Trying To Squeeze InLet’s face it: Dog owners spend a lot of time discussing dog butts and what emerges from them. Puppy bums lend themselves to lots of joking. But this article, adapted from one I wrote for Your Dog, the Tufts University veterinary school newsletter, deals with some medical problems that are no laughing matter.

That doesn’t mean I was going to put in graphic disease photos. Dog butts are cute and funny.


Diseases of the anal area occur frequently in dogs, from those that are easily prevented and resolved to others that are unpredictable and persistent. Although owners might prefer not to think about or investigate this part of their dog’s anatomy, anal diseases naturally benefit from early diagnosis and treatment.

Luckily, symptoms are generally easy to spot.

“It’s worthwhile to know what normal looks like in this area, so it can be checked periodically,” says surgical specialist John Berg, DVM, at Cummings School of Veterinary Medicine at Tufts University. “Owners of older dogs, especially those whose tails cover the anal region, need to be especially vigilant.” Frequently encountered diseases include anal sac impaction, perianal fistulas, and perineal hernias, discussed here.

Anal Sac Impaction

The most common problem, one particularly affecting small and overweight dogs, is impaction of the anal sacs. Located beneath the skin and anal sphincter muscles at the 4 and 8 o’clock positions, these organs are lined by cells that produce a malodorous, oily brownish fluid. It’s usually discharged in small quantities when feces pass through the rectum and squeeze the sacs.

“We don’t know for certain why the sacs are there or why the fluid is produced,” Dr. Berg says. “It’s theorized that the fluid may lubricate the stool and make it easier for the dog to defecate.”

Unquestionably, the fluid has a marking function, creating a signature odor that other dogs can identify — which explains why dogs sniff each other’s rears. Dogs, and especially puppies, may also expel the fluid out of fear. The effect is skunk-like, as some owners can attest.

If it’s not eliminated naturally, the fluid in the anal sacs thickens, becoming more difficult to expel. “Sacs have narrow necks that the fluid has to travel through to come out,” Dr. Berg says. “If the fluid thickens, it’ll get blocked inside that neck.”

The sacs will then distend and the dog will experience discomfort. Bacteria may develop in the sacs and eventually abscesses can form. With no escape route for the infected contents, the anal sacs can rupture.

But that’s the worst-case scenario. The complications of anal sac impaction can usually be avoided by eliminating the sacs’ contents before they thicken, an easy procedure called “expressing” that can be done by veterinarians, groomers and, if properly instructed, owners (see instructions, below).

The obvious sign of a dog’s having blocked anal sacs is “scooting” or “scooching.” The dog will drag his rear across the floor, sometimes leaving behind a brownish stain. This behavior may simply mean that your dog needs to scratch an itch, but more often it’s intended to relieve the pressure of built-up fluid.

Sometimes, scooting is enough to resolve the problem after one or two attempts. If your dog continues to rub, lick or otherwise exhibit discomfort around the anal area, you should consult your veterinarian.

Many owners never need to have their dogs’ anal sacs expressed. And most owners of dogs with a tendency toward anal sac blockage — and if your dog becomes blocked once that usually indicates a tendency — an easily deal with the problem by having a groomer express the sacs regularly or by learning how to do it themselves.

But in some cases, particularly if the anal sacs are prone to infection, it may be best to have them permanently removed. Because the sacs are in the same area as the sphincter, which rings the anus, some owners worry that the procedure will sever nerves in the area and leave their dogs fecally incontinent. However, if the surgery is done properly, that shouldn’t occur, Dr. Berg says, acknowledging that incisions in this area may be more at risk of infection than usual incisions in other areas, but noting that infections are usually easily treated with antibiotics.

No question: You should consult a veterinarian before trying to express your dog’s anal sacs for the first time. However, once you see the proper technique, you can expect to follow these steps.

  • Have a damp, sterile cloth ready.
  • Put on disposable surgical gloves.
  • Raise your dog’s tail and find the anal sacs. You can feel but not see them. They’re soft, half the size of a grape, at the 4 and 8 o’clock positions of the area around the anus.
  • Grasp the skin surrounding both sacs between your thumb and forefinger and squeeze. If you feel resistance, which suggests that the sacs are blocked, insert a finger into the anal canal and a thumb on the outside and squeeze them gently.
  • When you see and smell the secretions, wipe your dog’s anal area with the damp cloth.

Note: Normal secretions are brownish and either liquid or, if the sacs are blocked, the consistency of peanut butter. If discharge looks pus-like or bloody, an infection may be present and you need to consult your veterinarian.

