Juvenile Pyoderma (Puppy Strangles)

Juvenile Pyoderma / Cellulitis (often misleadingly termed "Puppy Strangles") is a fairly common, but alarming disorder that can be seen in many breeds including Afghan puppies from 3 weeks to 4 months of age. It appears initially as acute swelling of the face, primarily of the lips, eyelids, chin, and muzzle. It may easily be confused, early on, with a sudden allergic reaction typical of a bee sting or a vaccine reaction. However, untreated it can progress rapidly into bumps and pustules which drain and scab. The lymph nodes under the neck may enlarge dramatically, which is what precipitated the term "puppy strangles." Half of the cases are lethargic. Up to one quarter of the cases may show fever, appetite loss, and joint pain. The cause of Juvenile Pyoderma is unknown, although an immune basis is postulated, because of the rapid response to immune-suppressive doses of steroids. Early, aggressive steroid treatment is needed to avoid excessive scar formation. If evidence of concurrent bacterial infection is present, then antibiotics are indicated.  It takes a great leap of faith, but the only really good way to treat juvenile Pyoderma is with the use of corticosteroids in combination with antibiotics. If corticosteroids are not used early in this disease permanent scarring of the affected areas can occur and if they are never used death is not uncommon. The swelling of the lymph nodes cuts off the puppy's ability to breath,  hence the common name of "puppy strangles".    In it's mildest form and before it became more understood some people used to think of it as 'milk spots'. It could be only a single pup from a litter or a whole litter that are affected.

It is really scary to use immunosuppressive medications in the face of what appears to be a really severe infection but it is essential IF the condition is in fact juvenile Pyoderma. Diagnosis of this can be confirmed by skin biopsy but it is usually best for your vet to make an educated guess and start treatment while waiting for biopsy reports  and hope for the best if the symptoms are severe, since biopsy results usually take a while to get back.

Many vets want to try Synulux at the first signs of the problem, this usually has proved to be a waste of valuable time on it's own and puppy should be put onto a course of Prednisolone 5mg  half tablet daily and Cephalexin 250mg half tablet twice daily. If the problem does not rapidly respond to treatment or is a severe case then Antirobe 75mg one tablet twice daily and Cephalexin 250mg half tablet twice daily.  If the problem is severe around the eyes Fulcithalmic cream can help soothe the eyes.

It is essential that hygiene and very good feeding are practised as poor management could escalate the problem     

The good news is that once successfully treated a relapse is extremely unlikely and most (not all) dog's immune system's appears to be extremely good for the rest of the their life.  Although not thought  to be hereditary (unproven either way ) it is very unwise to breed from a dog who has been affected

Thumbnails please click for full viewing

affecting just the eyes but it can be as little as one small 'pimple'


a very severe case Showing the ears also swollen


Please send us any additional histories if you have them of Afghan pups who have had Juvenile Pyoderma and photographs would be very helpful as we would like to add to this section and thank you to the people who are helping so far

Puppy 1 case history
Very healthy puppy, birth weight 1lb 2 1/2 oz who did very well up until 7 weeks. Developed two small spots on eye lid and was taken to vet for check up. Put on Synulux for one week but condition was worsening rapidly and spreading to lips. At 8 weeks was put onto Prednisolone 5mg 1/2 tablet once daily and cephalexin 250mg 1/2 tablet twice daily, condition not improving quickly and pup's lips and eyes very swollen and sore and glands swelling but pup seemed happy throughout. Medication changed to Antirobe 75mg 1 tablet twice daily and continued with the Cephalexin as before.
1 week later although glands still very swollen the spots were lessening and pup was put back onto Prednisolone along with the Antirobe and Cephalexin, Puppy began to make rapid progress and left for new home aged 10 weeks and 5 days fully recovered armed with a full progress chart for the new owners vet. There was no scarring. Innoculation was delayed until puppy was totally cleared, this pup was never bred from.

Showing bottom lips badly affected, sorry but not very clear


Puppy 2 case history
Healthy puppy birth weight 15oz at 6 weeks a single small pimple type spot appeared on eye (puppy milk spot?)  vet suspected early  Pyoderma and a skin biopsy taken confirmed his suspicion, pup had a short course of Prednisolone, puppy never appeared ill and there were no further developments and dog has had no other health problems to date. Inoculation was delayed until 12 weeks to be on the safe side. This pup later did a lot of winning but was never bred from, a sibling produced a single Pyoderma pup.


Puppy 3 case history
Healthy puppy birth weight 1lb 5oz did extremely well up until 6 weeks when a small spot appeared on eyelid, was thought to have been a scratch from a puppy nail and vet was treating as such. Eyes worsened rapidly and pup was on Synulux and eye cream, by eight weeks puppy was covered on it's face with open sores and antibiotics were changed, owner very worried, pups head was becoming very swollen and the stud dogs owner was dropping in almost daily to see progress but saying nothing.. Puppy was still being treated for infection and swelling was so bad in glands that the puppy was very close to death at this point as pup was having severe breathing difficulties, stud dogs owner told the breeder to ask the vet if it could be puppy strangles! treatment was immediately changed to Prednisolone and Antirobe and puppies health started to improve dramatically. Puppy left home at 3 months continued a further weeks treatment from new owners vet fully armed with all the relevant information and had no further problems. Inoculation was delayed until the condition was totally cleared.  There was no scarring and this pup later became a multiple BIS winner but was advised not to be used at stud.
(I feel this puppy would have been saved a lot of suffering had the stud owners made their suggestion a lot earlier as the breeder had never seen a pyoderma before and had no idea of what was happening and could find no one prepared to discuss it with them!)


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