* Please note that the following information provided is based purely on personal experience. Any discussion of treatments, evaluation, and prognosis is specific to Chase and should not be used as advice or guidance on treating your animal. Please consult your pet’s veterinarian to discuss all information provided here. 

Chase was diagnosed with Canine Apocrine Gland Adenocarcinoma in 2020.

As our dogs age, there grows a weariness in the back of every dog owner’s mind. The small, faint whispers start to echo with each passing birthday: “What will be the first big health problem?” The sad truth, and probably why we bond so tightly with them, is that dogs do not live as long as we do. There comes a day when a vet visit isn’t routine anymore – but a bookmark between life before and life after a cancer diagnosis. It’s a stark reminder that life is unfair, sometimes tragic, and completely unscripted. 

Chase was diagnosed with Canine Apocrine Gland Adenocarcinoma in late 2020. There are other names used interchangeably with the official diagnosis, such as Anal Sac Adenocarcinoma, Anal Sac Tumor, or Anal Tumors. How does a dog get diagnosed with AGASACA? Well – most often by routine visits or visible changes or new behavior in your best bud. For Chase, it was a little more subtle. 

It was around the beginning of November that I noticed Chase paying attention to his bum a little more than usual. Odd right? Dogs are gross. But this was new. COVID was in its second or third wave when my job sent us home again full time, and I was spending way too much time in the house. Naturally, you start to notice things – has my floor always looked that gross? why is there dog fur stuck to the bathroom walls? how many shoes does one person need? Oh and – why is Chase always sniffing his butt now? 

That last sentence smacked me in the face as I was walking into the living room one day, ready to take my lunch break. Gross. There he was again, sniffing, spinning in circles, trying to lick his butt. Double gross. Was he itchy? Was he constipated and this was his way of telling me? Maybe his glands are full? Why am I constantly thinking of my dog’s butt? After speaking about the new behavior with a few friends and family I decided to be on the safe side, and maybe get out of the house, and scheduled him for a routine wellness visit with his vet. It was then that his vet performed a rectal exam and noted that she had felt a very small, but very new tumor near his left anal gland. Dogs can get tumors in their butt? Yes. And they can be quite deadly, fast. 

What will be the first big health problem? The question wasn’t an echo anymore, it was a full-blown stereo in my head as I drove home after agreeing to get the material tested for cancer cells. “Don’t panic yet. Let’s just see what it is first.” his vet reassured me quickly. Oh, but it was too late. When we got home, I pretended everything was fine, but I needed to research. And what I found was not consoling at all. 

It was about a week later when his vet called as I was driving home. It was mid-to-late November and it was dark, cold, and yes, I was still thinking of my dog’s butt. She tried hard to sound optimistic on the phone, but I knew even before she told me. It was cancer, and the number of cancer cells found in the tissue was a lot. Before I even pulled into the driveway, I had already made up my mind I was going to do everything I needed to do to give Chase the best shot at beating this. But that’s the thing with cancer, it eventually wins.

——— 

Before I continue, here’s a big disclaimer: I wanted to document the entire process of Chase’s diagnosis, as well as the day-by-day updates of treatment(s), to help other dog owners should their pet be diagnosed with AGASACA. I didn’t find a HUGE amount of owner accounts of Anal Gland cancer, as well as clear timelines, symptoms, treatments, costs, and transparency of their situations. I wanted to change that! Should you have any questions, feel free to comment below or email me directly. I will not post medical documents here, but if you are a vet or if your pet is diagnosed with the same type of cancer and you need reference material and information, please email me directly! Lastly, I have to stress: I am not a vet and you should consult your vet before starting, stopping, or changing treatment. Every situation varies and you should consult your veterinarian before making any decisions. 

——— 

What is Canine Apocrine Gland Adenocarcinoma or AGASACA?

“Apocrine gland anal sac adenocarcinomas are malignant tumors of the anal glands. These are paired glands located on either side of the rectal opening. Anal glands are sweat glands that contain a brown, malodorous liquid that is eliminated upon defecation.

AGASACAs are locally invasive tumors with a high rate of metastasis to regional lymph nodes (including sublumbar and medial iliac lymph nodes inside the abdomen and inguinal nodes located in the groin). Tumors can also spread to distant sites including the liver, spleen, and lungs. Metastasis is possible even in cases where the primary tumor is only a few millimeters in size.

Tumor cells sometimes secrete a hormone that causes blood levels of calcium to rise above normal. Dogs affected with high blood calcium levels show increased thirst, urination, lethargy, and in some cases, this can lead to severe heart and kidney damage. Spaniels are affected more frequently than other breeds. Typically, only one gland is affected, however, the disease can occur in both glands either simultaneously or several years apart.

For more information, please visit NC State Oncology or MSPCA Angell for a full breakdown of this specific type of cancer in dogs and full reference to the above information. 

What are the Signs and Symptoms of Canine Apocrine Gland Adenocarcinoma or AGASACA?

