Cat Anal

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This article aims to explain the issues relating to problems caused by anal glands or anal sacs in cats.
The anatomical details here are important:
When discussing this topic, it is simpler to refer to anal sacs, rather than anal glands, as it is the sacs themselves that tend to be the focus of the problems.
Cats are like dogs, ferrets, skunks and many other animals, in that all of these species have two small anal sacs which produce a strong smelling glandular secretion. The sacs, one on the left and one on the right of the anus, lie just beneath the skin, at o’clock positions often described as “4 o’clock” and “8 o’clock”.
Each sac is connected by a narrow duct to the rectum, just inside the anus. Every time the animal passes feces, the anal sac is physically squeezed out by the physical pressure caused by the bowel movement, with the secretion coating the outside of the feces.
Some animals are able to empty the anal sacs independently of passing feces, by contracting the muscles in the anal sac, causing the secretion to be pushed out separately.
The anal sac secretion is a carrier of important messages in the animal world. Anal sac scent marks are one of the ways that pets leave a sign to let other animals know that they have passed by: they are an important part of territorial messaging in the animal world.
The anal sacs can become diseased for different reasons, although compared to dogs, anal sac disease in cats only happens rarely.
The most common problem is simple: the anal sacs stop emptying properly, and become over-full. Anal sacs are normally around the size of a small pea (5mm diameter), but they can expand to the size of a large pea (over 10mm diameter). If they are over-full like this, the anal sacs may become painful and itchy.
Other issues that can affect anal sacs include impaction (when the secretion changes from liquid to almost solid), bacterial infections including abscesses, and neoplasia (tumors, or cancer).
A cat’s anal glands may become overly-full if their diet lacks enough bulk to push their anal secretions out during defecation.
There are different reasons anal sacs may not empty properly, but the most common cause may be that in some cats, the diet is not bulky enough to enable the sacs to be squeezed out effectively by the fecal pellet or poop.
In their natural state in the wild, cats are more likely to eat fur, skin, bones and other non-digestible matter that passes through their digestive system intact, resulting in large, firm, feces which effectively places pressure on the anal sacs, squeezing them and emptying them out. Modern pet cats tend to eat highly processed food, resulting in smaller, less bulky, softer fecal pellets, or even just soft stools, that may not be effective enough at emptying the anal sacs.
For most cats, this is not a problem: the anal sacs continue to empty effectively naturally. Sometimes, however, the anal sacs swell up because of the build-up with accumulated secretion which is not emptying out. The anal sacs become swollen and uncomfortable, causing the cat to feel itchy in this area.
Some cats start to scoot their rear end along the ground. Sometimes the scooting behaviour solves the problem: some cats are able to naturally empty their own anal sacs by doing this. But in most cases, the anal sacs remain over-full and itchy, and human intervention is needed to sort things out.
The most common symptom of anal gland problems in cats is a combination of itchiness and discomfort, often leading to scooting, licking, and chewing at the anal area.
The most common sign of anal sac problems is itchiness and pain in the area around the anus. The cat may be “scooting” along the ground, licking under the tail, or even chewing around the base of the tail.
Sometimes they might show pain when defecating in the litter box. Sometimes cats start to hold their tail in a different way. Occasionally there may be a foul odor from the anal area, or a discharge of foul smelling fluid from the anus, or from an opening in the skin beside the anus (a so-called “fistula”).
While most anal gland problems can be resolved through simple at-home treatment, some more severe cases and complications may demand a trip to the veterinarian so that your cat can receive expert care.
Impaction may be treated with manual expression. This is best done by your DVM veterinarian and it is usually a simple procedure that can be done during a routine consultation.
If the anal sac is impacted, the secretions may be very thick and even semi-solid. In such cases, saline may need to be instilled into the sac to help to liquify the impaction so that it can be squeezed out.
After the anal sacs have been expressed, they may sometimes be flushed with saline or an antiseptic solution. For these more complex and potentially uncomfortable interventions, sedation may be needed.
Infections of anal sacs are sometimes referred to as “anal sacculitis”. After manual expression of affected anal sacs, a topical product may be instilled into the sacs, through the small ducts that connect the sac to the rectum.
This infusion may include ingredients such as antiseptic or antibacterial products, anti-yeast medication, and/or anti-inflammatory drugs to reduce inflammation and irritation. This procedure may need to be repeated a few times e.g. once weekly.
