Persistent perianal ulceration

Re: Persistent perianal ulceration

Anthony Todd — Thu, 10 Jan 2013 20:27:28 GMT

[quote user="Kate Richardson"] never even vaguely full or impacted at any stage of the process.[/quote]

Infected or irritating glands never are, well yes, the odd "impacted" gland if one can define what is meant by that....

In fact "normal" glands are usually at least half full or more, depending on diet and faecal consistency, with the usual greyish or yellowish dolce latte.

Glands with little or no content are grounds for a pack in my book, if accompanied by any symptoms of perianal irritation as in the cases posted.

Re: Persistent perianal ulceration

Kate Richardson — Thu, 10 Jan 2013 17:13:45 GMT

[quote user="Niall Taylor"]

[quote user="Kate Richardson"]

http://www.vetsurgeon.org/forums/t/10413.aspx?PageIndex=1

Does it look anything like this case?[/quote]

Yes, but not so bad...

Now I need to work out how Anthony knew that too

How is your case doing?

Thanks for this,

Niall

[/quote]

I was wondering how Anthony knew that too

My dog is doing really well now having Cortavance spray applied once daily to the perianal area and no other meds having been weaned off prednisolone over 3 months ago. Anal glands were repeatedly checked and were never even vaguely full or impacted at any stage of the process.

Re: Persistent perianal ulceration

Bob Russell — Wed, 09 Jan 2013 11:14:55 GMT

Human steroid topicals are very cheap indeed and can be used without breaking cascade. Should we be using Fuciderm as often as we do? Do we really need a topical antimicrobial that much?

I got a bit of a shock when I found out how much a large tube of Fuciderm was.

Re: Persistent perianal ulceration

Rajat — Tue, 08 Jan 2013 19:10:38 GMT

Hi Niall

It was 0.122% betnovate cream/ointment (Betnovate) not 1%! Mimms say RRP £1.43 for a 30g tube.

Re: Persistent perianal ulceration

Niall Taylor — Tue, 08 Jan 2013 18:45:46 GMT

[quote user="Kate Richardson"]

http://www.vetsurgeon.org/forums/t/10413.aspx?PageIndex=1

Does it look anything like this case?[/quote]

Yes, but not so bad...

Now I need to work out how Anthony knew that too

How is your case doing?

Thanks for this,

Niall

Re: Persistent perianal ulceration

Anthony Todd — Tue, 08 Jan 2013 16:36:34 GMT

[quote user="Kate Richardson"]Does it look anything like this case?[/quote]

Yes, but not so bad, and AGs were my bet in that one too, or at least they should have been eliminated by a trial packing with a potent steroid prep.

Re: Persistent perianal ulceration

Kate Richardson — Tue, 08 Jan 2013 15:04:53 GMT

http://www.vetsurgeon.org/forums/t/10413.aspx?PageIndex=1

Does it look anything like this case?

Re: Persistent perianal ulceration

Rajat — Tue, 08 Jan 2013 14:46:21 GMT

erm if memory serves it was 1% betamethasone cream, but I will look it up when I get back to work and let you know later today!

Had found it it in mimms btw, , under topical steroids...

Re: Persistent perianal ulceration

Niall Taylor — Tue, 08 Jan 2013 14:41:54 GMT

[quote user="Rajat"]I have had some cases where stronger steroid creams (human preps) were needed for significant pruritus triggers- these may help you too.[/quote]

Any brand names Rajat?

Niall

Re: Persistent perianal ulceration

Niall Taylor — Tue, 08 Jan 2013 14:37:26 GMT

[quote user="Anthony Todd"]If the content isn't like ripe dolce latte I'll bet my life the A/Gs are the cause[/quote]

hmm... <note to self - avoid cheese board if ever invited to eat at Chez Todd>

[quote user="Anthony Todd"]I'll bet London to a jar of jam... [/quote]

Brilliant expression though!

Niall

Re: Persistent perianal ulceration

Niall Taylor — Tue, 08 Jan 2013 14:34:54 GMT

Thanks for all the responses. We had considered Atopica but have stopped short as it seemed to be a bit of a sledgehammer to crack a walnut situation. We'd probably go for referral before taking that step (after all, a problem shared is a problem two people have). The anal glands have been checked regularly and are consistently empty but I hadn't thought that there might be persistent pruritis despite appearing empty. I guess flushing UGA & infusing panalog or similar might be a sensible option.

At the moment the saline wash appears to have produced a tiny wee improvement & the owner is going to give whaddyacallit honey a go. I'll keep you posted as to progress.

Cheers,

Niall

Re: Persistent perianal ulceration

Anthony Todd — Mon, 07 Jan 2013 18:36:39 GMT

[quote user="Michael Woodhouse"]Cortavance spray?[/quote]

Please, please just eliminate the anal sacculitis as a possibility first!

If the content isn't like ripe dolce latte I'll bet my life the A/Gs are the cause!

Pack with the strongest steroid plus AB cream or ointment now available.

The excoriation usually comes from "scooting" and appears exactly as described.

Re: Persistent perianal ulceration

Michael Woodhouse — Mon, 07 Jan 2013 18:09:26 GMT

Cortavance spray?

Re: Persistent perianal ulceration

Rajat — Mon, 07 Jan 2013 18:06:15 GMT

hi Niall

I have had some cases where stronger steroid creams (human preps) were needed for significant pruritus triggers- these may help you too. Is the dog licking/biting its arse or is the ifnlammation spontaneous? glands empty?thickened?

Atopica will be expensive, and systemic whereas protopic cream may do the same without systemic dosing. I have used it a few times to good effect where local immuno modulation was called for...

Re: Persistent perianal ulceration

Anthony Todd — Mon, 07 Jan 2013 16:36:45 GMT

[quote user="Utlendigur"]Any anal gland problems[/quote]

I'll bet London to a jar of jam, although I didn't plant the red star it is, surely, a local problem and not systemic??

Oh for a Panolog infusion into both emptied sacs...

Re: Persistent perianal ulceration

Bob Russell — Mon, 07 Jan 2013 15:25:11 GMT

I would tend to agree with trying atopica. The biopsies don't rule out anal furunculosis do they? Most other things seem to have been tried so with informed consent I cannot see much of a reason not to give it a go!

Re: Persistent perianal ulceration

Utlendigur — Mon, 07 Jan 2013 15:12:59 GMT

[quote user="tess"]

Atopica worth a go?

[/quote]

Why the red star?

Any anal gland problems? Anything further in on rectal - polyps/massess/irregular roughened mucosa? Any diarrhoea? Worming? Buster collar (won't stop scooting but may r/o licking causing trauma)? Hypoallergenic diet?

Re: Persistent perianal ulceration

tess — Mon, 07 Jan 2013 12:55:21 GMT

Atopica worth a go?