Puppy strangles is a rare but serious skin disorder most frequently seen in puppies. This condition is also referred to as juvenile cellulitis, sterile granulomatous dermatitis, or lymphadenitis.

The hallmark of strangles is the sudden onset of pronounced facial swelling, especially around the muzzle and eyelids, followed by enlargement of the lymph nodes in the neck. As these lymph nodes swell dramatically, it can appear as though your puppy is being strangled—hence the name. Alongside this, painful, oozing, crusty, pimple-like skin lesions develop, typically causing significant discomfort.

At the earliest signs of swelling, many pet parents might mistakenly believe their puppy has suffered a snake or spider bite. No matter the suspected cause, any substantial swelling demands immediate veterinary attention. If left untreated, puppy strangles can escalate into a life-threatening condition.

While primarily affecting puppies between 3 weeks and 6 months old, puppy strangles has been diagnosed in dogs as old as 4 years.

Signs that your puppy might have strangles include:

• Fever and overall malaise
• Noticeable facial swelling, especially around the muzzle and eyes
• Enlarged lymph nodes, often starting beneath the chin and along the neck
• Swollen joints causing discomfort
• Lethargy and decreased activity
• Painful, bleeding, crusted, oozing pustules on the skin—commonly on the face, muzzle, and ears, but sometimes on paws, anus, and genital areas
• Reduced appetite and less interest in drinking water
• Patchy hair loss
• Limping or lameness due to joint inflammation

The exact cause of puppy strangles remains unknown, but veterinary experts strongly suspect it involves an abnormal immune system reaction. This is because it predominantly affects young dogs with immature immune defenses and tends to improve with high doses of steroids that suppress immune activity.

Genetic factors may also play a role since certain breeds—including Golden Retrievers, Gordon Setters, and Dachshunds—are statistically more prone to developing this condition.

During your puppy’s exam, the veterinarian will look for classic signs such as symmetrical facial swelling, notably swollen lymph nodes, fever, and painful, raised skin lesions with crusts. Though these symptoms strongly indicate puppy strangles, your vet will likely order additional tests to confirm the diagnosis and rule out other diseases:

• Complete Blood Count (CBC): Dogs with puppy strangles often show elevated white blood cells indicating inflammation, along with mild-to-moderate anemia.
• Cytology of Skin Lesions: A microscope slide is gently touched to the oozing lesions to collect cells. This helps identify if secondary bacterial infections have developed.
• Skin Scrapings and Hair Plucks: These tests help exclude other causes such as mange, fungal infections, or ringworm.
• Bacterial and Fungal Cultures: Sometimes necessary to definitively rule out infectious causes.
• Skin Biopsy: Although more invasive, a biopsy can provide a definitive diagnosis by revealing characteristic skin changes like granulomas and pyogranulomas typical of puppy strangles. Often, however, a diagnosis and treatment plan can proceed without this step.

Puppy strangles causes substantial pain and leaves your pup vulnerable to secondary bacterial infections. If the infection spreads unchecked or your puppy’s pain causes them to stop eating and drinking, the condition can quickly become life-threatening.

The good news is that treatment is highly effective. The goal is to calm your puppy’s overactive immune system and reduce inflammation. Vets commonly prescribe Prednisone, a powerful steroid, or other immunosuppressants such as Cyclosporine.

High doses of steroids are usually needed for several weeks or even months, then gradually tapered as your pup improves to prevent relapse. If any skin lesions become infected, antibiotics will be necessary. Your veterinarian might also recommend pain relief medications to keep your puppy comfortable during recovery.

Most puppies begin showing improvement within a few days of starting treatment, but complete resolution typically takes 10 to 14 days. Some affected areas may experience permanent hair loss or scarring.

It’s crucial to avoid popping or squeezing any pustules, as this can cause further pain and invite bacterial infections.

Currently, there is no known preventative measure for puppy strangles, but once successfully treated, the condition rarely recurs.