A rare but serious immune-mediated disorder called Puppy Strangles may occasionally be seen in young dogs between 3 weeks and 4 months of age. It begins with acute swelling of the muzzle, eyes, lips, ears, and lymph nodes. Within 24-48 hours, papules, draining pustules, and crusts develop in these areas. Retrievers, Dachshunds, and Gordon Setters seem to be predisposed to this disease. Sometimes called Juvenile Cellulitis / Lymphadenitis, Puppy Strangles can present with joint pain, fever, and anorexia (loss of appetite). Without appropriate treatment, the disease can be fatal. Fortunately, almost all puppies respond quickly to treatment and make a full recovery.
Strangles will have a very rapid onset of symptoms and is often initially mistaken for an insect sting. The skin of the face and head will become edematous (thickened by cellular uptake of water) and painful, but not necessarily itchy. The submandibular lymph nodes (below the jaw) will become so enlarged and painful, they may rupture and drain. With a fever, the puppy will become very depressed and may stop eating.
Severe swelling causes damage to the outer layers of the skin including the hair follicles. The hair will easily fall out, and permanent scarring can occur if the disease persists. The edema will cause the skin to “ooze” a sticky serum, and crusts and scabs will begin to form.
Puppy Strangles is treated with immuno-suppressive doses of oral corticosteroid drugs like prednisone. Treatment should be swift and aggressive to yield the best results and prevent permanent scarring. The lesions are susceptible to secondary bacterial infection, so antibiotics may be prescribed concurrently. Topical therapy may be useful with cool water soaks and mild astringents, but puppies often find the restraint and pain undesirable making the struggling and stress associated with topical therapy counterproductive.
The veterinarian may perform skin scrapings, fungal cultures, cytology, bacterial cultures, or skin biopsies to definitively diagnose the skin disorder.
Fortunately, Puppy Strangles is fairly rare, and the majority of dogs respond well to treatment. Within a week, there should be notable improvement. Therapy may be continued for up to a month, and the disease does not recur after complete resolution.