Anal Gland Ruptures

[Chris]

Hi Raven,

I’m sorry to hear you’ve been dealing with this with your kitty Nyx. We see this issue quite often in dogs, but not nearly as often in cats. They can certainly develop impacted (blocked) anal sacs but I have rarely seen them develop into an abscess and rupture (but it does of course happen).

Nyx did not exactly rip open the skin but what happens is when the anal sac is blocked and an infection develops, a hole or fistula, will more often develop more on the outside skin. As the infection develops and tries to evacuate itself, the skin becomes more fragile. This is painful and irritating, so cats will often lick these areas and eventually the abscess will break through the skin.

The way we treat them is exactly as you described with an antibiotic and an anti-inflammatory, sometimes added pain medication. They typically heal within about two weeks.

While underlying causes can be various, what happens is the tiny little ducts that connect the anal sac to the anal opening become irritated or inflamed, preventing the anal sac material from being expelled normally during bowel movements. The anal sac fluid then becomes thicker and harder to get out, furthering the problem. Bacteria can very easily get up into the anal sacs because they naturally live in the digestive tract and are present in stool. The bacteria also get trapped when the ducts don’t express, leading to an abscess. These most always break open on the skin as you’ve seen.

Underlying causes can include stool quality. This can be either chronic diarrhea or constipation. Overweight or obese cats often have issues with them too, possibly because the muscles involved in bowel movements are weaker. But it’s not always stool-related. In dogs, the most common denominator for recurrent anal sac issues was atopic dermatitis, or skin allergies. If your cat has any other signs like chronic recurrent itching, other skin or ear problems, etc., this would be a potential underlying cause to look into more.

Adding fiber to the diet is one strategy but may only help if stool problems are the underlying cause. And then, it depends on whether it’s loose stool or harder stool that is the issue you’re seeing.

Unfortunately, I do find that many pets with anal sac disease continue to have problems. The full abscess issue doesn’t recur frequently, but they usually still have harder anal sac material and require manual expression every few weeks. For whatever reason, it does appear to be difficult for the ducts to return to the way they once were and for the anal sac material to be fluidy and easy to express again.

So, consider adding more fiber for soft stool (a teaspoon with each meal is a starting point for cats), miralax for harder stools/constipation (1/8-1/4 teaspoon once to twice a day), and see if having them expressed manually at your vet practice every couple of weeks may help. For prescription diets, I have had some success with the high fiber diets like Royal Canin GI Fiber Response or Hill’s Biome (but make sure it’s the high fiber verson).

Skin allergies and food allergies causing such problems is too much to get into here, but you can follow up with your vet further if these may be a possibility.

Surgery is also an option. The anal sacs are not a necessity to have. However, I always have a board-certified veterinary surgeon to this surgery because they do them far more often and that lowers a lot the risk of any nerve damage caused by surgery.