Surgery for 10 and a Half Year Old Pug

[Lirpa]

My ten and a half year old female Pug, Ruby, has had a problem with her anal sacs since 2004. At that time, unbeknownst to me, they were impacted and infected. She was scooting her butt on the carpet and seemed to be grumpy so I took her in thinking she had worms.

The vet where I lived at the time said that she had too much fat around her bumhole so she was unable to express them herself when pooping. At the time, I chose to not do the surgery because I know I would not want to have surgery on my bum so did not want to put her through it.

During the allergy, season I have to take her to the vet once a month to have her anal glands expressed. During the winter months I can stretch it out to every two to three months. Since I have taken her in regularly to get them expressed for years she has not had anymore infections or full impactions...that is until now.

I took her in last week and the vet tech and the veterinarian were unable to express her left anal sac. Her left anal sac is always more full and harder to express than her right sac but usually they are able to express it by popping the crust on the gland by pressing down and massaging it. Last time it was pretty crusty and it blew out and all over the ceiling, the wall and on the vet's face and in her hair We were all pretty impressed!

The vet prescribed 5 mg of prednisone (yes I know, evil) for a week to reduce the inflammation in order to attempt to express them today.

The vet techs (both very experienced and excellent techs) were unsuccessfull in expressing the left sac today. The vet techs advised that the left gland had a lot of scar tissue so more than likely surgery to remove the sac will be necessary since the gland is fully impacted. So I am supposed to come back when the vet is back next week on Tuesday. At that time, the vet will attempt to express it then if not then surgically remove it.

Has anyone had an experience with this surgery with their dog?

I am nervous about the small chance that permanent fecal incontinence will occur. My vet is very experienced and has a good track record with this surgery but of course being the worry wort that I am, I am still nervous.

Also, the vet tech mentioned that since the sac was huge and impacted that it would be easy to remove since it pops out without having to search for it, therefore minimizing the risk of snipping the nerve(s) that control the sphincter.

 

[ytain]

Re: Anal Sac Removal Surgery for 10 and a Half Year Old Pug

What is your dog's diet?

From my past research on appropiate diet for dogs and cats, the correct diet for dogs and cats are raw meat, organs and raw bones. Dogs can tolerate some steamed veggies, but cats no, since felines require higher protein intake than the dogs.

However, vaccination enters into the picture so your dog might have inherited vaccinosis from their parents etc., and the current vaccination shots your dog might have had (rabies shot etc., required by law in many areas) which could have compromised further the immune health generationally if you can consider the Pottenger's experiment with cat colonies.

Ytain

 

[Lirpa]

Re: Anal Sac Removal Surgery for 10 and a Half Year Old Pug

Ruby eats organic grain-free wet dog food with a little bit of organic grain-free dry dog food. Both the wet and the dry food have organic human-grade chicken meat fit for human consumption as the first ingredient. No soy, wheat, fillers, etc.

I also make her plain browned hamburger and cooked chicken, without any grease or spices since she has a tendency for pancreatitis. I really wanted to put her on the raw diet. I tried switching her to the raw diet slowly by mixing it in with her regular food over a period of time. She kept on puking it up and seemed weirded out by the raw meat. I gave her a raw beef soup bone and she licked it once and was freaked out by the blood oozing out of the marrow in the middle and would not eat it.

That along with the fact that I only have a half-refridgerator made me go with the canned organic food, just a bit o' organic kibble for crunch and supplementing with cooked hamburger and chicken. I do feed her canned sardines in water about twice a month.

She is in really good shape physically due to being obsessed with fetching the tennis ball and daily walks.

Her skin allergies (and subsequent overproduction of anal gland juice and gummy ear goo) are due to a bad vaccine reaction she had when she was two or three years old. In the car on the ride home after the vaccination, her face was hugely swollen (looked like a Sharpei!), had hives all over her body and had trouble breathing.

She had been properly vaccinated in a series as a puppy and had one or two yearly boosters then had a severe reaction to her yearly booster the next year. Prior to that bad vaccine reaction, she did not have any allergies.

