Section: Veterinary Care In-depth
Diagnosis In-depth
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 (licking, "scooting") 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. This test checks the major organs to see if they are functioning normally (important if the dog will need anesthesia) 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 the flow of feces. This can make defecation difficult and may alter the shape or size of the stool.
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