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ANAL SACCULECTOMY

The anal sacs are situated either side of the anus at 8’o’clock and 4’o’clock. They are pockets which vary in size depending on the size of dog and presence of any disease, and have small openings towards the opening of the anus. They hold secretions from glands, and are occasionally know as “scent glands” as the liquid they hold is very strong (and offensive) smelling.

 

 

 

 

 

 

 

 

 

 

 

 

These sacs tend to empty their contents when a dog passes faeces. On occasion they can spontaneously empty when a dog barks or jumps, or can even do so without any sudden activity, expelling their liquid and scent to the outside.

 

The anal sacs can become problematic for several reasons:

 

* Impaction – this is where the sacs fail to empty naturally, so the liquid secretions inside build up, causing the dog to feel discomfort. The dog may lick at its rear end, or drag their bottom across the floor in an attempt to release the pressure of two full pockets around the anus.

* Anal sac infection

* Anal sac rupture – if the impacted gland is not emptied, the gland may eventually rupture, causing the foul liquid to run into the tissues around the bottom, causing a painful infection and abscessation. The rear end will be extremely hot, swollen and painful. The abscess may eventually burst, causing a hole to appear in the skin near the bottom. Before the abscess bursts, the infection can make the patient extremely unwell.

* Anal sac adenocarcinoma – cancer of the anal sac.

 

 

 

 

                                                                                                       A ruptured anal sac

 

 

 

 

 

Many dogs experience anal sac impaction, they may go on to express the impacted material spontaneously or after rubbing the area, but if the pressure does not relieve; manual expression may be required, whereby the liquid inside the sac is squeezed out. If the material is not easily expressed, the vet may recommend flushing of the gland. Sometimes a diet change may be recommended to help the problem.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For cases that suffer from frequent impactions or multiple infections or rupture, the vet may recommend that the glands are flushed and filled with a mixture of anti-inflammatory and antibiotic. In more severe cases, or cases which involve cancer of the sac, a surgical cure is to perform an ANAL SACCULECTOMY. The surgery involves complete removal of the anal sacs.

 

Pre-operative Considerations:

 

• As the surgery can be quite lengthy, patients must be of good general health and able to undergo general anaesthetic

• Dogs who have suffered for a long time with disease of the anal sacs are likely to have developed a lot of scar tissue – this is likely to make the surgery more challenging, and can increase the likelihood of short term problems after the operation

• An empty rectum is essential for the surgery to be performed – this is why we ask that all patients are starved for 24 hours before the operation and taken out for toilet purposes before attending the practice on the day of the operation

• If there has been anal sac rupture or abscessation, the surgery cannot go ahead until the area is fully healed, this may mean some weeks of medical treatment with washes, antibiotic and anti-inflammatory treatment

 

The Surgical Procedure:

 

* The patient undergoes a pre-operative examination, then a combination sedative/painkiller is administered. The patient is then anaesthetised, and the rear end is clipped short and cleaned. The anal sacs are flushed with antiseptic.

* The vet prepares a resin which is instilled into the sacs, making them easier to surgically dissect

* A short incision is made into the skin over the gland, and the surgeon gently dissects the sacs out from between the muscle layers around the rectum

* Once the sac is removed, sutures are placed to close the space, these may either be dissolving sutures underneath the skin, or skin sutures which sit on top of the skin

* The patient is cleaned and recovered from anaesthesia by the nursing team

 

What to expect immediately after Surgery:

 

* Any surgery around the rectum and rear end is very uncomfortable. We supply pain relief by injection while the dog is in the surgery, and often an Elizabethan Collar is required to prevent the dog licking at the area and worsening the discomfort and soreness

* Pain relief will be provided for use at home, some cases may also require antibiotics

* The recovery phase differs tremendously for this procedure.

* Some dogs act as if nothing has happened and return to normal within 24 hours of the procedure

* Some patients refuse to pass faeces for a number of days post operatively

* Other patients exhibit diarrhoea after the surgery (often when scarring is present and the tissues have had to be manipulated extensively) – if this is the case then you may be required to keep the dog restricted to a small area and clean the rear end regularly. This will resolve in a matter of days, and medication can be provided to help reduce the volume of diarrhoea

* Some dogs lose some ability to hold faeces, and may need to poo more regularly. This will resolve in a number of days. We recommend frequent opportunities for toileting in the week post-operatively or for the dog to be kept restricted to an area where the furnishings can be more easily cleaned.

* For a few weeks post surgery your dog may have accidents where faeces is passed unexpectedly – this usually occurs when they bark or jump up, and is caused by the swelling and tissue disruption during the surgery. In almost all cases this resolves over a few weeks.

* Very occasionally we see infections in the surgical sites – this is made more likely if the patient is able to lick and interfere with the site and would be treated with bathing and antibiotics.

 

Long term expectations:

 

* We expect full recovery within about a month of the procedure, and return to normal toileting patterns

* With any surgery in this area, there is a risk of long-term incontinence. This is a rare long term side effect, and usually where a very large dissection has been required in an attempt to remove a cancer of the anal sac

* If the anal sac has ruptured before surgery, there may be small pieces of the sac tissue within the surgical site that aren’t removed, and these may then cause an abscess or irritation after the surgical site has healed, this would mean a second surgery was needed. This happens only very rarely.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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