Perianal Fistulas

The problems associated with keeping the anal area infection-free are exacerbated in dogs with broad-based, low-slung tails. This anatomical feature is one of the reasons, it’s hypothesized, that German shepherds are predisposed to a less common and far more serious condition: perianal fistulas.
As this disease, which is sometimes termed anal furunculosis, progresses, an initial scattering of pinhole-size sores may become deep, draining, painful ulcers surrounding the anus. “The warm, moist area under the tail and the large numbers of bacteria in the area make an excellent environment for bacteria to multiply,” Dr. Berg says. “Abscesses form, open and then drain.”

Although perianal fistulas are sometimes diagnosed in other breeds, including Irish setters, Labrador retrievers and some Arctic breeds, the great majority of them occur in German shepherds. The condition usually develops when the dog is 5 to 8 years old, occurring more frequently in males than females. The diagnosis is visual. The disease doesn’t show up in blood tests, and no special imaging techniques are required to see the lesions. Owners must simply remember to check under their dog’s tail.

The cause of perianal fistulas remains unknown and, for many years, antibiotics were the standard treatment. When the drugs didn’t provide more than temporary relief, as frequently occurred, veterinarians often recommend surgical removal of the infected tissue. This was expensive and often ineffective in preventing the fistulas from returning.

In recent years, oral doses of the immunosuppressant drug cyclosporine have had a far higher success rate in treating the disease. This success may also shed light on why German shepherds are prone to developing perianal fistulas. The breed is hereditarily predisposed to disorders of the immune system, and the dogs’ responsiveness to an immunosuppressant suggests the disease falls into this category.

Although a course of cyclosporine is expensive — $1,000 to treat a typical GSD — Dr. Berg estimates that approximately 80 percent of dogs who take the drug experience a complete resolution of their fistulas. “Generally, they will have a very dramatic improvement within a couple of weeks,” he says. Some dogs who don’t have a good response initially may improve with a higher dose. “Some vets measure the dose by monitoring the blood levels of the drug. Other vets gauge the dose by the response to treatment,” he says.

Generally, dogs stay on the drug for six to eight weeks. In the majority of cases, the fistulas disappear by this time and tend not to recur. “There are dogs who do relapse and some whose fistulas don’t totally dry up,” Dr. Berg says, “But with this disease, if you can make it much, much better that’s often enough to produce a significant improvement in quality of life.”

A small percentage of perianal fistulas is resistant even to cyclosporine. They recur even when the infected tissue is surgically removed. In those cases, a veterinarian may recommend amputation of the tail. This may seem like a drastic measure, but because it prevents the area from becoming reinfected by exposing it to the air, it is an effective one.

Brenda Griffin of Tucson [Ed. note: yes, she’s a friend, though I never met Bean] was shocked when her veterinarian suggested tail amputation for her 3-year-old German shepherd, Bean, a decade ago, before cyclosporine was widely prescribed. But when Bean continued to develop fistulas after several rounds of antibiotics and three surgeries, she was desperate enough to try it — and surprised at the results.

“I thought not having a tail would throw off his balance and make him look odd,” Griffin says, but neither of those things happened. Bean resumed his athletic activities with his previous grace, and no one who wasn’t acquainted with him pre-surgery noticed anything amiss. “People would ask, ‘What kind of dog is that?’ because they’d never seen a German shepherd without a tail,” she laughs. “But the surgeon was so neat you never would have guessed a tail was ever there.”

More important, the perianal fistulas didn’t return. “I’m convinced the tail amputation saved his life,” Griffin says. Bean lived to the ripe old age — for a GSD — of 12 without experiencing more anal area problems.

Perineal hernias

Like perianal fistulas, perineal hernias are often easy for owners to diagnose by sight. When the muscles of a dog’s pelvic diaphragm weaken, the pelvic and/or abdominal organs may intrude through the pelvic canal into the region around the anus called the perineum. When this intrusion, or herniation, occurs, owners can observe an abnormal soft mass on one or both sides of the anus. They’re also likely to notice that the dog strains to defecate.

“Because the rectal wall has lost support, it deviates to one side,” Dr. Berg says. “And if the dog’s stools may not easily pass through the deviated area, having to go around a U-shaped bend, defecation is more difficult.” A veterinary visit for a rectal exam will almost always confirm a perineal hernia.

The reasons for the development of perineal hernias aren’t completely understood, but most cases occur in middle-aged or geriatric male dogs who are intact. This points to prostate enlargement and the concomitant straining to defecate as a source of the problem. Testosterone may also directly weaken the pelvic diaphragm. Other theorized causes of perineal hernias include hormonal imbalances, damage to the nerves of the pelvic diaphragm and straining due to other rectal diseases. “Also, females may have a stronger pelvic diaphragm because they need it to be stronger during child birth,” Dr. Berg says.

