Once the anal glands in dogs and all the care we must provide them are known, it remains to be seen the involuntary implication of these cavities in a somewhat more worrying pathology: the formation of anal or perianal fistulas.
In this article on our site the differences between anal and perianal fistula will be clarified, and the breeds most affected by this painful disease will be revealed. Keep reading and find out what are the symptoms of anal gland fistulas in dogs and how to treat them.
What is perianal fistula?
Although we tend to call it "anal gland fistula" to understand each other better, or for convenience, the truth is that it is more correct to speak of perianal fistula.
A fistula is an abnormal communication between a body cavity and the outside, ie the skin surface. An "unauthorized" channel is opened through which accumulated secretions or fluids can drain, such as an abscess in case of infection. But it can also happen the other way around, that microorganisms enter and contaminate a content that is, in principle, non-infectious.
Many structures present in the area adjacent to the anus may be involved in a perianal fistula, such as: hair follicles, apocrine sebaceous glands and, the most recognized and evident, the anal glands.
Whenever there is a perianal fistula, are the anal glands involved?
Not always, but it is clear that the proximity of the affected areas, and the fact that they drain into the rectum, often means that they end up being a responsible party in the process.
Most of the time, the anal glands of dogs are not the cause, but victims Although it has long been believed that the continuous impaction of the secretion of these glands was responsible for the appearance of anal fistulas, today that theory is ruled out.
So even if our dog needs to "skate or sled" around the park every week, dragging his anus across the lawn to try to release the anal content, that doesn't mean that in the future he will necessarily suffer from this pathology.
Symptoms of perianal fistulas in dogs
At first we can confuse them with an impaction of the anal glands, if we already have experience in this matter, since some symptoms are common in both impaction and fistulas:
- Our dog will tend to constantly lick the anal area, nibble even when the lesion is advanced or contaminated by bacteria.
- We may notice that it is difficult for you to have a bowel movement (tenesmus).
- You can have your tail raised to avoid rubbing against the perianal region, and to avoid sitting down.
- We can see that the tail is chased, without it being a game.
If the dog lives in a rural area, we do not see him defecate regularly or he has a lot of hair and does not live closely with us, we may see the process when he is already very advanced. Depending on the extension of the trajectory of the fistula, and the secondary contamination by bacteria that have penetrated when a cavity was opened to the outside (anal sac, apocrine glands…), non-specific signs of already generalized infection such as: dejection, apathy, anorexia or fever.
When lifting the tail, the area surrounding the anus, where the anal glands and the other structures mentioned are located, will appear torn, showing open cavitiesof depth only measurable by our veterinarian through the use of cannulas.
It is not always easy to determine if the anal sac is affected or if it is only the other structures, as it is difficult in severe cases to find the normal drainage path of the anal glands. Therefore, when we find perianal fistulas in dogs, it is usually assumed that the anal glands have something to do with it, or pay the consequences, and should be included in a possible surgery.
Most Affected Breeds
Precisely, thanks to observation, it was concluded that almost all those affected by this pathology were German Shepherds, and This led to a reconsideration of the false belief that it was the impacted and undrained content of the anal glands that was responsible for anal fistulas in dogs.
This breed represents 80%, to get a quantifiable idea, of the affected dogs, although its crosses and others such as the setter and the Labrador also appear well positioned in these unfortunate statistics. However, they have been seen in dogs of many breeds and mongrels, in a wide age range.
An Immune deficiency (lack of immunoglobulin A) due to genetic issues in this breed, and its crosses, seems to be responsible for these perianal fistulas form, involving the anal glands in them.
Treatment of perianal fistulas in dogs
In the past, surgery was the first choice. But they are aggressive, expensive, very painful techniques, with a mediocre success rate and frequent relapses in a very short time.
Surgical resection was intended to be avoided using new techniques such as cryosurgery ("remove tissues with cold"), or chemical and electrical cauterization, but there are possible collateral damages that make it necessary to rethink its use, such as stenosis of the right. For this reason, laser surgery seems to be a better option as an alternative to the classical technique, although the anal sphincter may lose some tone.
The success of the surgery also depends on the extension and depth of the fistula, since sometimes the rectal sphincter is affected, and there is very little maneuverability there without causing damage greater than those to be repaired.
The saculectomy (surgical removal of the anal sacs), is indicated whether the involvement of the anal glands in the process, as if it is not known whether the chicken or the egg came first. In addition to the resection of the entire surrounding affected area.
And surgery is the only option?
Luckily, having determined that these perianal fistulas in dogs are based on an immunological problem, has managed to open a new veterinary treatment option. But the answer is variable and many times it is done in order to pave the way for surgery.
Immunosuppressants are the key:
- Tacroliums in ointments, if the fistula is not very extensive, they can control the process. However, these processes usually give rise to relapses, depending on the time it took us to start treating our dog and the severity and extent of the lesions.
- Antibiotics such as metronidazole may be necessary if there is bacterial contamination of the lesions, which is very frequent.
- The corticosteroids Topically used in mild or systemic cases were a good option until the arrival of other safer immunosuppressants.
- The cyclosporine, finally, has emerged as the drug of first choice. This immunosuppressant achieves notable improvement in several weeks, but it comes at a high price.
Most of the time, both treatments are combined for perianal fistulas in dogs, that is, the lesions are drastically reduced with medical treatment (cyclosporine, tacrolimus…) and, later, they undergo surgery in which the sacculectomy will also be performed.
Some veterinarians recommended performing a caudectomy as well (amputating the tail), so that the area could better ventilate in the face of future relapses, but there is no agreement on this point.
Conclusions
Once we have reviewed the main symptoms of anal fistulas in dogs and their possible treatments, we can conclude that:
- Perianal fistulas are not always caused by the anal glands, they often suffer the consequences. Only in some cases the anal glands are solely responsible, and it is difficult to prove it.
- The problem appears to have an immunological basis and primarily affects German Shepherds and crossbreeds, although it can be seen in any dog.
- It is a chronic problem and it leads to relapses, even if it is treated correctly.
- The combination of medical treatment with immunosuppressants and surgery once the lesions have been reduced is usually the most indicated.
