Both medical and surgical treatment are used in conjunction with each to lessen the opportunity for a reoccurrence as the infection has proven to return to 80 percent or more of dogs, dependent on the course of treatment the dog has undergone. The medical side of the treatment is generally performed by a board-certified internist or veterinary dermatologist.
Treatment may include the following
- A dietary change to a specialised protein diet
- Metronidazole or similar antibiotic
- Oral immunosuppressive drugs/ anti-inflammatory, such as azathioprine, prednisone, cyclosporine
- Tacrolimus or similar topical immunosuppressive medications
Surgical treatments are usually performed if:
- When contusions/lesions are small,
- Remove of anal sacs that are affected
- Fistulas are completely healed after medical treatment , or
- To make dogs more less uncomfortable in recurrent or very severe cases
Dead (necrotic) tissue associated with the fistulous tract may require surgical treatment to promote healing. Both laser treatments and cryosurgery are commonly used in this instance. In Cryosurgery the affected tissues are frozen using a special probe. These frozen cells die and are usually shed, thus allowing further healing to take place. The pain is usually lessened straight away after surgery, leaving your dog in a lot less discomfort. Lasers have a similar effect to that of freezing, where is kills the lining of the fistulas and the affected area will heal slowly over time.
In certain cases an amputation of the tail is required. This procedure facilitates the healing of existing fistulas and decreases the likelihood of a recurrence; it may also allow easier cleaning of the area and aeration of the site.