Monday, September 3, 2012

Not more anal glands!

Anyone who thinks that being a veterinarian is a glamorous, fun job where you get to play with puppies and kittens all day is delusional! Fun, yes but after your first run in with an anal gland, no glamor! I seem to be having a run of patients needing help regarding their anal glands. With this in mind, I took a picture of one of my most recent sacculectomy cases to show off.

Let's go back to basics. Anal glands are the scent secreting glands located just inside the internal and external sphincter muscles of the rectum. There is one on either side of the anus between 3-4 o'clock and 8-9 o'clock. Normally, when the dog (or cat) defecates, the anal glands are self expressed. Problems occur for a number of reasons. Some of these include when the material becomes too thick to easily be expressed, the ducts leading from the glands to the anus become blocked, the area becomes inflammed leading to blockage of the ducts, the glands become infected or rupture of the gland. The list goes on.

When deciding to go forward with surgery, you have to weigh the pros and cons seriously. Pros: no more smelly glands that can become infected or ruptured (takes 7 - 9 weeks to heal and are much more likely to rupture again). Cons: fecal incontinence, infection, inflammation, dehiscence of the incisions. This is not a surgery to be taken lightly.

So when we have a case where we need to remove them, I want to avoid a particular complication at all costs. Fecal incontinence is no fun. The dog is just walking along, feces falls out and s/he has no idea it happened. I have only had one case where it occured and it resolved in two weeks.

One of my tools is coloured wax. Who knew that Crayola crayons would have so many uses! It can be a bloody surgery and having a contrasting colour really helps. During the surgery prep I infuse both the glands with the colored wax. This allows me to make my incision just that much further away from the anus; thereby decreasing the chance I will tick the nerves to the sphincters off.

Back to the picture. I made an incision over the gland so you could see how thick it was from the chronic infections. At the bottom of the picture you can see the duct. Since I didn't place a ruler by the gland, it is difficult to have perspective on the actual size. Small, but large enough to be a pain in the......well, you get the idea!