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Little puppy of bernese mountain dog in bed. Cute animals
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Bringing home a new puppy is an exciting time, and you want to do everything you can to ensure they have the best start to life. There’s a lot to cover, which also means it can be a little overwhelming, especially if they get sick. Despite all of the things that you can do to prepare, there are still illnesses and reactions that you may not be able to immediately identify. One of these, although rare, could be what’s known as “puppy strangles,” or juvenile cellulitis. It is also sometimes called sterile granulomatous dermatitis and lymphadenitis. If your puppy suddenly develops dramatic swelling around the face, you might wonder if an insect has stung or bitten your pup or if they are having an allergic reaction. It might not cross your mind, but they could be suffering from this rare disease.

What Is Puppy Strangles?

Rottweiler puppy laying down in the grass.
©Stefan Werner -

The name itself is probably enough to raise alarm bells, especially if you’ve heard of “strangles,” the highly contagious infection in horses. Luckily, despite partially sharing the same name, puppy strangles doesn’t result from infectious bacteria and isn’t contagious to other dogs or humans. Instead, experts believe that a hereditary autoimmune issue likely triggers this uncommon skin disease. Puppy strangles is considered to be idiopathic, meaning the cause is unknown, and the disease can appear spontaneously.

This rare disease occurs mainly in puppies, hence the name, and is rarely seen in older dogs. Most times, puppy strangles can be treated, but even if treatment is delayed, there can be lasting effects. If not treated, puppy strangles can be fatal.

Symptoms of Puppy Strangles

The beginnings of juvenile cellulitis symptoms might resemble another classic viral infection: mumps. Swelling of the jaw and neck is common in mumps in dogs, so these signs can be mistaken for puppy strangles early on.

“The most common clinical signs associated with puppy strangles would be swelling on the face—especially of the lips, eyelids, and muzzle—as well as ears, with hair loss and oozing pimples and enlarged lymph nodes under the jaw,” says Dr. Mitzi Clark, Assistant Clinical Professor of Dermatology, Dermatology Section Chief, Cornell University – College of Veterinary Medicine.

Pustules, which are similar to pimples but contain yellow fluid called pus, also appear on your puppy’s skin when they have this condition. Less commonly, these bleeding, crusty lesions can spread from the head and neck to other parts of the body. As the lesions rupture, they can be painful. The pimples, particularly in and around the ears, can lead to secondary infection. In severe cases, permanent hair loss and scarring may occur.

Other symptoms can include lack of appetite, joint pain and swelling, fever, and lethargy. If you suspect puppy strangles or notice a sudden onset of these symptoms, call your veterinarian.

Which Dogs Are Most at Risk?

Typically, just one puppy from an otherwise healthy litter will develop the disease, if at all. Even if one puppy has puppy strangles, it will not be passed on to other dogs in the litter. Symptoms normally appear when they are between three weeks and four months of age. Veterinarians sometimes see it in older puppies, but it’s exceptionally rare for the disease to occur in adult dogs.

“While a puppy of any breed could be affected, breeds such as the Golden Retriever, Miniature Dachshund, Gordon Setter, Labrador Retriever, Siberian Husky, Lhasa Apso, Beagle, Pointer, Rottweiler, Cairn Terrier, Weimaraner, Rhodesian Ridgeback, Miniature Poodle, English Springer Spaniel, and Chesapeake Bay Retriever, may be predisposed,” says Dr.Clark.

Labrador retriever puppies exploring together in the grass.
©okeanaslt -

It’s reassuring to note that, while this condition might appear when your puppy goes through their vaccination cycle, no links between the two have been discovered.

There’s no definitive way to prevent puppy strangles from developing, but buying from a reputable breeder decreases the likelihood of dealing with the condition. Responsible breeders will likely choose not to breed from adult dogs that had the disease as puppies. Notifying the breeder if your puppy is diagnosed with puppy strangles. Diagnosis can help prevent the predisposition from being passed on.

How Is Puppy Strangles Diagnosed?

Don’t delay getting your dog to the vet when they display signs of facial swelling. Because the symptoms can be similar to other serious, often contagious, diseases, your vet will want to rule out other causes. In rare cases, puppy strangles can be life-threatening, and prompt treatment reduces your pet’s discomfort and minimizes the chance of permanent hair loss or scarring.

A veterinarian might have reason to believe that a dog is suffering from the disease after they do a consultation and physical examination. However, they will typically do further diagnostics to be sure that it is puppy strangles. “Sometimes the diagnosis is made based on the exam findings, age, and clinical picture of the puppy. Testing such as skin cytology, skin scrapings, skin culture, and/or skin biopsy can be used to help support the clinical diagnosis and rule out other causes,” Dr. Clark says.

Other illnesses like demodectic mange, a parasitic skin infection, can sometimes be mistaken for puppy strangles, but skin scrapings would rule these out. Examining the contents of the pustules under a microscope would also rule out bacterial causes, unless there is a secondary infection in addition. Your veterinarian might recommend a skin biopsy under sedation when there is doubt. They may also suggest blood work or a chemistry panel if your pet has severe secondary symptoms, like a high fever.

Treatment Options For Puppy Strangles

Fortunately, the outlook for this rare disease is positive. “Most cases of puppy strangles will respond well to medications within a few weeks of treatment,” Dr. Clark says. Since it’s not contagious, other dogs in the litter won’t be affected, and the disease will not be passed on to you or other pets at home.

Typically when diagnosed, your dog would receive high doses of a steroid medication, such as prednisone, to suppress the incorrect reaction of the immune system. Depending on the disease’s severity, they may also need antibiotics to treat secondary infections that are affecting your dog in addition to puppy strangles. Your puppy will usually return to their bouncy self within a couple of weeks, with no risk of recurrence. You’ll just need to allow some time for any patchy hair loss to regrow. Delays in treatment can result in some permanent bald patches and scarring.

Miniature Poodle puppy chewing on a pink ball.
©duncanandison -

Topical treatments, such as medicated shampoos, applications of hot packs, or creams, can help ease your dog’s discomfort. However, only apply these under advisement from your vet, as some could aggravate the symptoms.

Completing the full treatment dose per your vet’s instructions is vital for success. Suddenly stopping the use of steroids without talking to your veterinarian isn’t recommended. Be aware that, as a side effect of the drug, your pup will likely be more thirsty and hungry during that time.

This article is intended solely as general guidance, and does not constitute health or other professional advice. Individual situations and applicable laws vary by jurisdiction, and you are encouraged to obtain appropriate advice from qualified professionals in the applicable jurisdictions. We make no representations or warranties concerning any course of action taken by any person following or otherwise using the information offered or provided in this article, including any such information associated with and provided in connection with third-party products, and we will not be liable for any direct, indirect, consequential, special, exemplary or other damages that may result, including but not limited to economic loss, injury, illness or death.
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