Perianal Fistula

This very serious medical condition can strike fear into the hearts of pet owners. Although it can happen to almost any dog, certain breeds are prone to this condition. In this article we’ll discuss what perianal fistula is as well as the symptoms and treatments, so should you keep an eye out for any irregularities in your dog. 

What is Perianal Fistula

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Perianal fistula is also known as anal furunculosis. It is a very serious medical condition in which a dog’s anus and the surrounding area becomes inflamed. Extreme pain can be caused, and it can even lead to issues and complications when your dog needs to poop. This condition often affects German Shepherds. 

What Tissues are Affected by Perianal Fistula

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When your dog has a perianal fistula, it is characterised by chronic, purulent, smelly, ulceracting, sinus tracts in both the anal region and surrounding skin. The condition is comparable to a carbuncle which is a many headed abscess. Some veterinarians prefer to use the term furunculosis, which is a skin condition characterised by the development of recurring boils. 

How Does it Happen

We are yet to discover why perianal fistulas form although impaction and infection of the anal sacs as well as adjacent sinuses and crypts have been suggested. It has been proposed that poor air circulation around the anal region is a major contributory factor. 

There are recent studies that suggest that the condition is most likely caused by an autoimmune disease. There is a genetic component related to perianal fistulas as well, as some families of the German Shepherd breeds are particularly prone to this condition. There is a study that suggests approximately 80% of cases appear in German Shepherds.  

What are the Symptoms of Paranal Fistulas?

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Various symptoms could indicate that your dog has a perianal fistula. 

If your dog:

  • Experiences pain when pooping
  • Struggles to poop
  • Is constipated
  • Has diarrhoea
  • Has mucus or blood in his poop
  • Extensively licks and bites his anus
  • Is restless or cries when he’s about to poop
  • Tries to bite if you try and lift his tail
  • Has low tail carriage 
  • A foul smell
  • Is irritable or aggressive

He might have a perianal fistula. It’s best to consult your vet immediately after observing symptoms to ensure that the right treatment path is followed. 

How is it Diagnosed

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When these symptoms first appear in your dog, it’s best to schedule an immediate appointment with your vet. A full medical exam will be conducted by your vet and that will be compared to the symptoms you found in your dog! This physical exam will include a rectal exam as it is possible for perianal fistula to be caused by an infection or a blockage of the anal sacs. Don’t be frightened if your vet suggests sedation for the exam. In rare cases, your dog could need to be sedated in order for the examination to take place. Your veterinarian will take samples of cells and tissues from the anal sacs or fistula. The samples will be looked at under a microscope or be used for a bacterial culture as well as sensitivity testing. 

How is it Treated

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When treating a perianal fistula, both medical and surgical treatments are considered. The perianal fistula has an 80% chance of recurrence therefore surgery might be necessary. If the condition is mild enough, your vet will most likely clip any hair in the anal area as well as cleanse that area with an antiseptic solution and flush the area with water. 

Treatments for a more severe case of perianal fistula include:

  • Adjustment in your dog’s diet
  • Antibiotics
  • Oral cyclosporine as well as ketoconazole
  • Anti-inflammatory and immunosuppressive medications such as prednisone
  • Topical immunosuppressive medications

The treatment can take from 7 to 9 weeks to be completed but recurrence often happens once treatment has stopped in moderate cases. 

Surgical treatment will include removing any infected tissue. This is done by either freezing it, cautery or laser surgery. In severe cases, removal of the anal sacs is necessary as well as the removal of the tail to help keep the area clean and aerated. This will aid in healing the current fistula and prevent a recurrence. This is, however, a treatment that is considered less. 

Is Treatment Curative

It is possible for the fistula to resolve after a lengthy treatment. Regardless of the steps taken, be it medical or surgical, the cases are oftentimes extremely frustrating for you and your pet!

Your dog could be unresponsive to treatment, as about 20% are. When this happens, intermittent treatment is required for the remainder of your dog’s life. Although these cases aren’t curative, they are palliative and drastically reduce the pain and discomfort that your dog may experience. 

What is the Recovery Like

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If your dog undergoes surgery or laser surgery, there will be open wounds for a few weeks. You’ll have to clean this daily as well as remove any dead tissue, bacterial or faecal material. Your dog will likely need to take stool softeners as recommended by your vet to ensure that your dog experiences no pain when they poop. Your dog will likely need to wear an e-collar to ensure that they cause no harm to their wounds. 

You’ll have to manage this condition through the remainder of your dog’s life through a special diet and medications. If your dog suffers chronic damage to the perianal area, it can impact the nerves in that area. This can cause faecal incontinence. 

It is best to have good pet insurance on hand if you think your dog might suffer from perianal fistula, as it can be very expensive to treat. Leaving it untreated could result in major health complications.

The Endnote

Perianal fistula can cause extreme pain and discomfort in your dog. It is possible for it to be recurring, however, treatments are available. You might have to make dietary adjustments for your pet to ensure that they are able to poop comfortably. If you suspect your dog has a perianal fistula, get them to a vet as soon as possible.