressors was completed by 311 zoo and aquarium professionals working in a range of roles from junior animal care staff to curator. Respondent profiles were created using Multiple Correspondence Analysis (MCA) and four distinct clusters were identified through Hierarchical Clustering on Principal Components (HCPC), highlighting common themes in different levels of experience and in job roles regarding stressors, satisfaction, and feelings about their work and workplaces. Overall, many zoo professionals were concerned with lacking the ability to feel empowered to do their best for animal welfare, and they described a link between the staff welfare and their perceptions of the welfare of the animals they cared for. Through identifying and understanding where organisations can better support their staff it is possible to target and reduce the number of common stressors faced by zoo professionals, leading to increased staff retention, higher job satisfaction, and an improved ability to perform at their best for animal welfare.

Flehmen, Osteophagia, and Other Behaviors of Giraffes (Giraffa giraffa angolensis): Vomeronasal Organ Adaptation.

The size of adult male giraffes (Giraffa giraffa angolensis) far exceeds the size of the females. At the Namutoni waterholes in Etosha National Park, bulls were seen many times each day screening adult females for their pending sexual receptivity by provoking them to urinate; this mainly involved sniffing their genitalia. If the female accedes to the male's invitation, she widens her hindleg stance, braces her body, and then urinates, usually for at least five seconds. The male places his muzzle and tongue in the urine stream, and then performs flehmen, often raising his head high in the air. Males never investigated urine on the ground. The bilateral papillae on the giraffe's hard palate connect with the nasopalatine ducts, which enter the bilateral vomeronasal organ (VNO). Unlike many mammals, the giraffe's VNO lacks a prominent connection to the nasal cavity and its connections to the oral cavity are primarily via the incisive papillae. Most days, some giraffes were observed searching for bones for extended periods, chewing them, and sometimes being troubled by a bone stuck in their mouth. A giraffe killed by lions was frequented for several days by a procession of giraffes investigating the carcass. A very dark-colored bull giraffe emitted loud pulsed growls that drove off most of the surrounding giraffes.

Psychological implications of humane endings on the veterinary profession.

The veterinary profession has a unique responsibility to animals during the final stages of their lives. The veterinarian's obligations extend to humane endings, involving all species of animals in a range of circumstances including, but not limited to, euthanasia of individually owned animals, euthanasia of animals for research purposes, depopulation of animals during emergencies, and slaughter of animals raised for food. The veterinary profession continues to improve animal welfare through advances in end-of-life decision-making and humane killing techniques,1-3 but the psychological impacts on veterinarians have not received the same level of consideration. Building on the influential AVMA Humane Endings Guideline, the AVMA recognizes that support for the mental health of veterinarians engaged in such activities needs to be a priority. This article aims to provide the foundation and rationale for improved preparation and establishment of sustainable mental health resources and to offer recommendations on pragmatic solutions to support and prepare veterinary professionals as leaders impacted by participation in humane endings-related activities. While end-of-life decision-making and implementation may present mental health challenges to veterinarians, it is crucial to recognize that there are stressors specific to each situation and that every individual's experience is valid. Addressing the mental health issues surrounding the decision-making process and implementation of humane endings activities start with a comprehensive understanding of each activity's unique context and the veterinarian's leadership role. Therefore, this article highlights the psychological impact of depopulation and its similarities and exclusive challenges compared with euthanasia and humane slaughter.

Assessing the Relationship Between Emotional States of Dogs and Their Human Handlers, Using Simultaneous Behavioral and Cardiac Measures.

Negative stress due to human handling has been reported for a number of domestic animals, including dogs. Many companion dogs display significant stress during routine care in the veterinary clinic, risking injury to staff and potentially compromising the quality of care that these dogs receive. On the other hand, positive interactions with humans can have a beneficial effect on dogs, particularly in stressful situations such as animal shelters. Research has shown that dogs can detect human emotions through visual, auditory, and chemical channels, and that dogs will exhibit emotional contagion, particularly with familiar humans. This study investigated relationships between emotional states of dogs and unfamiliar human handlers, using simultaneous measures of cardiac activity and behavior, during two sessions of three consecutive routine handling sets. Measures of cardiac activity included mean heart rate (HRmean), and two measures of heart rate variability (HRV): the root mean square of successive differences between normal heartbeats (RMSSD); and the high frequency absolute power component of HRV, log transformed (HFlog). We also assessed human handlers' emotional state during handling sessions following an intervention designed to reduce stress, compared with sessions conducted on a different day and following a control activity. Polar H10 cardiac sensors were used to simultaneously record cardiac activity for both canine and human participants, and behavioral data were collected via digital video. The strongest influence on the dogs' stress levels in our study was found to be increasing familiarity with the setting and the handler; HRmean and SI decreased, and HRV (as RMSSD) increased, significantly from the first to the third handling set. Canine HRV (as HFlog) was also highest in set 3, although the difference was not statistically significant. There were no strong patterns found in the human cardiac data across handling set, session, or by pre-handling activity. We did not find consistent support for emotional contagion between the dogs and their handlers in this study, perhaps due to the brief time that the dogs spent with the handlers. Recommendations for application to dog handling, and limitations of our methods, are described.

