When an owner suspects that his dog may have something unusual going on in the area around its anus, he should take his pet to a veterinarian as soon as possible. In most cases, an anal sac problem is not an emergency. However, if ignored, the condition can quickly get worse and become increasingly difficult to treat. The goals of treating anal sac disease are to relieve the dog’s discomfort and pain, unplug and empty impacted sacs, reduce inflammation, eliminate associated infections, heal abscessed areas and remove identifiable tumors.
The first and most urgent treatment for a dog with impacted anal sacs is to manually – and very gently - express the contents of the sacs. This should be done by a veterinarian or by a skilled veterinary technician. In cases that recur frequently, the dog’s owner can be taught how to perform this procedure at home. However, most owners find the process offensively smelly and unpleasant and prefer that somebody else handle it outside of their presence. If an infection is present, the veterinarian will flush the anal sacs with sterile saline or another appropriate substance and apply an antibiotic or antibiotic-and-steroid medication directly into the affected areas. It is almost always necessary to use heavy sedation, and sometimes general anesthesia, for those procedures. Anal sac abscesses often rupture. They are treated the same way, using saline, antibiotics and topical steroid treatments. If an abscess is present but has not yet ruptured, hot packs can be applied to the area several times a day, to help bring the abscess to a head. The veterinarian can then lance the abscess to establish a route for drainage, which will greatly reduce the dog’s discomfort. A full course of broad spectrum oral antibiotics are often recommended for dogs with anal sac disease.
Some dogs have chronic recurrent anal sac problems. In those dogs, long-term treatment includes managing the dog’s weight, increasing the amount of insoluble fiber in its diet and making sure that it gets an adequate amount of physical exercise. In severe cases, the anal sacs can be removed surgically by a procedure called an “anal sacculectomy.” Identified tumors can also be surgically removed, if necessary.
With appropriate treatment, the outlook for dogs with non-malignant anal sac disease is good. Most dogs respond well to non-surgical medical management of the condition. When the anal sacs are surgically removed, because of cancer or for some other reason, the prognosis becomes more guarded. Dogs may develop fecal incontinence after an anal sacculectomy, or if a lot of scar tissue has built up from recurrent problems. If no treatment is undertaken, the prognosis for a return to normalcy is guarded to grave.