Most of us in the veterinary field face a horrible dilemma. The majority of our days are filled with details and particulars that are deemed rather unfit for discussion at the dinner table, any social gathering, and anywhere outside the professional confines of the clinic. It’s always fun to talk puppies and kittens, but a great deal of what we do during the day revolve around bodily fluids (blood, feces, urine, vomit), wounds, parasites, and the selected greatest and grossest hits of infection and disease.
Anything interesting happen at work today? Yes. Most of it was gross.
So, I’d like to discuss the grossest of all things for one moment. Please feel free to put away your chocolate custard, beef stew, and bean soup, for one moment, while we explore dog and cat anal sac disease.
Cats and dogs have anal sacs located near the periphery of the anus. These sacs excrete a liquid, often when animals defecate, that mixes into their stool and gives forth a particular and specific smell akin to a garbage bag filled with a rotting animal that has been soaked in plague juice. At times, though, the ducts that excrete the anal sac fluid can become blocked, forcing the sacs to become enlarged, uncomfortable, swollen, and irritated. Sometimes these sacs can become so blocked that they burst forth with a mixture of all of the aforementioned dinner-party unmentionables in one fell swoop. Other times they slowly leak out at convenient times and places such as Sunday morning at 5:13 a.m. on your pillow next to your head. Often, they don’t do anything but get bigger and more uncomfortable. There are times when severe stress and discomfort can cause animals to release their anal sacs all over (seemingly) everywhere in the world.
Owners complain about their dogs and cats “scooting” their back ends over the ground or that their pets are licking their back end obsessively. The clinical signs may be more vague and scary, especially for older animals who have not ever had this problem. We may find out animals straining to defecate (as the sacs block the exit of the anus), walking stiffly, uncomfortable, not interested in eating, and, in extreme cases, vomiting. I’ve seen some dogs become so affected that they scream in pain when touched and refuse to move. I’ve seen some cats stop eating or moving and refuse to go into the litter box.
Why does this happen? you ask (while not at the dinner table). There are a few common reasons:
• Anatomical irregularities that are uncontrollable: Some dogs and cats, for whatever reason, just don’t seem to have anal sacs or anal sac ducts in the right position to allow for easy release. We have seen puppies whose anal sacs fill up monthly and need help.
• An extended period when the animal’s feces are soft and unable to naturally press on the sacs to express them: When animals have parasites (such as Giardia) or chronic diarrhea due to dietary issues or underlying illnesses, we often are not thinking that during the whole of this period, their anal sacs are (metaphorically) laughing with power as they grow bigger.
• Infiltrative disease (such as cancer): This is not very common, though it can occur. The anal sacs become diseased and cancerous. It can happen in any dog, but one tends to see this more in spaniel breeds. It does not have a good prognosis, but this condition is rare. Very rare.
• Animals, especially as they get older, learn different postures to deal with changes in the body. I have seen so many cats and dogs with untreated back pain that have to posture differently to defecate, and because of this, do not seem to express their anal sacs with the same proud efficiency that they once did. As the anal sacs get worse, they become even more uncomfortable, the animals defecate less, develop chronic soft stool, and this glorious cycle continues until you have a cat or dog that is constipated and has horribly painful anal sacs.
What can you do about it?
First, express the anal sacs. This is not something one should just try at home. I am speaking for all citizens of earth, in general, by saying that you should not do this in your kitchen before the family wakes up. Partly, because the smells of putrid sub-par day-old fish byproduct mixed with armpits and feces will probably wake them up, but also I wonder if this aspect of your relationship with your pet is one you really want to explore. While some people do learn to do this at home with their animals, I personally will not do it at home on my animals. But it is possible.
Alternatively, we can express your animal’s anal sacs so you don’t have to watch, smell, see, and, in some tragic cases, taste. We have safe zones in the clinic where no one walks for fear of spraying anal sacs. Some groomers do this for you, but few do them to completion. Ask your groomer before you assume, and talk with us about how soon you should come back for a recheck. Sometimes the anal sacs can be so full and painful that sedation may be required.
Second, animals may need additional treatment, such as antibiotics or anti-inflammatories. Most bad cases of anal sacculits, anal sac impaction, or anal sac abscesses need medication and aggressive rechecks before they are not painful or affected. It’s not generally the case that medications alone will work.
Third, we must remove the cause. Are allergies causing chronic licking, which is causing the anal sacs to be inflamed? Is your animal’s diet not allowing for a normal stool texture? Do you need to add fiber to the diet? Is your dog anxious, and this anxiety manifests in back-end licking? Are there intestinal parasites present? Is there infiltrative disease? Is there a chronic infection? Is there another animal in the house that is over-grooming the affected animal? We need to fix this.
Fourth, sometimes the anal sacs need to be removed. It’s not a cheap therapy, and it is surgery. But sometimes after coming into the clinic every two weeks and having anal sac disease a constant part of their lives, some owners elect to remove them.
As a final note, most dog owners know or have heard of anal sac issues, but most cat people are thinking that this is not applicable. This problem affects many mammals. So I’m sorry to say that even the sweetest of felines has the foulest of anal sac scents. I’ve had a run, lately, of seemingly ill cats who magically became “new” cats after their anal sacs were expressed. And, for those who play with the skunks, beavers, and opossums of your neighborhood, though I’m sure you have more on your mind, also be aware. Humans have them too, but I will let you and your loved ones google that on your own on your non-work computer.
Enjoy the warm weather. It will make things more convenient for when you need to open the windows after the scent of your animal’s anal sacs permeate the walls of your Chicago apartment.
Brett Grossman, DVM
Medical District Veterinary Clinic