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There may be excessive licking, and often self-mutilation
together with reluctancy to sit. Tail movements may become
painful and there may be a resentment of any approach to
the anal region. Often the dogs start losing weight.
The cause remains undetermined. Impaction or infection
of the anal sacs has been suggested, as well as poor ventilation
because of the broad-based tail and low carriage. Indeed
tail amputation at one time enjoyed popularity as a method
of treatment.
Recent work indicates the condition may represent an abnormality
of the immune function. It has been compared with Crohn's
disease in humans, as this disease can also cause perianal
fistula. Dogs often have concurrent inflammatory bowel disease
and when we took biopsies of the colon, we found this to
be the case with Tess.
Because the exact cause is not known it has resulted in
an inability to identify a routinely successful therapy.
Until recently surgery has been the treatment of choice.
However it is directed at the lesion and not the underlying
cause.
Recent success of medical treatment with immunosuppressive
medication has supported the theory of an immunologic abnormality.
However, using a drug like cyclosporine in as large a dog
as Tess will cost around £20 a day.
Tess is therefore being treated with an immunosuppressive
dose of prednisolone in combination with a selected protein
diet. The response of perianal fistula to this treatment
has also been described as encouraging and, indeed, in Tess'
case the ulcers soon disappeared.
It has been accepted that some cases are unresponsive and
therefore Tess has regular check ups to closely monitor
her weight and a possible recurrence of these fistula. After
an initial loss in weight, Tess is now in a good condition
and hopefully we will be able to keep this pain in the bum
under control.
By Ingrid Segboer MRCVS
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