Today is the
second Sunday I came back from a break in Perth
Australia. Last Sunday, I wrote about 2 related
cases of house-breaking in two Cocker spaniels.
Today, I saw two cases related to the anus of the
dog. One in a 4-month-old Silkie and one in a
CASE 1. OLD DOG.
ANAL SQUAMOUS CELL CARCINOMA
Around 3 weeks before the surgery on March 23,
2010, Vet 1 diagnosed anal sacculitis, expressed
the anal sacs and sent the dog home. As the dog
was still licking the anal area, the owner came to
me for a second opinion. "Vet 1 said it is anal
sac infection," the personable lady in her 30s
said. A wound that does not heal would need
KNOWLEDGE OF ANATOMY
In 99% of the cases, it will be anal sacculitis.
But in this case, the lump was vertically below
the anus, not at 4 or 8 o'clock position. This is
where the vet student will find need to apply
their knowledge of anatomy, a dull subject. Could
this Pom be suffering from a chronic anal
tumour resection in a Pomeranian.
The anal sacs were normal. A lot of yellow
oil was expressed out prior to surgery
Follow-up on Sunday, April 18, 2010
The daughter in her 30s together with her dad,
came for a review, 3 weeks after the anal surgery
of her male Pom, 5 years old. Many Singapore
owners don't bother to come in for reviews as the
dog's problems had resolved by surgical excision.
The culture of Singaporeans is to be frugal and so
they do not go for reviews of their dogs. But this
attitude is at the expense of the older dog with
tumours, some of which can be prevented.
"What's the result of the pathology report on the
tumour?" she asked after I took out the stitches.
The details of the histopathology report are as
The ellipse of skin measures 1.2 cm x 1.0
cm. It has a darkish lesion measures 0.7
cm x 0.6 cm. The underlying subcutaneous fat
measures 0.4 cm thick.
The skin sections show ulceration of the
epidermis. Beneath the ulcer is an
infiltrative squamous cell carcinoma which
is composed of irregular, closely-packed
nests of atypical squamous cells. There is
focal keratin pearl formation. Other areas
show irregular anastomosing trabeculae of
tumour cells. Most of the atypical squamous
cells have voluminous eosinophilic
calcification. There is surrounding
desmoplasia and focal dystrophic
calcification. The tumour reaches the
resection margin. No lymphovascular tumour
embolus is seen.
ANAL LESION, EXCISION BIOPSY. Well to
moderately-differentiated squamous cell
ADVICES TO OWNER
1. Inspect anal region weekly for any hard lump as
the tumour has spread past the resection margins.
I explained that it was not possible to cut bigger
as the wound will have difficulty in healing.
2. Get lump excised when it is small.
3. Get two retained testicles removed as soon as
Many Singapore dog owners don't bother with the
dog's backside tumours and so they grow larger. If
this circum anal tumour was excised at 0.5cm x 0.5
cm when it was very small and Tardak (androgen
inhibition drug) the prognosis is said to be good,
according to the Tardak manufacturer.
A red ulcerated bleeding hard lump? I suspected it
was a circum anal tumour due to its position. In
my 30 years in practice, I had not seen anal sac
discharge at the 6 o'clock position, ventral to
the anus. This does not mean it will never happen.
The probability is rare. So, the owner accepted my
advice to get the tumour excised and sent for
histopathology. It was a squamous cell carcinoma.
Circum anal tumours occur in old dogs. Dogs are
said to be old when they are over 5 years of age.
Hard swollen lumps even at the 4 and 8 o'clock
position can still be circum anal tumours or
perianal tumours. So, be vigilant and not be sued
for misdiagnosis in this litigious age.
CASE 2. PUPPY -
Clipper Burns. Silkie X, 4 months, male
"Do you think that the groomer was did not do a
professional job?" the father of a 5-year-old
daughter with big curious eyes asked me. "Before
going to the groomer yesterday, he was normal.
Today, he would rub his backside and lick it all
the time. He was sleepy and did not want to eat. I
felt that he has a fever."
The puppy had fever. His anal area had been
shaved. His anus had a raised, reddish ring. His
scrotal area was brownish for 75% of the area. 3
small brown patches of skin looked as if they were
"Talk to the groomer," I said. "Was the puppy
having itchy backside prior to grooming?"
"This will be the last time I send my dog to her,"
he said. "Where do you find certified dog
"Some groomers don't express anal sacs," I said to
the groomer when the owner phoned her. "This is
because some dogs feel the pain and the owner
blames the groomer."
"But the course tells us to express anal sacs as
part of the grooming services," the groomer said.
"You know about this compulsory course conducted
in the Temasek polytechnic?"
"I am only saying that some groomers learn from
experiences similar to what has happened know and
so, to avoid bad complaints, do not express the
anal sac." I said to the young lady who must be a
"Does it mean groomers don't operate on the anal
"No, no," I answered. The owner was listening. "It
is just that some dogs will experience intense
pain after the groomer had expressed the anal sac.
You may have to let the owner know after grooming,
In this case, I suspected it was the clipper burns
around the shaved anal area and near the scrotal
area and subsequent application of a anti-bleeding
purplish black potassium permanganate or iodine
powder that burned the anal area and scrotum and
caused the intense itchiness. The puppy just had
to rub her backside to relieve herself of the
The groomer's clipper had nicked the superficial
skin of the anal area and below it and the groomer
had dabbled he powder onto the wound, as this is
the common practice in Singapore. I expressed the
anal sacs. There was a very small amount of brown
oil plus numerous specks of blackish powder which
would be the potassium permanganate or iodine. But
to prove it would require money and time.
So I better not instigate the owner who was
already angry and would then had a big ugly fight
with the poor groomer.
"Will you let me know how much it costs?" the
groomer said. "OK," I asked my assistant to phone
her after the owner had paid the bill.
This was a case where the vet could pour oil into
the fire and made the owner extremely angry.
Puppies are like babies. They are especially
loved. This could lead to litigation and
complaints to the veterinary authorities if the
vet or his assistants played the game of running
down other professions.
As for the fever, it could be a bacterial
infection caused by clipper wounds. Or a viral
infection as the dog vaccines protect against the
major diseases. In any case, this puppy's primary
complaint was an itchy backside and the problem
needed to be resolved promptly with medication.
KIND TO OLDER DOGS & CATS ---
GET TUMOURS REMOVED EARLY ---
WHEN THEY ARE SMALLER. More case studies, goto: