Anal and perianal disease

Question 1

Are bacteria a significant finding in anal gland secretion?

Answer 1

No

Significant finding = purulent exudate +/- intracellular biology

Question 2

How is anal gland impaction treated?

Answer 2

Express anal glands
Add fibre to diet to improve faecal consistency
Small steroids dose
Treat underlying disease
(If recurrent - flush and pack, consider anal sacculectomy)

Question 3

What is the treatment for chronic infection of the anal glands?

Answer 3

Emptying and flush with local antibiotics
Warm soap to draw puss out
AVOID systemic antibiotics - poor MIC in lumen

Question 4

What are the treatment options for anal sac adenocarcinoma?

Answer 4

Surgery
Chemo
Or radiation
Treat hypercalcaemia

Question 5

What is anal furunculosis?

Answer 5

Deep infection of the hair follicle
Causes abscess with pus and necrotic tissue
PAINFUL

Question 6

Anal furunculosis is predominantly immune mediated. What breed is predisposed?

Answer 6

German Shepherd

Tail carriage and sloping stance is a risk factor

Question 7

What is the treatment for anal furunculosis?

Answer 7

Systemic antibiotics based on C&S
Immunosuppression - pred, azathioprine, ciclosporin
Skin hygiene - chlorhexidine wipes, washes
Surgery if anal sac involvement or poor toleration to treatment

Question 8

What is the prognosis for anal furunculosis?

Answer 8

Early intervention = better prognosis

Lifelong therapy and management often required