Companion Animals' Roles for AIDS Survivors, Mostly Aging Males, during HIV/AIDS and COVID-19 Pandemics.

Long-term HIV/AIDS survivors responded online concerning their experiences during the AIDS and COVID pandemics. Recruited from web-based organizations for AIDS survivors, 147 answered questions on: frequency of experiencing stigma, isolation, aloneness, or grief/sadness; pet ownership; and sources of human support during each pandemic. Conditional inference trees were run to identify relevant demographic factors. Post-hoc comparisons were conducted to compare dog owners and cat owners. AIDS survivors reported more frequent feelings of stigma, aloneness, and sadness/grief during the AIDS pandemic than during COVID. Cat owners' sadness/grief during AIDS was greater than non-owners. During COVID, older respondents unexpectedly were less often sad/grieving than younger ones; dog owners less often felt alone and isolated than non-dog owners. Support during the AIDS pandemic retrospectively was rated better for older respondents; young gays' support was greater than young straights. During COVID, support was better for men than women. Contrastingly, women with pets felt less support than those without; men with dogs felt more support than those without. Cat owners more often felt isolated and unsupported during COVID than dog owners. Few dog or cat owners received support from family members in either pandemic; during AIDS, family support was better for owners of dogs than cats.

Animal Tourism: Thai Caregivers' Perspectives on Their Relationships with Elephants and Tigers.

This study explored the perspectives of elephant mahouts (n = 55) and tiger caregivers (n = 18) working in 4 private or 2 government facilities in Thailand to learn their experiences and viewpoints pertaining to use of animals in tourism. Interviews were conducted in Thailand at facilities in four cities. Mahouts working in private tourism facilities used one-to-one management and were significantly younger and more poorly compensated than those working at government-funded zoos, where some had shifted to group management. Tiger caregivers in tourism had direct contact with young tigers, with group management; these caregivers also were significantly younger than in government zoos, and with fewer benefits. Mahouts and tiger caregivers differed in how they viewed their relationships with their animals. Most mahouts considered their elephants as family members; a slight majority of these questioned the ethics of use of elephants in tourism. Tiger caregivers classified tigers as family or friend equally often; one-third of tiger caregivers declined answering on their approval of using tigers in tourism. What to do with aging tigers is a problem; this may explain some tiger caregivers' reticence to answer questions about using young tigers in tourism. While solving some problems, animal tourism creates several challenges.

Comparative Assessment of Heart Rate Variability Obtained via Ambulatory ECG and Polar Heart Rate Monitors in Healthy Cats: A Pilot Study.

Chronic exposure to stressful environments can negatively impact cats' health and welfare, affecting behavioral, autonomic, endocrine, and immune function, as with cats in shelters. Low-stress handling practices likely improve shelter cat welfare, but data supporting improved outcomes remain limited. Cardiac activity, particularly heart rate variability (HRV), is an indicator of stress and emotional state in humans and non-human animals, tracking important body functions associated with stress responsiveness, environmental adaptability, mental, and physical health. HRV studies in cats are limited, involving mainly anesthetized or restrained cats. This pilot study tested the feasibility of obtaining HRV data from unrestrained cats, using a commercially available cardiac monitoring system (Polar H10 with chest strap), compared with data from a traditional ambulatory electrocardiogram. Simultaneous data for the two systems were obtained for five adult cats. Overall, the Polar H10 monitor assessments of HRV were lower than the true HRV assessment by ambulatory ECG, except for SDNN. Correlation between the two systems was weak. Possible reasons for the lack of agreement between the two methods are discussed. At this time, our results do not support the use of Polar H10 heart rate monitors for studies of HRV in cats.

