Hello to all,
Unfortunately, it seems that one of my almost 8-week-old puppies (the breed is the Coton de Tuléar, which I am saying openly because they are all reserved, and I won't be breeding anymore anyhow, so I have no need to advertise) has an auto-immune problem which presents very closely to the symptoms for Juvenile Cellulitis, otherwise known as Puppy Strangles.  Fourteen years ago I had a puppy with these symptoms, and the situation was taken care of with steroids (cortisone).

I'd just be interrested to know if any of you experienced breeders have ever run into this, and what happened.  I discovered the symptoms only yesterday, and recognising them from 14 years ago, went straight to the vet.  We are still trying to determine exactly what is going on, he is speaking to a pathologist this morning, has taken blood and so on.

Thanks for any input.

I have had a Bernese with Strangles and wrote a little article to go in the breed club magazine. Thought you might like to read it so have copied it for you. :-

ROVERS STORY. By Aileen Trevett.

At last the long awaited day had arrived and after 9 weeks of waiting Treacle produced her puppies. It was a reasonably straightforward birth, a bit long and needing a couple of Oxytocin injections but the result was five beautiful pups.
Four boys and a girl!
The first five weeks went well with all pups feeding and growing on as expected, we got the weaning process going and they were doing fine. Then disaster struck!
This is the story of Rover one of the boy’s so named as he was born in the car in the vets car park!

Rovers Diary:                       

