Middle aged man cuddling with his emotional support dog, dog yawning

Why pet owners are switching to online vet care with Dutch

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Dogs are lovingly known as man’s best friend, providing invaluable companionship and love that can help us feel more at ease in the world. However, some dogs provide support that is so essential to their owner’s daily well-being that it becomes necessary for them to be around their owner most of the time. In some cases, these dogs can be categorized as emotional support animals or ESAs with a letter from a licensed mental health professional.

What Is An Emotional Support Animal?

Emotional support animals are often a vital part of a person’s treatment plan - usually for mental health disorders - but they don’t fall under the same category as service animals, defined as "a dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability."1 While ESAs provide necessary companionship, relieve loneliness, and may even help minimize the effects of depression and/or anxiety symptoms, they aren’t trained in the same way that service dogs are.

The latter receive specialized therapy dog training in order to help a person with a specific set of needs, meaning that they are almost exclusively owned by people with such needs. ESAs are not technically limited to working with people who need support for mental illness symptoms and are therefore not recognized as service animals under the Americans with Disabilities Act. Nevertheless, ESAs still provide very valuable therapeutic services that help their owners - or even others - to cope with otherwise debilitating symptoms from mental health disorders.

Emotional support animals are sometimes referred to as ‘companion animals’ or even ‘therapy animals,’ because they provide necessary and comfort for their owners with acute mental health conditions. Their mere presence is enough to help their owners manage day-to-day symptoms that might otherwise become overwhelming.

ESAs are still considered pets more than anything, so they aren’t allowed in public places. Service dogs, on the other hand, perform essential tasks for their owners, which means they need to stay with them at almost all times, including in public spaces. Both ESAs and service animals are allowed in all housing facilities, as stated in the Fair Housing Act (FHA), even if the building doesn’t normally allow pets.

Unlike service animals, emotional support animals are not legally permitted in public spaces


ESAs or therapy animals are often used in clinical settings to provide additional comfort for individuals in need. This can include schools (a common trend in recent years has been to have therapy dogs visit college students during exam periods in order to help relieve stress2), mental health clinics, nursing homes, hospice care, and hospitals. The animal is qualified enough to provide effective comfort and joy to people in these settings, which means that they have a calm demeanor and ideally, are used to being around people.

Regardless of whether a person has an ESA or a service dog, they, as the handler, are responsible for the care, well-being, and supervision of the animal. Certain types of behaviors are unacceptable for a service dog, such as uncontrollable barking, jumping on strangers or the handler themselves, running away from the handler, and ignoring commands. Businesses reserve the right to deny access to any service animal that exhibits such behaviors.1

The service dog must also be under the direct control of the handler. This is most commonly seen in the form of a harness or leash, but if the handler is unable to use such items due to their disability, the dog must then respond extremely well to the handler’s voice commands or other signals.

Other important responsibilities as a service dog handler include cleaning up after the dog, especially in public places, making sure that the dog is properly vaccinated according to all local and state laws, and should be housebroken.

How To Register Your Dog As An Emotional Support Dog

While there are several types of animals that can be ESAs, the most common (and most widely accepted) are domesticated dogs and cats. There is no restriction on breed type, although some breeds might be better suited as ESAs, due to temperament, physical needs, or size.

The Americans with Disabilities Act (ADA) doesn’t require owners to register their Emotional Support Animal, but the ESA only qualifies as such if it has been prescribed as a necessity by a licensed mental health professional. Some people may still prefer to register their ESAs to make interactions with landlords or other official entities easier.

The ESA letter acts as a type of prescription, stating that the person in question requires an animal (again, usually a dog or a cat) to help alleviate symptoms of mental illness. This can include anything from Generalized Anxiety Disorder to PTSD or phobias. The letter should be printed on the official letterhead of the mental health professional - including licensing information - and the mental health professional should also sign it.

Only a licensed mental healthcare professional can write an ESA letter

What Rights Does ESA Status Grant?

Unlike service animals, emotional support animals are not legally permitted in public spaces. ESAs are nevertheless exempt from ‘no pets’ rules in housing under the Fair Housing Act, and can usually accompany the owner during travel or certain other situations with proper documentation. However, there is no legal requirement for business (including airlines as of January 2021) to permit emotional support animals even if shown official documentation.3

The Fair Housing Act protects tenants with emotional support animals

While the ADA legally permits service animals to accompany a child to school, emotional support animals are rarely allowed. However, this can be determined on a case-by-case basis, particularly in relation to the child’s Individualized Education Plan (IEP) or Section 504 plan.1

Both emotional support dogs and service dogs provide invaluable comfort to their owners. The former is most often used by people suffering from mental health disorders, while the latter is more practical for people with physical disabilities or psychiatric disabilities that present with physically debilitating or potentially hazardous symptoms. At the end of the day, an emotional support animal can provide enough support by simply being around their owner.

