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Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 10449
Experience:  I have been a practicing veterinarian for over 30 years.
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We have a 13 week old red/ Irish setter puppy. We got her at

Customer Question

We have a 13 week old red/white Irish setter puppy. We got her at 7 weeks old with a Uti and infection in umbilical cord. By 10 weeks old she has started to get swollen glands in her neck, swollen face, high fever 104, swollen joints where it is hard for her to walk. Our vet put her on steroids and it helps until we start to wean her off. So every two weeks we are back to the above symptoms and a very sick puppy. The vet is now considers g puppy strangles. Are there any other diagnosis that we could possibly explore or questions to ask our vet to help her help our puppy.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Deb replied 1 year ago.

Hello, I'm Dr. Deb and will do my best to help you today.

I'm sorry for this problem which your pup is having; I know it must be quite distressing to see her this way.

Based on the description of her symptoms, I would agree that it sounds as if she has developed puppy strangles aka juvenile cellulitis. In fact, your description couldn't be more classic for this condition which is considered autoimmune in nature and thus requires high doses of steorids (2 mg/kg twice daily) in addition to antibiotics if infection is present (which is often the case). A definitive diagnosis can be confirmed with a biopsy (prior to treatment) although the presentation is typically so classic, that most vets don't bother.

Once the lesions have significantly or completely healed (which might take a few weeks), then a very slow tapering off of steroids is done which can take up to 4-6 weeks in some patients or even slightly longer. I can't be entirely sure, of course, but I suspect that the steroid dose may be decreased too soon which is why she's having a relapse.

Other possible diagnoses include: demodex (a skin scraping should rule it in or out), vasculitis, panniculitis (sterile or infectious but quite rare, and bullous or mucus membrane pemphigoid (which are autoimmune skin diseases). Aside from the first one I mentioned, these others would require a biopsy to confirm.

If this were my case since she's responsive to steroids, I'd keep her at the high dose for a longer period of time before slowing tapering which might be 25% reduction of the initial dose for several weeks, then 50% for 1-2 weeks, then 75% for several weeks and then every other day for several weeks and then stop. I realize that every vet has their own protocol but this one has worked well for me for the few cases that I've seen.

I hope this helps. Deb

Customer: replied 1 year ago.
She does not have any lesions.
Expert:  Dr. Deb replied 1 year ago.

That's good that she doesn't appear to have a secondary infection since many puppies with puppy strangles do. Because there's always the risk of such a problem developing, most vets will also treat with broad spectrum antibiotics although I'm certain that not all do.

I was using the word "lesion" rather broadly in the context of her symptoms; as long as her glands are enlarged and the face is swollen, high dose steroids should be given before tapering.


Expert:  Dr. Deb replied 1 year ago.
I'm just following up on our conversation about your pet. How is everything going?
Dr. Deb
Expert:  Dr. Deb replied 1 year ago.

Hello again,

I'm just following up on your puppy. How are things going with her? Deb