Just want to give you my experience with the chronic anal sac issues in case it might be a help for you..Ihad this issue with my ursus son , beginning when he was about 16 months old..My vet did the same thing as yours...he expressed, flushed, and then put my guy on Cipro as well as metronidazole..We repeated this proces several times..My dog's anal sacs repeatedly became infected..We tried going to different food, including grain free and finally a raw diet, which in the case of my guy actually worsened his situation, although I don't kow WHY! It is very true that soft stools contribute to the problem because the stools do not have enough firmness to express the sacs, ye even when my dog was NOT having an issue with sioft stool, his condition did not improve..After dealing with this for more than one year(which is as long as I could stand watching my poor dog go through this) I consulted with another vet at a specialty hospital, as well as with a surgeon..
The choices given to me after having exhausted nutritional changes were 1) removal of the glands or 2) medicating with
cyclosporine(an immunosuppressant drug)..Of course there were drawbacks to both choices...surgery is risky because one wrong mov can leave the dog fecally incontinent(although I am not sure how much this happens..) Use of immuno supp drugs was not something that appealed to me either due to possible long term complications...Ultimately I chose the surgery, but opted to go with a top notch surgeon who has done very complex soft tissue surgeries successfully for years..It's a painful recovery from this surgery, but I am happy to report that my guy recovered successfully and there were no more issues...The big problem with chronic anal sac issues is that they can lead to the development of perianal fistulae--which are tracts which open through the skin near the anus, and provide drainage from the chronically infected area...my guy was beginning to develop the start of these tracts, and these fistulae can become infected as well, and cause even more difficulties..Also beware of rupture of the anal sac...
Just wanted to tell my experience..I tried every non-invasive method to get this under control--but ultimately chose the surgery..Even directly instilling the sacs did not help..everyone makes his/her own decision depending upon how they view the options, and I am certainly no expert...Hope this helps...if you have any questions please feel free to email me at RockSD717@aol.com
Good Luck! I hope things improve!!!!!