Stress-Related Behaviors in Companion Dogs Exposed to Common Household Noises, and Owners' Interpretations of Their Dogs' Behaviors.

Sudden, loud noises are one of the most common triggers for fearful behaviors in dogs, and many companion dogs suffer from noise sensitivity. Existing research focuses on dramatic infrequent sounds (e.g., thunderstorms, fireworks). Anecdotally, and based on reports of undesirable behaviors in response to noises in the home, many common household noises may also be causing fear and anxiety in companion dogs. However, these responses have not yet been studied in home environments. We surveyed 386 dog owners about their dogs' responses to household sounds, and recorded dog behaviors and human reactions from 62 videos and compilations available on an online video sharing platform, featuring dogs reacting to common household noises. Numerous signs of canine fear and anxiety were reported by survey respondents and observed in the videos, in response to both daily, and irregular but "normal," household noises. Responses were significantly stronger to sounds characterized as high frequency intermittent than to sounds characterized as low frequency continuous. Respondents appeared to underestimate their dogs' fearfulness, and the majority of humans in the videos responded to their dogs' behaviors with amusement; welfare concerns were rarely expressed. While these videos cannot be used to calculate actual prevalence of these issues, our data support that some owners are underestimating fearfulness in their dogs in response to household noises, and responding inappropriately to dogs' expressions of fear and anxiety. Better education is required for dog owners to accurately interpret canine body language, to both safeguard dogs' welfare and minimize development of anxiety-related behavior problems.

How Does the Social Grouping of Animals in Nature Protect Against Sickness? A Perspective.

Sickness behavior is broadly represented in vertebrates, usually in association with the fever response in response to acute infections. The reactions to sickness behavior in a group member or potential group member in humans is quite variable, depending upon circumstances. In animals, the reactions to sickness behavior in a group member or potential group member evoke a specific response that reflects the species-specific lifestyle. Groups of animals can employ varied strategies to reduce or address exposure to sickness. Most of these have scarcely been studied in nature from a disease perspective: (1) adjusting exposure to sick conspecifics or contaminated areas; (2) caring for a sick group member; (3) peripheralization and agonistic behaviors to strange non-group conspecifics; and (4) using special strategies at parturition when newborn are healthy but vulnerable. Unexplored in this regard is infanticide, where newborn that are born with very little immunity until they receive antibody-rich colostrum, could be a target of maternal infanticide if they manifest signs of sickness and could be infectious to littermates. The strategies used by different species are highly specific and dependent upon the particular circumstances. What is needed is a more general awareness and consideration of the possibilities that avoiding or adapting to sickness behavior may be driving some social behaviors of animals in nature.

Characteristics of Plant Eating in Domestic Cats.

Plant eating by domestic cats is of interest to veterinarians and cat owners, especially with the current trend to keep cats totally indoors. Feline grass gardens are commonly provided to such cats as a reflection of cat owners believing in the need or desire of cats for eating plants. Two surveys with 1000 to 2000 returns from cat owners were launched over 10 years to test different hypotheses regarding plant eating. These hypotheses are that plant eating: (1) is a response to the cat feeling ill; (2) induces vomiting; (3) is a means of expelling hair balls from consumed hair. Additionally, a perspective acquired from observations of wild felids is that plant eating reflects an innate predisposition acquired from the ancestral cat. In this study, very few cats showed signs of illness before eating plants. However, 27 to 37 percent of cats, respectively in the two surveys, frequently vomited after eating plants, indicating that gastrointestinal disturbance may be related to vomiting in some cats. Young cats consumed plants more frequently than older cats and appeared ill and vomited less frequently in association with plant eating. Short-haired cats ate plants as frequently as long-haired cats, arguing against the hairball expelling hypothesis. Some guidelines for cat owners with indoor cats are provided.

An Ancient Practice but a New Paradigm: Personal Choice for the Age to Spay or Neuter a Dog.