Friday 20th May 2005, Rover was a little quiet today, not ill, eating and drinking as usual but just not quite right somehow. Nothing to bother the vet about, the puppies had been wormed on the previous day and we put it down to a bit of tummy ache. They were wormed with a preparation called Milbemax
Sat 21st May: Rover is not happy today, he is sitting in a corner and shaking his head a lot. Looked in his ears and the right one is swollen and sore, He is in obvious discomfort and so a call to the Vet brings out the on duty vet who prescribes Canaural ear drops to be applied twice a day, and he confirms he thinks it is an ear infection.
Sun 22nd May: Rover worse today his ears are puffy looking on the earflaps and very swollen inside, the ear canal is completely blocked and he is grumpy with the other pups. Call Vet out who agrees he is very uncomfortable and prescribes Dexadreson by injection 2mg/ml 50ml per ml. This is a steroid to help reduce the swelling and reduce the pain, also Synulox 50mg one twice a day to fight the infection and continue with the ear drops three times a day. Rover is eating a little still and will come for a cuddle but is wary of the other pups puling on his ears. Try to contain him alone but he is more miserable and prefers to be in with the rest of the pups.
Mon 23rd May: Obviously no improvement overnight and much more depressed puppy this morning. Rover is very lethargic and will not eat very much. His nose and lips look a little sore and swollen and he has a sore on his top lip this morning.
A trip to the vet is in order first thing and a different Vet (My usual one luckily for Rover).
As I walk into the consulting room she takes one look at poor Rover and announces, “He has got PUPPY STRANGLES”
(A word here to warn every one of this horrible disease, I had heard of it, I am a great reader and have read most of my collection of dog books from cover to cover but you don’t relate to things properly until they happen to you!!  A paragraph in J.M. Evans and Kay Whites Book Of The Bitch was the only piece I could find on it and it put the fear of God into me!)
A thorough examination by the vet confirms her worst fears, a very high temperature 103.5ºF depression, swelling to the pinnae (ear flaps) and lips, his age (It affects puppies between the ages of 4 to 16 weeks) his glands are inflamed in his neck and under his jaw. It is time to give some intensive treatment, and this is the most crucial time in this illness to act with very high doses of steroids and some anti-biotics to contain the infection of the broken skin
My vet admitted poor Rover into the surgery for the day and started intra-venous drips of steroid and anti-biotics: Augmentin IV 25mg/kg and Dexadreson ½mg/kg, with a dextrose saline fluid replacement and careful nursing.
I call on a regular basis throughout the day and he is doing OK. His temperature is dropping and he has had his doses of drugs for one day so he can come home overnight. I go to pick him up at 6pm and find a sad little puppy with a very red and swollen muzzle and purple bumps on his nose and lips.
Home we go armed with some high calorific food to try to get him to eat and an appointment for the next morning with the vet. At home Rover wolfs down some of the dog food and I give him a little cooked chicken, it disappears faster than the eye can see so no problem with getting him to eat! He is happy to be re-united with his brothers and sister and settles down to sleep with no problems overnight.
Tues 24th May: Rover is looking poorly again this morning, off his food and lethargic again. Back I go to the vet who declares that he will be fine to be nursed at home as he is drinking well and she gives him his intra-venous steroids, a smaller dose .25mg/kg, and anti-biotics and checks his temperature. It is raised again 102ºF but not as high as yesterday morning. The glands in his neck and jaw are the size of walnuts and the vet is worried they may break open and discharge the pus out causing deep wounds and scarring. There is some swelling to his anus and his little willy is spotty but does not seem sore. Armed with some prednisolone (Steroid) 5mg one twice a day and some Synulox 250mg Half a tablet twice a day and an appointment to see the vet again the next morning we set of for home. During the day Rovers ears seem better, not so swollen and less sore but his lips and nose are very angry looking and the purple bumps are breaking open and weeping, all in all he looks awful!  However by the evening he is eating well and although not too keen to get involved in puppy scrapes he will stand on the sidelines and bark encouragement to the other pups as they play. The others seem to know he is sore and if they bounce up to his face they lick rather than bite him! I think he has given one or two sharp nips and they know he means business!
Wd 25th May: No trip to the vet today Rover is about the same. Glands in his neck still up but no bigger he will eat well and play a little today. All the sores around his mouth and nose are weeping and I clean them with warm saline and Mum helps too!
This morning his eyes are showing small bumps on the eyelids, I think they must have been there before but very small and now the fur around them looks thinner so I can see them better. Continue the 125mg Synulox and 5mg Prednisolone twice a day. His anus and willy are no worse and we hope we have reached a plateau with this illness. 
Thurs 26th May: A brighter happier puppy awoke this morning. His face looks awful and the sores are spreading into all the oedematous areas as we expected, it seems to run a pattern of swelling and weeping, purple bumps, open sores then scabbing over. Some of the first sores are now scabbing over. Luckily the swelling in his ears has gone down and they did not open up on the outside just on the insides of the flaps these sores are drying up well now. His eyes look about the same today, lets hope they will not get worse. Continue the Synulox and Prednisolone as before.
Fri 27th May: Continues to improve. Appetite normal now and will play with me. He still does not want to join in with the other pups but will bark at them and bounce around on the sidelines! He looks like a panda this morning with bald eyes and his muzzle has lost most of the fur as well. He is rubbing his face in the grass today and I think the scabs must be itchy. Tried bathing with a tea tree lotion 50g/litre, which seemed to help the itchiness but he does not like the smell much! Still if it helps its worth a try. Continue the drugs as before.
Sat 28th May: Back to the vet this morning for a check up. Temp still slightly raised but not anything to worry about. The vet decided to try dropping the Prednisolone to one 5mg tablet once a day so will drop this evening’s dose. A good day for Rover today with him playing a little with the other pups and far happier in himself. Eating and sleeping well, sleeping a little more than the others I suppose but not lethargic like he was earlier in the week.
Sun 29th May Another good day. Eyes looking spottier and definitely bald. His anus has broken into a weeping sore and I am now bathing regularly to keep clean. The spots on his willy are about the same not sore just there!
Mon 30th May This morning Rovers eyes are sore and the spots have started to weep. Phoned vet and increased Prednisolone to 1½  (7.5mg) daily to try to damp the eyes down a bit. We are doing so well we do not want to step backwards at this stage. Apart from that he is a happy little chap and much more like a normal puppy now.
Tues 31st/Wed1st June/ Thurs 2nd: Gradual improvements as the days go on. All sores starting to dry up and scab over eyes going through the weepy open sore scabby routine as the rest did. The glands are now almost back to normal with non of them bursting open thank goodness!
Fri 3rd June: Back to vet for a check up. Reduced the Prednisolone again to 1x 5mg tablet once a day. Synulox staying the same (this is actually a reducing dose because as his bodyweight goes up the dose per kilo actually reduces). Vet very happy with him and wishes to see him again next Friday to reduce the prednisolone and hopefully discontinue the Synulox and wish him well for the future.
Sat 4th: Three of Rovers siblings go today and he is left with one brother to play with. He is now playing quite well if still a little careful of his sores. I feel he is about a couple of weeks behind the others in size but hopefully will rectify this as he continues to improve. There is a possibility that he will never make the size he was destined to be, but a little smaller and well is better than not being here at all!
Mon, Tues, Wed, Thurs: Every day a small improvement as the spots burst and scab over Rover gets more like a normal (If horrible to look at) puppy. But we love him all the same, and his new owners waiting patiently to take him home love him too.
Fri 10th June: Off to the Vet again for what will hopefully be our last trip. She is very pleased with his progress and reduces the Prednisolone to one 5mg tablet every other day and discontinues the Synulox. She is happy to hand over his treatment to the new owners vet who will continue the reducing dose of Prednisolone until finally stopped, and will fax them through his history. So he has been discharged and is well on the way to a complete recovery. (We all hope!).

