C09999444 / invoice 10000

07/03/2026 Consult nurse: Sandy

Reason for presentation: Possible blocked anal gland, scooting and fishy smell.

History for today:
Licking and scooting.
Fishy smell.
Eating and drinking normally.
Normal faeces.

Previous medical/surgical concerns:
History of atopy, anal sacculitis, otitis externa, keratoconjunctivitis sicca and allergic conjunctivitis.
18/06/2025 - Bilateral otitis externa, anal gland impaction, Grade 2 dental disease, overweight. Treated with Dexamethasone Ketotifen.

Current medications:
Apoquel 5.4mg 1 tablet once daily, orally.
Tacrolimus twice daily.
Elocon every second week.

Diet: Veggie dips one a day.

Examination:
Demeanour: BAR
Eyes: Clear
Ears: Small amount of wax, canals open.
Nose and Throat: No abnormalities detected
Mouth/teeth/gums/dental grade: Grade 1 dental disease.
Resp rate: Lung fields clear
Heart rate: Regular, nil murmurs, pulses strong and synchronous
Abdominal palpation: Comfortable and relaxed
Urogenital: Small mat of hair over vulva causing minor irritation, trimmed.
Musculoskeletal: Ambulating well but not thoroughly examined
BCS: Good
Coat/skin: Healthy
Rectal/Anal sacs: Left anal sac full but easily expressed. Right anal sac half full, slightly thickened but expressible. Not painful on expression.
Palpate lymph nodes: Within normal limits

Assessment: Anal sacculitis.

Treatment:
Anal glands expressed.

Next vaccination due:

Discussion:
Anal glands were expressed. Left was full, right was half full and slightly thickened.
No pain on expression.
Surgery (anal sacculectomy) was discussed as an option for recurrent issues.
Risks of surgery include infection and potential for faecal incontinence due to nerve damage, which is increased with bilateral surgery.
Surgery is best performed when the area is not inflamed.
Currently, the glands are not causing significant issues and are not painful.
Allergy medications are controlling skin condition well.
Decision made to continue monitoring for now rather than proceeding with surgery.

Plan:
Continue current medications.
Monitor for signs of anal gland discomfort.
Revisit if symptoms worsen.

Next revisit: As needed.