The role of surgery in the management of canine anal furunculosis. A review of the literature and a retrospective evaluation of treatment by surgical resection in 51 dogs

Abstract

The aetiopathogenesis of canine AF remains unclear. Whilst recent advances in medical management by the use of various immunomodulatory medications (such as cyclosporine) hold promise, this approach has yet to be refined with respect to affordability, long-term efficacy and morbidity. With meticulous surgical dissection and reconstruction techniques (anoplasty), excellent success rates can be achieved following a single surgical procedure with minimal complications. Surgery remains a viable treatment option, alone or in combination with immunomodulatory medications, until a more thorough understanding of this debilitating disease is achieved.

Risk factors for postoperative complications following bilateral closed anal sacculectomy in the dog

“…Two of the dogs in this study underwent anal sacculectomy as part of a management strategy for ongoing AF as has been recommended (Milner ). Both dogs had very mild AF lesions but which involved the anal sacs and surgical intervention was limited to routine closed anal sacculectomy following a period of medical management involving low‐dose prednisolone therapy (one dog) or cyclosporine therapy (one dog).…”

Association of canine anal furunculosis with TNFA is secondary to linkage disequilibrium with DLA‐DRB1*

“…Many treatments, including both medical and surgical approaches (7), have been tried with varying degrees of outcome and efficacy. However, recent studies have shown the clinical benefit of immunomodulatory therapy with ciclosporin and other immunomodulatory drugs such as azathioprine (8–10).…”

Long-term prospective evaluation of topically applied 0.1% tacrolimus ointment for treatment of perianal sinuses in dogs

“…Although satisfactory short-term results are often achieved through surgical intervention (up to 80% of dogs improve), lesions redevelop in a high proportion (50% to 90%) of affected dogs, with complications including fecal incontinence or rectal stricture. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Perianal sinuses reportedly respond to immunosuppressive treatment protocols, which supports the hypothesis that the disease is immune mediated. 7,8,13,[15][16][17][18][19][20][21][22] Administration of prednisone at a high dose (2 mg/kg [0.91 mg/lb], PO, q 24 h for 2 weeks, followed by 1 mg/kg [0.45 mg/lb], PO, q 24 h for 4 weeks) and feeding of a novel-protein diet (ie, diet including protein to which dogs had not previously been exposed) resulted in short-term improvement or cure in 67% of dogs with perianal sinuses and concurrent colitis in 1 study.…”

“…These findings underscore the importance of thorough examination of the affected anal area at the time of initial examination and recommendation of anal sacculectomy should anal sacs be involved in the perianal sinuses. 19,35 The anal sacs of German Shepherd Dogs are located deeper within the perianal tissue, and they extend further cranially into the external anal sphincter than in other breeds. 10 Therefore, a meticulous technique and good anatomic knowledge are needed to ensure complete anal sacculectomy in German Shepherd Dogs, with minimal adverse sequelae.…”