By Wendy C. Brooks, DVM, DipABVP
Educational Director, VeterinaryPartner.com
Also called Juvenile Cellulitis or Sterile Granulomatous Dermatitis and Lymphadenitis
Photo courtesy of Dr. Patricia Lechten. Used with permission.
Puppy strangles is a classical disease though fortunately not a common one. It comes up suddenly, manifesting as marked swelling of the muzzle, eyelids, and face in a puppy between the ages of 3 weeks and 6 months of age. The owner may be inclined to think the puppy was bitten by a stinging insect or a spider.
Soon the lymph nodes of the throat become spectacularly enlarged, giving the puppy the appearance of having the mumps. It doesn’t take long for the swelling to give way to pimples that rupture, bleed, and crust. The inner surface of the ear flaps are commonly involved as well and occasionally lesions in other body areas occur. Lesions are painful more than they are itchy.
Fever, joint swelling, and loss of appetite occur in approximately 25 percent of patients. If treatment is delayed, permanent hair loss can result in the most severely affected areas. If the puppy is sick enough, the condition can be life-threatening.
Predisposed breeds include the Golden Retriever, Dachshund, and Gordon Setter.
Despite the extreme inflammation and secondary infections, the heart of treatment for this condition is immune-suppression. High doses of corticosteroids such as prednisone are needed as this condition appears to be an immune-mediated disease. In other words, the puppy’s immune system is acting excessively and inappropriately and it must be subdued. Antibiotics may be needed for the secondary infections but antibiotics alone will not treat this condition. Once suppression of the overly active immune system occurs, improvement is usually rapid.
Photo by MarVistaVet
Because the treatment involves suppression of the immune system, it’s best to rule out conditions that look similar as immune suppression would be inappropriate for treatment. Generalized demodectic mange, an infection beginning with mange mites, also has a facial orientation and can look similar to juvenile cellulitis. Skin scrapes can check for mites. A severe infection can be ruled out by looking at samples of the pimple contents under the microscope, ascertaining that there aren’t any bacteria despite the dramatic number of inflammatory cells. There can be a secondary infection, though, in which case the doctor must use clinical judgment about the appearance of the lesions and the patient’s history to make the diagnosis.
The condition generally resolves in 10 to 14 days and does not recur.