Although the distended area may look frightening to an owner, perineal hernias shouldn’t be considered a cause for immediate alarm unless the bladder is involved and the dog can’t urinate. The condition isn’t particularly painful and some dogs display no symptoms at all. Nevertheless, surgery to repair the hernia is recommended. “Most dogs are straining to defecate or they’re constipated, and only surgery can take care of the problem,” Dr. Berg says.

The standard surgery to resolve perineal hernias is fairly simple. “The surgeon makes an incision over the swelling next to the anus, pushes the organs back into place and then uses a flap of a muscle in the area to coverlose the defect, creating a new diaphragm,” Dr. Berg explains.

While the dog is under anesthesia, another simple surgery is indicated: neutering. If the prostatedog is left intact, the problem is likely to recur, Dr. Berg says. “One reason, among many, to get your dog castrated early in life is to prevent perineal hernias.”

Anal tumors

It’s not uncommon for owners who check an older dog’s anal area to notice masses, or tumors, in the area. There’s no reason to panic, especially in the case of intact male dogs, who are subject to perianal adenomas. These tumors of the skin in the anal sacarea are benign most of the time.

Along with removing or biopsying the mass and submitting it for histopathology to determine its type, neutering is recommended in these cases. Cancerous tumors of the anal area are much rarer, but they do occur, so it’s important to have your veterinarian check any growths.

32 thoughts on “Diseases of the Dog’s Anal Area”

  1. Cyrano, aged legally blind Beagle, just had the “works” done at my friend Stacy’spet products store; his anal glands were stretched and full, though I saw no scooting. After Debbie expressed them, his bath and nails were a cinch, he was so relieved. My vet has shown me how to express the glands and while I can be handy, it is a skill I in which need a lot of coaching. Excellent article – I have other dogs in need but no fistulas, etc. so far.

  2. Great post, my dogs are so smart, we trained them where to pee and pooped and we make sure that they are not going to sit and lay in the they will be free from the parasites.

  3. This is some very important information. I don’t think I realized how many things could go wrong before. It’s so important to be aware of all the major health concerns for our pets, probably more so than for ourselves. We can feel if there is something wrong in our own body whereas we may not be able to tell if there is something wrong with our pets before the symptoms get worse.

    1. Yes, it’s been a revelation. But I gotta say, writing for Tufts has made me aware of way too many things that can go wrong!

  4. Thank you for the educational article. The subject is almost as uncomfortable to talk about as when similar issues occur in humans, but maybe even more important to talk about. As pet owners, we speak on behalf of our pets, so identifying issues to the correct doctors and care givers is ever so important. Thank you for doing the research to familiarize us with the symptoms, as well as the treatments for these diseases. Identifying and eliminating the problems will lead to happier dogs!

  5. I must admit I had a visceral reaction to this post—it made me queasy!

    It’s hard to imagine being able to perform an anal gland extraction on my squirmy dog—I can barely trim his nails successfully.

    All of these issues are great reasons to keep our dogs in good overall health, with strong immunity— starting with providing them the basics of clean fresh water, complete nutrition, plenty of exercize and a clean (toxin-free) home and yard environment.

  6. Well I digested all that quite slowly as I suspected my dog has an issue with what you describe as scooting and the brownish smear left behind, so I shall have to get a vet to do what you describe as expressing the glands, as I can’t really be sure of doing it myself without hurting him or properly. I just thought he was constipated. It started two days ago on the last day of our boating holiday and he was scooting around on the boat deck and later having trouble doing number 2. He was wearing one of those doggie life jackets as he’d been swimming and I thought maybe something in the water had upset his tummy but other dog owners in the area reassured me but never suggested this problem. Thanks for enlightening advice.

    1. Most groomers know how to do this too, Juliette, so you can save yourself some money. It’s very common, especially among small dogs. The combination with constipation is a bit unusual, though: It’s usually firm stools that cause the anal sacs to express themselves naturally. So maybe, for this first time, a vet visit would be smart.

  7. I just read this post after having given my 5 year old female shitzu-cross a bath. When I bath her I always comb out the residual poo near her anus under the water to loosen it off. When I did this today, the poo was stuck a bit and when I pulled it it created a hole on a brownish bump under her anus. Then all this brownish gunk with white specks came oozing out. I squeezed it gently, and a LOT more came gushing out until it became a clearish brownish liquid. Once I took her out of the bath, I trimmed the hair around her bum, applied hydrogen peroxide and ozonol cream. She did not show any signs of discomfort or scooting previously. But I could tell she was relieved to have this done. However, when I watched a youtube video of how to express anal glands it showed them expressing from above and inside the anus hole. This hole is like a pimple under her anus hole. Is this cause for concern?

