Anal Sac Disorders in Cats

Introduction

Anal sacs are kind of like the appendix in humans. They are organs left over from a time when they may have been necessary—thought to be for territorial scent marking from when our pets’ ancestors were wild. They are 2 small sacs that hold strong-smelling secretions from glands near the anus, as their name implies. When all systems are working properly, a small amount of thin to watery secretion is expressed from the sacs with each bowel movement.

However, like the appendix in humans, anal sacs often cause trouble when they are not expressed completely or the secretions become too thick to be expressed with the bowel movements. When this happens, impactions occur, which can then lead to infections and rarely, fistulas. Cancer can occasionally occur. This is more common in dogs but does occur in cats.

Common Problems with Anal Sacs

Anal sacs are prone to a number of problems, including impaction, infection (sacculitis), and neoplasia (cancer). Fortunately, impaction is by far the most common problem, and cancer is fairly uncommon, although it must be on every veterinarian’s rule-out list, and is an important reason why you should have your pet seen by your veterinarian when anal sac problems arise.

Symptoms of Anal Sac Disorders

One of the most common symptoms of anal sac problems is scooting on the floor. Pets will usually choose a particular surface to scoot along (often your favorite carpet!), chosen for the texture to rub their sore or itchy bottom against. Although many people think that scooting means a pet has worms, usually it means a pet has anal sac problems. Other symptoms of anal sac disorders include scratching at or near the anus, licking at the anus or base of the tail, hesitancy or straining to defecate, and not wanting to sit or lift their tail.

Anal Sac Secretion

Anal gland secretions are strong-smelling. Maybe not as strong as a skunk, but still very strong nonetheless. One of the ways you might notice your pet has an anal gland problem is by detecting this very strong odor. It can be foul-smelling, somewhat fishy, and hard to get rid of. Washing your pet’s hind end with pet shampoo might be necessary to get rid of the odor. Be especially gentle though, because their anal area is likely to be very tender when they are having anal sac issues.

Impacted Anal Sacs: Causes and Treatments

When the anal sacs are not expressing properly with each bowel movement, they can become impacted. This can happen due to soft feces or diarrhea, when they are creating excessive secretions (due to unknown causes) or when they have skin disorders that change the makeup of their secretions.

When anal sacs are impacted, they can become very uncomfortable to downright painful. Often a veterinarian can relieve impacted anal sacs by digital expression, usually by inserting a gloved finger rectally and compressing the anal sac between their finger and thumb.

Many cats will not tolerate this procedure very well. If the pet can’t or won’t tolerate it, they may need to be sedated or anesthetized (fully asleep) so the veterinarian can accomplish the task. The anal sacs may then need to be flushed in order to soften their secretions before expression.

Dietary Modifications to Aid Anal Sac Health

Some cats are troubled by recurring anal sac impactions. For these felines, modifying their stool consistency can be very helpful. The best way to do this is through adding fiber to their diet. Adding canned pumpkin is one easy way, and most pets like it.

A common starting point is 1-2 tablespoons per day for cats, and this amount can be frozen in ice cube trays to prepare ahead for daily feeding. You’ll have to find a dose that works for your cat, as too much can cause loose stools or be constipating for some pets.

Beware of cats that vomit often, as pumpkin will stain carpets and furniture. If your cat doesn’t like canned pumpkin or tends to vomit, you can try Vetasyl fiber capsules instead, for a good source of fiber.

Another good option for both cats is Hill’s Science Diet W/D, a prescription diet very high in fiber. Feeding a percentage of your cat’s diet, starting at 20% to 25% W/D, can help the stool bulk up enough to express the anal sacs better, and helps to avoid their impaction.

Anal Sac Infections and Abscesses

Anal sac infections and/or abscesses are fortunately less common than impactions, but they are still relatively common. The symptoms are the same as previously described, but sometimes more pain is shown by the pet, and some bloody discharge is seen by the owner in the area near the anus. Occasionally the cat owner will see small sores below and to either side of the anus, where abscesses may be draining.

Anal sac impactions may lead to infections and abscesses but it is difficult to be sure of the exact cause. They are usually treated by expressing the anal sacs, with or without sedation and/or anesthesia depending on what the pet will allow, in addition to appropriate oral or injectable antibiotics. The veterinarian may also choose to infuse antibiotics and/or steroids into the anal sacs to help with healing and inflammation. Most commonly, anal sac infections will clear up with a course of antibiotics and in most cases will not recur.

Anal Sac Cancer: Signs, Diagnosis, and Treatment

Thankfully, cancer of the anal glands occurs only rarely in cats. Symptoms of cancer present much like impacted or abscessed anal sacs. Symptoms may respond well to treatment initially, similar to benign cases. However, if there is a cancerous tumor associated with the anal gland itself, the symptoms of discomfort will usually recur after initial treatment. A biopsy is indicated as soon as possible if cancer is suspected, in order to get a definitive diagnosis and initiate appropriate treatment.

It is very important to follow up treatment with re-checks if advised, and especially if your cats’ symptoms recur. Cancer, especially if caught early, can be successfully treated in many cases. Your veterinarian may refer you to a board-certified surgeon, and/or a veterinary oncologist for specialized cancer treatment to help give your cat the best possible outcome.

Surgical Consideration for Chronic Anal Sac Issues

You might ask, if anal sacs are such a problem, why don’t veterinarians remove them more often, like the appendix in humans? The answer is that it can be both an expensive and a tricky surgery to perform. Most general practitioners prefer not to do the surgery, which means you would likely need to seek the services of a board certified surgeon, which may be beyond the means of many pet owners. Also, the perineal region (around the anus) is innervated with all the important nerves that control the anus itself as well as important muscles of the hind end.

Problems that might occur in surgery while dissecting around the anal sacs include injuring those nerves, possibly resulting in issues with continence (bowel movements) and even difficulties with motor function. Thus removing the anal sacs for recurring impaction is not a surgery that is commonly advised.

That said, you are certainly invited to discuss surgery with your regular veterinarian, and discuss the pros and cons. If your pet is miserable on a frequent basis, it is definitely worth discussing.

Prevention and Routine Care for Anal Sacs

In terms of prevention, people sometimes wonder if they should have their normal cats’ anal sacs expressed just for good measure, even if they are not showing any signs of a problem. There is no need to have a normal cats’ anal sacs expressed if they are not showing any symptoms of a problem. In general it is wise to avoid squeezing tissues that have the potential to become inflamed and infected. For cats that have a strong history of impaction, routine expression may be advisable, but this is best addressed on a case-by-case basis.