Perianal Fistulas

Perianal fistulas occur commonly in German shepherds.

Perianal fistulas (PAF) occur most commonly in young adult male German shepherds but the cause of the disease is unknown. Initial lesions are small, inflamed draining ulcers that progress to deep necrotizing pyogranulomatous fistulous tracts in the perianal tissues. Clinical signs include constipation, licking, tenesmus, odor, perirectal bleeding, pain, weight loss, decreased appetite, and behavior changes.

The diagnosis of PAF is made based on clinical signs, history, physical exam, and histopathology. Medical treatments include immunosuppressive drugs, stool softeners, perianal cleansing and hydrotherapy, antibiotics, and hypoallergenic diet. Combinations of prednisone and metronidazole or cyclosporine and ketoconazole (JAVMA Apr 1, 2002) have been successful. Surgical treatment may be necessary for PAF resistant to medical management or for those with concurrent anal sac disease. Surgical techniques include radical excision, cryotherapy, cautery, anal sacculectomy, or tail amputation. Recurrence of PAF is not uncommon.

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