    1. I think it sounds fine — what you describe sounds very much like anal gland fluid. But I am not a vet and I never expressed Frankie’s anal glands. So I would keep an eye on it, just to make sure, and consult a vet if anything changes.

      Good for you for taking such good care of your pup!

  8. our little chihuahua is 13 years old. Strains to go to bathroom, been on different types of meds nothing seems to work. When he does go it is very little. There is a tumor so I assume that is what is causing the blockness The vets say just keep him comfortable with the meds and all and if no better it is our call.
    How do you put your dog down when they seem fine one day and not the next, how do you know they are even in pain.
    Don’t know what else to do for him. He just stays close to us and follows us around all the time

    1. Oh, I’m so sorry to hear about this; it’s so heartbreaking. 13 isn’t old for a chihuahua. I would get a second opinion to see if there are other options. There are also ways to determine quality of life, when the bad days become more common than the good ones. I would also suggest a hospice vet, someone who could help you through this difficult time. They have more experience in pain regulation and assessing quality of life than many other vets.

  9. I have a six week old lab mix she has a red sore above her anus. It’s not coming out of the hole or connected to it it’s more out of lower tail near the anus. It would be considered the 12oclock position. She’s not biting it, scratching it, or rubbing her butt across the floor. Any ideas? Maybe food allergy I did just change her food when I got her yesterday and it appeared today?

    1. Sorry — this ended up in my spam bin! Hope by now the problem resolved itself and that a visit to the vet wasn’t required.

      1. that sounds just like what my 4 week old pup has ive got a litter of 6 and only one has that exact same thing ^^ changed their foods also two days ago could it be due to straining or something more serious?

  10. My dog is half german Shephard, half lab. Hes 7 years old. He is eating, doing his normal batheroom thing, nothing different. Hes a inside dog. When he was walking away from me I noticed something sticking out under his tail, this is at 12 oclock. Its hard and a lump. You havevto lift his tail to see this. What is this? Going to call the vet today to get him in. My dog is my world, my husband just finished radiation/chemo, and I have my 89 year old mom living with us, due to early stage altimerz sp? My dog I love him and cant see without him. I pray its not cancer. I cant handle more bad news here. What else can it be besides cancer. Im not working, husband on SSDI, dont know how im going to pay for treatment if cancer. My dog comforts me as being a care provider is hard enough for 1 but I care for 2. With no help. Hes my best friend. Follows me all day, end of my day, I lay curled up beside him until he falls asleep, I do this every night. Sorry this is long, I just love my dog so much. Hes a male dog.

    1. Aw, Betty, let me give you a virtual hug; I’m sorry you’re going through such a tough time. There are a LOT of benign anal area tumors; it’s an area that gets inflamed quite a bit because of…well, where it is. I am sending good thoughts that it is not anything serious. Please let me know what your vet says.

      And you never have to apologize here for loving your dog and finding comfort in him!

      All my best, Edie

      1. Hi Edie:

        Maybe you can help me? My dog Baxter is a Pomerian mix and only I believe him to
        be 8 yrs or maybe 9 as I adopted him. He has a lump which is about the size of a golfball on the right side of his rectum under his tail. My vet said it is a tumor but now I notice that it is bleeding like a brownish liquid. He runs, plays, eats, poops okay and pee wees ok other then the lump. What should I do. He is my pride and joy and I love him so much. He does not seem like he is in pain but will not let me try to clean him in that area. please help me.

        Thank you

        1. Aw, I’m sorry to hear little Baxter is having problems. I wish I could help but I don’t have any kind of medical training. It could just be anal gland fluid but it sounds like you’d better check with the vet. Hope it’s easily treatable.

    2. Hi, my dog has the same thing as yours. He’s an 11 year old chihuahua. He acts and eats normally. We took him to the vet today and he took the thing out and sent it to the pathologist to find out what it is. I’m also hoping it’s not cancer, I don’t know what I would do… I was just wondering what was your dog’s diagnose? I’m hoping it was something good. I understand that your dog is everything to you.

