Packing anal glands

Re: Packing anal glands

Evelyn Barbour-Hill — Thu, 25 Mar 2010 03:07:58 GMT

[quote user="Utlendigur"]Not Barbara (can't remember her first name) who used to lecture by talking almost inaudibly with her back to the students, and would spend all afternoon dissecting out furunculosis lesions?[/quote]

Barbara Weaver. Who were were all terrified of.

No, it was Jerry Lucke I was referring to.

[quote user="Utlendigur"]I did manage to empty one into the face of one of our more miserable clients - not my fault she peered under the tail when I commented on how explosively full the glands were[/quote]

O, that's something I've longed to do but I haven't achieved it yet

Re: Packing anal glands

Louisa Huntington — Wed, 24 Mar 2010 18:05:54 GMT

i am a Uk new grad in Canada and I have seen my boss use Synotic or Otomax to pack the glands.

Re: Packing anal glands

Vikki Moran — Tue, 23 Mar 2010 14:12:29 GMT

the last one i did, i used surolan. usually i just use whatever ear antibiotics we have an open bottle of.

Re: Packing anal glands

Vikki Halliday LLB — Tue, 23 Mar 2010 10:12:11 GMT

[quote user="Evelyn Barbour-Hill"]Have you noticed that surgeons rather shy away from the anus[/quote]

I wonder why? -

Re: Packing anal glands

Utlendigur — Mon, 22 Mar 2010 23:32:11 GMT

[quote user="Evelyn Barbour-Hill"]At Bristol it was done by the anaesthesia lecturer.[/quote]

Not Barbara (can't remember her first name) who used to lecture by talking almost inaudibly with her back to the students, and would spend all afternoon dissecting out furunculosis lesions?

I try not to emoty anal glands unless there is a problem ie don;t do routinely at boosters. I did manage to empty one into the face of one of our more miserable clients - not my fault she peered under the tail when I commented on how explosively full the glands were

We generally try emptying them first. If the problem isn't resolving we try oral antibiotics (usually nisamox or clindamycin) +/- steroid. If that still isn't working we culture and flush with hibitane and pack with fucithalmic. We very rarely need to go further so don't do many anal gland removals (all the ones I can remember doing recently were because of suspicious masses) but so far haven't had any problems with incontinence other than the odd one in the first 24hrs that has, as someone else put it, not quite pinched off the end of the faeces.

Re: Packing anal glands

Evelyn Barbour-Hill — Mon, 22 Mar 2010 22:26:47 GMT

[quote user="Jon Bray"]Can anyone who does lots of anal gland removals give us an estimate of the incidence of long term faecal incontinence post-surgery? I've done a few with no problems but obviously if this does occur it is quite likely to be indirectly fatal.[/quote]

This may be hubris, but I've never had incontinence as a result. (Oops. Oh come on, you know very well what I mean).

I wonder if the risk is exaggerated? Perhaps it comes from the days when the surgery was less carefully performed?

Have you noticed that surgeons rather shy away from the anus, and the surgery gets done by the one person who's interested, no matter what their nominal speciality. At Bristol it was done by the anaesthesia lecturer.

I've packed anal sacs with all sorts of things, and flushed them with even more including phenol, but rarely achieved a permanent cure without surgery.

PS this is NOT intended to stir controversy

Re: Packing anal glands

Rob Reid — Mon, 22 Mar 2010 08:16:10 GMT

We do quite a lot of anal sacculectomies (closed technique) and the only issue with incontinence I tend to see is a transient one for 3-4 days post-surgery and even that is only occasional. I did have one that was incontinent for about 3 weeks post-op (couldn't 'nip off' the faeces when passing but that resolved as well.) I think the key is just to stick to your surgical principles and get plenty of pain relief in.

On the subject of packing, I tend to fush with pevidene and pack with otomax - find this works ok.

Re: Packing anal glands

Michael Woodhouse — Sun, 21 Mar 2010 00:40:51 GMT

[quote user="Jon Bray"]Continuing this theme, does anyone empty anal glands at every booster as routine [/quote]

I hate emptying anal glands. If we charged £100 it wouldn't be enough. I'm not doing it for fun AND the dog doesn't like it!

Re: Packing anal glands

Anthony Todd — Sat, 20 Mar 2010 23:27:06 GMT

I used to differentiate an anal gland itch from other forms of posterior pruritis in cats and dogs by emptying then filling with Panalog via an I/V cannula in front of the owner [some vets give a GA].

Richard Halliwell somewhat condescendingly pointed out that the rather large amount of triamcinalone in Panalog would act systemically and mask any pruritis anyway...... and he's right as usual. Except he thought anal gland itch was a total myth until I proved it [apart from the systemic triamcinalone point....]

"Infected" A/Gs have a thin content whereas a full A/G is cheesy and normal although clients think it is somehow therapeutic and used to be a cure for distemper in rural New Zealand. The fouler the smell and more the content the more effective the expression would be.

There's no way I could ever infuse an abscessed A/G so they got steroids and antibiotics then infused in 14 days. Don't think I ever had to remove A/Gs once I started this regime.

Why Panalog was ever withdrawn is a mystery to me. It was magic in allergic/infected otitis and great for lubricating urethral catheters in cats and threw in a bit of logic as well.

