Tuesday, December 18, 2012

Anal Glands, The "Scoot" Story






There are a few old wives tales that I have made it my life mission to eradicate.

I have mentioned some of them in the past.

The item for today’s gripe is: scooting. 

“Hey Doc, I think that Boomer has worms.”

This the usual way the tale begins to unravel.

“Huh?” I say with a slight pause. “Why do you think that is?” (I have learned over the years to do less talking and more listening).  I expect to hear that Boomer is vomiting and his dad is seeing moving pieces of spaghetti in the vomitus. Or, that Boomer's stool sample had wiggling pieces of rice sized particles making an escape from their transport vehicle...

But instead what I usually hear is, “I've seen him scooting on the carpet.”

“Oh,” I reply, (why I sound surprised I’m not really sure at this late date). “Well let’s check the anal glands first, then talk about skin disease, and then intestinal worms.”

I say it in this order because in my experience this is the order of likely culprits for ‘itchy butt syndrome’.

Anal glands are in reality the anal sacs. These are found in dogs, cats, and all mammals, (yes, even us humans), and reside just inside the anus at the 4 and 8 o’clock positions. In a normal pet they are about the size of a raisin an should empty every time your pet defecates.

In the wild they prove a very effective defense mechanism for skunks to fend off potential threats. But some domestic animals have lost their ability to empty them voluntarily or efficiently. For these pets the anal glands become full or impacted, and they can also abscess causing a painful infection.

Some pets will ‘scoot’, or ‘drag their butt on the carpet’ in an attempt to relieve the pressure and discomfort of the over filled anal sacs.

The material in the anal sacs is normally a light brown mildly turbid foul smelling oily liquid that some describe as “fishy” but I describe as “pungent and offensive.”  In healthy pets the sacs are easily expressed and empty completely with a digital rectal manual approach. For those pets with difficulty emptying voluntarily the sacs will become distended and the fluid will become thicker. This further complicates the ability to express or empty the material. This makes them more painful to be expressed. If the sac is visibly evident externally and the skin covering it is red, or in the worst case has ruptured due to abscessing, then it will likely be impossible to empty, or even palpate rectally due to it being so painful.

For the cases that can't be expressed or even palpated, I start antibiotics, warm compresses, pain medications and  a re-check in 2-3 days.I also advise an e-collar and very close monitoring.

For the pets with thick and/or more difficult to express anal sacs I empty them as much as possible and schedule a re-check within a few days/week.  We often try to keep the sacs empty in the hope that the sac will return to its original size and not continue to accumulate fluid and hence need repeated emptying.

I have some patients who come in for scheduled anal sac emptying routinely. Some of them are monthly and some of them are quarterly. Every pet is different and the amount of time between assisted emptying varies significantly. How do we decide when to re-check? I usually say to come back in 3 weeks. If they are swollen and distended re-check again in two weeks. If not, try to re-check again in 5 weeks, etc..

For our clinic I would say that the hounds are the most popular breeds seen for anal sac issues.

For those pets who arrive with an impacted or abscessed anal sac we schedule re-checks more frequently and often need to prescribe an antibiotic, an analgesic and I also prescribe a topical antibiotic cleaner (because your butt isn't too sanitary to begin with, and I don’t like the idea of an infection next to the most unsanitary place on the body).  Pets with abscessed anal glands should also have an e-collar to go home with to try to discourage the licking that accompanies any painful condition.

I learned an important “veterinary pearl” from a veterinarian I worked with many years ago. He told me that “every pet that comes in acting painful or uncomfortable in general, or has weird behavioral symptoms, is panting, or that you can’t figure out what is wrong with them, should have their anal sacs checked.” This advice has proven to be correct many times.

If Boomer is still scooting after the anal sacs have been checked and are empty then the next usual cause is itchy skin..dogs with itchy feet, ears, or face often also have itchy butts.

For many of my clients who live with pets with recurrent anal gland issues I offer an in-house tutorial on ‘anal sac expression 101’. I have few clients that dare to try, but it isn't hard, so if you can handle the whole idea of performing a rectal exam, then ask your veterinarian, or veterinary technician to show you how.  Like everything else we do in veterinary medicine, learning how to be proficient at this takes practice.

There are some other aspects of anal sacs that should be discussed.

For future topics of discussion are;
1. Anal sac expression techniques. Why having your vet check them is important, and how your groomer expresses them vs how your vet does.

2. Long term treatment options for chronic anal sac problems.

3. "Why my dog?” What factors contribute to the problem?

I saw little Abby, the sweetest dachshund in the world a few weeks ago. She was brought in because her owners noticed redness on her butt. They had never seen her scoot, or lick, and she had never given them any clue as to having a sore butt or any kind of anal gland problem. After I palpated her anal glands and felt that the left side was indeed as swollen and painful as it looked we started Abby on twice daily compresses of an antibiotic/anti-fungal solution, or antibiotics and an oral analgesic. I rescheduled her for a re-check 3 days later and told her that I was fairly certain that the anal gland would rupture before then.



The anal sac on the left (at the 8 o'clock position) is very inflamed, bulging, swollen, and oh yes! painful! The skin covering the anal sac is thin and fragile. In many cases when the anal sac has progressed to this point it will rupture regardless of what you do. A ruptured anal sac is open to infection and should be treated topically so the infection does not persist or spread.


Three days later, sure enough, the abscess had ruptured. But little Abby was still wagging her tail, and no worse for the wear. This time I was able to empty the right side without causing her any pain. We decided to continue the antibiotics and compresses and discontinued the pain meds.



One week later the abscess and infection were gone. Abby, still happy as can be, was scheduled to be re-checked in a month. We are going to keep a close eye, (and palpate with a finger), monthly to try to avoid impaction and abscessing in the future.



For more information on anal sacs, or to learn about surgical removal of the anal sacs visit the blog on surgery palooza.


7 comments:

  1. Hi Y'all!

    You've explained a lot. Hawkeye had to have surgical intervention with his anal glands. He went regularly for anal gland checks and then one time the tech found blood and a hard lump, so the vet referred us to a surgical hospital. Hawk still has regular vet checks and it's been a couple of years now.

    BrownDog's Human

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  2. Thanks a lot. This article really helps. My cat still scoot on the carpet after her anal gland was expressed. I might take her to the vet more often.

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    1. Some pets need the glands expressed every few weeks, but if they are empty and they are scooting ask about whether it might be allergies, even parasites.
      thanks for reading

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  3. Just curious, in the top picture where you can see the swallow abcess.... the dachshund has dark black spots around the anus..... we have noticed this on our dachshund and don't know what they are . Is this something to cause alarm ? As you never mentioned it in the article ! Thanks very much

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    1. The spots are pigment spots in many cases. In some cases they may also be the openings to the anal sacs or secondary infections or abrasions if the pet was scooting. Please ask your vet to look at your dogs spots the next time you visit. We are always happy to answer questions.

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    2. My chihuahua has had her glands expressed she's had medication xrays blood tests even had anersetic perseger to look more in depth at front and back passage, and vets can't find a thing wrong with her yet she is scooting all the time even when she out walking can anyone help me with this

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    3. If the anal sacs are empty and dont appear to be the source of the discomfort look for intestinal parasites by submitting a fecal sample to a diagnostic lab for microscopic analysis. Then look at atopy/pruritis (itching), and then look at things like perianal fistulas. Thats my rule out list.

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