After the reaction, I did a bunch of research into vaccines and became aware of the danger of over-vaccination and how it causes allergies and cancer.

Since 2003 she has not had any yearly multi-vaccine boosters or bordetella. I have only vaccinated for Rabies every three years because it is the law. This year I am going to do a blood titer test for Rabies immunity and hope that the local government in charge of Rabies Licensing will accept that since she has had mast cell tumors removed twice.

More than likely the Rabies vaccine is good for life but since it is required by law, I have been doing it in case she is ever bitten by a wild animal or a dog with a questionable rabies immunity to avoid her being away from me in quarantine. I know the authorities would make her go into quarantine if I did not have proof of immunity.

I am sure the vaccines caused the mast cell tumors and the allergies (and the anal sac issue).

 

[ytain]

Re: Anal Sac Removal Surgery for 10 and a Half Year Old Pug

Ok, thank you for telling the diet for your dog.

The problem of anal sacs not being expressed could be due to not enough calcium that could make the poops of specific consistency that could aid in expressing them the nature intended (think correct function of the machine). The wet food don't adequately provide enough calcium. And since you described your dog's experience to a bone, the only way to introduce more calcium is to get organic egg shells and dry them thoroughly in the oven and then pulverize in a grinder and sprinkle an amount in her wet food till you reach a balance. You have to determine/calculate how much calcium found in a sprinkle of powdered eggshell in relation to the amount of calcium contained in the wet food.

The commercially prepared only provides minimum guaranteed nutritional profile for a dog established by the organization who determined the nutritional profile of the pets.

Ytain

 

[Lirpa]

Thank you, Ytain for the info!

 

[anart]

Hi April, I'm not sure what to advise about Ruby, but I hope she ends up much better off. The surgery might be the way to go, but I just don't know enough to know for sure! Perhaps HerrEisenheim will notice the thread and chime in with his thoughts on it.

 

[1984]

[...] I really wanted to put her on the raw diet. I tried switching her to the raw diet slowly by mixing it in with her regular food over a period of time. She kept on puking it up and seemed weirded out by the raw meat. I gave her a raw beef soup bone and she licked it once and was freaked out by the blood oozing out of the marrow in the middle and would not eat it.

Hi April - FWIW, my 10 year old doberman did the same thing the first few times I gave him raw beef. (This was beef parts from a local grass-fed beef cattle business I deal with. The beef was specifically for feeding dogs.) This is a dog that thinks he's human and doesn't like dry dog food at all, so I thought he'd go crazy for it. He sniffed it and walked away! I tried mixing it with some organic dry food and he wouldn't eat that either. Needless to say, I was at a loss for why he wouldn't eat it - he certainly loves steak! Finally, I just put it in his bowl and left it there for him to figure out. He did eventually go back to it and started eating it. He loves it now and goes crazy when he hears the baggie open because he knows it's dinner time.

Re: the sac draining, as he neared about 5 years old, he had to have his sacs drained twice a year or so and since he's been on the raw beef I haven't had to take him in for that (over a year). Perhaps you could par boil the raw meat and see if she'll eat it that way? It also helped his coat tremendously (he's a blue doberman and they have genetic-caused skin and coat problems). My doggie thrives on the raw beef so I think it might help Ruby.

Hopefully, as Anart mentioned, HerrEisenheim will stop in soon and provide professional input.

Either way, I hope everything works out for your Ruby. :)

 

[Lirpa]

@Anart...thank you for the input and support:). I think the surgery will be good in the long run because the only other option is to treat it like an abscess and let it burst and flush it which would be quite painful and it more than likely will become impacted again due to the scar tissue.

@1984...thank you for all the good information! Ruby will chew on cooked bones but I know how dangerous cooked bones are due to sharp splinters, I give her a bigger one that she cannot crack off bits from and only for short bits of time. I did leave that raw bone out for several days and she would not touch it :(. I will try the parboiling the beef and the ground eggshells that Ytain suggested.

