Perianal Fistula Management in Dogs

Perianal fistulas are a common cause of perineal and tail irritation in dogs. Large breed dogs, especially German Shepherds, are overrepresented. Historically, treatment has consisted of various invasive procedures, including debridement/excision, fulguration, laser treatment and chemical debridement. Failure rates with surgical treatment are high, including recurrence of the fistulas and formation of an anal sphincter stricture.

New research has shown that many of these fistulas develop secondary to an underlying food allergy. For the past 8 years, treatment has shifted from surgical excision toward immune modulation with various agents. Prednisone, cephalexin and an immune diet were tried initially but recent protocols have included the use of cyclosporine, ketoconazole, and hypoallergenic diets. Success rates have been encouraging and the patient's quality of life has improved markedly with these new medical therapies.

Drs. Dennis Crow and Reid Garfield have established protocols for treatment of perianal fistulas. If you are confronted with one of these challenging cases, please do not hesitate to call the Animal Dermatology Clinic for additional information.