Anal Sacculitis

Description

Infection and Inflammation of the anal sac leading to Anal Sac abscess or cellulitis. Anal sacculitis can have a variety of predisposing factors including obesity, diet, skin disease, colitis and perianal swelling.

Signalment

A common condition of older small breed dogs, particularly chihuhuas and poodles.

Diagnosis

History and Clinical Signs

The anal sacs are enlarged and inflamed and often painful. Typically owners report that the animal has been licking the perineal region and scooting. Contents of the anal sac may appear bloody, purulent and may be increased in volume, fever may be present if the sacculitis is severe. If the anal sac ruptures, the tracts will be at the 4 or 8 o'clock positions. See Anal Sac Disease - General for further signs.

Treatment

Due to the pain, sedation or general anaesthetic may be needed to allow expression. After expression the sacs should be flushed following cannulation. The glands can be flushed using:

• Lactated Ringer's
• Mild antiseptic solution such as 0.05% chlorhexidine.

Following flushing, antibiotics should be used either systemically or topically (with or without the use of a corticosteroid). The flushing may need to be repeated at 10-14day intervals until resolution. If recurrent episodes occur anal sacculectomy is indicated. This surgery involves careful dissection and removal of both anal sacs. Two techniques are described 1) closed and 2) open. When performing the closed technique the external anal sphincter muscle is not transected and the lumen of the anal sac remains closed; hence decreasing the chance of faecal incontinence and local infection following surgery. Inflammation and fibrosis of the perineal region should be treated prior to surgery as this will also decrease the surgical risk of anal sphincter damage and resultant faecal incontinence. The main complications of this procedure include faecal incontinence which may be temporary or permanent, scooting, inflammation, infection, dehiscence, tenesmus, rectal prolapse, fistulation, haematochezia, stricture formation and seroma formation.

Prognosis

Is usually good.

References

Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA

Nelson, R.W. and Couto, C. G. (2009) Small Animal Internal Medicine (4th Edition) Mosby Elsevier

Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial

Foster, A. and Foil, C. (2003) BSAVA Manual of Small Animal Dermatology (2nd Edition) BSAVA

Fossum, T.W. (2007) Small Animal Surgery (3rd edition) Mosby Elsevier