This is what I got when I googled Perianal Fistula Common names or abbreviations:
Perianal Fistula Anal Furunculosis Description or definition: A perianal fistula (anal Furunculosis) is a chronic inflammatory, ulcerative disease most frequently found in, but not exclusive to the German Shepherd Dog. What is a perianal fistula, you ask? Let’s break it down, piece by piece. Peri: all around, near, enclosing, surrounding Anal: of, relating to, or situated near the anus Fistula: an abnormal passage leading from an abscess or hollow organ to the body surface, or from one hollow organ to another and permitting the passage of fluids or secretions. Perianal fistulas, also known as Anal Furunculosis, are ulcerated tracts that develop around the anus. The tracts are similar to the root system of a plant, spreading out in all directions. These abscesses eat out the flesh around the anus and often into the intestinal tract. There are often unseen, but deeply infiltrating fistulous tracts that can spread up inside the tail and down into the back legs, along the rectal wall up to 3 and 4 inches deep, and into the dog’s internal organs, eventually causing death. Perianal fistulas are becoming more widespread by the day, and they hit without care to gender or age. They are most commonly diagnosed between the ages of two and five, but have been diagnosed in dogs as old as ten. The symptoms of the primary lesions are deep, draining, fistulous openings around the anus which will not heal. They may spread to involve a large portion of the perianal area. Some dogs will show few signs of discomfort other than licking the anal region. But as the problem advances, there may be damage and scarring that prevents normal defecation. These dogs may experience fever, constipation, pain when passing feces, bloody feces, diarrhea, weight loss, lethargy, butt scooting, and open sores often with a malodorous discharge, similar to the odor of having the anal sacs expressed. Some dogs with severe perianal fistulas may not be able to close the anus properly, leading to incontinence. The cause of perianal fistulas has not been determined. There are many theories as to the cause, and several studies have been performed to investigate the possible immunological, bacterial, endocrine, or anatomic basis for the disease. Theories include: A) Possible anal sac problems. An infection which starts in the anal sacs, spreading back into the rectum. B) The basic conformation of the German Shepherd Dog, with a broad base tail which hangs down doesn’t allow much air circulation in the anal area, keeping it warm and moist and prone to breeding bacteria. Another known fact is that German Shepherd Dogs have an increased density of perianal apocrine sweat glands. It is not known if this could make the breed more prone to fistulas. Perianal fistulas are found in German Shepherds more (approximately 70 %) than any other breed. They are also found commonly in setters and retrievers, which carry their tails down, covering the anal area. However, they have also been diagnosed in beagles, which carry their tail up for the most part, and in Australian Shepherds, which don’t have much tail at all. C) Genetics is also a suspect, many feeling that we have done so much line breeding and inbreeding that we have turned our beautiful breed into a genetic nightmare causing immune system problems. Similarities in the clinical appearance of canine perianal fistulas and perianal fistulas in humans with Chron’s disease have been reported. In humans with Chron’s disease, the immune system is thought to play an important role. D) Stress as a whole is being studied as another factor many feel may be involved. It is a known fact that stress affects the body’s ability to defend itself against disease. E) Irritable bowel disease (IBD) and /or food allergies are also being considered as a possible link to perianal fistulas. Many dogs with fistulas have a black tar-like substance on and around their rear area. It is believed this to be the result of old dried blood coming from the small intestines, indicating something internally is amiss. F) Some believe that over-vaccinating could be factored in as a perspective trigger. Yearly vaccinating directly involves the body’s immune system. This may be why some dogs develop perianal fistulas and others do not. The course of treatment varies, as does the success rate. Although many different methods of treatment have been proposed for this problem, none have been reported routinely successful in the control of the disease. There are some that believe the only course of treatment is surgery. And there are many different types of surgical treatments, as well as drug treatments. A) Chemical cauterization is the excision of superficial fistulas with a chemical solution inserted in the deeper tracts. The wound is allowed to heal by second intention. Success is claimed to be in excess of 80%, but with fecal incontinence occurring in about 20 %. B) Heat cauterization is the excision of the diseased tissue, followed by heat cauterization. C) Deroofing and fulguration is where all chronic tissue and scar tissue is excised and the lining electrofulgurated. This method spares the sphincter muscle, but fistulas do return in a high percentage of cases. It is not successful if more than half of the anal circumference is involved. D) Cryosurgery is the application of nitrous oxide into the fistulous tracts with second intention healing. Success rates are claimed to run from 50-95%. Fecal incontinence and stenosis is low compared to some of the other surgical options. E) Surgical excision is a complicated surgery. It involves removing all diseased tissue and much of the surrounding tissue. All fibrosis causing rectal or anal stricture is also removed. Incontinence runs 13-29% due to damage to the sphincter muscle. F) Laser surgery is claiming a 95 % success rate. A synthetic sapphire tip and continuous impulse of 13-15 watts is used to excise the fistulas. Flatulence increases in some dogs, fecal tone is reduced, and fecal incontinence develops 20% of the time. G) Tail amputation must include the lateral skin folds up to the second or third cocygeal certebra. Superficial lesions may heal but deeper fistulas