How do I know if my cat has anal gland issues?

Cats have two anal glands on either side of the anus that secrete fluid when they defecate. However, when anal glands are not working properly, diseases such as impaction, infection, and rupture can follow. Anal glands can also be affected by cancer. If you are a cat owner, read on to learn:

• What do feline anal glands do?
• What are the symptoms of anal gland disease?
• What are the types of anal gland disease in cats?
• How is anal sac disease diagnosed and treated?

A vet diagnoses anal gland problems using a rectal examination and other diagnostic tests, such as biopsy or bacterial culture. Treatment of anal gland disease depends on the type of disease and may include antibiotics, anti-inflammatories, surgery, and sometimes oncology referral. Most anal sac problems are noncancerous and are treated relatively easily.

Anal glands in cats are surrounded by thin membranes, or sacs, and the terms anal glands and anal sacs are often used interchangeably. The two small anal sacs are located under the skin on either side of the anus and produce a thick, strong-smelling liquid when a cat defecates. This liquid may be used to mark territory and is often released out of fear or when the cat is physically hurt. Anal sac disease results when these glands are affected by abnormalities such as impaction, infection, and cancer.

There are a variety of conditions that can affect the anal sacs, and most share common symptoms. Some common signs of an anal gland disorder are:

• A foul odor
• Anal scooting
• Discomfort when sitting or reluctance to sit
• Redness and swelling around the anus
• Overgrooming or biting at the base of the tail or anus
• Open sores around the anus
• Constipation
• Blood on the outside of stools
• Painful defecation or vocalizing when defecating

Symptoms can range in severity, and not all cats experience every symptom. In addition, simply smelling anal gland fluid does not necessarily mean your cat is experiencing a problem. It’s normal for fluid to come out of the glands under a variety of circumstances, and the unmistakable smell of anal gland secretions can linger on surfaces for quite a while. If your cat is startled at home and expresses their glands, you might still smell it later in the day.

The anal glands can be affected in several different ways. Anal sac diseases are often interrelated and range in severity and how commonly they are seen in cats.

Anal sac impaction

Anal sac impactions are the most common anal gland disorder in cats, and they occur when fluid in the glands isn’t released normally and builds up. An owner may see or feel enlarged glands around the perianal region, and the affected cat may have irritation or discomfort in the area.

Anal gland rupture

Anal gland fluid is normally excreted into the rectum just inside the anus through tiny ducts. When something blocks the ducts or the fluid becomes too thick to escape, pressure from the impaction can build up. The skin over the gland develops a blister-like swelling, and the gland can eventually rupture. When an anal gland ruptures, it leaves behind an open, inflamed, draining hole near the anus that can be seen during a physical exam.

Anal gland infection

Bacteria can build up in the anal sacs, leading to an infection. Infections often occur in association with ruptured anal sacs and anal sac impactions. An anal sac abscess develops when a pocket of pus forms and is trapped around the infected gland. Cats with infected glands may show more signs of pain than cats with impacted glands, and it can be difficult to tell the difference between the two condtions, but they are treated similarly.

Anal gland cancer

Cats can develop tumors in their anal sacs, including adenocarcinoma, a malignancy of glandular tissue. While adenocarcinoma is a very common type of cancer elsewhere in the body, anal gland cancer is rare in cats. Anal sac adenocarcinomas are malignant and are usually very aggressive, often spreading to other parts of the body before they are diagnosed, and recurrence of anal gland cancer is common.

A complete physical including a rectal exam is necessary to diagnose anal sac disease in cats. During a rectal examination of a cat with anal sac disease, a vet may find the cat’s glands enlarged and firm, which can be painful for the cat. Other clinical signs may be visible to the naked eye, such as swelling, redness, or an open sore. It can be difficult to rule out a tumor with the naked eye if the tissue is significantly altered by anal sac abscess, impaction, rupture, or a combination of anal sac issues.

Anal gland disease can occur as a result of another underlying condition, especially conditions that cause excessively loose or firm stools. Diagnostic testing may be recommended to check for other health issues as well as anal gland tumors. Additional tests may include:

• Blood tests
• Fecal tests
• Culture of gland secretions
• Anal gland biopsy
• Imaging such as X-rays

Once the type and severity of the anal gland disorder is determined, an effective treatment plan can be created.

Treatments vary depending on the anal sac disorder that is diagnosed. Medical treatment options may include:

• Manual expression of the anal glands
• Lancing and draining abscesses
• Flushing glands and infusing antibiotics
• Antibiotic, steroid, or pain medications
• Surgery, in severe cases
• Palliative care for malignant tumors

“Management of the underlying cause of the anal gland issue is also necessary for overall treatment,” explains Dr. Jo Myers, a veterinarian on the Vetster platform. “Obesity, frequent diarrhea from inflammatory bowel disease, and dehydration from chronic kidney disease can negatively affect normal anal gland function.” Cats who have had previous anal gland issues are likely to have them again, so management of the underlying condition is crucial for long-term treatment. Recurring anal sac issues can harm a cat’s overall quality of life. Surgical removal of the anal glands is a treatment reserved for severe or recurrent cases that do not respond to other treatments. Removing the anal sacs may lead to additional problems, such as fecal incontinence. However, surgical removal is the only way to treat cancerous anal sac tumors. Chemo and radiation therapy may be options, but the prognosis of anal sac cancer is often poor at the time of diagnosis, even with treatment.

Does my cat need their anal glands expressed?

Healthy anal sacs express on their own when a cat defecates and do not need to be manually expressed. If an expression is needed, it’s safest to let a veterinary professional express the glands. Expressing glands at home can be dangerous if it is not well tolerated by your cat. Cats who regularly develop impacted glands may need to have their glands routinely expressed, but this should be done only on the recommendation of a veterinary professional. In addition, the underlying cause of the recurring anal gland problem needs to be diagnosed and treated by a veterinarian.

Talk to a vet any time you notice any of the common signs of anal sac issues, such as swelling, tenderness, excessive scooting, and overgrooming the anal area. Always talk to a vet before attempting a manual expression at home because it may be unsafe or make the problem worse. Other medical issues,  such as intestinal parasites or constipation, may be causing the symptoms. If your cat has had anal gland issues in the past, it’s best to talk to a vet about long-term management to treat the underlying cause and prevent recurrence. Connect with a vet in a virtual vet appointment through Vetster today if your cat is showing signs of anal gland issues .

How do you know if your cat needs an anal gland expression?

Cats with healthy anal sacs do not need to have them expressed. Signs of anal sac disease include swelling, redness, tenderness, scooting on the floor, overgrooming or biting at the anus, and discomfort when sitting, among others. Expressing a cat’s glands at home can be unsafe and worsen your cat’s condition, so it’s best to let a veterinary professional handle it.

Should I be worried if my cat is scooting?

Scooting is a common sign of anal irritation from conditions such as allergies, fleas, dietary intolerance, anal sac disease, and intestinal parasites. If your cat is scooting, talk to a vet for a definitive diagnosis and proper treatment.

What does anal gland cancer look like in cats?

The most common anal gland cancer is anal gland adenocarcinoma. Anal sac tumors may not be visible other than apparent swelling of the glands. It can be difficult to determine if enlarged glands are due to anal sac impaction, infection, or a tumor.