This disease is not well known and when Rover was first diagnosed with it I tried just about every breeder I knew to see if they could shed any light on it. I was surprised that so few had ever heard of it and the cases recorded in Bernese are minimal. I only found one other breeder who had had a case.
Through some digging on the Internet and phoning all and sundry I have gathered some information we should all be armed with if venturing into the realms of breeding a litter.
The disease has many names; Puppy Strangles, Canine Juvenile Cellulitis, Juvenile Pyoderma and Puppy Face are some of the ones I have heard. The Veterinary definition of the disease is, and I quote a book on skin diseases of the dog and cat, “Canine juvenile cellulitis is a granulomatous condition of puppies, affecting the skin of the face, the pinnae and the submandibular lymph nodes.” It is not considered to be hereditary although there is some evidence for a hereditary factor as some Breeds, and some lines within a breed may be pre-disposed. As far as I can trace back there has been no other incidences in the last 5 generations of Rovers breeding. If fact there are so very few Bernese that have ever contracted it as to assume it is an extremely rare condition in the breed. There is some information to point to it being more prevalent in some breeds; Dachshunds, Labrador Retrievers, Golden retrievers Lhasa Apsos and Gordon Setters tend to be the most commonly affected, though there have been cases in most breeds if very isolated. Puppies are usually febrile (high temperature) depressed and sometimes anorexic. There is acute swelling of the muzzle lips and eyelids. Sterile pustules often develop in the skin of these areas as well as on the surface of the earflaps. After the pustules rupture, small ulcers, draining tracts or crusts develop. Submandibular (under the jaw) Lymphadenopathy (Swelling of the lymph nodes) occurs and, occasionally the lymph nodes will abscessate and drain. Permanent areas of hair loss and scarring may result if the lesions are extensive.  It is a condition that requires large doses of steroids, prednisolone being the drug of choice; the dosages may be reduced once the open sores and swelling of the glands start to reduce. If a secondary bacterial infection is suspected (and it’s very difficult to keep out due to the nature of a puppies habits!) some form of systemic bactericidal antibacterial drug can be used concurrently (hence the Synulox in Rovers case)
The prognosis is usually very good as long as it is treated correctly and quickly. Apart from the possibility of permanent scarring or hair loss the puppy usually does well and lives a normal life. The few people I have spoken to in detail who have had cases of the disease report a full return to health and a normal happy life. I found only one incidence who reported hair loss or scarring, however that is not to say that there are plenty of cases where this was the end result. I understand from others that I was lucky to pick up Rovers case very quickly and very lucky to have a vet who trusted her knowledge and went ahead with the steroids immediately. Many vets will do skin scrapings first to rule out infections and days may be lost waiting for results to come back, days that are crucial to the puppy who needs the steroids immediately (steroids are NOT the right treatment for infections!) Getting those steroids in as soon as possible seems to be the key to successful treatment with the least amount of lasting scars.
I am not a vet or have any more knowledge than most laymen but when something like this happens we tend to gather what information we can. As always some of that information is not correct and I have tried to present the facts as I have found them to be true. I found a lot of ‘Old Wives Tales’ and tried to stick to what I know to have been true in this article.  It has been an awful time with Rover but he is well on the way to recovery now and we hope he will have a happy life.
I wrote this diary in order to spread the word about a disease that can appear at any time in any litter. I feel the more we know about it the better chance of treating it successfully. It does not pay to be blind in our faith that these things happen to others and not us. Let hope through our experiences others can have a better understanding if they should be unlucky enough to encounter this awful disease and have a problem with it.
I think Rover came out of it very well, it could all have been so much worse without a vet who knew what she was looking at!

I don't normally post, I'm more of a lurker, but this is one that really caught my eye. I had a guide dog pup that had puppy strangles and I had certainly never heard of it before then. His symptoms and treatment were almost identical to the post above including all the hair loss. Due to his depressed immune system, his hair loss was pretty much all over but especially around the eyes. The vet also did skin scrapes and there was an increase in demodex (sp?) mites on his body too.

He was a very poorly boy and went right off his legs, I had to do physio in the bath and everything. He was given a chance to be a guide and went through further training to give him a chance when he was older, but always had poor skin, was quite small and had digestive issues. He became the much adored pet of an older couple and is having the most amazing life.

We had a client rush a two-week puppy in to our practice, in tears because the pup was so 'flat' and poorly. There were no specific signs, but it was given an antibiotic injection just in case. Two days later it came back, with some swelling around the eyes. I'd seen this before, so suggested that the vet might like to consider puppy strangles. Within minutes of research the pup was started on steroid therapy. Pup got worse before he got better, but by 4 months he was a completely normal puppy, albeit with a scarred muzzle. He's now about 10 years old and is a very happy, healthy dog.

