Anal Sac Disease Research Articles

Modified closed sacculectomy in 50 dogs with non‐neoplastic anal sac disease

Modified closed sacculectomy in 50 dogs with non‐neoplastic anal sac disease

Ultrasound Morphology of Presumed Normal Anal Sacs in Dogs and Cats.

Ultrasonographic evaluation of canine and feline anal sacs is a practical promising modality to identify anal sac disease. However, limited data are available about normal ultrasound morphology of the anal sacs. This study describes the ultrasound morphology of presumed normal anal sacs in a larger sample of client-owned dogs and cats. A single-institutional prospective cross-sectional descriptive study was performed, and 137 dogs and 131 cats were included. The most common ultrasound features of the evaluated anal sacs in the dorsal plane were oval shape (99.3% of dogs and 98.5% of cats) and bilaterally similar content (94.2% of dogs and 95.4% of cats), mostly hypoechoic with diffusely hyperechoic points or unformed echogenic material (42.6% of dogs and 44% of cats). Gas in the lumen of the anal sac was detected in two dogs and mineralization in one dog. There was a statistically significant positive correlation between body weight and the size of anal sacs in dogs ≤15 kg and cats and a correlation between age and the size of anal sacs in cats. This simple method provides additional clinically significant information in detecting abnormal findings in asymptomatic patients and could contribute to the early detection of anal sac disease.

Histopathological diagnosis and surgical complications following bilateral anal sacculectomy for the treatment of unilateral canine apocrine gland anal sac adenocarcinoma: 35 cases (2019-2023).

To report the histopathological diagnosis of both anal sacs in dogs undergoing bilateral anal sacculectomy for the treatment of unilateral apocrine gland anal sac adenocarcinoma and to compare the surgical complication rate associated with this procedure in this population with previously published literature. Records were retrospectively reviewed for dogs that underwent bilateral anal sacculectomy for the treatment of apparently unilateral apocrine gland anal sac adenocarcinoma, at a single institute between 2019 and 2023. Clinical staging, surgical treatment, histological findings, intra- and postoperative complications were evaluated. Thirty-five dogs were included. Only five of 35 (14%) dogs were found to have histologically normal contralateral anal sacs. Non-neoplastic anal sac disease was found in 23 of 35 (66%) dogs and bilateral apocrine gland anal sac adenocarcinoma was seen in seven of 35 (20%) dogs. None of the dogs diagnosed with bilateral neoplasia had evidence of bilateral neoplasia before surgery despite a thorough work-up. Complications attributable to the primary tumour removal were seen in 9% of dogs intraoperatively and 14% of dogs postoperatively, commonly tumour capsule disruption and surgical site infection, respectively. Bilateral anal sac disease was diagnosed histologically in the majority of presumed normal anal sacs, with 20% of cases being found to have bilateral apocrine gland anal sac adenocarcinoma. The surgical complication rates of this cohort were comparable to those reported for unilateral anal sacculectomy alone. These findings promote and encourage the use of bilateral anal sacculectomy in cases of suspected unilateral anal sac neoplasia.

A Cross-Sectional Study on Canine and Feline Anal Sac Disease.

Simple SummaryAnal sac disease is a common problem in private practice, but there is surprisingly little information available about anal sac disease in the literature. In this article, the incidence, predisposing factors, diagnostics, treatment options, and recurrence rates were investigated by the use of a questionnaire which was distributed among veterinarians in private practice. Dogs were more commonly affected than cats. Diarrhea and skin problems increased the risk for anal sac disease, and certain breeds were more often affected. Diagnosis was made based on the presence of clinical signs and characteristics of the anal sac content. Manual expression and treating any potential underlying disease were the most important treatments. Surgical removal was performed in the case of frequent recurrence. Surgical outcome of anal sacculectomy can be improved when surgery is performed after medical management. Future studies should investigate if these findings reported by veterinarians can be confirmed by asking veterinarians to keep a logbook on dogs and cats with anal sac disease.Limited data are available on canine and feline non-neoplastic anal sac disease. Therefore, the aim of this study was to obtain observational data on the incidence, predisposing factors, diagnosis, treatment, and recurrence rate of canine and feline anal sac disease. To this end, a questionnaire was distributed among veterinarians. The incidence of non-neoplastic anal sac disease was estimated at 15.7% in dogs and 0.4% in cats. Predisposing factors were diarrhea, skin problems, several dog breeds, and particularly small breed dogs, male cats, British shorthairs, and obesity in dogs. Diagnosis was made based on the presence of clinical signs and characteristics of the anal sac content. Manual expression and treating any potential underlying disease were the most important treatments for all three types of non-neoplastic anal sac disease. Anal sacculectomy was performed in refractory cases. The most recurrent anal sac disease condition was impaction. Diagnosis of anal sac disease should be based on clinical signs and rectal examination, as the evaluation of the anal sac content is not reliable. Surgical outcomes of anal sacculectomy can be improved when surgery is performed after medical management. Future studies should investigate these findings in prospective trials.