Extensive practice and knowledge of the methods and effects of castration of male livestock and even humans has been widespread since ancient times, but only a few decades ago did neutering (including spaying) become a routine part of canine husbandry. In the US, the 6-month neuter became standard practice. Only recently, however, have some of the consequences of this major physiological alteration become evident. As the data-based study on 35 breeds reveals, there are major breed differences associated with effects of neutering, especially with early neutering, including increased risks of joint disorders and some cancers. The study of mixed-breed dogs reveals that the risk of joint disorders is increased in the large dogs. Implications of breed-specific and sex-specific effects for age of neutering have prompted the consideration of a new paradigm with regard to this practice. This involves focusing on each individual dog when deciding upon the appropriate age of neutering to avoid increasing the risk of a joint disorder or cancer above that inherent for the breed. For many breeds, particularly the smaller dogs, no effects were found for the age of neutering on joint disorders and the cancers followed. In these cases, the caregiver has a wide range of choice for neutering without increasing the dog's risk for these diseases. In the future, additional research may reveal more about other increased risks for age-related cognitive dysfunction or elevated levels of luteinizing hormone caused by gonad removal, and lead to revised guidelines.

Introducing Clinical Behavioral Medicine to Veterinary Students with Real Clients and Pets: A Required Class Activity and an Optional Workshop.

Addressing behavior problems in clinical practice requires diagnostic expertise as well as excellent client skills in communication, gained by experience. This issue was addressed by introducing clinical behavior to first-year veterinary students. The program was implemented over four successive terms (2017-2019) at St. George's University School of Veterinary Medicine. The clinical practice hour was introduced after a brief first-year clinical behavior course (7 lectures). Students were divided into 6-8 person teams. In a class demonstration with a student and his/her dog having behavior problems, two students served as clinicians; a third student, as a scribe, recorded case details. They discussed signalment, history, presenting problems, and possible treatment approaches for 25 minutes; then, the class divided into the assigned teams to develop their specific treatment plans and write up and submit team case reports. During each term, the student Animal Welfare and Behavior Committee organized an optional behavior workshop (enrollment was 24 veterinary students from years 1 through 3). Participation in the workshop included an introductory session and two clinical sessions. Four dog and/or cat cases were scheduled for each of the two sessions. Six students addressed each case: three students were lead clinicians. Workshop evenings concluded with a discussion of all cases. Students were presented a certificate of completion. Students gained early experience in clinical communication, behavior problems, and case write-ups. The abundance of students' pets with behavior problems made this a context that simplified recruiting real cases, but variations could be adapted as appropriate in other communities.

Assisting Decision-Making on Age of Neutering for Mixed Breed Dogs of Five Weight Categories: Associated Joint Disorders and Cancers.

The early neutering of male and female dogs and its relationship to an increased risk of joint disorders and some cancers has recently become a concern, raising questions about the standard practice in the U.S. and much of Europe of neutering by 6 months of age. A noteworthy recent finding from this center is that there are major breed differences with small-dog breeds generally showing little vulnerability to neutering compared with breeds of larger body size. These findings on purebreds raise questions for dog owners and veterinarians about mixed-breed dogs. The purpose of this study was to examine a sample of mixed breed dogs of five weight categories using the same veterinary hospital database and diagnostic criteria for joint disorders and cancers as used in the newly published paper on 35 breeds and previous papers on the Golden Retriever, Labrador Retriever, and German Shepherd Dog. The weight categories were <10 kg (739 cases), 10-19 kg (546 cases), 20-29 kg (992 cases), 30-39 kg (604 cases), and over 40 kg (258 cases). Males and females were analyzed separately, as were various ages at neutering. The joint disorders examined were hip dysplasia, cranial cruciate ligament tear or rupture, and elbow dysplasia. The cancers were lymphoma, mast cell tumor, hemangiosarcoma, and osteosarcoma. There was no significant increased occurrence of one or more cancers, compared with intact dogs, in any weight category. However, in the three categories of dogs weighing 20 kg or more, neutering before 1 year generally was significantly associated with risks of one or more joint disorders above that of dogs left intact, commonly to 3 times the level of intact dogs, with sex differences in the degrees of joint disorders associated with neutering. For the dogs in the two weight categories <20 kg, no increased risks were found for joint disorders. This information can be useful to dog caregivers in deciding on the age at which to neuter specific dogs, and for veterinarians offering guidance to pet owners.

Assisting Decision-Making on Age of Neutering for 35 Breeds of Dogs: Associated Joint Disorders, Cancers, and Urinary Incontinence.

