Wednesday, January 31, 2018

3348. A 10-year-old Golden Retriever has anal sac discharge after 2 treatments by the vet

Feb 1, 2018

"I feel very peck chek (frustrated in Chinese Hokkien dialect) as my dog passes smelly bloody anal discharge for the 3rd time. She was treated by Vet 1 twice, within 10 days, and the problem returned. The vet had told me that a biopsy (over $500) will be needed if the discharge occurred at the 3rd time!

She had paid $3000 for her dog eyeball removal and was wary of veterinary fees.
Her friend referred her to me. Dr Daniel expressed smelly black anal sac oil via digital expression.
The owner wants a cure, not going to the vet the 4th time to express oil.

This is a case of a possible anal sac necrosis with or without a tumour. Medical therapy by expression of the sacs has not worked.

Possible treatments are:
1. Catheterise the sacs and irrigate with saline and antibiotics. Sedation is needed.
Medication after antibiotic sensitivity test. Wait and see if the bleeding recurs.
2. Biopsy. The owner wanted a permanent cure and this was not a cure.
3. Anal sacculectomy as medical therapy via anal sac expression for 3rd time (rectal digital expression) still shows bloody smelly discharge at Toa Payoh Vets.
The owner would consult her husband as one complication is faecal incontinence after removal of the anal sacs.

Owner wanted Option 1 which is scheduled 2 weeks later as the anal sacs now are inflamed.  She is worried about faecal incontinence and will have to clean the backside if that occurs.

E-collar, R/D diet to reduce weight from 25 kg to 22 kg and provide fibre.
Blood test normal findings.

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