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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 28936
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My 3 1/2 month old labrador puppy has a fungal infection, as

Customer Question

My 3 1/2 month old labrador puppy has a fungal infection, as our vet has told. He has ulcers around his nose and chin... The area appears pink and gives off a foul smell.
It Even bleeds sometimes.
It started as an eye infection but has now spread.
We are giving him fluconazole, dexamethasone & amoxicilin.
It's been a week now.. But condition hasn't improved...
What can be done
and how long will it take??
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 2 years ago.
I'm puzzled by the history you provided. A fungal infection is confirmed by a fungal culture. Fungal infections of puppies (ringworm) rarely cause ulcers, a foul smell, and bleeding. Dexamethasone is contraindicated when addressing fungal infections as that corticosteroid immunosuppresses the local skin immune system and would make remission of infections very difficult. Amoxicillin is a poor choice for bacterial skin infections and has no effect on fungal infection. Can you upload a photo of Lazer's face to our conversation? You can use the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or you can use an external app such as imgur.com or dropbox.com. I can be more accurate for you if I can see what you're seeing.
Customer: replied 2 years ago.
I have attached the photos
Customer: replied 2 years ago.
O Ya, we've been asked to dip cotton balls in warm water with boric acid powder and place on his eyes.. This has helped reduce the secretion n swelling.
And we have to clean the snout with povidone-iodine
Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you! This looks like classic canine juvenile cellulitis (juvenile pyoderma, puppy strangles). The cause and pathogenesis of this disease are unknown but there's a highest incidence in puppies between 3 weeks and 6 months of age. Labrador retrievers may be predisposed. Vesicles, pustules, serous to purulent exudate, crusts, cellulitis (inflammation of tissue), and alopecia develop on the lips, muzzle, and eyelid margins. The ear pinnae (flaps) may be swollen and exudative. It would be wise to obtain a third opinion from another vet who has seen this relatively common skin disorder of pups. It's treated with prednisone at 1 mg/lb twice daily until lesions resolve (approximately 1-4 weeks) and the prednisone is then tapered completely over the next few weeks. Any secondary bacterial infection should be addressed with systemic antibiotics for a minimum of 3-4 weeks and 1 week beyond complete clinical resolution. Please respond with further questions or concerns if you wish.
Customer: replied 2 years ago.
What about the foul smell??
Customer: replied 2 years ago.
There are secretions from those lesions.. N even blood sometimes
Expert:  Dr. Michael Salkin replied 2 years ago.
"serous to purulent exudate" = secretions...if the skin ulcerates, bleeding occurs as well..."purulent" means pus is present and pus has a foul smell...please continue our conversation if you wish.
Customer: replied 2 years ago.
Is it fatal??
Expert:  Dr. Michael Salkin replied 2 years ago.
It usually responds nicely to treatment as I described above. Some pups are left with scars on their face but most pups recover without any lasting symptoms. In general the prognosis is good if response to therapy is seen within 4-5 days. Death may occur in puppies if the disease isn't treated.
Expert:  Dr. Michael Salkin replied 2 years ago.
I have to leave my computer for a few hours but I promise to reply as soon as I return if need be.
Customer: replied 2 years ago.
Hi doctor... I've clicked attached the most recent pictures of lazer...
Customer: replied 2 years ago.
Also doc, the Lymphnodes in his neck and near the ears are enlarged. Although "less hard" as compared to a few days back
Customer: replied 2 years ago.
And he keeps rubbing his Muzzle & eyes with walls or the furniture...and also cries in pain doing so. Is the condition itchy and painful?
Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you! Even more indicative of puppy strangles. Lymphadenopathy - swollen lymph nodes - is common and, yes, lesions are often painful but not necessarily itchy. Please get him started on the proper therapy as soon as possible. Feel free to bring our conversation to Lazer's vet.
Customer: replied 2 years ago.
Which antibiotic would you advice empirically? Awaiting sensitivity reports
Expert:  Dr. Michael Salkin replied 2 years ago.
A cephalosporin such as cephalexin or cefadroxil. This class of drug is particularly good when addressing Staphylococcal infections - the most common of the skin infections in dogs.
Customer: replied 2 years ago.
Won't cephalosporin reduce immunity?
And should we check him for diabetes?
Expert:  Dr. Michael Salkin replied 2 years ago.
No, that's not a feature of cephalosporins.
Why would a 3.5 month old pup be suspected of being diabetic? This is mainly a disease of older adults and causes increased thirst, volume of urine, and increased hunger.
Customer: replied 2 years ago.
What would you say about antibiotic Cefprozil?
Expert:  Dr. Michael Salkin replied 2 years ago.
I don't have any experience with that cephalosporin. It's not commonly prescribed to dogs.