There’s no denying 2020 was a bad year, but for Denver’s Kate Zerbi it was a living nightmare. She kicked off 2020 with a new diagnosis of multiple sclerosis (MS) and a painful breakup, and things got only worse from there.

First, she had a near-fatal case of COVID-19 with long-term health impacts. Later, flesh-eating bacteria entered her body through a microscopic cut she didn’t even know she had. “It was high up in my groin, so there was nothing to amputate to stop the spread. Either the antibiotics were going to work, or I was going to die,” Zerbi says.

Little did she know that Scout, the German shepherd puppy she got in February of 2020, would become her emotional support animal (ESA) and, she says, “the reason I didn’t give up.”

At night, when panic would set in, Scout became Zerbi’s security blanket. And during the day, Scout senses when Zerbi is about to lose her balance or buckle over in pain. The dog runs to her owner’s side before it happens to provide physical or emotional support.

More Than Just a Pet

The American Kennel Club describes ESAs as pets that provide daily emotional support and comfort to their owners. By that definition, it would seem that most pets — even the unconditional ones — could be ESAs. But an ESA is different from a much-loved pet who brings you joy.

“A true emotional support animal has the ability demonstrate compassion when you’re in need. For example, if you’re crying with your face in your hands, the dog will come over to you and lick your hands and face as if to say, ‘Hey, pay attention to me. Let me love you and take care of you,’” says Lauri Frenkel, founder of A Pet’s Purpose in Georgia. The nonprofit rescues and places animals with the potential to be service dogs, therapy dogs, or emotional support animals.

“There are a lot of dogs that make wonderful family pets, but they might not notice if you have a panic attack while they’re enjoying a new squeaky toy or bone,” Frenkel says.


Emotional Support Animals, Service Animals, and Therapy Dogs

Many people don’t realize that emotional support animals, service animals, and therapy dogs have different roles. However, they can all benefit people with MS.

Emotional support animals: An ESA should provide comfort in ways that align with your specific needs, Frenkel says. If you have MS, an emotional support dog who’s in tune with you may also provide physical assistance. For example, they can act as a brace when you have mobility or balance issues.

Even so, your ESA can’t always join you wherever you go — even if you have a doctor’s note stating your need for such an animal. Federal law doesn’t require businesses, including stores and restaurants, to let them in. The one exception: Housing. Under the Fair Housing Act, you can live with an emotional support animal in places that are otherwise not pet-friendly.

You used to be able to fly with your ESA in the aircraft cabin. That changed in late 2020, when the U.S. Department of Transportation announced changes to some rules and definitions in its Air Carrier Access Act. Now airlines can recognize emotional support animals as pets. And pets often fly in the cargo hold.

Therapy dogs. The goal of pet therapy is to provide comfort and companionship to others, especially patients, caregivers, and staff in health care facilities. Most any breed can be trained to do this job. Nonprofit groups such as Therapy Dogs International evaluate and certify therapy dogs based on their obedience and temperament.

Why might you want to sign your dog up or volunteer with an organization that helps train them if you have MS? One overarching reason is that it can help address some of the physical and emotional challenges of life with this disease. Research links volunteering with:

  • Increased physical activity
  • Optimism
  • Sense of purpose
  • Social connection
  • Fewer depressive symptoms
  • Less hopelessness

Service dogs. Service dogs are trained to perform specific tasks that help you live more independently with a disability. These aren’t standard obedience tasks like sit and stay. They must be directly related to your disability. If you have MS, a mobility dog can pull a wheelchair or provide physical support (such as bracing) for your balance issues.


Unlike ESAs and therapy dogs, service dogs can go just about any place their owners go. However, if your service animal barks or growls at other people, a business can legally tell you to leave. And you must comply.

You can get a trained service dog from a number of nonprofit and for-profit organizations, but they often come at a high price: in some cases, upward of $25,000. Some charge much less, but Frenkel says many people with disabilities are dismayed by both the cost and the wait to receive a service dog.

How to Train an ESA for MS

If you have MS, you may not need a professionally trained service animal. Perhaps you need an emotional support animal, or an emotional support animal who also happens to be a sturdy and calm enough to lean on when you feel wobbly.

To get one of these special dogs, you can seek out an organization like A Pet’s Purpose or hire a dog trainer to work with you and your current dog or a new one. “It’s still expensive, but a few thousand dollars for a private trainer is a lot less than $20,000 for an assistance animal,” Frenkel says.

She doesn’t recommend training a dog yourself, but some people, including Zerbi, do just that.

“I’m teaching Scout obedience commands and she’s learning how to differentiate objects,” Zerbi says. “In time I’d like her to be able to get me my inhaler and pick up a hairbrush or towel from the floor, plus any other things I think could be useful as my disease progresses.”

WebMD Feature



Kate Zerbi, MS patient, Denver.

Lauri Frenkel, founder, A Pet’s Purpose, Madison, GA.

American Kennel Club: “Everything You Need to Know About Emotional Support Animals,” “Service Dogs 101 — Everything You Need to Know.”

U.S. Department of Transportation: “Traveling by Air with Service Animals.”

Humane Society: “Travel safely with your pet by car, airplane, ship or train.”

Therapy Dogs International: “Therapy Dogs International (TDI ).”

American Journal of Preventive Medicine: “Volunteering and Subsequent Health and Well-Being in Older Adults: An Outcome-Wide Longitudinal Approach.”

U.S. Department of Justice: “Commonly Asked Questions About Service Animals in Places of Business.”

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