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Sunday, May 3, 2009

Anal Gland Answers

Dan sends in this scenario.

Hello there, I have a small Terrier who is about to turn 9 years old. He never had anal gland issues until about 6 months ago, when I noticed him scooting. I have taken him to my vet and the techs expressed his glands (one was impacted and came out like paste). Since then I have returned monthly and had them expressed, no problems.

My question is this….

His normal defecation isn’t nearly as large and firm (not runny but soft). I asked the vet tech if he needed more dietary fiber to increase his stool volume and if that would help his glands. She told me no but in my research of the issue it appears that many vets do believe that fiber seems to help. What is your opinion of fiber offering any aid in anal gland maintenance and also will it help his loose stools?

Anal sacs are normal structures in dogs and cats, one on either side of the anus. In wild canines and felines the secretions from the sacs normally express onto the stool during defecation and are used for scent marking. In pets there really is no purpose for them. Most animals never have any problems with them at all. Small breed dogs tend to have a much higher chance of impaction or difficulty expressing the material than other dogs, and anal sac issues are very rare in cats.

The most obvious sign of full anal sacs are when a dog sits on their hind end and "scoots", or drags their bottom along the ground. Many people have the impression that this indicates worms, but this is rarely the case, and "scooting" is a classic sign of full anal sacs. In most cases having them expressed at the vet is a very simple and straightforward procedure. However, sometimes the secretions can be unusually thick and cause impactions. In very severe cases infection can occur, and can then cause the sac to rupture through the skin next to the anus.

Truthfully, there are still a lot of unknown things about why pets have problems. We do know that it happens almost exclusively in dogs, and most commonly in small breeds. Overweight pets seem to have a higher tendency for issues, so losing weight may help. Anatomical differences can cause the sac opening to be malpositioned, making natural expression difficult. And some pets naturally begin to produce unusually thick secretions, making it diffcult to express on their own.

There really aren't any good and accepted ways to prevent or reduce problems. Like you found, Dan, many vets (myself included) do believe that increasing the fiber in the diet may help. However, there are no studies to support this belief and it's purely anecdotal. I do think that I've seen cases in which it has helped, and it surely doesn't hurt to try as it the fiber doesn't cause any harm. Most often I recommend adding some canned pumpkin to the dog's food, usually anywhere from a few teaspoons to a few tablespoons (there isn't a generally accepted amount) depending on the size of the dog. Canned pumpkin is cheap, easy to obtain, and they like the taste of it. Another option is adding a few teaspons of Metamucil or similar fiber supplements to the food. The fiber may or may not help with the soft stools, so you may want to ask your vet about special foods to help with digestive issues.

The only other options are regular expression (most commonly by a vet or their staff), or surgical removal of the glands. Surgery is an option of last resort, and usually only recommended when there are repeated impactions or infections, or you have to have them expressed monthly or more frequently. The reason it's not done more commonly is that there is a slight risk of permanent post-operative complications with fecal incontinence. It's probably in only 10-20% of the cases, but there can be some damage to the muscles or nerves of the anal sphincter, making it difficult for the dog to hold feces inside, potentially leading to stool coming out at any time without any control.

If you want to discuss this further, I would recommend talking to your vet rather than the tech. My own techs normally do the expressions also, so it's not necessary for the vet to be involved in routine expression. However, if you want to discuss the surgery and other options, you'll need to talk to the vet.

Good luck!

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