Re: Packing anal glands

Jon Bray — Sat, 20 Mar 2010 22:38:42 GMT

Continuing this theme, does anyone empty anal glands at every booster as routine and is thus in a position to tell me whether asymptomatic dogs are any less likely than itchy dogs to have full anal glands?

I ask because emptying the anal glands of "scooting" dogs does anecdotally seem to work - but we rarely get returns even when said anal glands are to all intents and purposes empty, and only a very few have obvious signs of infection.

I'd also be very interested to hear of any studies looking at treatments for itchy anal glands - some people find "half a weetabix SID" works well in some cases, although I'm not convinced dogs which suffer with this problem have stool that is any softer than average. One vet I know swears by z/d and certainly I've read elsewhere (BSAVA lecture I think) that a lot of adverse reactions to food have perineal pruritus as a symptom.

Can anyone who does lots of anal gland removals give us an estimate of the incidence of long term faecal incontinence post-surgery? I've done a few with no problems but obviously if this does occur it is quite likely to be indirectly fatal.

Re: Packing anal glands

Michael Woodhouse — Tue, 06 Oct 2009 13:27:31 GMT

'Pathocef' is a long acting intramammary sold in packs of 4 tubes.

Re: Packing anal glands

Skeptvet — Tue, 06 Oct 2009 02:24:40 GMT

I usuall flush with dilute chlorhexidine and then infuse mometomax, as well as prescribing PO antibiotics and NSAIDs.

Re: Packing anal glands

Karen Eggleton — Mon, 05 Oct 2009 23:34:09 GMT

I find oral clindamycin hit & miss, though I always try it first. Did another one with otomax on Friday and that was fine-think the first one was scarred from previous abscess and otomax is much thicker than canaural to instill. Perhaps I have a problem, but I love packing anal glands. So satisfying!

Re: Packing anal glands

James Allsop — Fri, 02 Oct 2009 13:24:06 GMT

I rarely 'pack' them - I normally find oral clindamycin or metronidazole very effective, occasionally with preds etc if the sack is thickened. On the occasions I have flushed them under GA where my colleagues have booked them in on my ops day i have irrigated the gland with dexadresson following a good clean out with saline.

Re: Packing anal glands

Alan Tevendale — Thu, 01 Oct 2009 07:46:23 GMT

personally I prefer to use canaural although I generally find that systemic antibiosis works fine and packing is not needed in the vast majority of cases

Re: Packing anal glands

Alan Tevendale — Thu, 01 Oct 2009 07:44:15 GMT

If you are still keen on packing with intra-mammary tubes why not find yourself a friendly local LA practice and buy on a small scale from them?

Re: Packing anal glands

Clive Ansell — Wed, 30 Sep 2009 21:17:02 GMT

I usually empty and lavage with saline or dilute chlorhexidine, and don't instill anything into the glands . Also take a swab for bacteriology at the time, then prescribe 2 weeks of antibiotics. If a recuring problem, then advise removal. Works for me.

Re: Packing anal glands

Ian Mostyn — Wed, 30 Sep 2009 21:13:53 GMT

I've never seemed to have a problem with my anal gland abscesses with emptying them and using clindamycin. Never felt the need to pack the glands although one local practice packs them with Dermobium, had some fun trying to remove that!!

Ian

Re: Packing anal glands

Stephen Ashman — Wed, 30 Sep 2009 20:15:06 GMT

I have used oral antibiotics or canaural instillation or pen/strep instillation before. Lately however I've been wondering if there is ever a true active infection of any consequence or if bacteria are just sitting in there; so I've just expressed them as normal and left them, no problems yet. Any views?

Re: Packing anal glands

Gillian Mostyn — Wed, 30 Sep 2009 20:00:46 GMT

Why wouldn't you just give a decent course of antibiotics - like you would with an infected gland anywhere else? I just give a 10 day course of tablets and the infection goes away. If it keeps recurring - usually due to conformation stopping them emptying rather than lack of efficacy of the antibiotic, then they get removed. Simples.

Re: Packing anal glands

Robert Whiteford — Wed, 30 Sep 2009 19:30:27 GMT

Express the contents, infuse with Tetra Delta ( contains steroid too) - the intra-mammary tube has a ready made nozzle - express the contents a week later - job done. .......or not - then ablate the sacs. Bacteriology not worth the lab fee

Re: Packing anal glands

Don Rutherford — Wed, 30 Sep 2009 19:01:24 GMT

After emptying the glands I inject Pen/Strep Injection via a cannula.

Seems to work every time.

Re: Packing anal glands

Gillian Mostyn — Wed, 30 Sep 2009 18:29:38 GMT

Thanks

Re: Packing anal glands

scarlet — Wed, 30 Sep 2009 18:11:09 GMT

have packed anal glands for years and it ,coupled with flushing it does seem to offer quick relief and can sort the problem out quickly - i think the theory was that systemic antibiosis not v good at penetrating anal sacs and the stuff in them!! use to use panolog then leo yellow - will try canaural that sounds good!! often i will do s swab first then tailor antibiosis to match obviously.

it just works!!!!!

Re: Packing anal glands

Gillian Mostyn — Wed, 30 Sep 2009 17:57:40 GMT

Why do you pack them? Sorry, not being funny - just never done it or seen it done. I assume for chronic infections? Do you not find systemic antibiosis effectrive?