Wednesday, January 3, 2018

Begins With The Letter "A"

This post carries a mature content warning. Seriously.


Yes gentle readers, today we are going to talk about your pet's anus. Frightened yet? If so, it's not too late to bail out and check if anything new has happened on Facebook in the last fifteen seconds. But if you're still with me, you're in for a special treat, because we are not just going to be talking about the anus generally. Nope, we're going to be specifically talking about anal sacs.

Most people call them anal glands, but technically they are not glands, so veterinarians are taught to refer to them by their correct name: anal sacs. However, most veterinarians soon encounter the situation I did after just a couple years in practice.
"The problem is with Bella's anal sacs," I said.

The client raised her eyebrows and said with a smile, "You have to be very careful how you pronounce that..."

Indeed.  Naively, I hadn't considered this before. I don't often blush, but this was an exception. Not long after that a colleague told me that he had decided to start an explanation of why there was inflammation around a dog's hind-end by first describing the basic anatomy: "So, your dog has anal sacs..."
Outraged, the client interrupted, "He most certainly does not!"

So be very careful how you enunciate that "a". Or just call them anal glands.

And why do they have these bizarre little structures you ask? They have them primarily to use for scent marking. All carnivores have them. Skunks have the most famous anal sacs, having turned a communication device into a weapon. But for our dogs and cats the stinky secretion contains information about them. What specifically we don't know, but we can guess gender and perhaps some individual identification markers. This is why dogs in particular will sniff poop. They are not necessarily interested in the poop itself, but rather in the bit of anal sac material that it is on it.

This then leads to the question of how they normally empty. They empty when the animal has an appropriately sized bowel movement. The pressure of this passing through the anus squeezes the anal sacs. When this does not happen, perhaps because there has been diarrhea or unusually small stools or just at random in some individuals, then the material can gradually build up and lead to problems. Typically a dog or cat with full sacs will lick at the area or begin to "scoot" in an unmistakable fashion whereby they sit down and then drag their bottom across the ground by pulling themselves along with their front legs. Note: scooting is not caused by worms! This old myth is remarkably persistent.

If they are successful in emptying their sacs by scooting or licking you will know - the smell is memorable. Gram for gram anal sac secretion is one of the most potently vile substances on the planet. However, if they are unsuccessful, you should call your veterinarian. One of the more glamorous parts of our job is to put on a latex glove, apply a little lubricant and "manually express" full anal sacs. And here's the cool part - if your dog has frequent issues with full anal sacs we can teach you how to express them at home!* No medical degree required! It's clearly not for everyone though...

If the sacs remain too full for too long the material can thicken and become difficult to express. This thickened material can also become infected, leading to the formation of an anal sac abscess. Some dogs do not give clear warning signs like scooting so unfortunately the first thing you may notice is blood near the anus when the abscess ruptures. Luckily this is usually easily treated with antibiotics, but it can be an alarming mess in the meantime.

Prevention is of course always better than treatment. There is no fool-proof way to prevent anal sacs from filling up, but adding fibre to the diet can help. A source of fibre, such as metamucil, oat bran or canned pumpkin, can increase the bulk of the stools and thus encourage the sacs to empty naturally. Appropriate amounts vary with the source of fibre and the size of your dog, so check with your veterinarian. Incidentally, we generally do not add fibre to a cat's diet but cats fortunately are much less likely to have issues with their anal sacs. One final note is that in some animals food allergies may play a role in anal sac disease, so ask your vet about that possibility.

I got through that without even telling my grossest anal sac story! I'm proud of myself.

 *What a bizarre world we live in. The "For Dummies" series actually has a tutorial on this:

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