Just Ask the Expert: Anal sacculitis refractory to standard treatment
Dr. Bloom welcomes dermatology questions from veterinarians and veterinary technicians.
I am treating a 5-year-old Great Dane that has anal sacculitis. Standard treatment consisting of cephalexin; an antibacterial, anti-inflammatory, and antifungal ointment; and a tapering dosage of hydrocortisone has been unsuccessful. I'm trying to avoid surgery. Any ideas?
Anal sacculitis may be associated with allergies, perianal fistulas, and gastrointestinal disease, particularly if the stools are not well-formed. It may also be idiopathic.
Recommended initial treatment protocols include frequent manual expression of the anal sacs, an increase in dietary fiber, locally infused combination antibiotic and corticosteroid products, and systemic use of corticosteroids. For grossly infected anal sacs, systemic antimicrobials may be initiated but are rarely effective.
For refractory cases, anal sacculectomy is frequently the best treatment option.
Paul Bloom, DVM, DACVD, DABVP
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