Anal Gland Removal
Dr. Cathy Reese
History. Your veterinarian will ask specific questions regarding defecation habits (straining, size/shape of stool, frequency, pain), appetite, weight loss, drinking and urination habits, what symptoms you have noticed and how long they have been going on.
Physical exam. Your veterinarian will perform a complete physical exam, including a rectal exam of the anal sacs. The veterinarian will attempt to express the anal sacs and note the quality of the secretions.
Blood tests. If your veterinarian suspects an infection or abscess of the anal sacs, he or she may recommend a complete blood count, which will assess the number and type of red and white blood cells and platelets. The white blood cell count will usually increase in an infection. If your veterinarian suspects an anal sac tumor, he or she will recommend a serum chemistry panel, important if the dog will need anesthesia. This test checks the major organs to see if they are functioning normally and also checks the levels of the major electrolytes in the body. Anal sac tumors can cause an increase in serum calcium levels.
Chest and abdominal X-rays. Anal sac tumors can spread to lymph nodes and lungs, and rarely to other organs or bones of the body. X-rays are used to check for obvious spread of the cancer, although microscopic spread cannot be ruled out. Chest x-rays are also important in older dogs that will be undergoing anesthesia, to make sure that there is no heart or lung disease that would make anesthesia risky.
Abdominal ultrasound. The most common location for anal sac tumors to spread is the sublumbar lymph nodes. These lymph nodes can become extremely large, and may be able to be palpated rectally. If not, they can be seen using an ultrasound. If the lymph nodes become very large, they can push on the colon and obstruct flow of feces. This can make defecation difficult and may alter the shape or size of the stool.
Anal Gland Removal
Anal sacculectomy. This is the technical term for surgical removal of the anal sac. It is often recommended for recurrent cases of anal sac infection or anal sac impaction, and is necessary for treatment of anal sac tumors. This can be done to one or both sides as needed. The animal is placed under general anesthesia and an incision is made over the anal gland. The gland is dissected away from the anal sphincter muscle and removed. It is submitted for biopsy.
The possible risks of surgery, besides the risks of general anesthesia, are fecal incontinence, chronic draining tracts from residual infection or secretory tissue, recurrence of the tumor, and straining to defecate from postoperative anal scar formation.
Sublumbar lymph node removal. If a tumor of the anal sac has spread to the sublumbar lymph nodes, then removal of the lymph nodes can be considered. This is a technically challenging procedure that can result in significant bleeding during surgery and could also result in temporary or permanent urinary incontinence since the nerves controlling urination are close to the lymph nodes. It is not curative, although it may alleviate some of the problems associated with the enlarged lymph nodes, such as difficulty defecating.