The anal sacs, or anal glands, are a pair of small sacs located under the skin on each side of the anus of dogs and cats. These sacs contain smelly material that is normally squeezed out when an animal passes stool. If your dog is scooting his bottom across the floor, he might have an impacted (clogged) anal sac.
 
Anal Sac Anatomy
Anal sacs lie between the anal sphincter muscles, the circular muscles that close the anus. Each sac has a small duct that leads to an opening in the skin next to the anus. Anal sac material is liquid or pasty in consistency, ranges in color from cream to brown, and has a characteristic fishy odor.
 
The function of anal sacs is not entirely clear but might have to do with scent marking and communication.
 
Symptoms of Anal Sac Problems
Dogs and cats with anal sac disorders have symptoms of anal discomfort (these are more common in dogs):

• Dragging the rear end across the floor
• Licking or chewing under the tail
• Constipation or signs of pain when passing stool
• Reluctance to sit down
• Swelling or redness near the anus
• Spots of blood or pus on floor or bedding after sitting or lying down

 
Other problems, like parasites, fleas, and orthopedic pain, can cause some of the same symptoms.
 
Types of Anal Sac Disorders
The most common anal sac problem by far is impaction, in which an anal sac can’t empty on its own and material remains in the sac. Scooting the bottom on the floor and licking the anal area are typical symptoms. Impaction happens more often in small dogs than in large dogs or cats. The causes of impaction are not fully known. Many dogs go through their entire lives without ever having impacted anal sacs; others experience it regularly. Allergies, skin disease, and changes in stool consistency might make a dog more likely to have clogged anal sacs.
 
Impacted anal sacs can become inflamed, a condition called anal sacculitis. Anal sacculitis causes painful, swollen sacs and often redness of the skin around the anus.
 
Infected anal sacs can form abscesses. An anal sac abscess first appears as a painful swelling beside the anal opening. It may rupture through a skin wound that drains pus or blood next to the anus.
 
Anal gland tumors are less common than impaction, inflammation, or infection. They can cause swelling, bleeding, or discomfort in the anal area.
 
Treatment
Veterinarians usually manage an impacted anal sac by gently expressing the material out of the sac. This process can be uncomfortable for the patient, especially if the material is too thick or dry to be easily removed. Some patients benefit from anal sac flushes or warm compresses applied to the anal area. Anal sac inflammation and infection are typically treated with antibiotics and pain relievers. The anal sacs can be surgically removed in patients with anal sac cancer or as a last resort for patients with other anal sac problems. (Surgical removal is not generally recommended for patients with simple anal sac impaction because of the possibility of complications after surgery.)
 
What You Should Do
If your dog or cat doesn’t have any symptoms of anal sac trouble and your veterinarian hasn’t found a problem, you don’t need to do anything in particular. There’s no need to change your pet’s diet or have the anal sacs expressed if they’re working normally. But be aware of the signs of anal sac impaction so you can have this uncomfortable problem taken care of before it becomes more painful for your pet.
 
Photo by Sheri Hooley

Acupuncture, the technique of stimulating points on the body by inserting tiny needles through the skin, is being used more frequently to treat animals. Most scientific studies of acupuncture have been conducted in humans. However, the existing evidence in animals led the American Animal Hospital Association and American Association of Feline Practitioners to endorse acupuncture as a treatment option for chronic pain.[1]
 
Anna Ponce, DVM, and I recently sat down to chat about acupuncture in pets. Dr Ponce provides acupuncture services for dogs and cats and has completed the coursework and examination requirements for certification in veterinary acupuncture. (Interview has been edited for length and flow.)
 
LAW: How did you decide to start doing acupuncture?
 
AP: My biggest push to learn acupuncture was having geriatric cats come in with arthritis. Some of them have kidney disease, and there is just no good long-term arthritis medication for these cats. Acupuncture is one of the modalities that has been mentioned, so I decided to explore that avenue and see what I could do to help arthritic cats. And that really opened my eyes to so much more that can be done with acupuncture.
 
What conditions do you think acupuncture helps the most?
 
It can really help with any condition: heart disease, kidney disease, coughing, behavioral issues, anxiety. But I think what we know it most commonly for is arthritis.
 
Which patients do you recommend it for, and how does it help them?
 
