Anal gland Gel

RE: Anal gland Gel

grumpyoldman — Mon, 01 Oct 2018 23:53:22 GMT

[quote user="Michael Woodhouse"]Interested if I may ask, why so many?[/quote]

I thought it was about average ; we have 7 vets at present turnover 2.5m ,only two do these surgeries regularly. The neuters are very variable. Most cats get spayed in small batches by charities so i miss a lot of that. The dog castrations and spays would be 4-5 per week each. We are not the cheapest in our area for this kind of work and I don't go looking for it. Oddly clients really like the Laproscopic spays and travel miles for it. There is a lot of loss leading on routine surgeries locally so I let them get on with it. I look at what i need to turnover in a day and if I cant stand there all day neutering and pay everyones wages from the proceeds, its not worth doing it. Over 30 years ago my first boss told me better to charge £60 for two spays than £40 each for three. You use less drugs and materials and there is less to go wrong. Any fool can work for nothing. The part of the market we are aiming at generally do not shop around for cheaper low skill services, we sacrifice the clients one rung above the PDSA and wave them on their way to the Franchises.

RE: Anal gland Gel

Anthony Todd — Mon, 01 Oct 2018 16:35:21 GMT

[quote user="Iain Richards"] but one cannot tell, visually, if the gland is infected or not, except perhaps frank blood. [/quote]

When the normal dolce latte consistency and darkish brown changes to pale yellow and watery, with some pain on expression [hardly ever any blood] I'd say it's infected.

We never cultured them 'cos I reckon you'd find a pathogen in all of them so we went straight for a cure, rather than via a culture.

Don't think I ever noticed any changes to the perianal skin though and the problem resolved with most non-steroid containing ear preps as well as Panolog.

PS I saw impacted AG's in cats too. Does that happen with high-residue dried food these days??

RE: Anal gland Gel

Iain Richards — Mon, 01 Oct 2018 11:02:37 GMT

[quote user="Anthony Todd"]

[quote user="Iain Richards"]bit I do treat the underlying atopy.[/quote]

That needs some corroboration??

[/quote]

Tee Hee, that's what I nearly typed!

I don't have the papers to hand, but one cannot tell, visually, if the gland is infected or not, except perhaps frank blood. The infections are mixed - as you'd expect. I've adopted the atopy reasoning for about 12 years or more now, and although I don't have any specific evidence, neither have I had folk complaining, "That dog came back in a couple of days for me to empty the glands." The perineal skin is a good place for malassezia and the scoot is just an itchy arse, no more. I suspect the "infected sacs" correlation, not causality.

(Caveat, single sided large glands do get emptied)

RE: Anal gland Gel

Anthony Todd — Mon, 01 Oct 2018 10:36:28 GMT

[quote user="robloxley"] rather than just anal sac problem[/quote]

But when seen with liquid, watery yellow A/G content hard to agree?

Mind you when infused with Panolog, with a lot of triamcinalone I'm not on very solid ground......

Got to be unusual to get atopy, or allergy, only perianally though?

RE: Anal gland Gel

Rob Loxley — Mon, 01 Oct 2018 10:29:44 GMT

[quote user="Anthony Todd"]

[quote user="Iain Richards"]bit I do treat the underlying atopy.[/quote]

That needs some corroboration??

[/quote]

I agree with Ian: a lot of the perineal rubbing we see is part of an underlying itchy skin disease rather than just anal sac problem

RE: Anal gland Gel

Anthony Todd — Mon, 01 Oct 2018 10:18:31 GMT

[quote user="Iain Richards"]bit I do treat the underlying atopy.[/quote]

That needs some corroboration??

RE: Anal gland Gel

Iain Richards — Mon, 01 Oct 2018 09:55:37 GMT

Have't removed one for yonks, I rarely empty them (unless obviously one sided) bit I do treat the underlying atopy.

