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ANAL SACS IN DOGS AND CATS
by T J Dunn, DVM
First published in Dog World Magazine
Anal sacs are often also called
anal glands even though they technically are not truly glandular in
structure. Few topics raise dog owners’ eyebrows (and lower dogs’ tails)
faster than the subject of anal sacs! These two small repositories of foul smelling material technically
are small pouches lined with cells whose job it is to continually produce an
oily semi-liquid substance that is stored within the sac. It accumulates
the heck are they for?’ For a credible response I draw on my extensive
knowledge of comparative anatomy, pathology, microbiology and biochemistry and
respond, “I have no idea”.
A typical examination of a patient
with anal sac disease (usually an impaction or infection) hoes like this...
"You think it’s his what?” asked the incredulous owner of the uncomfortable
Basset Hound on the exam table. I restated my diagnosis, knowing the owner
probably never heard the term anal sacs before.
“Barkley has an anal sac infection. See how swollen and inflamed it is
next to his anus. In fact the abscess is nearly ready to break through to
the surface of the skin. We’ll need to open this abscess and allow the
infection to drain, and then we’ll flush it, check the other anal sac, and send
him home on antibiotics. Warm compresses for a few days will speed up the
healing, too.”
WHAT ARE THEY
Anal sacs are small paired pockets located
between the internal and external anal sphincter muscles, one on each side of
the anus at the 4 and 8 o’clock position. The sac empties through a short and
narrow duct to the surface near the inside edge of the anus.
Each sac is lined with abundant sebaceous (oil) glands and numerous apocrine
(sweat) glands. The secreted substance is a semi-oily, brownish fluid that packs an odor strong enough to gag a maggot! For unknown reasons some
dogs' anal sacs produce a rather thick, semi-solid material which is much more
prone to impacting the sac due to the sac's inability to pass this semi-solid
material through the narrow duct to the outside. In many of these cases
the sac will become infected, cause pain and inflammation and even break through
to the skin surface. The abscessed anal sac may need surgery to provide
drainage and curettage of the damaged and infected sac and surrounding tissue.
Antibiotics are indicated in abscessed anal sac disease.
WHAT THEY DO
One study indicated that anal sac disorders
affects about 12% of dogs. There are a number of theories why dogs, cats,
skunks, and other mammals have anal sacs and what possible use they may have.
One theory states that anal sac contents, when excreted with the passing stool
or by anal sphincter muscle contraction, act as a powerful territorial scent
marker somewhat akin to humans posting a No Trespassing sign. Another theory
states that the anal sac material lubricates hard stool, which makes passage
easier. Humans do not have anal sacs. It’s bad enough that some humans get
hemorrhoids, which are dilated, irritated blood vessels at the anus; luckily,
dogs do not get hemorrhoids.
CAUSES OF ANAL SAC PROBLEMS
There are no predictable antecedents to painful anal sac disorders.
Infections, obstruction and subsequent overfilling (called impaction), and
rupture with drainage through the perianal skin are the most common
clinical
presentations. Anal sphincter muscle dysfunction, enlarged anal sacs that
are not compressed properly by the anal sphincter muscle, hypersecretion from
the anal sac lining, obstructed or constricted anal sac ducts all may be
predisposing circumstances for anal sac problems.
IMPACTED ANAL SACS
Some dogs may be born with very narrow
channels that lead from the sacs to the edge of the anus, thereby
obstruction the flow of anal sac material. Acquired damage to the duct can
occur when perianal infections, trauma, allergies and inflammation compress or
obstruct the narrow channel leading from the sac to the surface. For
unknown reasons some dogs produce a thick or dry material from the sac lining
which makes passage of the material through the narrow ducts impossible.
AGE/BREED CONSIDERATIONS
There is no age or sex predisposition to
anal sac pathology. Uncommon in large breeds, infections and impactions
are often experienced by small breeds such as Toy and Miniature Poodles,
Chihuahuas, and Lhasa Apsos. Cocker Spaniels, Basset Hounds, and Beagles
rank high on the list of breeds affected by anal sac difficulties.
DIET
Some groomers and animal health care workers believe feeding a diet rich in
fiber aids in emptying the sacs. The pressure of the firm stool against the
colon wall near the anus may help to express the anal sac contents. Dogs
that have an existing problem such as infection or obstructed ducts, though,
probably won’t respond to dietary changes; modifying the diet with more or less
fiber yields inconsistent benefits. As a practitioner for over 35 years I
have seldom seen a change of diet have any beneficial impact on the frequency of
anal sac problems.
GROOMERS
There is a difference of opinion regarding routine expressing of the anal sacs.
For example, veterinarian Mark Thompson in his presentation about anal sacs
in Current Veterinary Therapy XIII, suggests routine manual expressing of the
anal sacs should not be done in a normal dog with no anal sac issues. Many
groomers make it a matter of routine, though, to express the anal sacs of their
dogs. Certified Master Groomer Sherri Glass, for example, has been
grooming dogs for 14 years and has taught grooming for 5 years at Cornerstone
Dog Grooming Academy in Clyde, OH. She relates, “I teach students to empty
anal glands on all small dogs, about 20 pounds or less in size. We also do
any size dog at owners request. If dog owners would meet their dogs
nutritional needs with high quality food, keep them at proper weight, and
provide plenty of good exercise, most dogs would not have to have the anal sacs
expressed.” Mr. Jeffrey Reynolds, Director of the National Dog Groomers
Association of America says “In states were it is legal for groomers to express
anal sacs, many groomers express them externally only either as a part of the
grooming procedure or at the owners request. When there is evidence that the
sacs are impacted, then they are not expressed and the owner is advised to bring
the dog to the vet.”
HOW TO RECOGNIZE A PROBLEM
There is an 88 percent chance the thought
of anal sacs will never even occur to you. However, if your dog is one of
the 12 percent that scoots his rear bumper along the carpet, frequently turns to
lick or bite at the base of his tail or anal region, or displays discomfort when
passing stool, it would be advisable to make an appointment with the
veterinarian. If left untreated, anal sac impactions, infections and
abscesses can be a reoccurring nuisance for your dog so be proactive about an
evaluation if your dog displays any discomfort in the tail or anal region.
THE ULTIMATE SOLUTION
“Do-it-yourself-anal-sac-expressing” can
be done at home once your veterinarian has instructed you. (Yuck… be
careful about contact with anal sac secretions or you’ll be very unpopular with
yourself and others!) Some cases respond to infusion of the sacs with
antibiotics in addition to oral medication. In chronic cases, careful
surgical removal of the anal sacs can be curative; the dog never has another
annoying bout of anal sac disease. Be sure to discuss the pros and cons of
surgery if chronic problems lead you in that direction.
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Surgery performed by Dr. Dan Paretsky,
Eagle River, WI The patient is a six year old Bassett Hound that had chronic, unresponsive anal sac infections and impactions. The surgical removal of the sacs completely resolved the problems. Click on an image for a close-up view in a new window |
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| The veterinarian points to a swollen anal sac abscess | Infected fluid is shown seeping for each anal sac duct | ||
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| Dr. Paretsky infuses the left anal sac with paraffin in order to facilitate location and removal of the sac. | Locating and isolating the sac. Careful dissection of the sac is imperative to preserve anal sphincter muscle. | With minimal bleeding and little trauma to the anal sphincter muscle, an excellent outcome is expected. | A view
of the resected anal sacs... The patient recovered well and greatly benefited from the anal sac surgery. |
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