Section: Veterinary Care In-depth
Treatment In-depth
Anal sac expression. The veterinarian rectally palpates the anal sacs and squeezes them to empty the sacs of the secretions. If the dog is too painful or if the secretions are too firm, then the patient may need to be heavily sedated or anesthetized to have this procedure done. Anal sac expression is often all that needs to be done for simple cases of anal sac impaction or mild cases of anal sacculitis.
Anal sac irrigation. This involves anesthetizing the patient and flushing saline into the opening of the anal sac to break up firm anal sac secretions so that the sacs can be emptied. This procedure is indicated when the anal sacs cannot be manually expressed. More severe cases of anal sacculitis often require subsequent irrigation with a topical steroid to help decrease the inflammation.
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Abscess lancing. An anal sac abscess, unless it has already ruptured on its own, needs to be opened up, or lanced and drained. The dog may be briefly anesthetized, and the abscess is opened up and flushed with saline. Antibiotics are indicated to treat the underlying infection. Warm compresses applied to the area are also helpful.
Anal sacculectomy. This is the technical term for surgical removal of the anal sac. This can be done to one or both sides. It is often recommended for recurrent cases of anal sac infection or anal sac impaction, and is necessary for treatment of anal sac tumors. 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, however it may alleviate some of the problems associated with the enlarged lymph nodes, such as difficulty defecating.
Chemotherapy and radiation therapy. Both of these treatment types have been used with mixed results in dogs that have anal sac cancer. There is unfortunately no cure for this disease, but adding these therapies to surgical removal of the tumors can help prolong the dog's life.
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