Outcomes and complications of anal sacculectomy for non-neoplastic anal sac disease in cats: 8 cases (2006-2019).

To describe the features of non-neoplastic anal sac disease in cats, the surgical procedure, complications, surgical outcome and prognosis compared to well-established data for anal sacculectomy in canine patients. A retrospective review of medical records of cats undergoing anal sacculectomy for non-neoplastic disease between 2006 and 2019. Eight cats were included in the study of which four of eight developed minor and self-limiting complications including defaecatory complications in three cases and superficial corneal ulceration in one case. No cat developed permanent faecal incontinence. No long-term postoperative complication was recorded. Median surgical time was 35 minutes (range, 20 to 42). Median hospitalisation time was 1.5 days (range, 1 to 4). The incidence of short-term minor complications is higher than previously reported in dogs, although this might be in agreement with a reported higher incidence in dogs smaller than 15 kg. Anal sacculectomy for non-neoplastic anal sac disease is a safe procedure in cats with relatively high rate of short-term but self-limiting, minor, postoperative complications.

Anal sac disease in dogs

Anal sac disease (ASD) can be divided into two main categories: inflammation and neoplasia. It is relatively common in dogs, with the inflammatory form having a reported prevalence of 12.5...

Perianal pruritus in dogs with skin disease.

Perianal pruritus has been reported in dogs with anal sac disease but not in healthy dogs. Some authors describe it as typical of allergy, but there is little evidence in support of this. The aim was to investigate the association between perianal pruritus and canine atopic dermatitis (CAD), adverse food reaction (ARF) and other skin diseases in dogs. Two hundred and fifty privately owned dogs with skin disease and without anal sac disease. The presence or absence of perianal pruritus, macroscopic and cytological evaluation of the perianal skin surface and the macroscopic appearance of anal sac contents were assessed. Chi-square and Fisher's exact tests were performed to compare the frequency of perianal pruritus with the clinical diagnoses and with clinical and cytological parameters. Perianal pruritus was seen in 39 of 75 dogs with CAD, in 29 of 57 dogs with ARF and in only 24 of 118 dogs with other conditions. The frequency of perianal pruritus in dogs with CAD and/or ARF was significantly higher than that in dogs with other diagnoses (P<0.0001). No other disease was significantly associated with perianal pruritus. Perianal pruritus was significantly associated with signs of perianal alopecia, erythema, excoriations, lichenification and hyperpigmentation; it was not associated with the presence of bacteria or yeasts or with anal sac impaction. Perianal pruritus was seen more frequently in dogs with AFR/CAD than with other dermatological diseases. This is the first study to evaluate perianal pruritus in dogs with skin disease and without anal sac disease.

Anal sac disease and its surgical treatment

Anal sac disease represents a frequent complaint in small animal practice, with prevalence in dogs estimated at 12%. The condition is reported most often in small breeds, and it is rare in cats. Repeated conservative management is often unsuccessful, and the clinician must then resort to anal sacculectomy to cure the disease. Similarly, surgery is an important part of the treatment for anal sac neoplasia. This article briefly reviews the different condition that may affect the anal sacs, and focuses on their surgical treatment.

