Module 6- Anal Sacs and Enemas

What are anal sacs?

• round cavity

• Serves as reservoir for anal secretions

• Located bilaterally at 4 & 8 o’clock

• Will refill

What species are anal scent glands found in?

All Carnivora

• (except bears, sea otters, and kinkajous)

Anal gland definition

Numerous specialized sebaceous glands that produce foul smelling secretions line walls of the sacs

Purpose of anal sacs

• deposit small amount of secretions on feces when’s bowel movement takes place

• Territorial marking

• No conscious control over release

What is the 1 species that has control over the release of their glands?

Skunks

*takes 10-12 days to refill sacs

How many mls of secretions do skunks hold

Up to 15mls

5-6 sprays

Why do impacted anal glands occur?

• when secretions cannot be deposited on feces

• Itchy/painful for animals

8 reasons for impacted anal sacs

A. Anatomy

B. Chronic diarrhea

C. High BCS

D. Poor muscle tone

E. Viscous secretions

F. Occluded anal gland ducts

G. Allergies

H. Hard stool

Clinical signs of impacted anal glands

• scooting

• Licking/chewing perianal area

• Stiff legged movement

• Pain upon palpation

• Tenesmus (Straining)

• Abnormal carriage of tail

4 types of anal gland expression techniques

• internal

• External

• cannulation

• Sacculectomy

What is an internal anal sac expression technique?

• most common

• Use lube

• Palpation of sac with index finger inside and thumb on outside

What is an external anal sac expression technique?

• palpation of sacs externally at 4 and 8 o clock

• Groomers method

What is a cannulation anal sac expression technique?

• may require GA

• Inset canula into anal sac ducts to flush

• Flush using dilute antibacterial solution

• Repeat until solution runs clean

What is a sacculectomy? Why would it be performed?

• surgical removal of anal sacs

• Used in chronic cases of infection, impaction, or neoplasia

Why do anal sac abscesses occur? How can we treat?

• impacted for too long (May burst due to infection)

• Animal may be febrile

• Red/brown exudate noted from abscess

• Tx: antibiotics , drain, cannulation

What is perianal adenocarcinoma

Malignant neoplasia derived from glands of anal sacs

• high metastatic rate

• Poor prognosis

What are perianal fistulas? Why do they occur?

• infectious lesion around anus in dogs

• Chronic inflammation or impaction

What breed are perianal fistulas most common in?

German shepherd

4 purposes for an enema

• evacuate feces from colon

• In still contrast media into colon

• Place medication in colon

• Irrigate colon in certain types of poisonings

What is an enema

Infusion of liquid into lower intestinal tract through the anus

4 types of enemas

1. Evacuant

2. Diagnostic

3. Medicated

4. Poisonings

What is an evacuant enema?

• placing fluid in colon to rehydrate dry hard feces

• Stimulates peristalsis

What are 4 solutions that are used for enemas

• warm water

• Mild soapy water

• Mineral oil

• Commercial pet enema solutions

T or F: we can use a fleet enema on cats and dogs

False

Never use

Can be hypertonic

When are enemas used in foals?

4-8 hours of age if they have not passed the meconium

5 reasons we would choose an evacuant enema

• constipation

• Obstipation

• Fecal impaction

• Prep for surgery

• Prep for radiology

What is a diagnostic enema? Why would we choose this?

instilling radio-opaque medium into bowel to visualize lumen of bowel on rads or prep for colonoscopy

• suspected foreign body

• Intusseusecption

• Neoplasia

• Ulcerative colitis

Define neoplasia

Abnormal mass of tissue

3 steps in performing diagnostic enema

1. Evacuant enema given first

2. Instill barium sulphate

3. May instill air to do double contrast if needed

What is barium sulphate solution

Radio-opaque solution that outlines lumen making any abnormalities or occlusions seen on rads

When would be chooose a medicated enema

Treatment of vomiting, or animals that can not swallow, or seizures

When would an enema be used for poisonings?

Enema of activated charcoal can be used to slow absorption of toxic substance

List 3 complications of enemas

1. Ruptured colon (given too large of amount or too much pressure)

2. Peritonitis (due to ruptured colon)

3. Hemorrhage (physical trauma in cases of ulcerative colitis)

7 steps of enema administration/prep

1. PE

2. Prep solutions & supplies

3. Glove up, lube enema nozzle, ensure there are NO rough or sharp spots

4. Insert into rectum

5. Place enema contained above animal (never force solution in)

6. Immediately place animal where it can deficate

7. Medical note

How much solution for an enema can be used in cats/small dog/large dog

Cats/small dog: 50-200ml

Large dog: 1L max

*as per DVM

How much of an enema can be inserted into cat/small dog/large dog

Cat/small dog: 5 cm (2”)

Large dog: 15cm (6”)