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Perianal Fistulas AKA Anal Furunculosis is a disease encountered most frequently in German Shepherds, but also found in Great Danes and all other breeds on occasion. It is characterized by chronic infection and ulceration of the tissues around the anus. More importantly, there are often unseen, but deeply infiltrating, fistulous tracts which run under the skin and along the rectal wall up to 3 and 4 inches deep.
While the exact cause of the disease is unknown, some German Shepherds seem to be unable to resist even superficial infections which may occur on and in the skin. This may be the result of an ineffective immune response resulting in predisposition to the development of skin infections as a persistent problem. Also, the conformation of the German Shepherd allows for the broad base of the tail to remain in almost continual contact with the anus, thereby spreading a thin film of feces over the perianal area. This is the area which is affected most frequently. Recent evidence, points to an immune-mediated process as the underlying cause of this disease.
The anal sacs are usually involved in the disease and are removed as part of the treatment. It should also be known that a dogs predisposition to the development of Perianal Fistulas is lifelong. Relapses, may sometimes occur even after apparent cure.
Symptoms: The primary lesions are deep, draining, openings around the anus which will not heal. They may spread to involve a large portion of the perianal area. Many dogs with perianal fistulas will show few signs of discomfort apart from licking the anal area, but in advanced cases there may be damage and scarring which prevents normal passing of feces. These dogs may experience constipation and extreme pain when passing feces. Other dogs with severe perianal fistulas may not be able to close the anus properly and become incontinent.
Treatment: No single technique has been shown to result in a cure for perianal fistulas. Surgical removal of the infected tissue followed by reconstruction of the surrounding skin has met with fair results. The key to success is to resolve the chronic, deep, fistulous drainage while maintaining fecal continence. The damage to the anal sphincter from the deep fistulas determines fecal continence, its preservation is of great importance to the surgeon. Many dogs will need more then one surgery.
It is very important that they are examined regularly until complete resolution of the tracts has occurred. When a second surgery is required, its purpose is to remove the smaller, perianal fistulas and, minimize the chance of recurrence.
Unfortunately, a percentage of dogs will not respond to surgery and will continue to have problems or incontinence. These are often identified during the initial examination and are named high risk patients prior to treatment.
For more information concerning this disease or support please visit Perianal Fistulas Information Site.
Scarlett Camron Duke
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