Place this in your mind and store it in your memory because it is a clinical truth. All anal gland problems are secondary to something else! Always.
When I was in vet school, around the time of Moses, we were told that anal gland problems only happen in small breed dogs because the ducts were too small to empty the anal sacs. Oh, my. We actually believed them.
It wasn’t too long in my practice that I found out that many dogs (and cats) have anal gland problems no matter what size or breed. Shot down that theory. So, if it wasn’t a size or breed problem, then what was it?
Let’s first look at the anatomy and function of anal glands. Yuk. Imagine that you are looking at your dogs anus. Yuk. If you imagine that it is a clock, then at the 5 and 7 o’clock positions, just underneath the skin, there is an anal sac in each position. The sac is lined with lots of glands which secret the oily, smelly substance that you hate and your dogs love. Each of the anal sacs have a small duct (about the size of a toothpick in large dogs) that connect the anal sac to the outside.
When the pet has a bowel movement, the muscles near the anal sacs contract and squeeze the sac and empty the fluid outside via the small ducts. The fluid covers part of the fecal material during elimination and it is a part of the pet’s marking abilities. When they poop, they mark their territory. The only function of these gland-lined sacs are for territory markings. That’s all.
When a pet has a problem with its anal sacs (we call them anal glands) it is because the sac is unable to empty itself. That happens when the small duct gets pinched off and will not allow the fluid to flow through to the outside. It is like taking a garden hose and pinching it and the flow of the water stops.
When the anal sac is unable to empty, the glands continue to manufacture fluid, so the sacs get fuller and fuller, much like a water balloon. While this is happening, the liquid component of the fluid starts to dry out and the anal fluid becomes more solid in nature. Some of you may have seen the vet express the sacs and a pasty ribbon like fluid comes out. It can also be inspissated with hard material. In time, if the sacs are not emptied, the sacs will get so full that they put pressure on the skin, rupture to the outside and create a draining tract. Dogs that are scooting are likely attempting to relieve the pressure from the over-full anal sacs. If the sac ruptures and creates a draining tract, surgery is required to repair the problem.
So, what do we (the vet) do about this? Some vets believe that this is a primary problem and that dogs need to have them emptied regularly as a prevention. This is why groomers make it part of their routine.
Other vets, like me, know that they are secondary to other problems and start looking for that. What I found many years ago was that the dogs that had recurring allergy problems were often the same dogs that had recurring anal gland problems. Hmmm. So, I started treating the underlying allergy problems and the anal gland problems were not so much of a problem. Notice I said, not so much, and not resolved. This is because, from a conventional medicine perspective, allergies are not resolvable, only controllable. I was controlling the allergies, and the anal gland problems, but not healing them.
Another white elephant in the room was those dogs that I saw who had had their anal glands removed surgically. Guess what. They continued to scoot even though the anal sacs (and glands) were gone. Another hmmm. The reason was that the underlying problem was still affecting the dog.
It seems that when a dog has an allergy, the skin at the mucocutaneous junction is chronically inflamed. Remember, this is where the anal sac ducts came to the surface. The inflammation of the skin was pinching the ducts, causing the obstruction of the ducts and not allowing the sacs to empty. Bingo. A lot of dogs who have had this problem for many years will have a very thickened area around the anus we call hyperkeratosis, caused by chronic inflammation. We have a primary cause. Maybe.
If the skin inflammation causes the anal sac problems and the skin inflammation is caused by allergies, then how do we resolve the problem? We certainly don’t want to just treat the symptoms with anti-inflammatory or immunosuppressive drugs. This protocol will just keep the symptoms at bay while in the long term, create a whole new set of problems (like cancer). Oops did I say that. Sorry, I am a holistic vet and it can’t be helped.
In order for us to solve the problem, Watson, we have to go down another pathway. The old conventional medicine pathway won’t get us where we want to be. I choose to jump over onto the Chinese medicine pathway and it gets a bit easier and has the potential to heal the problem.
In Chinese medicine, anal sac problems are caused by chronic damp-heat in the lower burner. We can eliminate this with acupuncture and Chinese herbs. SI MIAO SAN (Four Marvel) is a great formula for this problem. But Chinese medicine is just another modality and is not a holistic mindset. But, we can use it to find the root problem.
Dampness, in Chinese medicine is caused by imbalanced spleen/pancreas and ALL spleen imbalance in dogs and cats comes from one source; INAPPROPRIATE DIET. In people it can be caused by too much sex, but since I am a vet, we won’t deal with this. 
Bingo. We have the root problem identified. It is the metaphoric hole in the bottom of the boat. Fix the hole, bail that water and we have healing. This means change the diet to a canine appropriate diet, fed fresh and raw, give the Chinese herbs and acupuncture if possible, fix the damaged gut that is the cause of the immune problems and we have healing. That’s it, enigma solved.
Did you notice that I didn’t talk about cats much? It is because cats are a little different with anal sac problems. A lot of them don’t react the same to underlying allergies, but the inflammation near the anus can be the same. They may not scoot like dogs. They may lick at the area or not show any direct symptoms at all. Often, it will cause enough pain during bowel elimination that they refuse to have a bowel movement and constipation can be the primary symptom. I can’t tell you how many cats I have seen for a second opinion for a cat with chronic constipation that had badly impacted anal sacs.
Well, now you know all that I know about anal sac problems. I won’t mention anal sac tumors as that is a whole other can of worms, but I will say that when there is a tumor, there is always a diet factor somewhere way back in time.
Hope this helps you understand a bit more about this very irritating health problem; for the pet, the caretaker and the vet. Now, you know the rest of the story.
