I am now treating two old dogs that have peri-anal fistulas. The current treatment here is cyclosporin (Atopica) once a day. This is in a capsule and Keflex 500 mg, morning and night. I've been treating them for two months now and the condition is improving. The vet here said it could take several months to resolve it. In addition, we used laser therapy, twice a week, to the area. The thought on the laser was to increase circulation to the area and that it would possibly help to shorten the healing time. This still not an inexpensive treatment. The Atopica is still very expensive. As a side note, my vet never mentioned surgery at all. I believe that years ago, surgery had been tried. I've never had to deal with this in 40+ years of owning GSD's, but the vet said that GSD's are one of the breeds that it is common in. I've never heard of anyone using Metronidazole for the treatment. I have heard of using Panalog topically to help with infection. To keep the area around the rectum clean, I was told to use Chlorhex 2% diluted 2 Tablespoons to a Gallon of water. I spray the rectum and blot it with a paper towel. Hope this info. helps. Mary -----Original Message----- From: Suzanne Jambe <suzannejambe@xxxxxxxxxxx> To: marhaven <marhaven@xxxxxxxxxxxxxx> Cc: SHOW LIST <Showgsd-l@xxxxxxxxxxxxx> Sent: Tue, Mar 10, 2015 11:45 am Subject: [ SHOWGSD-L ] Re: Fistula Treatment? Cyclosporin and ketokonazole. Many years ago had experience with this, and at the time it was cutting edge treatment. Now I think it's the standard. The use of anti-rejection drugs as are used in transplant patients has been very effective, it was very expensive at one time, but I believe may have been authorized for veterinary use and priced lower now. Sent from my iPad On Mar 10, 2015, at 11:22 AM, "Carolyn Martello" < marhaven@xxxxxxxxxxxxxx> wrote: I have a friend in Canada that has an older dog that recently developed fistula. The Vet gave her metronidazole and an ointment ....and the dog is not improving at all. She is a bit isolated and has no internet.....and hoped I would know someone that has experience with this. I don't. Is this the current treatment for this problem? Any advice for her? Carolyn marhaven@xxxxxxxxxxxxxx www.marhaven.com