For example, this morning I recommended it for a dog that has arthritis in her knees, elbows, back, and hips. She’s had x-rays, so we know arthritis is there. It took a long time to get her on the right combination of drugs to be comfortable, but she still has off days and I absolutely think she would benefit from acupuncture.
 
Acupuncture has local effects like decreasing inflammation and pain, and it also helps get the body back in balance. Chronic issues are obviously going to take more time. Acupuncture is not going to make these issues disappear. It doesn’t miraculously make degenerative joint disease return to normal, but it definitely helps the pain and inflammation. [It helps the body release] serotonin, endogenous opioids, and beta endorphins. In my opinion, there’s not a pet that can’t benefit from acupuncture, even if it’s as a preventive measure.
 
When would you not recommend it?
 
I wouldn’t not recommend it for just about any patient, but the biggest consideration is whether the patient will tolerate acupuncture. Some dogs and cats fall asleep, they snore, they love their acupuncture, they look forward to it, they’re very relaxed. And then some patients are just not going to tolerate having needles placed in them.
 
You would not want to put a needle through infected skin. You wouldn’t want to put a needle in a tumor because it would increase blood supply to that area. Certain points are contraindicated in pregnant dogs to avoid inducing labor. And you would not do electroacupuncture [delivery of electrical current through acupuncture needles] in a dog with seizures. But other than that it’s very safe. There’s really not a patient that I would say should not get it. It’s a matter of whether they tolerate it, which I feel most of them do.
 
How do cats handle it?
 
I have one cat patient who is very good for his acupuncture. He tells me when he’s had enough needles, so he dictates how many needles he gets. When he starts to meow a little bit and get a little twitchy, we’ve reached our limit, and then he walks into his carrier, lies down, and rests there [with the needles inserted]. Another cat that I treated really enjoyed it and just lay there the entire time, comfortable.
 
Can you describe a typical acupuncture session?
 
We use very tiny sterile needles that go in acupuncture points throughout the body. The needles are even smaller than insulin needles. I do a traditional Chinese exam along with my Western exam, make my traditional Chinese diagnosis, and pick acupuncture points based on that. A session might include 5 to 40 needles, depending on what I’m treating; it’s normally 10 to 20 needles. The time patients sit with the needles inserted could be anywhere from 10 to 40 minutes.
 
Placement of the needles is based on meridians through which qi (chi), or energy, flows and where acupuncture points are located. The strongest points tend to be on the limbs, but those can also be more tender points for dogs and cats. So we often use more points on the back because they’re easier to access and they tend to not be quite as sensitive as the points on the limbs. When a needle’s inserted it causes a de-qi response, essentially a tingling or warming sensation, and sometimes a muscle twitch.
 
I also use different modalities. Dry needling is insertion of the tiny needles. In electroacupuncture, we hook up electrodes to get higher stimulation. In aquapuncture, we inject vitamin B12 under the skin at acupuncture points to get a longer effect.
 
How do you integrate acupuncture with Western medicine?
 
I believe that they complement one another. I think that acupuncture can benefit the patient in ways that Western medicine can’t, especially with end-of-life comfort and pain relief. I definitely wouldn’t throw out Western diagnostics. Bloodwork and x-rays are very important and can help tailor your acupuncture treatment. I think the best type of medicine is an integrative approach, having them work together.
 
Would you describe your acupuncture training?
 
You have to be a licensed veterinarian to practice acupuncture [in animals], but you do not have to have a certification in acupuncture to practice it. Being certified shows that you have gone through the training and that you know what you’re doing.
 
I took a 6-month course through the Chi Institute [of Traditional Chinese Veterinary Medicine] in Florida. The course is 150 credit hours in 5 sessions: 2 online lecture sessions and 3 on-site sessions including lectures and a hands-on lab. After you complete the sessions you take a 200-question written exam and a practical exam. The final requirements for certification are a 30-hour internship with a certified veterinary acupuncturist and submission of a case study of a patient that you have followed for at least 3 months. I’ve done all of the coursework and the test. Once my internship hours are finished and my case study has been approved, I’ll get my certification.

Reference
1. Epstein ME, Rodan I, Griffenhagen G, et al. 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Feline Med Surg. 2015;17(3):251-272.