I noticed Chase “paying attention” to his bum more. Specific behavior included sniffing it frequently and licking the area. It became very during downtime throughout the day. And since I was working from home most of that year, I had gotten pretty familiar with every routine Chase had, even down to physically grooming habits and rituals. The first few times I noticed this new behavior and sudden attention to his behind, I brushed it off. But then my spidey-dog-mom senses started to tingle, and I figured “Maybe getting him in early for his physical will ease my worries.”

Other symptoms include (but not all may be present):

“Clinical signs reported include straining to urinate or defecate, pain on defecation, blood in the stool and changes in stool size. The only clinical sign in many instances is a swelling of the area around the anus called the perineum. Hypercalcemia (elevated blood calcium) occurs in approximately 25% of cases and if present is associated with the following clinical signs – lethargy, hind limb weakness, increased urination and increased thirst.” Read the complete breakdown from Ethos Vet network. This is a must read!

Chase did not exhibit any of these, but I credit this to how small the original tumor was when discovered by his wellness vet. The only reason his 5mm tumor was caught so early was a slight behavior change AND an anal exam administrated by his vet at a yearly physical. A lot of pet owners will not agree to this exam or even question it. But Anal Sac Tumors have the potential to spread locally and distantly to other areas of the body like the lungs, liver, and spleen. It is VITAL you ask your vet to perform an anal exam at least once a year on your pet – especially if they are ages 7+.

Most pet owners are alerted by visual or severe behavior changes, and often times they are found too late. If you notice any of the above signs and they are not normal, please make an appointment with your wellness vet to perform an exam. Most often times, anal sac tumors are caught too late. (This means cancer has already metastasized to other areas of the body, such as lymph nodes and major organs.)

At diagnosis, Chase did not exhibit any of these and did not have enlarged lymph nodes or metastases to other organs – just the 5mm tumor felt by his vet during his rectal exam. 

How long will my dog live with AGASACA?

“The prognosis is guarded for anal sac adenocarcinoma and few dogs will be cured of this disease. The average survival time is approximately 12-18 months for dogs with anal sac adenocarcinoma. Dogs that have surgery to remove the anal sac tumor will have an improved length of survival. If there is evidence of elevated blood calcium or metastatic disease prior to surgery, the survival time is typically shorter. It is important to have your veterinarian perform regular wellness examinations on your dog, including a rectal examination, to increase the likelihood of detecting anal sac tumors early in their development. – Author: Anastasia Olsen, DVM”. 

Chase was officially diagnosed in November 2020. His first surgery was in late November 2020. But first, his vet did an x-ray and an ultrasound, along with a full blood panel to confirm the cancer was localized near his left anal gland. At this point, he was just over 10 years old. So when his vet told me that even though the tumor she found was small (5mm, think the size of a pea!), there is a possibility it had already spread, either distantly or locally. Yes, a tumor that small can wreak havoc in a body. Nature is wild. When the call came, I nearly had a panic attack – fully expecting the worst possible news. To our surprise, Chase was clear and showed no signs of metastases.

She explained he was cleared for surgery and gave us the instructions on how to prepare. He stayed overnight and we picked him up the following morning. His recovery was rather uneventful, although there is always a possibility of incontinence with

removing tissue from the rectum, he was only constipated from the anesthesia and meds for a couple of days, after that, he started to defecate normally without issue. We slowly returned back to his normal routine and he bounced back to his normal self pretty quickly.

Throughout the rest of 2021, we saw his vet every 2.5 months for a rectum exam and overall body check to make sure there were no new signs of his cancer returning. We did not do ultrasounds or blood work every 3 months, but every 6 months. 

The short answer to the question above is: it depends. It depends on so many variables that it’s hard to say. Chase was very much a lucky pup because his vet and vet tech caught the original tumor so quickly – even before it spread, and at such a small size. The next lucky break was going 17 months without reoccurrence. But that’s the thing with cancer, it most likely always comes back stronger. 

I’ve gathered some material over the last two years of research that helped me determine Chase’s likelihood and possible prognosis. Because if you are like me, when something needs to be researched, you won’t stop until you find every single shred of information to soak up. 

Also – if you are a vet or concerned dog parent, and you’d like more medical information about Chase, please email directly.

Chase’s Initial Treatment:

• November 2020 removal of localized tumor (5mm) with clean margins
• 2-3 month post-op rechecks
• 15 months clear until January 2022, spread to two lymph nodes and polyp growth

2022 Reoccurrence:

• Removal of iliac two lymph nodes
• 18 days of daily definitive radiation therapy (5 days per week)
• Palladia or Carboplatin

For this approach, we were given the following for prognosis: “The average survival time with this protocol is 2.5 years.”

——————-

Helpful Documents:

• Step By Step Surgery Notes
• VeterinaryCancer.com 
• Tufts

Studies:

• Clinical Stage, Therapy, and Prognosis in Canine Anal Sac Gland Carcinoma
• Canine anal sac adenocarcinomas: clinical presentation and response to therapy
• ANAL SAC ANAL GLAND ADENOCARCINOMA (ASAGACA): HOW COMBINATION THERAPY IMPACTS OUTCOME. THE BLADES, THE DRUGS, AND THE NUTRICEUTICALS FROM THE PERSPECTIVE OF THE SURGEON AND THE ONCOLOGIST