will still require surgery. This generally is a last choice of dog owners. H) Prednisone has been showing some limited success. An experiment at Michigan State University showed one-third of the dogs responded well, one-third showed a reduction in the inflammation, and one-third showed no response. The treatment begins with high doses of the drug, reducing down to one-half the prescribed dosage over a period of time. Prednisone does have many side effects, including increased thirst and appetite, increased urination, hair loss, damage and weakening of the skeletal system, just to name a few. I) Cyclosporin, an anti-rejection drug used in humans who have had organ transplant surgery, has been tested. The theory behind this experiment is that perianal fistulas are related to autoimmune problems. Cyclosporin suppresses the immune system of the dog, allowing the dog’s body to stop attacking itself and the fistulas to heal. Cyclosporin can be started and stopped fairly safely though experience has shown that a certain level has to be reached and maintained in the bloodstream to get optimal use of the drug. Testing of the blood must be done to maintain the proper level of the drug. Initially, the success rate was 100%, but the fistulas returned in about one-third of the cases. The drug, as well as the testing, is extremely expensive, making it beyond the reach of most dog owners. Cost of treatment can run into thousands of dollars. J) A relatively new study, which was done in Australia, has shown to be successful at a more moderate price. The use of Imuran and Flagyl was involved in an experiment in 1999. The dogs showed anal irritation to be reduced or eliminated within two weeks. Non-healing areas were usually associated with anal sac rupture or chronic fibrosis. Visible improvement reached a plateau 4-6 weeks after starting treatment. Immunosuppressive therapy continued for 5-24 weeks before surgical removal of anal sacs and/or residual fistulae. All dogs remain disease free 7-10 months postoperatively. K) Several years ago, a German Shepherd Dog was presented to Michigan State University for treatment of perianal fistulas. It was also discovered that the dog had multicentric lymphosarcoma. A multi-drug chemotherapy treatment was started to treat the lymphosarcoma. After 4 weeks of chemotherapy, it was noted that the perianal fistula problem had completely resolved. The doctors conducting this experiment now believe that perianal fistulas are just an external manifestation of a systemic disease. The German Shepherd breed also has a problem with infiltrative/inflammatory bowel diseases, particularly affecting the colon and rectum. A prospective study was initiated to investigate the possible association between perianal fistulas and colitis/proctitis. L) In a 2001 study in Italy, it was noted that two German Shepherd Dogs, and one Pomeranian dog with perianal fistulas were found to be carriers of Babesia spp, without showing specific clinical symptoms and sign of babesiosis. These dogs were treated with imidocarb dipropionate once a week for 4 weeks. This therapy led to a complete recovery from the perianal fistulas without subsequent relapses; no surgery was needed. This is the first time a relationship between perianal fistulas and babesiosis was noted, and is suggested that examinations of blood smears should be recommended as a laboratory routine in the diagnosis of perianal fistulas. For years, there have been many speculations as to the cause and the best method of treatment for perianal fistula. However, recently more veterinarians and scientists are leaning toward a relationship between perianal fistulas and a dogs immune system. With the defect thought to be immunological rather than anatomical, surgical excision and tail amputation can likely be unsuccessful. A thorough search for underlying disease with consequential chemotherapy is suggested today as the proper answer to the problem. As more studies are done, and as medical advances are made, it is hoped that perianal fistulas can be controlled or cured. References: http://www.geocities.com/Heartland/Pointe/1672/msuarticle.html Perianal Fistula is Beth --- On Thu, 1/8/09, Connie Paterson <[email protected]> wrote: From: Connie Paterson <[email protected]> Subject: Re: [Chihuahuas] Please Pray for my liitle Smidgen To: [email protected] Date: Thursday, January 8, 2009, 10:00 AM What dogs are at risk for perianal fistulas? Perianal fistulas most commonly occur in middle-aged (5-8 years old) male dogs, but can occur in dogs as young as 1 year and as old as 14 years. German Shepherds are particularly prone to this disease, and in one study accounted for 84% of the dogs diagnosed. This may be due to the larger number of glands in the perianal area when compared to other breeds, or the way the tail is set and carried. German Shepherds are also more prone to immune-mediated diseases, which may be a component of this condition. Other breeds that have been reported as having perianal fistulas include Labrador Retrievers, Irish Setters, Old English Sheepdogs, Border Collies, Bulldogs, Spaniels, and mixed breeds. Someone wanted to know if Chihuahua's are prone to this? i looked it up and got this tidbit of information. Connie M. Paterson --- On Thu, 1/8/09, Beth Michl <classy1ride@ yahoo.com> wrote: From: Beth Michl <classy1ride@ yahoo.com> Subject: Re: [Chihuahuas] Please Pray for my liitle Smidgen To: chihuah...@yahoogro ups.com Date: Thursday, January 8, 2009, 12:58 PM Hi Michelle, Smidgen just turned 6. She has a ulcer a couple months ago, it went away within a week, now she has another one. I googled her symtoms and Perianl Fistula is what I got. I have an appt early Saturday morning. So scared for my little girl... :-( Beth --- On Thu, 1/8/09, eridanusdesign@ aol.com <eridanusdesign@ aol.com> wrote: From: eridanusdesign@ aol.com <eridanusdesign@ aol.com> Subject: Re: [Chihuahuas] Please Pray for my liitle Smidgen To: chihuah...@yahoogro ups.com Date: Thursday, January 8, 2009, 9:51 AM You have my prayers. How old is yout baby? Have they ever had anal gland problems? best, michelle, henry and vinnie keeping warm in the beautiful Catskills A Good Credit Score is 700 or Above. See yours in just 2 easy steps!