 

[Z...]

The vet where I lived at the time said that she had too much fat around her bumhole so she was unable to express them herself when pooping.

yes pugs have funny anatomy of the tail area but the nutrition as always plays important role

At that time, the vet will attempt to express it then if not then surgically remove it.

I am fairly certain surgery will not be needed in the end . At least this is always the case in my practice. A course of steroids and antibiotics is a must. I also use homeopathic silica 30c twice a day one granule in the mouth. for at least a week.

Has anyone had an experience with this surgery with their dog?

Only once I was contemplating resorting to the surgery but then I decided to be more patient and use more silicia and eventually I was able to empty the gland.
I am sure your vet knows what she is doing ( despite the fact the gland blew in her face - it happened to all of us - at least once :) ) but in pugs due to the anatomy of their tails and fatty deposits around it the gland needs to be emptied per rectum. Most of the vets try only from the outside, or maybe they have already attempted this?

I am nervous about the small chance that permanent fecal incontinence will occur. My vet is very experienced and has a good track record with this surgery but of course being the worry wort that I am, I am still nervous.

This is very small chance so don't worry about this now.
I would be slightly more worried about the effect of anaesthesia on a 10 year old pug especially if your vet doesn't use intubation and inhalation anaesthesia.

As others noticed diet plays important role in this problem. After all, The Nature has put the glands exactly there for a purpose. When dogs and other carnivores eat fair amount of bones their feces becomes as hard as rock and of crumbly consistency. This is perfect natural design for regular emptying of the gland, unfortunately the nature couldn't provide for our shortchanging the dog. It is not wonder more then 60% of domestic dogs suffer from this problem nowdays.
I know feeding bones to a pug might sound scary, but why don't you try with chicken necks only slightly braised in lard (enough to take off the raw edge which you say your dog doesn't like), as long as chicken bones are raw they will not splinter and if Ruby has good teeth she will be able to crunch them.

 

[Lirpa]

Thank you Herr, for the great advice. I will respond more in depth tomorrow if I am not working. Thanks to all of you for the input!

 

[Lirpa]

@ Herr

She was prescribed 5 mg of prednisone on February 9th. Her doses were two tabs twice a day for three days, one tab twice a day for three days, 1 tab once a day for three days then 1 tab every other day, for three days. They did not prescribe antibiotics at that time since they were impacted but not infected.

I returned to the vet's office Feb 14th so they could try to express them again which was unsuccessful. Both times they did try to express in the rectum. I always ask for the vet with small hands for Ruby's sake ;).

I did get the Silicea 30c and started dosing her one pellet three times a day this last Saturday evening and will continue with that. I crush it between two spoons without touching the pellet and put it in some chicken broth to dissolve then let her lap it up. Is that okay to do it that way? (oops just saw in your post that it should be twice a day not three times a day so I will switch to that).
What do you think about the dose of 5mg prednisone? Is that enough? Too much for a 24 lb Pug?

I know that Pugs have a hard time under anesthesia so when I first moved here, I grilled them about their anesthesia protocol and they were very nice and open about sharing their protocol with me.

They do use inhalation anesthesia and intubation. They use SevoFlo which is an anesthesia used on infants. Post-op they do not remove the tube until she is sitting up, coherent and practically trying to chew the tube out. They also have someone stay with her during recovery instead of just putting her in a cage by herself in the back.

I also always get the all of the bells and whistles for surgery for her. Pre-op blood work, iv fluids, pain injection then pain meds to go home, etc. to ensure her safety and comfort.

In July 2009, they cleaned her teeth under anesthesia and she recovered very well. They use less anethesia than most vets...the relief vets that cover the regular vets when they are out of town are always surprised at how much less anesthesia they use for surgery.

Summer or Fall of 2010, they removed a mast cell tumor and four other suspicious growths under anesthesia and since she was under, they cleaned her teeth too. She recovered quickly and well from that induction too.