Comparison of anal sac cytological findings and behaviour in clinically normal dogs and those affected with anal sac disease

No previous study has explored the relationship between cytology and the frequency of behaviours associated with anal sac disease (ASD). The goals of the study were: (i) to compare the cytological findings between anal sac secretions from normal dogs with no history of ASD to those with non-neoplastic ASD; (ii) to determine whether anal sac cytological findings can be used to differentiate between normal dogs and dogs with ASD; (iii) to explore the correlation of anal sac cytology and behaviour between normal dogs and dogs with ASD; and (iv) to describe behaviours typical of ASD as reported by owners. Thirty dogs were selected for this study, based on their behavioural history as detailed in a questionnaire completed by their owners. Of the thirty dogs, ten were considered normal insofar as they had no history of ASD clinical signs. The remaining 20 dogs were characterized as having ASD, with a chronic history of perianal pruritus, but no other pruritus. All dogs had their anal sacs manually expressed, and the discharge was examined microscopically in a blinded manner. A total of 171 oil immersion fields (OIFs) were examined from normal dogs and 333 OIFs from dogs with ASD. The behavioural results for dogs with ASD revealed that scooting recurred with a median frequency of 3 weeks post-anal sac expression. There were no clinically statistically significant cytological differences between normal dogs and those with ASD, thereby leading to the conclusion that cytology is an ineffective tool for diagnosing ASD.

An approach to anal sac diseases

Disease of the anal sacs is a common reason for presentation of dogs to a veterinary surgeon. It is less common in the cat. Little is known of the aetiology or pathogenesis of anal sac disease. Management of anal sac disease is, therefore, often symptomatic, frequently ending with surgical removal of the sacs as a response rather than a planned strategy.

Gross and cytological characteristics of normal feline anal-sac secretions.

This study was conducted to characterize the gross and cytological characteristics of secretions from normal feline anal sacs. Thirty cats with no recent history of anal-sac disease were selected consecutively and their anal sacs manually expressed. The color, cell counts, or presence of solid portions of the secretions in the youngest cats (<1 year old) were not significantly different from the rest. Young cats (<1 year old) tended to more often have watery secretions. The secretions contained 13 (median) epithelial cells per 600x magnification microscopic field, basophilic background debris, and a mixture of Gram-positive cocci (83 per field; median), Gram-negative cocci (38 per field; median), and Gram-negative rods (1.8 per field; median). Most secretions had occasional neutrophils, and a minority of cats had occasional yeasts in their secretion. Erythrocytes were found only rarely. Extreme heterogeneity existed in gross color, consistency, and amount of solid material. Hence, these latter parameters would not be valid indicators of anal-sac disease.

Gross and cytological characteristics of normal canine anal-sac secretions.

A study was conducted to characterize the gross and cytological characteristics of secretions from normal canine anal sacs. Fifty dogs with no recent history of anal-sac disease were selected consecutively and their anal sacs manually expressed. Of the 47 dogs with known or estimated ages, 27 were < 1 year olds. However, these youngest dogs were not significantly different from the rest in cell counts, viscosity, or presence of dark or light solid portions of the secretions. For all dogs combined, the secretions typically contained 41 (median) corneocytes per 400x magnification microscopic field, lots of basophilic background debris, and a mixture of Gram-positive cocci (173 per field; median), Gram-positive rods (29 per field; median), and Gram-negative rods (two per field; median). Although median counts across 10 400x fields per sac indicated no leucocytes or yeasts, many of the normal dogs had an occasional 400x field with non-degenerate neutrophils and yeasts. Erythrocytes were not a feature of these anal-sac secretions, and mononuclear leucocytes were found only rarely. Extreme heterogeneity existed in gross colour, consistency and the amount of solid material. Thus, these latter parameters probably would not be valid indicators of anal-sac disease.

Cytological examination and physical characteristics of the anal sacs in 17 clinically normal dogs.

To quantify numbers of leucocytes, keratinocytes and microorganisms in, as well as the turgidity, colour and consistency of, anal sac exudates in clinically normal dogs. Selection criteria were formed based on the absence of clinical signs associated with anal sac disease, and the absence of factors potentially affecting colonic flora. Anal sacs were palpated for turgidity then expressed onto a swab, where colour and consistency were noted. A squash preparation made from any exudate was heat fixed and stained with modified Wright's stain. Eight representative 1000x oil immersion fields from each were examined for leucocytes, erythrocytes, keratinocytes, bacteria and yeast. Results were summarised, and cytological counts grouped into quartiles (minimal, few, moderate, numerous). Due to the multivariate nature of the study and limited subject numbers, further significant statistical analysis could not be performed. Seventeen dogs satisfied the selection criteria. The physical characteristics of the exudate and sac varied, though 31/34 sacs were empty or soft, 22/27 exudates were light or dark brown and 19/27 exudates were a thin liquid. Total leucocyte, keratinocyte and bacilli counts were extremely variable. Yeasts were present in 26/208 microscopic fields examined cytologically. Only 5/208 fields showed numerous cocci. A single instance of intracellular bacteria and a single erythrocyte were noted following examination of all fields. In this study, the characteristics of normal anal sacs and their exudate varied but greater than 70% showed similar features. Exudate cytology was highly variable, though yeasts were uncommon, and intracellular cocci and erythrocytes extremely rare.