I had a Cavalier puppy with Juvenile Pyoderma in the 1980's. She was one of a litter of five, and there was no previous history. The puppy was reserved but I told her folks that she couldn't go until she was right, and they said they were willing to wait. I think she must have had a much milder case than Rover, her lymph nodes were enlarged, but the pustules on her muzzle were the most noticeable symptom. She had AB's, but I don't think she had any steroids, apart from a topical applications. From memory, I think she stayed to about 12 weeks, by which time she had healed, and it was just a case of waiting for the hair to grow back. I went to visit about six months later, and she had grown into a largish, sturdy Cavalier with a placid nature, and no scarring.

Hello Nimue,

I had a case of Puppy Strangles/Juvenile cellulitis  in a litter many years ago. Fortunately only one puppy in the litter of eight was affected . I recognised it immediately for what it was took puppy Abby ( who hence became known as scabby Abby by my kids) to the vets. They had never heard of the condition and I told them what it was and that it would require steroids and antibiotics to clear it up. It is not infectious so I was able to reassure the other families that as long as their puppies remained well,all would be well. And they did. Abby stayed with us for quite a while. She had to be weaned off the steroids before she could start her course of vaccinations. All the lesions healed, even the nasty ones around her eyes. The advice I got was that there could be a hereditary component to this condition so siblings should not be bred from, and they weren't . It was Clemmie's last litter so there was no issue about breeding from her again. The condition is caused by an over response by the immune system which goes into overdrive -hence the swollen lymph glands (lymphadenopathy)- and secondary bacterial infection can occur -hence the nasty pustules. Abby was listless and off her food for a few days but bounced back to normal energy levels, although still looked a mess. I think I wrote about this on the forum many years ago and my memory of the events is now a wee bit hazy.

I tend to believe that the worst always happens to me, and certainly events in my life bear witness to that. A month or so before this happened to me I was speaking  to a breeder -I think I was trying to find a puppy for someone as mine were reserved. She was in absolute meltdown as her whole litter of GR puppies had the condition. I'd never heard of it so looked it up. When Abby developed her symptoms, I was on to it straight away.

My theory as to why this puppy got this is that her mother picked up an infection during pregnancy, perhaps swimming in the lake where we lived. Only one puppy in its sac was infected and this provoked a response in its i immune system, which subsequently went into overdrive . This is my theory anyway.

Hope this helps.

The condition is also called Juvenile Pyoderma. Abby was 3/4 weeks when she developed symptoms.

Dear Aileen

Thank you so much for taking the trouble to copy your article for me!  I really appreciate it!

Hi Jan,  Lovely to hear from you again.  I've been wondering how you are doing.
Thanks so much for your story.  It's a real help.  My vet took a sample this morning from the swollen saliva glands to send in to the lab.  He is determined to make as exact a diagnosis as he possibly can, and like most vets, he is not familiar with the problem.  He says that there are auto immune problems other than strangles which present in a similar way, and so he would like to be sure where we are and what she has.  We'll have the results tomorrow.  Magnolia seems to feel pretty chipper, runs about, eats, plays with her sisters.  I'm a nervous wreck.

' It does not pay to be blind in our faith that these things happen to others and not us. '

Right on !!

My sister rehomed a rescue dog aged 11 months who was picked up as a stray at 14 weeks and had puppy strangles. He was treated by the Rescue and then adopted by my sister and her family. He’s fine in himself, but the fur on his muzzle is very thin and scarred and he has a very sensitive digestive system. He has a lovely temperament considering everything he went through as a pup.

Hello to all.  I just thought I would post an update here, especially in thanks to those who have sent their very valuable and much appreciated experiences.
The lab reported an infection of the salivary glands, as my vet had suspected.  He had said, upon examining her, that he didn't think it was the lymph nodes which were swollen, but the salivary glands.  He was spot on.  Whether the infection caused the autoimmune reaction or visa versa seems fairly irrelevant, and my puppy (yesterday 8 weeks old) is now being treated with cortisone together with an antibiotic.  My vet is keeping very close track of her.  She seems remarkably chipper:  eats, plays, has no digestive issues, and the swelling around the eyes and the mouth has receded, not entirely, but still...  She does seem to require rather extensive naps, which is completely understandable.  And I will do anything she needs at any cost and keep her with me for as long as it takes, even forever, if need be.

That's great news . Onwards and upwards

Good news, hope she continues to improve, our pets do cause us heartache at times, especially when they are so young