Dogs that have cryosurgery or laser surgery will have open raw wounds for several weeks that will require daily gentle cleaning to remove dead tissue, bacteria, and fecal material from the area. Laxatives (stool softeners) such as lactulose may be added to the treatment, especially in dogs with severe pain during defecation. Some of these pets will need to wear an e-collar at all times in order to prevent self-mutilation.
Unfortunately, perianal fistulas may require lifelong medical management with special diets and drugs that suppress the immune system. These drugs can have serious side effects and should never be combined with any other medications (including those for arthritis) unless approved by your primary care veterinarian. Prognosis for initial healing early lesions is good; however, recurrence is common, particularly in dogs with moderate to severe disease. Chronic damage to the perineal region by perianal fistulas or after multiple surgeries may affect the nerve supply to the area, leading to fecal incontinence (when animals are not able to control when/where to defecate).
Effective preventive measures are not known. High quality diets may decrease the chance of inflammatory and allergic intestinal diseases, which are often associated with perianal fistulas. Since German shepherds are at an increased risk for the disease, heredity may play some role in its development; thus, dogs with perianal fistulas should not be bred.