If an anal sac infection has progressed to abscess formation, this needs to be surgically drained. Sometimes the abscess may have already burst, with a fistula opening to the skin creating a discharge beside the anus.
If this has not happened, a scalpel blade will be needed to lance the abscess. The abscessed area then needs to be flushed with an antiseptic solution, and infused with a topical product such as antibiotic. Systemic antibiotics will also often be prescribed by your veterinarian.
Cancer of the anal sacs, or anal sac adenocarcinoma, is rare in cats. The most common signs are difficulty or pain when defecating, constipation, swelling beside the anus, and sometimes ulcerated areas, and/or a brown or bloody discharge.
Fecal pellets may appear abnormal, and the cat may have an abnormal tail carriage. Like any cancer, this condition requires a detailed investigation by your veterinarian so that an accurate diagnosis can be made. Treatment of this specific problem can include surgery, chemotherapy and in some cases, irradiation.
In cases of anal sac tumors, if an anal sac impaction or infection does not respond to treatment, or if a problem of this type continues to recur, surgical removal of the anal sacs (so-called “anal sacculectomy”) may be recommended. In most cases, both anal sacs will be removed even if there is only a problem with only one sac.
Some complications are possible after this surgery, including wound infections, fistula formation and fecal incontinence.
If a cat has discomfort in the anal area because of these small glands under the tail, warm compresses can be applied to the anal region twice daily. A highly digestible, low-fat, high-fiber diet may help to create firmer, bulkier stools which will naturally massage the anal sacs during defecation.
You may want the help of an expert the first time, but expressing your cat’s anal glands is simpler than it sounds.
Anal sac expression is generally a task to be undertaken under professional supervision for the first time, if you wish to learn to do this yourself.
Essentially, you should wear a protective glove, the cat’s tail should be raised with one hand, and you should use your index finger and thumb of the other hand to gently squeeze the tissue immediately below the anus.
Visualise squeezing two small sacs at 4 and 8 o’clock. Squeeze gently but firmly, and you may be able to feel the small pea-like structures gradually reducing in size as their contents empty into the rectum. Sometimes their secretion is ejected straight out of the anus like a water pistol, and you may need to take care that you don’t inadvertently squirt the secretion onto yourself.
Anal sac or anal gland problems are rare in cats, but a basic understanding of the anatomy and functioning of these structures, along with their common problems, will make it easier to deal with such issues if they arise.
It is rare for cats to need to have their anal sacs squeezed, and it is best to follow the advice of your veterinarian before deciding that this is needed.
Most cats naturally have healthy anal glands and anal sacs. The best way to prevent problems is to keep your cat on a good quality diet that produces firm, reasonably bulky fecal pellets.
There are many possible causes of a sore bottom in a cat, so it is always best to get the opinion of a veterinarian about what is going on before deciding on any treatment plan. As a general supportive therapy if you cannot immediately see a veterinarian, you can safely use warm compresses such as wads of cotton wool, soaked in warm water, and applied gently to the area around the anus.
Dr Pete Wedderburn qualified as a vet from Edinburgh in 1985 and has run his own 4-veterinarian companion animal practice in County Wicklow, Ireland, since 1991. Pete is well known as a media veterinarian with regular national tv, radio and newspaper slots, including a weekly column in the Daily Telegraph since 2007. Pete is known as "Pete the Vet" on his busy Facebook, Instagram and Twitter pages, regularly posting information on topical subjects and real-life cases from his clinic. He also write a regular blog at www.petethevet.com. His latest book: “Pet Subjects”, was published by Aurum Press in 2017.
Thank you so much for the informative article. My question is do we need to get pretty litter and check the colors? Is that affected with anal gland problems? We’ve never had any other problems with our cat she’s 15 right now. Our other two cats lived to be 23 and 25. So we’re pretty good with cats but we’ve never had this problem.
Hi there. I don’t believe that Pretty Litter would do much to help you with anal gland issues—it’s primarily useful for identifying pH fluctuations in the urine. I would recommend consulting with a veterinarian to determine the appropriate steps to take. Wishing you and your cat all the best!
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, DVM, MS, DACVIM, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign
Last full review/revision Aug 2018 | Content last modified Aug 2018
Rectal diseases in cats can result from injuries, tumors, or infections.
