1. There does not appear to be a Table 2, but it is referenced in the text (page 7).

Response: It seems there may have been some confusion regarding Table 2, which is referenced in the text. I’d like to clarify that Table 2 is indeed included in the manuscript.

2. In the Discussion section on page 15, a reference is made to effect sizes in four outcome areas, yet no effect sizes were reviewed in the article.

Response: Thank you for bringing this to our attention; we have corrected the mistake in the updated manuscript.

3. Also in the Discussion on page 15, the word “power” is used: “The increased number of studies provided greater power in assessing variance heterogeneity and potential group differences.” Unless a specific power analysis was performed (if so, it should be discussed), the word “power” could be changed to “support” to reflect a review rather than an analysis.

Response: Thank you for your suggestion. We have replaced the word “power” with “support” as per your suggestion to better align with the sentence.

Similarly, on page 16, the term “meta-analysis” is used. Unless a secondary analysis of pooled data was performed, the term “meta-analysis” should be changed to “analysis.” If a secondary pooled analysis was performed, that should be defined and described in the body of the paper.

Response: Thank you for your observation, and I apologize for any confusion. I want to clarify that a secondary pooled analysis was indeed conducted as part of the study, and it has been appropriately defined and described in the body of the paper.

4. Page 16, Society for Healthcare Epidemiology of America is noted as an organization of interest for animal-assisted therapy, as is Pet Partners. The authors may want to consider including the global organization called International Association of Human-Animal Interaction.

Response: Thank you for your insightful suggestion. We included the International Association of Human-Animal Interaction in the updated manuscript.

5. On page 17, the authors cite lack of blinding as a limitation and introduction of bias. I would be curious to know how the authors propose blinding in studies that involve interactions with animals. I strongly suggest this sentence be removed.

Response: Thank you for your suggestion. We have removed the sentence citing the lack of blinding as a limitation and the potential introduction of bias from the updated manuscript

6. The work done by Hinic and others [3] was not a randomized controlled study as noted in Table 1. Please double-check that all studies listed are correctly labeled as randomized studies.

Response: Thank you for bringing this to our attention. We have reviewed the studies listed in Table 1 and have corrected the labeling of the work by Hinic and others [3] to accurately reflect that it was not a randomized controlled study.

7. Check punctuation for spacing.

Response: Thank you for your suggestion. We have reviewed and corrected punctuation for spacing in the updated manuscript.

8. Check all abbreviations and use abbreviations after first use is defined.

Response: Thank you for your guidance. We have carefully reviewed all abbreviations in the manuscript and ensured that they are defined upon their first use.

9. Check capitalizations in midsentence (page 4: “Dog”; page 7: “Unrepresentative”).

Response: We appreciate your attention to detail. Capitalization issues have been addressed and corrected in the updated manuscript.

10. Page 6: “The articles should to be published in English.” Wrong tense—change to “were.”

Response: Thank you for pointing out the tense issue. We have made the necessary correction in the updated manuscript.

11. Page 1: Three categories of interventions were provided in section 2.4. It would strengthen the paper to include definitions of these categories for the reader.

Response: Thank you for your constructive feedback. We have incorporated definitions for the three categories of interventions mentioned.