Puppy Strangles (also called Juvenile Cellulitis or Sterile Granulomatous Dermatitis and Lymphadenitis)

Facial swelling and ruptured, crusted pimples
classic for strangles

Puppy strangles is a classic 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. It may appear as though the puppy was bitten by an insect or a spider.

Soon the lymph nodes of the throat become very 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.  


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.

Puppies with strangles have a fairly characteristic appearance and are usually diagnosed on that basis. That said, because the treatment involves suppressing the immune system, it is best to rule out conditions that might look similar but for which immune suppression would be inappropriate. Generalized demodectic mange, an infection involving mange mites, also has a facial orientation and can look similar to juvenile cellulitis. Skin scrapes can be performed to check for the presence of mites. A skin biopsy should settle any questions about what condition is present. 

A severe infection can be ruled out by looking at samples of the pimple contents under the microscope, noting that no bacteria are present despite the dramatic number of inflammatory cells. A secondary infection, though, can be present 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.

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