What is Anal Gland Disease in Cats?

By Dr. Phil Good, DVM

Introduction

Anal gland disease is discussed far more often in dogs than in cats, and that imbalance can leave cat owners unprepared when it happens to their own pet. Feline anal sac problems are genuinely less common than the canine equivalent, but they are not rare, and cats are considerably better than dogs at hiding the discomfort they cause.^[1]

A dog with an irritated anal sac will usually scoot across the carpet in full view of the family. A cat is more likely to slip away, overgroom quietly under the tail, or begin avoiding the litter box — signs that are easy to read as a behavioral problem rather than a medical one. Recognizing what these glands do, what goes wrong with them, and which signs warrant a same-day visit can spare your cat a painful abscess and spare you a more complicated repair.

What Are Anal Glands in Cats?

Cats have two small anal sacs — often called anal glands — sitting just beneath the skin on either side of the anus, at roughly the four o’clock and eight o’clock positions. Each sac is lined with sebaceous and apocrine glandular tissue that produces a brownish, oily secretion with a distinctly pungent odor.^[2]

That secretion is a scent-marking tool. Each sac empties through a narrow duct that opens just inside the anal margin, and in a healthy cat the sacs are emptied naturally by the pressure of a firm stool passing through the rectum. Cats may also release the contents suddenly when frightened — an unmistakable smell familiar to anyone who has handled a badly stressed cat.

The system depends on two things working together: a secretion fluid enough to flow, and stool firm enough to compress the sacs as it passes. When either changes, the sacs stop emptying reliably, and that is where disease begins.

Common Anal Gland Problems in Cats

Feline anal sac disease is usually described as a progression, though not every cat moves through every stage.

Impaction. The secretion thickens or the duct narrows, and the sac fails to empty. The sac becomes distended and uncomfortable but is not yet infected. This is the earliest and most treatable stage.

Sacculitis. Retained secretion becomes a growth medium for bacteria, and the sac lining becomes inflamed and infected. The secretion often turns yellow, creamy, or blood-tinged. The cat is now genuinely painful.

Abscessation and rupture. Infection builds under pressure until it forms an abscess, which appears as a hot, swollen, reddened area beside the anus. Left untreated the abscess ruptures through the skin, producing an open, draining, foul-smelling wound. This stage is painful and requires prompt veterinary care.^[1]

Neoplasia. Tumors of the anal sac — most significantly anal sac adenocarcinoma — are uncommon in cats but are reported, and they tend to behave aggressively when they occur. A firm mass associated with an anal sac, particularly in an older cat, should never be assumed to be a simple abscess.^[3]

Causes of Anal Gland Disease in Cats

Anal sac disease is nearly always secondary to something else. Identifying the underlying driver is what keeps the problem from returning.

• Chronically soft stool or diarrhea. Loose stool does not generate the pressure needed to empty the sacs. This is one of the most common contributors, and any ongoing diarrhea in a cat deserves investigation in its own right.
• Constipation. Cats that strain, or that pass stool infrequently, may also fail to express the sacs normally.
• Obesity. Excess body fat alters the anatomy around the anus and reduces the efficiency of natural expression. Weight in cats influences a surprising range of conditions, and this is one of them.
• Allergic and inflammatory skin disease. Inflammation around the anus can narrow or obstruct the ducts. Cats with food allergies or atopic disease are affected more often.
• Inflammatory bowel disease and other chronic GI conditions. These alter stool consistency over long periods.
• Low dietary fiber. Diets that produce small, poorly formed stools reduce the mechanical pressure the sacs rely on.
• Reduced activity. Sedentary, strictly indoor cats may be modestly more prone to problems.
• Individual anatomy. Some cats simply have narrow ducts or unusually positioned sacs and will have recurrent trouble despite excellent management.

Symptoms of Anal Gland Disease in Cats

Cats mask pain well, and the signs here are quieter than in dogs. Watch for:

• Excessive grooming or licking under the tail. In cats this is more common than scooting and is frequently the first sign.
• Scooting or dragging the rear along the floor. Less typical in cats than dogs, but meaningful when it appears.
• Straining, crying, or obvious discomfort when defecating.
• Avoiding the litter box. A cat that associates the box with pain may start eliminating elsewhere. This is a medical sign, not misbehavior.
• A strong, persistent foul odor that does not resolve with normal grooming.
• Swelling, redness, or a draining wound beside the anus.
• Tail chasing, biting at the rear, or sudden irritability when touched near the tail base.
• Hiding, reduced appetite, or withdrawal — often the only signs a stoic cat will offer.

Because a cat that stops using the litter box is often assumed to have a behavioral problem, anal sac disease is a diagnosis that gets missed. Any sudden change in litter box habits warrants a physical examination before behavior is blamed.

Diagnosis of Anal Gland Issues in Cats

Health Background and Physical Examination

Your veterinarian will ask about stool consistency, litter box habits, grooming behavior, diet, weight history, and any prior episodes. A general physical examination follows, with close attention to the perineal area, the skin, and body condition.

