perianal/ anal sac fistula in GSD

RE: perianal/ anal sac fistula in GSD

vetbl.locum — Thu, 16 Dec 2021 07:22:44 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/30101/perianal-anal-sac-fistula-in-gsd/234422#234422"]was on cyclosporin, worth a try?[/quote]

Yes I thought it was useful, easy to do but expensive.

Cannot recall dose protocol Sorry

Rgds

RE: perianal/ anal sac fistula in GSD

Andrei Uricaru — Wed, 15 Dec 2021 23:45:34 GMT

Hi Francisco,

One could try Tacrolimus cream which works well on anal furunculosis. However, if your fistula is truly anal sac-skin due to surgical error, then Tacrolimus would not work. If so, my advice is to remove the anal sac using the closed method i.e. folley or wax method without cutting the anal sphincter muscles.

I hope this helps, Andrei.

RE: perianal/ anal sac fistula in GSD

Neil Wheadon — Wed, 15 Dec 2021 12:48:59 GMT

[quote userid="11202" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/30101/perianal-anal-sac-fistula-in-gsd/234412#234412"]I seem to recall that I treated a few with cyclosporin??[/quote]

The last one I saw a few years ago was on cyclosporin, worth a try?

Neil

RE: perianal/ anal sac fistula in GSD

vetbl.locum — Wed, 15 Dec 2021 00:36:18 GMT

I seem to recall that I treated a few with cyclosporin?? for anal furonculosis but that was along time ago

Don't see as many cases of furonculosis these days

Disagree with Julian regarding usefulness of cyro for these cases

rgds

RE: perianal/ anal sac fistula in GSD

Julian Earl — Tue, 14 Dec 2021 09:43:30 GMT

In my limited- experience of these challenging cases, some form of potent anti-inflammatory medication is required as well as the antibiosis. I have never seen one treated successfully by cryosurgery though and fail to see the rationale to be honest! Indiscriminate extensive freezing and sloughing? Thorough cleansing is required, broad-spectrum antibiotics simply because of interfering at this particular site! Anal gland removal seems a logical necessity to try and reduce inevitable ongoing contamination, especially subcutaneously?

Althouh not n practice now, I shall be interested to see the conclusion of this case and thread! Thank you...!

HTH?

RE: perianal/ anal sac fistula in GSD

Anthony Dennison — Fri, 10 Dec 2021 16:03:57 GMT

[quote userid="11493" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/30101/perianal-anal-sac-fistula-in-gsd/234270#234270"]Thanks Neil and Beats. The problem is that while the fistula persists, I think the anal gland discharges, which I think it's the reason why the client came back again. And that's why it developed the secondary pyoderma. I can't keep the dog on cephalosporin forever.[/quote]

Topical skin protection around it like vaseline, or F10 ointment?

RE: perianal/ anal sac fistula in GSD

Neil Wheadon — Fri, 10 Dec 2021 16:03:13 GMT

[quote userid="11493" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/30101/perianal-anal-sac-fistula-in-gsd/234317#234317"]I have cryo but use it for distichiasis. Not sure about the logic here. Would you expand please?[/quote]

OK 35 years ago this memory

He used to anaesthetise, cut away any dead tissue then simply cryo the rest of the fistula's

I would strongly suggest finding a reference to do this from somewhere as I did one but a long time ago. It did seems to help

Maybe a paper under Churchill Frost?

Neil

RE: perianal/ anal sac fistula in GSD

Francisco Gomez — Fri, 10 Dec 2021 09:36:31 GMT

I have cryo but use it for distichiasis. Not sure about the logic here. Would you expand please?

RE: perianal/ anal sac fistula in GSD

Neil Wheadon — Fri, 10 Dec 2021 09:01:30 GMT

[quote userid="11202" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/30101/perianal-anal-sac-fistula-in-gsd/234310#234310"]What ever happened to cryo ..?[/quote]

That's a very good question. I made a fine job of a recurrent blood blister on my right arm, a sort of 80's tatoo

[quote userid="11202" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/30101/perianal-anal-sac-fistula-in-gsd/234310#234310"]Seems so 80's [/quote]

Some of us are stuck there. Off to see the Human League on Tuesday where they are running through 'Dare' as it's been 40 years. If you get a chance Phil's voice has stood the test of time.

Neil

RE: perianal/ anal sac fistula in GSD

vetbl.locum — Thu, 09 Dec 2021 22:58:58 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/30101/perianal-anal-sac-fistula-in-gsd/234269#234269"]We use to Cryo them[/quote]

What ever happened to cryo ..?

Seems so 80's

RGds

RE: perianal/ anal sac fistula in GSD

Beats — Thu, 09 Dec 2021 07:50:12 GMT

For me this is a case of finding a means of topical management at home +/- visits to you to get hair shaved on ventral tail and around perineum periodically and anal glands expressed perhaps.

Daily baby wipe cleaning of the area at home?

I might consider a trial of TEVA's tacrolimus cream (30g tube) applied daily on area that is prone to developing the pyoderma and around the fistula?

RE: perianal/ anal sac fistula in GSD

Jill Butterworth — Wed, 08 Dec 2021 21:34:24 GMT

Waiting for a more specialist surgeon to reply, but rather than closing the fistula, could you dissect out the rest of the anal sac in that case and marsupialise it or hope you get some second intention healing? It's quite likely to be very disrupted and difficult to identify structures, but the inside of the sac looks a bit like fish scales. I hate this kind of surgery as the faecal contamination is inevitable as everyone says, I doubt it will resolve, just management and hope you don't make things worse and warn the owner.

RE: perianal/ anal sac fistula in GSD

Francisco Gomez — Wed, 08 Dec 2021 21:00:20 GMT

Thanks Neil and Beats. The problem is that while the fistula persists, I think the anal gland discharges, which I think it's the reason why the client came back again. And that's why it developed the secondary pyoderma. I can't keep the dog on cephalosporin forever.

RE: perianal/ anal sac fistula in GSD

Neil Wheadon — Wed, 08 Dec 2021 19:51:19 GMT

No.

We used to see loads of these , but now it's all French Bulldogs

Definately don't close it

We use to Cryo them, treat them with antibiotics, debride them, I've seen them on cyclophosphamide. The more treatments, the less likely any will work.

Does anyone remember Frostie at the RVC in Camdem. They wheeled him out to give us surgery lectures in the last century, he used to take referrals for these.

In my opinion, they are chronic, frustrating and long standing. As long as the client knows that you'll be OK

Neil

RE: perianal/ anal sac fistula in GSD

Beats — Wed, 08 Dec 2021 19:12:12 GMT

Irrespective of the origin, I don't think I would surgically close a fistula in that location. I can't see what good could come from doing so.