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Health Issues
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ASAC
Issue Description
An anal sac adenocarcinoma is an uncommon and aggressive malignant tumor found in dogs that arises from the tissue of anal sac. They are the second most common cancerous cause of hypercalcaemia (high serum calcium) in dogs.
An anal sac adenocarcinoma is an uncommon and aggressive malignant tumor found in dogs that arises from the tissue of anal sac. They are the second most common cancerous cause of hypercalcaemia (high serum calcium) in dogs.
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Other Names
Anal Sac Adenocarcinoma
Breeds Commonly Affected
English Cocker Spaniel
German Shepherd Dog
Alaskan Malamute
Dachshund
Springer Spaniel
Symptoms
Anal sac adenocarcinomas first appear as small lumps associated with one of the anal sacs, but they can grow to a large size. Smaller tumors are undetectable without a rectal examination, while larger tumors can cause pain and straining to defecate. Between 25-50 percent of dogs with these tumors will also develop hypercalcaemia through secretion of parathyroid hormone-related protein by the tumor. Symptoms of hypercalcaemia include increased drinking and urination, vomiting, loss of appetite, weight loss, and bradycardia (slow heart rate). Anal sac adenocarcinomas also have a tendency to metastasize to the lymph nodes, spleen, and lungs. The sublumbar (iliac) lymph nodes are the most common site of metastasis and can become larger than the original tumor.
Anal Sac Adenocarcinoma
Breeds Commonly Affected
Symptoms
Anal sac adenocarcinomas first appear as small lumps associated with one of the anal sacs, but they can grow to a large size. Smaller tumors are undetectable without a rectal examination, while larger tumors can cause pain and straining to defecate. Between 25-50 percent of dogs with these tumors will also develop hypercalcaemia through secretion of parathyroid hormone-related protein by the tumor. Symptoms of hypercalcaemia include increased drinking and urination, vomiting, loss of appetite, weight loss, and bradycardia (slow heart rate). Anal sac adenocarcinomas also have a tendency to metastasize to the lymph nodes, spleen, and lungs. The sublumbar (iliac) lymph nodes are the most common site of metastasis and can become larger than the original tumor.
Diagnosis
Anal sac adenocarcinomas are often suspected due to location and behavior, but a biopsy is necessary for a definitive diagnosis. Needle aspiration biopsy is a common first step. Cytology reveals clusters of cells with uniform round nuclei. These cells do not have many of the features usually associated with malignancy, such as a high nucleus to cytoplasm ratio or prominent nucleoli. Ultrasonography and radiography are performed to look for metastasis.
Treatment
Aggressive surgical removal of the tumor and any enlarged sublumbar lymph nodes is essential for treatment of the tumor and associated hypercalcaemia. There is a high recurrence rate, although removal of lymph nodes with metastasis may improve survival time. Radiation therapy and chemotherapy may be helpful in treatment. Severe hypercalcaemia is treated with aggressive IV fluid therapy using sodium chloride and medications such as loop diuretics (increased kidney excretion of calcium) and aminobisphosphonates (decreased calcium release from bones).
Prognosis
Because of the prognostic significance of tumor size at diagnosis and the presence of metastatic disease, the most favorable prognosis can be expected with early detection and aggressive treatment. Although hypercalcemia has been associated with a decreased survival time in some studies, it has not been a consistent finding.
Anal sac adenocarcinomas are often suspected due to location and behavior, but a biopsy is necessary for a definitive diagnosis. Needle aspiration biopsy is a common first step. Cytology reveals clusters of cells with uniform round nuclei. These cells do not have many of the features usually associated with malignancy, such as a high nucleus to cytoplasm ratio or prominent nucleoli. Ultrasonography and radiography are performed to look for metastasis.
Treatment
Aggressive surgical removal of the tumor and any enlarged sublumbar lymph nodes is essential for treatment of the tumor and associated hypercalcaemia. There is a high recurrence rate, although removal of lymph nodes with metastasis may improve survival time. Radiation therapy and chemotherapy may be helpful in treatment. Severe hypercalcaemia is treated with aggressive IV fluid therapy using sodium chloride and medications such as loop diuretics (increased kidney excretion of calcium) and aminobisphosphonates (decreased calcium release from bones).
Prognosis
Because of the prognostic significance of tumor size at diagnosis and the presence of metastatic disease, the most favorable prognosis can be expected with early detection and aggressive treatment. Although hypercalcemia has been associated with a decreased survival time in some studies, it has not been a consistent finding.
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