Neutering (including spaying) of male and female dogs in the first year after birth has become routine in the U.S. and much of Europe, but recent research reveals that for some dog breeds, neutering may be associated with increased risks of debilitating joint disorders and some cancers, complicating pet owners' decisions on neutering. The joint disorders include hip dysplasia, cranial cruciate ligament tear or rupture, and elbow dysplasia. The cancers include lymphoma, mast cell tumor, hemangiosarcoma, and osteosarcoma. In previous studies on the Golden Retriever, Labrador Retriever and German Shepherd Dog, neutering before a year of age was associated with increased risks of one or more joint disorders, 2-4 times that of intact dogs. The increase was particularly seen with dogs neutered by 6 months of age. In female Golden Retrievers, there was an increase in one or more of the cancers followed to about 2-4 times that of intact females with neutering at any age. The goal of the present study was to expand and use the same data collection and analyses to cover an additional 29 breeds, plus three varieties of Poodles. There were major breed differences in vulnerability to neutering, both with regard to joint disorders and cancers. In most cases, the caregiver can choose the age of neutering without increasing the risks of these joint disorders or cancers. Small-dog breeds seemed to have no increased risks of joint disorders associated with neutering, and in only two small breeds (Boston Terrier and Shih Tzu) was there a significant increase in cancers. To assist pet owners and veterinarians in deciding on the age of neutering a specific dog, guidelines that avoid increasing the risks of a dog acquiring these joint disorders or cancers are laid out for neutering ages on a breed-by-breed and sex basis.

Contagious Yawning in African Elephants (Loxodonta africana): Responses to Other Elephants and Familiar Humans.

While spontaneous yawning is common across all vertebrate classes, contagious yawning is less common and has been observed only in a few species of social animals. Interspecific contagious yawning in response to yawning by humans has been observed only by chimpanzees and dogs. After confirming additional occurrences of intraspecific contagious yawning in a group of captive African elephants previously studied, we further investigated the potential for the same group of elephants to engage in interspecific contagious yawning with familiar human handlers. Ten captive African elephants, most of whom had been previously studied, were observed over 13 nights for evidence of intraspecific contagious yawning. Seven of these elephants were also involved in trials where familiar handlers performed staged yawns, as well as trials with staged non-yawning gapes, or trials with no yawns or gapes. Incorporating previously collected contagious yawning data, we describe nine instances of intraspecific contagious yawning in the elephants. Three of the seven elephants yawned contagiously in response to humans during the interspecific yawning trials. This is the first report of interspecific contagious yawning by elephants in response to yawns by familiar humans.

Geographic Availability of Assistance Dogs: Dogs Placed in 2013-2014 by ADI- or IGDF-Accredited or Candidate Facilities in the United States and Canada, and Non-accredited U.S. Facilities.

Assistance dogs' roles have diversified to support people with various disabilities, especially in the U.S. Data presented here are from the U.S. and Canada non-profit facilities (including both accredited and candidate members that fulfilled partial requirements: all here termed "accredited") of Assistance Dogs International (ADI) and the International Guide Dog Federation (IGDF), and from non-accredited U.S. assistance dog training facilities, on the numbers and types of dogs they placed in 2013 and 2014 with persons who have disabilities. ADI categories of assistance dogs are for guide, hearing, and service (including for assistance with mobility, autism, psychiatric, diabetes, seizure disabilities). Accredited facilities in 28 states and 3 provinces responded; accredited non-responding facilities were in 22 states and 1 province (some in states/provinces with responding accredited facilities). Non-accredited facilities in 16 states responded. U.S./Canada responding accredited facilities (55 of 96: 57%) placed 2,374 dogs; non-accredited U.S. facilities (22 of 133: 16.5%) placed 797 dogs. Accredited facilities placed similar numbers of dogs for guiding (n = 918) or mobility (n = 943), but many more facilities placed mobility service dogs than guide dogs. Autism service dogs were third most for accredited (n = 205 placements) and U.S. non-accredited (n = 72) facilities. Psychiatric service dogs were fourth most common in accredited placements (n = 119) and accounted for most placements (n = 526) in non-accredited facilities. Other accredited placements were for: hearing (n = 109); diabetic alert (n = 69), and seizure response (n = 11). Responding non-accredited facilities placed 17 hearing dogs, 30 diabetic alert dogs, and 18 seizure response dogs. Non-accredited facilities placed many dogs for psychiatric assistance, often for veterans, but ADI accreditation is required for veterans to have financial reimbursement. Twenty states and several provinces had no responding facilities; 17 of these states had no accredited facilities. In regions lacking facilities, some people with disabilities may find it inconvenient living far from any supportive facility, even if travel costs are provided. Despite accelerated U.S./Canada placements, access to well-trained assistance dogs continues to be limited and inconvenient for many people with disabilities, and the numerous sources of expensive, poorly trained dogs add confusion for potential handlers.