Dog Health & Care

Treatment of Canine Perianal Fistulas, or Infected Anal Glands

According to the American College of Veterinarian Surgeons (ACVS),  perianal fistulas are tube-like formations inside the dog’s skin around the anal glands. They appear as two oozing pin-points, one on each side of the dog’s rectum. The best that can be said about it is a reoccurring chronic condition that releases a thickened liquid that is foul, putrid, odorous, ulcerating, described as sinus tracts in the perianal tissues with an unknown cause. Unfortunately, the breed of dog that is the most susceptible is the German Shepherd, even though other purebred or mixed breed dogs can also develop it, such as Setters or Retrievers.


canine perianal fistulas
Credit: Wikipedia

Medical treatments for canine anal conditions

Treatments are usually placed at the end of the article, but since our readers may have a dog or know of a dog with this condition, and treatments are their main purpose of reading this article  …. I will place the treatment section here. I had a reader request information on this particular disease, so I hope this article helps.

According to the VCA Hospitals, there are many traditional medical treatments for perianal fistulas as it is not a well-understood disease at this time.

  • If the condition is considered mild, it can improve with medical treatment — but the improvement will not be permanent.
  • Antibiotics are used, such as metronidazole.
  • The most popular treatment is a combination treatment of ” cyclosporine” and “ketoconazole” for 16 to 20 weeks.
  • For secondary bacterial infections, antimicrobials are prescribed and also topical tacrolimus (an immunosuppressive drug, trade names Prograf, Advagraf, Protopic)  in many cases.
  • Keep the anal area clipped with systematic and careful bathing.

Surgery can be used to remove infected tissue with/without simultaneously using cryotherapy. However, surgery as a treatment for  canine perianal fistulas is considered high risk for potential complications, used only when traditional medical treatments repeatedly fail.

Another surgery is removal of the dog’s tail. According to ACVS, “Removal of the tail may allow better aeration and cleaning of the area, which will facilitate the healing of existing fistulas and also help decrease the recurrence rate.”

The ACVS states there is an 80% reoccurring rate of dogs with perenial fistulas, which is why many of the treatments are combined.  The vet in charge of these treatments is a board-certified veterinary dermatologist.


Natural treatments for the canine perianal fistulas

(from the Encyclopedia of Natural Pet Care) 

Credit: 2010 Vets
Credit: 2010 Vets
  • Many cases have an autoimmune cause or an underlying allergy, so it may be wise to do a hypoallergenic food trial.
  • Also used are oral anti-inflammatory/immunosuppressive drugs, such as prednisone, cyclosporine, and azathioprine.
  • Dogs with this condition should change to a novel protein diet for 12 weeks.
  • A novel protein diet is a diet selected that contains a new or “novel” protein and carbohydrate source, meaning that your dog has not eaten this protein source in the past.
  • Naturally build up a dog’s immune system with Primalix Immune, (dogs that are on autoimmune disorder medication or have chronic arthritis cannot take this medication). It is also excellent for dogs with allergies.
  • Keeping the anal glands exercised can be done with diet. The fiber in bran, fiber, grated raw vegetables, and psyllium husks.
  • Keep any foods away that the dog is sensitive to, even in the slightest.

Herbal therapy for canine perianal fistulas

Herbal therapy for chronic anal conditions can be done by applying warm moist applications of hot chamomile, lavender, and calendula or red clover tea. Once the saturated cloth cools slightly, hold on the anal glands for three to five minutes with one hand while gently stroking and talking to your dog in order to relax him or her. Repeat this until the mixture is too cool to be if any use.

The treatment above is meant to loosen, soften and stimulate the impacted anal glands so they will flow on their own. Repeat this several times a day for however many days it takes to clear the glands out. After three days, if the glands are still impacted then gently “milk” the glands with slight pressure on both sides of the anus. Cover the abscessed area with gauze to catch the contents.

If the anal gland is abscessed, add several drops of grapefruit seed extract or tree tea oil to the above mixture.


Homeopathy for canine perianal fistulas

  • Give Belladonna 6c, 1 pellet or tablet every four hours for three treatments.
  • The next day, give the tissue salt Silica 6x every four hours all day (24 hours).
  • For impacted anal glands, give Silica6x to your dog once a day for 10 days or more, or until the condition improves.


Color therapy for canine perianal fistulas

  • If the abscess on the anal glands has not yet come to a head, use a green systemic front followed by indigo directly on the anal glands.
  • To drain the abscess, use a few orange and yellow tonations.
  • If a fever accompanies the condition, place the color magenta over the chest area along with a blue systemic front.
  • If the abscess is beginning to drain, you can stimulate the draining and healing with a turquoise systemic front over the anal gland area followed by indigo.


