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recent studies have shown success with topical tacrolimus 0. 1 ointment along with prednisone, metronidazole and a novel protein diet. Dietary changes may be helpful in dogs suffering from fistulas due to a suspected association between perianal fistulae and food allergies. anal furunculosis is a chronic debilitating disease of the perianal, anal and occasionally the rectal tissue. Although a range of different breeds can be affected, including irish setters, collies, old english sheepdogs, labradors, bulldogs and spaniels, the german shepherd dog is highly predisposed. Paller a et al(2001) a 12-week study of tacrolimus ointment for the treatment of atopic dermatitis in pediatric patients. Misseghers b s, binnington a g & mathews k a (2000) clinical observations of the treatment of canine perianal fistulas with topical tacrolimus in 10 dogs. Three of these had anal sac involvement, and the owner of 1 dog had complied poorly with treatment instructions. During the 2 years following treatment, all dogs were maintained on intermittently applied tacrolimus ointment, 4 dogs also received prednisone every other day, and 11 dogs remained on the novel-protein diet. Perianal fistula, also known as anal furunculosis is a serious medical condition that most commonly affects german shepherd dogs. Perianal fistulas are characterized by chronic, purulent, smelly, ulcerating, sinus tracts in the anal region and surrounding skin. More recent studies indicate that the condition is more likely caused by an autoimmune disease. An anal fistula in a dog consists of an abscess in the perianal region, accompanied by fissures that repeatedly drain. In most cases, your vet will start with medical management and proceed to surgery if conservative treatment fails. capsaicin cream and tacrolimus ointment are effective for recalcitrant cases. Treatment of acute anal fissures with pain and bleeding involves adequate fluid and fiber intake. Tacrolimus for the treatment of fistulas in patients with crohns disease a randomized, placebo-controlled trial william j. Feagan, lloyd mayer, therese johnson, joseph galanko, christopher martin, and robert s.