Open versus closed bilateral anal sacculectomy for treatment of non-neoplastic anal sac disease in dogs: 95 cases (1969-1994).

To determine complications associated with anal sacculectomy in dogs with non-neoplastic anal sac disease and compare complication rates for open versus closed techniques. Retrospective study. 95 dogs. Medical records were reviewed for information on signalment, history, physical examination findings, type of anal sac disease, surgical technique (closed, standard open [surgery performed prior to 19801, or modified open [surgery performed after 19801), and postoperative complications. In 57 dogs, a closed technique was used, and in 38, an open technique was used. Only 3 dogs developed short-term complications (excessive drainage, scooting and inflammation, and seroma formation), and 14 developed long-term complications (continued licking of the surgery site, fecal incontinence, fistulation, and stricture formation). Development of postoperative complications was significantly associated with surgical technique. Dogs that underwent standard open sacculectomy prior to 1980 were 13.67 times as likely to have a long-term complication as were dogs that underwent closed sacculectomy. Weight of the dog, type of anal sac disease, age at the time of surgery, and whether the wound was closed surgically were not significantly associated with whether dogs developed postoperative complications. Results suggest that anal sacculectomy is a safe and effective treatment for non-neoplastic anal sac disease in dogs and is associated with a low rate of complications. The standard open technique was associated with the greatest number of complications, whereas complication rates for the closed and modified open techniques were similar to each other.

Disease conditions of canine anal sacs.

The literature about the anal sacs of healthy dogs and the pathogenesis, diagnosis and therapy of anal sac impaction and sacculitis are reviewed. Knowledge about the physiological role of the anal sacs is still confusing. The colour and consistency of the anal sac contents are variable in healthy dogs and there are no pathognomonic signs of anal sac impaction or sacculitis. The wide variation in macroscopic detail of anal sac secretions may give rise to misinterpretation and thus overdiagnosis of sacculitis. Other diseases such as vaginitis, flea allergy, atopy, proctitis, parasites and perianal fistulae can lead to similar signs and must be eliminated from the differential diagnosis before the anal sacs are incited as the cause of the signs. Further research is necessary on the morphological, physical and biochemical aspects of the anal sacs and their secretions to define more precise criteria for the diagnosis of impaction and sacculitis. It is imperative that controlled therapeutic trials should be performed, and such studies are indispensable for the rational therapy of anal sac disease.

Canine cryptorchism and subsequent testicular neoplasia: case-control study with epidemiologic update.

A retrospective study of 2,912 cryptorchid dogs identified 14 breeds with significantly high risk. Among six distinct closely interrelated breed groups (e.g., toy, miniature, and standard poodles), the risk in the smaller breed was always greater than that in the larger relative, suggesting that genetically influenced maldescent could be, in part, related to physical size or the rate of growth of the involved structures. Testicular tumors were diagnosed in 5.7% of the cryptorchid dogs; half had only Sertoli cell tumors, one-third had only seminomas. The relative risk for Sertoli cell tumor or seminoma was not directly related to a familial risk for cryptorchism. Using the health experience of a control population composed of male dogs with anal sac disease (N = 4,184), there is an estimated relative risk of 9.2 in cryptorchid dogs to develop a testis tumor (95% confidence interval, 5.9-14.3) and 4.2 in dogs with inguinal hernia (95% confidence interval, 1.8-9.5). Considering that the anatomical development of the genital tract, testis descent, and tunic relationships in dog are very similar to that in man, and that the associations of cryptorchism and inguinal hernia with testis neoplasms are also similar, the dog should be an excellent model system to further investigate the causes of human cryptorchism.