A follow-up article on the Signs and Symptoms of Perianal Fistulas will be posted next Tuesday.

If you would like a pdf format of this article, please click HERE.



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  1. Durden's Mom
    May 10, 2017 at 6:22 pm — Reply

    The regiment of Belladonna/Silica is rotating, correct? I’m also assuming that it should continue until symptoms improve (or beyond based on the recurrence rate)?

  2. Sara Khan
    April 12, 2017 at 12:38 am — Reply

    Please suggest best diet plan for Anorectal disorders

  3. Fred
    September 14, 2016 at 5:44 pm — Reply

    The big problem in treating this is that I cannot even go near my Shepherds rear to clean her bum. She is very sore and will not even sit in a bath tub or let me rinse her with a hose. I hope the cyclosporine my vet is prescribing will at least take down the pain so I can start cleaning her up.

    • September 17, 2016 at 3:12 am — Reply

      My little Chihuahua has chronic issues with her anal glands, and is super sensitive about me going near them. I take an antibiotic ointment and gently rub it into the opening of each gland; almost overnight the antiobotic will open the gland up and it will begin to drain on its own. I do this daily for about a week.

      My dog likes to check out what I am placing on her. She smells it to see if it is safe for her. But before that, I hold a very warm wash cloth to her bottom end to soothe it, speaking very softely.

      Is your dog a long-haired breed? Can you take scissors and cut the mass of hair away?

    • Helen
      January 3, 2018 at 12:30 am — Reply

      Would taking her swimming help, hopefully in salt water. Her tail would be extended in the water, better than nothing.

      • January 3, 2018 at 12:59 am — Reply

        I would not suggest salt water. It works for humans but in the rectal area may be very painful. I use Tripe Antibiotic Ointment for about a week. Pus will begin heading out in about one to two days. However, it will be extremely painful before you apply the ointment so be very gentle. If it does not pus out or the pain worsens, contact your vet immediately.

    • January 3, 2018 at 1:00 am — Reply


      I would not suggest salt water. It works for humans but in the rectal area may be very painful. I use Tripe Antibiotic Ointment for about a week. Pus will begin heading out in about one to two days. However, it will be extremely painful before you apply the ointment so be very gentle. If it does not pus out or the pain worsens, contact your vet immediately.

  4. June 4, 2016 at 2:48 am — Reply

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  5. minidoxinlover
    April 27, 2016 at 12:48 pm — Reply

    I had no idea why or how this would happen to my beloved pet companion, and after 5 months of treatment of an anal abscess that caused a perianal fistulas this is what I have learned and wasn’t told by my Vet. Change dogs food to Hilsl I/D, carefully clean after pet has gone outside or to the bathroom with moistened toilet wipes, milk the anal glands daily by gently pushing around the rectum, once done clean with “tucks” wipes. My dog is currently in remission but I still care for her daily like this because of the high rate of re occurrence.

    • April 30, 2016 at 9:45 am — Reply

      Yes, this is a difficult situation that most people do not like to deal with. I have a chihuahua that I deal with continuously. I put TAO (triple antibiotic ointment) on it and it pulls the infection and mass out after I milk the glands. I also place her on a mild antibiotic by mouth.

  6. Archie
    November 24, 2015 at 4:12 pm — Reply

    Massimo is Ozonia vet available online for purchase?

  7. October 2, 2015 at 11:54 pm — Reply

    To whom it may concern,
    I recently discovered that the problems related to the German shepherd on the peri-anal glands (infections, ….) could successfully treated with the cream named OZONIA VET produced by an Italian company named INNOVARESE SRL and located in Reggio Emila , Italy.
    I have personally treated my GSD and results has been super fantastic (for him and for us).
    Please, if you know people with the same problems, please forward the name of the cream to them.
    I confirm I have not interests with the INNOVARES company and I’m only an happy customer.
    My best regards
    Massimo De Santis,
    m.+39 331 3826825

  8. Violet
    September 3, 2015 at 2:00 am — Reply

    Bunch of hog wash crackery, both with medical treatment and conservative treatment. On order to clear an analysis gland, you slip a gloved finger inside the anus, directed inferior and lateral then use the thumb from below the pocket and pull contents up toward the index finger. Repeat in the other side. This can be followed with a rinse of gentle soap and water or you favorite herbal cleanser that is very mild. Essential oils should always be diluted in a simple coconut oil or other light oil. Keeping hair shaved around the rectum and following the prescribed diet will help keep down the incidence of further impaction. But simply staying in top of clearing the impaction before it becomes infected will go a long way in keep your family friend from unnecessary pain and odor which will keep the hugs coming.

    • September 25, 2015 at 4:41 pm — Reply

      Are you a professional and how many dogs have you treated in the past six years?

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