  11. My pit bull terrier/lab/chow mix had a mashve infection inside her uterus that warranted emergency surgery to spay her at age 6. Soon after she began having issues with her anal sacs. I’d never even heard of such things until this issue arose& I’ve owned many dogs over the years. The vet examined her& relieved her of the fluid build up causing her discomfort. Not long after this,a few months maybe, I noticed her neck was swollen up to her head between her ears. She was repeatedly opening her mouth really wide, similar to a yawn but more like you would to pop you ears on a plain. Also shook her head& held it slightly tilted to the side, indicating her ears where bothering her. She’s had ear issues since birth I think. I took her to her vet for an exam that found her heart was enlarged to twice it’s normal size& he constituted theSwelling to the heart problems. He felt that blood was not being pumped out at the same rate it was coming in and the built up blood was the swelling. Also he found that her anal sacs needed expressing again. Since that visit we’ve tried different meds to see what helped& I found that she had her best days after a visit to the vet. The reason was she has to be given a sensitive before going to help her anxiety. This would relax her& allow the swelling to go down which made her feel wonderful the following day or two until it came back. They put her on a milder version that she takes twice daily with her heart med. A few weeks ago she got a very aggressive digestive bug that liquefied her bowls to the state of a water constancy. The vet gave her probiotics which took care of the problem. Strangely it also improved her swelling in her neck& she felt better than she had in a long time. Then yesterday she woke up with her anal sacs extremely swollen along with her neck that was swollen more than ever before. I’d asked the vet multiple times if the two could be connected& he didn’t seem to think so until yesterday. Although he doesn’t know how exactly or why. I just want to find out what the cause is so that we can work on the best solution for her. Any help or insight would be greatly appreciated.

    1. I don’t have any insights, but it sounds like you’re doing everything you can for your poor puppy. I’m very sorry you’re going through this and I hope a solution is found soon.

      1. my dog has a wet bum lately for no reason he is completely normal other then this im not sure if i should be concerned or not he is a chihuahua x Mimi dovermin mix can u give me some advice please im worried it nite b worms or something more tarrifing

        1. Wish I could help but it sounds like something you should consult your vet about. It may be absolutely nothing; I just don’t know, sorry!

  12. I have a 10 week old Boston Terrier pup that was born here. He has never been able to defecate on his own. It just leaks out. He has seen 2 different clinics and both say they think his muscles are very immature and he also has a fistula on his rectum. When he is upset (like being in his pen alone) he will drop more than any other time. I think there is something else going on. I have never EVER seen this dog “hunch” to try and go. He is playful, intelligent, adorable, eats and drinks normally. Sometimes he will leak urine if you pick him up with a full bladder. It was suggested that he see a neurologist, but is this the route I need to go? He has had enema’s and xrays and all showed normal other than a soft stool. It has a peculiar odor to it, not like an expressed anal sac, but just different. Any suggestions would be helpful. This puppy has never had a normal stool on his own and his mother still cleans his bottom when she sees he is leaking. I try to keep her away from him because she causes the rectum to get irritated. Advise please…I dont’ know where to go from here or what to ask to have done…

    1. Aw, I’m sorry to hear you’re having so much trouble with your puppy. Because I’m not a medical professional I can’t help, but I will ask around and see if I can find anyone that might have some ideas.

  13. Hi Edie, I have a little Malti-tzu mix who is 7 years old. She is the sweetest little girl ever…well behaved and never complains about anything. Yesterday I noticed she was taking a really long time to go potty. When she finished there was a little spot of feces left, so I cleaned her up when we came inside. I didn’t see anything unusual at the time. This morning she didn’t want to go out to potty, so I picked her up and carried her out. She tried to hold on to my arm when I went to put her down and as I placed my hand over her tail and back end to set her down, she jumped and made a little whimper. I cradled her (like the baby she thinks she is) and looked at her bottom and was surprised to see a large, hard lump to the left of her anus. She has pink skin and the area looks pinker than usual. Could this be a blocked gland? Of course it is Labor Day and the Vet’s offices are closed. Any recommendations are greatly appreciated.

    1. Aww, poor baby! It sounds very much like that could be a blocked anal gland. There are a lot of on line vets. I just asked my friends on FB for a recommendation and will get back to you via email.

  14. don’t know if you can advise me but I’m pretty desperate. I live in gambia and vetenary diagnosis is a bit ….well its not good.
    My dog has petechia in his groin area fir 4 years but recently it worsened and became an abcess treated with amoxycillin. A few weeks before this his anus/rectum moved to one side and there is a hard swelling at the side of it. Hes still not well at all…..

    1. I can imagine how difficult it is for you to be in a place without good resources for veterinary advice. I can’t offer any medical opinions but maybe you can try this free online service, PetCoach: I have never used them, but when I browsed around online looking to find help, I came across the site. I hope the problem is nothing serious — it could just be a blocked anal gland — and that your improves. Best of luck.

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