Since she has been under a couple of times within the last two years, I do want to avoid surgery if I can. Even though they have a great protocol, I am still leery of putting her under at her age.

When I take her in tomorrow (Tuesday), I will ask them to continue on with the prednisone and add antibiotics and try to express them again.

I was unable to find chicken necks at the local store but they did have chicken wings. Would that be okay for her without any choking danger?

modified for correction and added content

 

[Z...]

I did get the Silicea 30c and started dosing her one pellet three times a day this last Saturday evening and will continue with that. I crush it between two spoons without touching the pellet and put it in some chicken broth to dissolve then let her lap it up. Is that okay to do it that way? (oops just saw in your post that it should be twice a day not three times a day so I will switch to that).
What do you think about the dose of 5mg prednisone? Is that enough? Too much for a 24 lb Pug?

It would be better if you could give it alone. at least 1 h before or after food. You could also dissolve the granule in small glass of filtered water and after it has been dissolved give her a teaspoon at least 3 times a day. before taking the the teaspoon make sure to stir the solution for at least a minute.
Yea that sounds like a right dose of prednisone.

I know that Pugs have a hard time under anesthesia so when I first moved here, I grilled them about their anesthesia protocol and they were very nice and open about sharing their protocol with me.

They do use inhalation anesthesia and intubation. They use SevoFlo which is an anesthesia used on infants. Post-op they do not remove the tube until she is sitting up, coherent and practically trying to chew the tube out. They also have someone stay with her during recovery instead of just putting her in a cage by herself in the back.

I also always get the all of the bells and whistles for surgery for her. Pre-op blood work, iv fluids, pain injection then pain meds to go home, etc. to ensure her safety and comfort.

Then you have very little to worry about

When I take her in tomorrow (Tuesday), I will ask them to continue on with the prednisone and add antibiotics and try to express them again.

I normally use Marbofloxacin for this, but I am not sure how open they will be to suggestions of this sort

I was unable to find chicken necks at the local store but they did have chicken wings. Would that be okay for her without any choking danger?

necks would be much better especially in the start until she gets used to crunching. Wings are still better then legs.

 

[Lirpa]

Thank you again for the great advice Herr. :)

They tried expressing the sac again and even stuck a catheter in there but it is all blocked so no results. They are not sure if there is a tumor in there or if it is just impacted.

They completely agreed with my request to continue with the prednisone and antibiotics and give it some more time. I think they were surprised that the relief vet that covers them on vacations did not initially prescribe antibiotics along with the prednisone.

Next week, they will try to express it again. He said there are still other options and ways to go at the sac to express it without removing it. He really wants to leave the sac removal as a last, last resort. So he will sedate her and try to go in through the duct or go in through the side of the sac, splice it open or something like that, etc. I cannot remember all that he said but it seemed reasonable. He did mention that once he got in there he would see if he needed to do a biopsy.

It will be interesting to see if it is a tumor since the left sac is the problem. She had a mast cell tumor removed from the left side of the outer edge her vagina in 2009 then a mast cell tumor removed from her left rear upper thigh and I noticed she has another bleeding growth on the backside of her left rear thigh. I wonder if the cancer has spread through her lymph nodes on the left side...

I will get some purified water and give the Silicea pellet in the manner you described. Wrangling her with a teaspoon might be a challenge so I will get syringe and squirt it in her mouth.

There is one other store that may have chicken necks.


Thank you again!

 

[Lirpa]

Since she was all into the cooked rib bone with some meat on it that she got at Christmas, I thought I would try to give her a small round raw beef soup bone again. I am glad she did because she is eating it!

She ate all of the marrow out of it and chewed on it a bit It is too big for her to chomp on it too hard so she is just lightly knawing on it and licking it now. Her little Pug legs are too short and she lacks that long jaw with her flat face so she cannot leverage it against her paws while she chews. I will have to get some longer ones for her but at least she is all into raw now! Woo hoo!

 

[truth seeker]

So glad to hear it's going well, April! :)