JUVENILE CELLULITIS aka "Puppy Strangles"
Anne Jones RN, BSNE

Breeders know it as "puppy strangles" but the correct veterinary terminology would be juvenile cellulitis or pyoderma.  As a breeder, you have either experienced it with a young pup or heard about it as one of the "horrors'" that can happen.  There was a time when puppy strangles was considered a death sentence but today we know more about the condition and how to treat it.   

The puppy with cellulitis is typically between age 4 weeks and 4 months, though it can appear earlier or later, and the first sign may be redness of the skin around the head and neck, with a particular flush of the ears.  Tiny pustules will appear and edema is noticeable and alarming.  The common name of "strangles" probably came from the swelling of lymph nodes as the infection spread, causing fear that the puppy will be unable to breathe.  Ulceration of skin is common, can cause scarring and permanent loss of hair.  Early treatment can be life saving and will certainly be essential if scarring is to be avoided.  Pustules and infected lymph nodes can spread to other parts of the body and is not limited to head and neck. 

This condition is autoimmune in nature so the first treatment will be with corticosteroids to calm down the immune system reaction.  Antibiotics are sometimes given immediately and will usually be a part of treatment as it progresses and infection sets in.  The general presumption in secondary infection is that streptococcus, which may or may not grow when cultured, is the causative agent.  Some veterinarians have recommended cleansing of the skin with hydrogen peroxide, chlorhexidine or Burrow's solution.  Cleansing may be palliative more than healing and should be done only by recommendation of the treating veterinarian, who may have other suggestions. 

Regardless of the treatment protocol, this is a life threatening condition and immediate treatment by your vet is essential.  As with any "rash", especially in a young pup, your own observations may not be accurate but the more important element is that early treatment will make a huge difference in the outcome.  Demodicosis is only one of other possible causes of skin problems in puppies, most of which do not respond to the immunosuppressant therapy that is critical in treating juvenile cellulitis.  Treatment will last at least two weeks and may last for two months.  During this time, exposure to other infections and diseases must be avoided because of suppression of the immune system.  Separating the pup from adult dogs may help prevent cross infection and hand rearing may be considered, though is not always necessary so long as exposure to other disease can be prevented. 

While the condition may occur in more than one puppy in a litter, the disease is not contagious and occurs in other pups for the same reason as the one first showing signs of illness; i.e. a weak immune system.  Certainly every effort will be made to avoid undue stress to the immune system as the pup grows older so discussion with your veterinarian will include the protocol for administering future vaccines and boosters.  None of the available references discussed this issue and it should be raised before starting immunizations.  Dietary and other considerations will include boosting immunity. 

Another issue is future breeding of the dam and this is difficult because there is no available information on genetics.  However we do know that any dam needs a strong immune system to pass along to future generations.  Consultation with your veterinarian before any future breedings are planned would be in order.   A breeder who had such a pup in a litter should fully disclose the illness to those who purchase any other pups from that litter.  It would be in the best interest of all pups to be carefully reared with full knowledge that one or more pups had been ill.  They can make wonderful pets and have a normal lifespan but it would be poor ethics to omit disclosure.  At the very least, discussion with your veterinarian is advised as to their management.