CASE 1
Case written: Dec 12, 2008 6.57am

The left anal sac area was hard, painful and swollen on the first day of consultation. Around 10% of the infected area was soft but it was best to treat this dog with antibiotics and anti-inflammatory injection to let the abscess "point" or ripen.

On the 2nd day, the young lady owner came saying that there was a big hole. The dog was put under general anaesthesia gas and operated. The oil was expressed. Some oil shot out from the right anal sac as well.

The deep hole was irrigated and flushed to clear all dead skin debris and pus. The edge of the wound was jagged. I used scissors to undermine the skin. Then I trimmed away the jagged edges of the skin and obtain fresh skin edges with blood supply. After that, 3/0 absorbable interrupted sutures to stitch up the wound.

Fortunately, it was easy to stitch up this wound compared to the one in the cat (CASE 2) as there was more skin.  The dog went home wearing an e-collar. No complaint was heard for the next 7 days and I presumed the wound would heal well. 

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CASE 2
Case written: Jun 26, 2007 3.17pm

What to do with such a large infected oval wound near the anus? The cat had licked out the fatty tissues under the skin. A big gap of 0.5 cm deep and 2 cm long was presented. She had stopped pooping. How to close such a big gap successfully?

1. Ideally, put the cat on antibiotics for a few days. Was the wound. But the wound is large.
2. The cat was fat, at 5.5 kg. Would she be able to survive the injectable general anaesthetic?
3. Anaesthesize the cat using xylazine and ketamine at 0.2 ml: 0.8 ml one syringe, IM
4. Clip the hairs, wash the areas. Syringe in 6% hydrogen peroxide.
5. Debride --- cut off dead skin edges and remove dead tissues from inside.
6. Relieve anal sacs of oil. Greyish brown oil seen from left gland. Right gland must have had ruptured resulting in a big hole.
7. Trim edges of wound --- convert to diamond shaped wound.
8. Undermine tissues to get loose skin.
9. Cut lowest end to extend the wound. Z-shaped wounds sutured.
10. Avoid anal sphincter (near the anal ring).
11. Elizabeth collar size 10.
12. Best to ward cat for 10 days but owner wants her home.
13. Warn the owner to confine the cat and if she runs around the home, she may rub stitches off.
14. In 14 days, wound will heal and stitches to be removed.