The anal sacs are glands located on each side of the anus. They are related to the scent glands in skunks and produce small amount of dark, foul-smelling liquid which is normally squeezed out during defecation. Anal sacs may become clogged (impacted), infected, abscessed, or cancerous. Anal sac disease is much less common in cats than in dogs. In cats, the most common form of anal sac disease is impaction.
Signs are related to pain and discomfort associated with sitting. The cat may scoot its buttocks on the ground, lick or bite at the anal area, and have painful defecation with straining. If the glands are impacted, hard masses can be felt in the area of the sacs. If a gland is abscessed, an oozing sore may be located next to the anus. A rectal examination by a veterinarian will usually be done to diagnose anal sac disease. Additional tests may be needed if infection or a tumor is suspected.
Your veterinarian can often squeeze out impacted anal sacs by hand. If the material in the sacs is too hard or dry, your veterinarian may infuse a softening agent into the sac. If infection is present, antibiotics might be prescribed. Supplemental fiber may be recommended to increase fecal bulk, which facilitates anal sac compression and emptying. If treatment is ineffective, a tumor is present, or the condition keeps coming back, surgical removal of the sac(s) may be required. A common complication from this surgery is fecal incontinence; however, the incontinence is usually temporary.
A rectal or anorectal stricture is a narrowing of the rectum or anus caused by scar tissue. Injuries that lead to strictures may result from foreign objects or trauma (such as bite wounds or accidents), or they may be a complication of inflammation. Tumors in the area can also compress the rectum. In cats, anorectal strictures are more common than rectal strictures, but neither condition is frequent. Treatment involves balloon dilation and the injection of medications into the region, both performed under anesthesia.
Malignant rectal tumors in cats are usually cancers involving lymph tissue (lymphosarcoma). Cats with rectal lymphosarcoma are treated with chemotherapy.
The growths called rectal polyps occur infrequently in cats. The polyps are usually benign (noncancerous) and do not spread. Signs include straining to defecate, blood in the feces, and diarrhea. The polyp can be felt by a veterinarian during a rectal examination, and its surface tends to bleed easily. An endoscopic examination may be required to see the polyp. Periodically, the polyp may protrude from the anus. Surgical removal is usually followed by rapid recovery and lengthy survival time. Your veterinarian may send a tissue sample from the polyp to a laboratory for microscopic analysis to confirm the diagnosis.
Rectal prolapse is a condition in which one or more layers of the rectum protrude through the anus. Prolapse may be classified as incomplete (only the innermost rectal layer is protruding) or complete (all rectal layers are protruding).
Cats of any age, breed, or sex may be affected, although the condition commonly occurs in young cats that have severe diarrhea or that routinely strain to defecate. Prolapse can be caused by a number of intestinal, anorectal, or urinary diseases.
An elongated, cylinder-shaped mass protruding through the anal opening usually indicates a rectal prolapse. However, prolapses involving other parts of the intestine can have a similar appearance. No matter what type of prolapse is present, any tissue mass protruding from the anal opening should be promptly examined by a veterinarian.
Identifying and eliminating the cause of prolapse is a key part of treatment. Small or incomplete prolapses can often be manually replaced by the veterinarian while the cat is anesthetized. This is usually followed by partial closure of the anus with stitches for 5 to 7 days to prevent the prolapse from happening again. In cases where tissue death is evident or where the living tissue cannot easily be repositioned through the rectum, surgery may be required. After treatment, a moist diet and a stool softener are likely to be recommended. Diarrhea occurring shortly after surgery may require additional treatment and should be discussed with your veterinarian.
A tear in the rectum or anus can be caused by a sharp object (such as a bone, needle, or other rough material) making its way through the digestive tract or from injury (such as a bite). The tear may involve only the surface layers of the rectum (partial tear) or penetrate all layers (complete tear). Signs may include constipation, straining, rectal bleeding, and reluctance to defecate. A diagnosis is based on these signs and inspection of the rectum and anus. Swelling may be present when the injury has been present for some time.
Treatment to avoid infection and close the wound should be started immediately. The tear will be cleaned and stitched closed. Depending on the location, abdominal surgery may be required. Antibiotics and stool softeners will probably be prescribed after surgery.
Also see professional content regarding disorders of the rectum and anus.
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Disorders Caused by Protozoa of the Digestive System in Cats
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