Question Details
Painful Defecation In A Dog
by jk176 - October 10, 2020    View Case Report
George is a 12 year old MN Cock-a-Poo who had a right anal sacculectomy on 6/3/20 to remove an anal gland adenocarcinoma.
It was excised with narrow margins. He had radiation treatment and one dose of chemotherapy. He has been on Vetoryl for many years.

Around the middle of September, he started having increased urgency to defecate and could not hold his stool for as long. He has trouble passing stool and doesn't seem to know when he is finished defecating. More recently he has started shrieking when defecating and he prefers to lay on his side to defecate. He also has started eating his stools after he defecates and his stools are smaller, softer, and malodorous. Otherwise he is doing well. His appetite and energy level are good. He is drinking and urinating normal amounts.

His tongue is lavender, noise is moist. His ears are clean. He has a cataract and corneal cloudiness in his left eye. He has a 2/6 systolic heart murmur, normal rhythm, clear lungs. His pulse is thin, toned and slow. His abdomen is non painful and there are no palpable masses. He was painful on rectal exam and when his temperature was take. No masses or strictures were palpable on rectal exam. The anus/anal sphincter area is painful and doesn't relax well. His gait is normal. He has alopecia on the right side of his tail/anus. When he sits down, his penis often protrudes from the prepuce.

His radiation oncologist told his owner that these signs are not a result of the radiation therapy.

Do you think these signs could be a result of impaired circulation/innervation of this area?

Is there an herbal formula that could help with this problem?

Thank you,
Jennifer

Jennifer Katz, DVM
Veterinary Clinic of East Hampton
Replies
by naturevet
October 11, 2020
Hi Jennifer

I completely agree with you that there is stasis in that region where the surgery was done, creating the chronic pain as well as alopecia at the surgical site. It is further confirmed by the desire to defecate while lying down. Generally, whichever side is uppermost is the problem. I would guess that means he lies on his left side a lot. Doing so relieves tension in the peri-anal region on the right hand side, and the presence of tension means 'Stasis'.

It also appears the inflammation has ascended a little from the rectum into the colon, producing a reflex irritation that causes the incontinence, soft malodorous stools (passed sooner than they should be) and the protruding penis when sitting (through a sacral reflex). The presence of a heart murmur suggests he has endothelial dysfunction (ED: a feature of all valvular incompetence dogs progressing eventually to CHF). ED is a form of stasis.

Given the presumed colon involvement, Cushings and cancer history, I would start with Xiao Chai Hu Tang, plus a Blood mover. Modified Xue Fu Zhu Yu Tang would be my suggestion.

If that doesn't helps, then consider a Damp Heat centered approach, using Si Miao San teamed with something like Xian Fang Huo Ming Yin.

One of these strategies is likely to work, probably the former.

I hope it helps you out!

Steve
by jk176
October 14, 2020
Hi Steve,

This is very helpful. Thank you!

I will let you know how it goes.

Jennifer
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