RE: Anal gland Gel

David Mills — Mon, 01 Oct 2018 00:54:37 GMT

[quote user="Michael Woodhouse"]

Interested if I may ask, why so many? How many vets have you or how many bitch and cats spays are you doing a week (to get a feel for frequency of the op)?

I appreciate we don't do huge amounts of small animal work but in 12 years I've removed 1 set of anal sacs, and remember seeing 1 other removal as a student on EMS.

[/quote]

Equally. I've done 2 in 10 years. And one of those borderline.

[quote user="avh"]

Eardrops seem to work ok. I use Canaural. I only operate if there is already duct damage from regular squeezing, chronic issues etc.

They are a bit like Canine Ear Disease. Diagnose and manage..seldom need Lat Wall resection etc Don't manage properly and then regularly squeeze too hard through an inflamed duct and get ductal strictures etc and thus requiring surgery.

[/quote]

Never seen duct damage, unsure what is being seen here? Also the comparison with ear disease is logically fallacious.

RE: Anal gland Gel

Anthony Todd — Sun, 30 Sep 2018 22:38:45 GMT

[quote user="avh"]I only operate if there is already duct damage from regular squeezing, chronic issues etc.[/quote]

I don't think I've ever seen "duct damage" and I've never had difficulty in draining any A/G [apart from A/G abscess] which seemed always to come unannounced and suddenly, without prior incident or history.

Any ear prep with Csteroid and your favourite A/B would be my suggestion now Panolog is gone.

Further esperiences would be helpful.

RE: Anal gland Gel

avh — Sun, 30 Sep 2018 18:34:34 GMT

Eardrops seem to work ok. I use Canaural. I only operate if there is already duct damage from regular squeezing, chronic issues etc.

RE: Anal gland Gel

Anthony Todd — Sun, 30 Sep 2018 11:52:53 GMT

[quote user="Martin Atkinson"]always down to diet.[/quote]

Has "AGs" as a complaint reduced with the advent of dried, cereal-based high residue but no bone fragments diet?

Don't you see the infected fluid-filled purulent AGs any more or ever?

RE: Anal gland Gel

Anthony Todd — Sat, 29 Sep 2018 09:22:48 GMT

This has been discussed before.

Once I started packing A/Gs with [bestest] Panolog, after emptying and flushing, we never had to remove any. There must be a suitable replacement for Panolog or maybe import it from Europe??

I assume we are talking about chronic "infected" A/Gs, ie with a purulent liquid content, and a lot of irritation??

I'm not sure if AGs, with the usual, normal, content ever cause problems needing removal and periodic manual expression seemed to work, but this was rarely necessary although owners often demanded it as routine [groomers apparently do this now].

RE: Anal gland Gel

Beats — Sat, 29 Sep 2018 08:02:14 GMT

foley catheter technique - any fans?

RE: Anal gland Gel

Evelyn Barbour-Hill — Sat, 29 Sep 2018 00:55:09 GMT

[quote user="grumpyoldman"] We were looking at Dental Amalgam as an alternative ,or inflating the sac with dermisol and tying off the duct with a small purse string. Everything else involves too much heat e.g. technovit.[/quote]

Sure you mean amalgam? You'd have a job getting that into the sac. (Quite apart from the faff of preparing it. Though I do know a method of preparing it without an amalgamator – it involves a condom.)

RE: Anal gland Gel

Michael Woodhouse — Sat, 29 Sep 2018 00:11:24 GMT

[quote user="grumpyoldman"]We do this on a weekly basis [/quote]

Interested if I may ask, why so many? How many vets have you or how many bitch and cats spays are you doing a week (to get a feel for frequency of the op)?

I appreciate we don't do huge amounts of small animal work but in 12 years I've removed 1 set of anal sacs, and remember seeing 1 other removal as a student on EMS.

RE: Anal gland Gel

grumpyoldman — Fri, 28 Sep 2018 23:18:06 GMT

We have had this problem with availability, it started a few months ago when we had a faulty batch that did not solidify into a single solid marble but developed a crumbly biscuit texture. We complained to the wholesalers who initially pissed my head nurse off by suggesting operator error after having used it very successfully for over 20 years. Not wise really, then they went off the market, we noticed the rubber bungs in the glass tubes had changed and sometimes the gel was much less viscous and expanded more in the glass tube pushing the bung out.

We were looking at Dental Amalgam as an alternative ,or inflating the sac with dermisol and tying off the duct with a small purse string. Everything else involves too much heat e.g. technovit.

The Charlesworth Paper was over 10 years, about 1 every 2 months ,didn't say how many had fistulated ,how often, and why they changed from one technique to the other half way through. We do this on a weekly basis and I find its a lot quicker with the gel ,an operating loupe, and a really good light, there are few minor complications which resolve in the first week. The gel also helps define the sac from adjacent & attached Masses. The dissection is also a lot easier after 7 days of pre op antibiotics because the capsule is less oedematous and friable and much less likely to break up during the dissection. Its also a lot easier to teach the new grads with the gel, buggering about with a cat spay hook really drives them insane.

RE: Anal gland Gel

Rob Davis — Fri, 28 Sep 2018 17:49:03 GMT

[quote user="Evelyn Barbour-Hill"]If you are careful you shouldn't damage the anal sphincter.[/quote]

Having also tried all the various methods, I personally favour the open technique which, by definition, involves deliberately transecting the external anal sphincter muscle. I know that it is supposed to have a higher complication rate, but I find it much quicker and easier and have had no significant complications using it.

RE: Anal gland Gel

Evelyn Barbour-Hill — Fri, 28 Sep 2018 15:00:02 GMT

I've removed anal sacs (not anal glands) every which way, and distending the sacs with filling material is the best way and eases the surgery considerably – for me. So I guess it's a case of "if it works for you....."

You can use various dental materials, although you don't get the heating that the original Vettec gives you. On the other hand, the faff of heating it up and getting it in while still hot was always the drawback of Vettec.

[quote user="robloxley"]

Also interesting to read Tim Charlesworth's paper https://www.ncbi.nlm.nih.gov/pubmed/24702484 that reported "Dogs that used gel to distend the anal sac were more likely to have postoperative complications than those that did not" (though bear in mind anything abnormal was recorded as a complication, and most were minor and self-limiting)

[/quote]

It was only 62 dogs. I can't remember whether all the dogs were done by one surgeon, and I can't access the full text now. It also found that dogs under 15kg were more likely to have complications.

If you are careful you shouldn't damage the anal sphincter.

RE: Anal gland Gel

Rob Loxley — Fri, 28 Sep 2018 13:51:27 GMT

RE: Anal gland Gel

Niall Taylor — Fri, 28 Sep 2018 10:01:11 GMT

I stopped using anal gland packing materials ages ago, it's much easier to remove them empty, with just a blunt probe to tell you the position of the gland. I got fed up of the mess and trouble it took getting technovit, candle wax or whatever other materials we used to use back in the day, only to have them ping across the room cos I happened to nick the gland during surgery (after which the surgert was much more straightforward too).

RE: Anal gland Gel

Beats — Fri, 28 Sep 2018 09:24:52 GMT

http://www.veterinary-instrumentation.co.uk/product.php?productid=3661&cat=0&page=1 ?

RE: Anal gland Gel

Martin Atkinson — Fri, 28 Sep 2018 08:55:01 GMT

We have an anal gland gel kit that is decades old. I do however find that it is of limited use as half the time the gland doesn't fill and then I nick the gland while dissecting out and the gel leaks so I've found it is just as easy to push a cannula through the duct just to give me better anatomical guidance. All that said I very rarely remove anal glands these days anyway, it is better to address the reason why they are filling: obesity, faecal inconsistency always down to diet.