Service animals are often an essential part of a person’s everyday life and without the animal, the person is unable to function normally or do normal activities. Service dogs do everything from guiding a visually-impaired person safely around obstacles in public, to alerting a diabetic individual to low blood sugar levels or opening doors for a wheelchair-bound person. The dog has undergone specialized training in order to qualify as a service animal, and is usually only owned by someone who needs help with specific tasks.

According to the Americans with Disabilities Act, "dogs whose sole function is to provide comfort or emotional support do not qualify as service animals under the ADA."1 State laws tend to determine specific rights of emotional support animals to enter public transportation, shops, aircrafts, etc.

Frequently Asked Questions

Can a therapist say no to an ESA letter?

Therapists are well within their right to refuse to write an ESA letter. Hopefully, they have legitimate reasons for doing so, but sometimes this might warrant further inquiry and evidence. Try and provide them with data about the benefits of Emotional Support Animals and if possible, why your specific symptoms would potentially improve with an ESA.

Can you have more than one emotional support animal?

Legally, there is no restriction on the type or number of ESAs, but more than one would be unusual. It’s up to you (and your mental health professional) to decide on the type and number of ESAs you need.

Can my vet write an ESA letter?

No. Vets are not allowed to write an ESA letter, because they aren’t legally qualified to make judgements in regard to a person’s mental health. Vets are there to care for your pet, not you. To obtain an emotional support animal letter, refer to a mental health care professional.

Do ESA letters expire?

According to the United States Department of Housing and Urban Development. ESA letters don’t expire. However, it’s best to always have a current ESA letter.

Small brown and white emotional support dog sitting on elderly woman’s lap, comforting her

Final Notes

Dogs generally offer a lot of comfort in a person’s daily life, in fact, there are many health benefits of pet ownership If you or a loved one is struggling with mental health-related symptoms, it’s possible that an emotional support dog can help. Animals can provide comfort and support during daily life, possibly alleviating acute anxiety, depression or other mental or emotional symptoms.

Whether you already have a dog, whom you would like as your official ESA, or you’re looking to adopt one, there are several factors to consider, as well as numerous benefits. It’s important to consult a licensed mental health professional in order to assess whether an emotional support dog is the right option for you and how it can fit into your treatment plan. Linked below are some mental health resources to guide you in your ESA journey.

Dutch offers convenient pet care and guidance, connecting pet owners with trained veterinary professionals from the comfort of their own homes with unlimited visits and follow ups.

Mental Health Resources

If you or someone you know is experiencing mental health challenges, reach out to a mental health professional and/or use the resources below:



  1. “Service Animals and Emotional Support Animals.” ADA National Network, 22 Mar. 2023, https://adata.org/guide/service-animals-and-emotional-support-animals.

  2. Stephanie Gibeault, MSc. “Therapy Dogs Can Help Relieve Student Stress, Study Shows.” American Kennel Club, American Kennel Club, 10 Apr. 2018, https://www.akc.org/expert-advice/news/therapy-dogs-relieve-student-stress/.

  3. “U.S. Department of Transportation Announces Final Rule on Traveling by Air with Service Animals.” U.S. Department of Transportationhttps://www.transportation.gov/briefing-room/us-department-transportation-announces-final-rule-traveling-air-service-animals.

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Frequently Asked Questions

Who is Dutch?

Dutch is an online veterinary pet telehealth service, created by pet parents and board-certified veterinary specialists. We use a science-backed approach to provide pets relief for their everyday physical and behavioral health issues. Dutch connects you with licensed veterinarians over video chat and messaging to help you get care for your dog or cat quickly wherever you are — without the stress or expense of a vet visit. We also partner with pharmacies who can deliver prescription medication (in applicable states only) and over-the-counter treatments directly to your door. Dutch isn’t a veterinary practice or pharmacy, but a company that helps facilitate these services for pet parents to make veterinary care more accessible to all.

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When booking a video call with a vet, you'll be asked a few questions about your pet’s health issue. Depending on the issue, you may also be asked to fill out a longer questionnaire about their symptoms and share photographs of them so our veterinarians can better understand what’s going on. You’ll then pick an appointment time that works best for you.

During your video call, one of our licensed veterinarians will talk to you about the symptoms your pet is experiencing, ask you questions, review your pet’s medical history if you’ve provided it, and answer any questions you have. The vet will ask to see your pet and their environment. And they may ask you to perform some simple checks on them if needed.

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How much will it cost for Dutch to treat my pet?

The Dutch membership starts at $11/mo for unlimited access to the vet. No more long waits for appointments or surprise bills.

In addition to the base membership plan, our veterinarians may also recommend additional medication (Rx and/or OTC) that you will have the option of adding to your plan at an additional cost.