A.First, realize that anal sacs are supposed to be somewhat full, not empty. In my experience, one of the practices contributing to anal sac problems is having them expressed too frequently. This creates a vicious cycle of inflammation resulting in an over-production of secretions and filling, which leads to a more frequent need to again be expressed.
In general, the higher quality the diet is, the better the chances to ultimately stop the problem. Adding fiber in the form of vegetables has also been shown to help. I have seen this condition remedied by switching dogs to an all-raw diet.
The only homeopathic I’ve had success with for this condition is a combination of Heel’s Hemorrhoid and Inflammation, and when indicated, their Infection remedy.