Overview of Anal Sacs
The anal sacs, often mistakenly called "anal glands," are two sacs located at the 4 and 8 o’clock positions between the internal and external anal sphincter muscles. These sacs contain sebaceous glands and are connected to the exterior through ducts that empty near the anal mucocutaneous junction. Their secretions, thought to aid in territorial marking and communication, are typically liquid, clear to translucent, and pale yellow in healthy dogs.
Anal Sac Diseases: Causes and Symptoms
Anal sac impaction occurs when these sacs are not fully emptied during bowel movements, leading to discomfort and possible complications. Studies show that 12.5% of dogs presented to veterinary practices have some degree of anal sac disease.
Causes of Anal Sac Impaction:
Hypersecretion of sebaceous glands
Constipation or chronic diarrhea
Laxity or narrowing of anal sphincter or ducts
Food allergies
Symptoms of Impaction and Infection:
Pain and discomfort
Scooting or dragging the perineum
Licking or self-trauma around the tail base
Thickened secretions (dark brown in impaction, pus-colored with infection)
Diagnosing Anal Sac Disease
Diagnosis is based on:
Clinical history and physical examination
Rectal examination with manual expression of the sacs
Palpation for masses
Cytology is not a reliable tool for diagnosing anal sac disease, as no significant differences have been found between secretions from normal dogs and those with disease.
Treatment Options for Anal Sacculitis
Acute Anal Sacculitis
Acute cases, often caused by short-term impaction, can usually be resolved with simple expression of the sacs. However, additional symptoms such as superficial perianal abrasions and localized skin irritation may require further attention.
Laser Therapy for Acute Cases:
Benefits: Reduces pain and inflammation, prevents continued symptoms, and may ease the expression process when performed beforehand.
Settings: 6–8 J/cm² using contact or non-contact delivery.
Application: Targets both superficial and deeper tissues surrounding the anal sacs.
The Luma delivers 1.1W over an area of 14.5cm², which results in a power density of 75mW/cm². In just one minute of treatment, this equates to 4.5 J/cm², making it effective for reducing inflammation and pain in both acute and chronic cases.
Recommended protocol with Luma: 1.5 minutes
Chronic Anal Sacculitis
Chronic cases present a greater challenge due to recurring impaction, inflammation, bacterial infection, and purulent secretions. Treatment typically includes:
Systemic antibiotics, anti-inflammatories, and pain medication
Regular manual expression, flushing, and packing of the sacs
Laser Therapy: Added to the medical protocol for better management.
Recommended Laser Therapy Protocol:
Induction Phase: Treat every other day to twice a week, coinciding with sac expression until a clinical response is noted.
Transition Phase: Gradually reduce treatment frequency as symptoms improve.
Maintenance Phase: Long-term treatments every 3–4 weeks to manage symptoms and prevent flare-ups, potentially avoiding surgical excision of the sacs.
Anal Sac Abscesses
Untreated impaction can lead to abscess formation, characterized by cellulitis and fistulous tracts. Treatment includes:
Traditional incision, drainage, debridement, and flushing
Systemic and topical medications
Laser Therapy for Abscesses:
Settings: 8–10 J/cm² for deeper and more extensive tissue involvement.
Frequency: Daily treatments for 2–3 days, then alternate days for 3–4 sessions or until cellulitis and fistulous tracts heal.
Takeaway for Clinicians
Laser therapy offers a safe, effective, and non-invasive option to manage both acute and chronic anal sacculitis, as well as anal sac abscesses. The Luma provides an optimal dose with its 4.5 J/cm² per minute treatment, which reduces inflammation and pain while aiding in faster healing. By incorporating photobiomodulation into treatment protocols, clinicians can reduce pain, inflammation, and the risk of surgical intervention while improving patient outcomes.
For further guidance on laser therapy protocols and best practices, contact our team at MedcoVet. Together, we can ensure the best possible care for your patients.