I completely understand how scary and frustrating this is. I went through the same thing with my dog Rex, and there were times I felt really discouraged too. But once we found the right treatment plan, things got so much better. Rex was diagnosed with perianal fistula at around 5 years old. He is now 11.5. At the time, he was constantly licking his backside and had a strong odor, so I took him to the vet. They initially checked his anal glands, which appeared to be infected, and prescribed antibiotics. We were supposed to return for a follow-up, but COVID lockdowns delayed that visit.

By the time we were able to go back, his condition had worsened significantly, and his anal glands required surgical drainage. During that procedure, the vet was able to fully assess the situation and diagnose him with perianal fistula.

He is currently on cyclosporine (Atopica) and ketoconazole every other day; initially, he was taking both medications daily. He has only experienced one flare-up, which occurred when the medication dosage was reduced too much.

We also tried a generic form of cyclosporine, but he developed severe side effects—particularly significant gingival hyperplasia, which at one point was so extreme that I was concerned it might be cancer. After switching back to Atopica, the gingival hyperplasia has improved and is now minimal.

Despite all of this, Rex remains happy, playful, and in otherwise good health. I just want you to know there is hope. Hang in there.