CHAPTER 10 ANAL SAC DISORDERS 171
Radiography: pulmonary metastasis, dystrophic calcification
Biopsy to rule out adenocarcinoma.THERAPEUTICS
Medical management of impaction by expression; affected dogs often require expres-
sion at approximately 3-week intervals.
Flushing of impacted sacs followed by infusion with corticosteroids and/or antibi-
otics.
High-fiber diet or fiber supplement to maintain stool consistency.
Weight loss.
Sacculitis: treatment based on culture and sensitivity testing; empiric treatment clin-
damycin (11 mg/kg/day) for at least 4 weeks; anal sac expression and lavage, fol-
lowed by infusion with corticosteroids and/or antibiotics; effectiveness inconsistently
reported.Anal sacculectomy may be necessary if medical management fails; complications
include incontinence (uncommon).
Adenocarcinoma: surgical excision, radiation, chemotherapy, radiation therapy; poor
prognosis.
Fig. 10.1.Chronic anal sac impaction causing unilateral pruritus with alopecia and lichenification.