Anal Sac Palpation and Expression

Gentle digital palpation of the sacs identifies distension, thickening, pain, or a mass. The sacs may then be expressed to assess the character of the secretion. Cats find this considerably more uncomfortable than dogs do, and sedation is often appropriate — both for the cat’s welfare and to allow a thorough examination.

Cytology

A sample of the secretion examined under the microscope distinguishes simple impaction from active infection, and identifies inflammatory or abnormal cells that would change the plan.

Bacterial Culture and Sensitivity

For infections that are severe, recurrent, or slow to respond, culture identifies the organism involved and confirms which antibiotic will actually work rather than relying on an educated guess.

Imaging

Ultrasound assesses the size and internal structure of the sacs and surrounding tissue. Where a mass is suspected, imaging is extended to evaluate the sublumbar lymph nodes and to screen for spread.

Fine-Needle Aspirate and Biopsy

Any firm mass associated with an anal sac should be sampled. Cytology or histopathology distinguishes an abscess from a tumor, and that distinction changes the treatment plan entirely.

Treatment for Anal Gland Disease in Cats

Treatment is matched to the stage of disease and, critically, to the underlying cause.

Impaction is treated by manual expression of the sacs, often under sedation. Warm compresses applied at home can ease discomfort and encourage drainage. If the secretion is very thick, the sacs may be flushed under sedation.

Sacculitis requires expression and flushing, usually combined with a course of systemic antibiotics and anti-inflammatory or analgesic medication. Some cases benefit from an antibiotic preparation infused directly into the sac.

Abscesses need to be lanced and drained, or, if already ruptured, cleaned and managed as an open wound. Antibiotics and pain relief are standard, and the wound is monitored until fully healed. Cats are usually noticeably more comfortable within a day or two of drainage.

Recurrent or refractory disease may justify surgical removal of the anal sacs — anal sacculectomy. This is definitive, but it is not undertaken lightly: the surgery carries a risk of damage to the nerves controlling the anal sphincter, and fecal incontinence is a recognized complication. It is reserved for cats whose disease genuinely cannot be controlled medically, or where a tumor is present.^[2]

Neoplasia is managed with surgery, staging, and — depending on tumor type and spread — adjunctive therapy, guided by an oncology referral where appropriate.

Alongside any of these, the underlying driver is addressed: dietary change to firm the stool, a weight reduction plan, allergy management, or treatment of chronic gastrointestinal disease. Without that step, the problem tends to return.

How to Prevent Anal Gland Problems in Cats

• Aim for well-formed stool. A consistent, appropriate diet producing firm stool is the single most effective preventive measure. Your veterinarian can advise whether added fiber is suitable for your cat.
• Keep your cat at a healthy weight. Weight control improves natural expression and reduces recurrence.
• Ensure good hydration. Adequate water intake supports normal stool consistency, particularly in cats prone to constipation.
• Treat underlying disease. Managing allergic skin disease or chronic gastrointestinal conditions removes the driver rather than the symptom.
• Encourage activity. Regular play supports normal gut motility and healthy body condition.
• Watch, and act early. Persistent grooming under the tail or a change in litter box habits is worth a phone call.

A note on routine expression: unlike the practice sometimes recommended for dogs, routine prophylactic expression of the anal sacs is generally not advised for cats without clinical signs. Manipulating healthy sacs can cause inflammation and may make problems more likely rather than less. Expression should be performed when there is a reason for it.^[1]

When to Contact Beyond Pets Animal Hospital

Arrange a prompt appointment if your cat shows visible swelling or an open, draining wound near the anus, cries when defecating, stops using the litter box, or is hiding, off food, or otherwise unlike themselves. An anal sac abscess is painful and will not resolve on its own.

Our team in Marietta can examine your cat, express and flush the sacs under appropriate sedation, treat any infection, and — just as importantly — work out why it happened so it is less likely to recur. Contact us to book an appointment.

Frequently Asked Questions

Do cats need their anal glands expressed regularly?

No. Healthy cats empty their anal sacs naturally when passing firm stool, and routine expression without a clinical reason is not recommended — it can irritate the sacs and contribute to the very problem it is meant to prevent. Expression is a treatment for cats showing signs, not a routine grooming procedure.

Why is my cat suddenly not using the litter box?

There are many possible causes, and several are medical rather than behavioral. Anal sac disease, urinary tract disease, constipation, and arthritis can all make the litter box painful to use, prompting a cat to look elsewhere. A physical examination should come before any behavioral plan.

Is anal gland disease in cats an emergency?

Impaction is uncomfortable but not an emergency. An abscess — a hot, swollen, painful area beside the anus, with or without discharge — should be seen the same day. A cat that is straining and unable to pass stool or urine needs immediate attention, as urinary obstruction is a genuine emergency and can look similar to an owner.

References

1. VCA Animal Hospitals. Anal Sac Disease in Cats. VCA Hospitals.
2. International Cat Care. Anal Sac Disease. International Cat Care.
3. Cornell University College of Veterinary Medicine. Feline Health Topics. Cornell Feline Health Center.

About the Author

Dr. Phil Good, DVM is the owner and lead veterinarian at Beyond Pets Animal Hospital in Marietta, Georgia, providing primary, surgical, and urgent care for dogs and cats across Marietta, Woodstock, Roswell, and Smyrna.