PERINEAL FISTULA

WHAT IS PAINWHAT ARE PERINEAL OR ANAL FISTULAS?

Anal fistulas or also called perianal fistulas are draining tracts around the anal region of dogs that start as small openings and progress to ulcerations (large wound). The condition is similar to inflammatory bowel disease in people (Crohn’s disease) and it is autoimmune. The immune system attacks the lining of the anus and creates large area of necrosis (dead tissue). The breed overrepresented is German Shepherd.

HOW DO I KNOW IF MY DOG HAS PERINEAL FISULAS?

The most common signs of perineal fistula are discomfort associated with defecation and bloody discharge around the anus. Most patients are restless, painful and they commonly lick at the anal region. The definitive diagnosis of perineal fistula is to obtain biopsy of the abnormal tissue to rule our cancer.

HOW IS PERINEAL FISTULA TREATED?

Perineal fistulas are managed with medications, surgery, laser and cold therapy (cryotherapy). The term management is used instead of “cure “because it is an auto- immune disease. Regarding medical treatment, most commonly antibiotics, special diet (novel protein), and immunosuppressive drugs (systemic and local) are used. Surgery treatment for perineal fistula entails removing the ulcerated tissue and the anal sacs to enhance healing of the anal and perineal regions. Cryotherapy or cold therapy is also used to freeze the abnormal tissue (fistulas) and kill their lining. Laser has been also used instead of surgery to minimize the inflammation associated with surgery. Tail amputation has been recommended in the past to better aerate the anus and facilitate healing.

WHAT IS THE AFTERCARE POST SURGERY, CRYOTHERAPY, OR LASER THERAPY?

Post-operative daily cleaning of the affected region is very important to prevent infection and promote healing of the compromised anus. Antiseptic solution and triple antibiotic cream should be applied daily and the fecal matter removed.  Pain medications, stool softeners and E-collar are needed during the recovery.

WHAT IS THE PROGNOSIS FOR PERINEAL FISTULAS?

There is not a cure for perineal fistulas as mentioned above and lifelong medical therapy is needed. The response to the medical management (special diet and medications that suppress the immune system) combined with surgery is good however 85 to 90 percent of patient will have a recurrence.