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What’s Causing Your Puppy’s Face to Swell?

Have you noticed sudden swelling around your little one's face? Uncover the mystery behind this alarming condition and learn the essential steps to ensure your furry friend's health and comfort.

puppy strangles


  • Puppy strangles, aka juvenile cellulitis, is a rare but alarming condition involving remarkable facial swelling as the first sign; the swelling soon affects the lymph nodes of the throat, which also become markedly enlarged
  • The swelling gives way to bumps that rupture, bleed, and crust over; the inner surface of the ear flaps may also be involved, and there can be lesions on other parts of the body as well
  • The cause of puppy strangles is unknown, but is assumed to be autoimmune in nature; it can occur in any puppy, but certain breeds are predisposed
  • Diagnosis of the condition is one of exclusion, meaning other diseases with similar symptoms must be ruled out before initiating treatment for strangles
  • Conventional treatment involves a multi-week course of high-dose prednisone, and often, antibiotics as well to address secondary bacterial infections

Puppies are irresistibly small, sleepy sweethearts who bring out our protective instincts. That’s why it’s so difficult when a pup you bring home, through no fault of your own, is diagnosed with a condition like “puppy strangles” (aka juvenile cellulitis, sterile granulomatous dermatitis, or lymphadenitis).

Thankfully, puppy strangles is rare. The telltale sign is sudden, dramatic swelling around your pup’s little face that you might think is the result of an insect bite or allergic reaction.

When your veterinarian names a condition called of all things “strangles,” it’s alarming, especially if you’re familiar with the highly contagious infection of the same name that occurs in horses. The good news is that puppy strangles isn’t caused from infectious bacteria and isn’t contagious to other dogs or humans.

Symptoms of Puppy Strangles

The characteristic facial swelling in puppy strangles soon affects the lymph nodes of the throat, which also become markedly enlarged, making your pup look like he might have the mumps. Soon enough, the swelling gives way to bumps that rupture, bleed, and crust over. The inner surface of the ear flaps may also be involved, and there can be lesions on other parts of the body as well. The lesions may be itchy and painful.

About 25% of puppies with strangles also develop fever, joint swelling, and loss of appetite. Delayed treatment can result in permanent hair loss in the most severely affected areas. Unfortunately, in very sick pups, the condition can be life threatening.

Any puppy can be affected; however, predisposed breeds include the Golden Retriever, Miniature Dachshund, Gordon Setter, Labrador Retriever, Siberian Husky, Lhasa Apso, Beagle, Pointer, Rottweiler, Cairn Terrier, Weimaraner, Rhodesian Ridgeback, Miniature Poodle, English Springer Spaniel, and Chesapeake Bay Retriever.1

Causes and Diagnosis

As noted earlier, in horses, the cause of strangles is a bacterium, specifically Streptococcus equi. In puppies, the condition is idiopathic, meaning the cause is unknown. However, it’s suspected to be an autoimmune disorder in which the animal’s immune system attacks the cells in the skin of the face.2

Puppy strangles is a diagnosis of exclusion, meaning other causes of your pup’s symptoms must be rule out before attempting to treat strangles. For example, demodectic mange tends to affect the face and can look similar to strangles. Your veterinarian may order blood tests, a skin scraping to look for mites, and a skin cytology to look for bacteria. According to veterinarian Dr. Wendy Brooks, writing for Veterinary Partner:

“A severe infection can be ruled out by looking at samples of the pimple contents under the microscope, noting that no bacteria are present despite the dramatic number of inflammatory cells. A secondary infection, though, can be present in which case the doctor must use clinical judgment about the appearance of the lesions and the patient’s history to make the diagnosis.”3

Treatment Options

Once other possible causes of your puppy’s symptoms have been ruled out, your veterinarian will prescribe treatment for strangles. The typical approach is to prescribe a corticosteroid (typically prednisone) to suppress the immune system, along with antibiotics to address any secondary bacterial infections of the skin.

The course of prednisone is often four to six weeks. In the first several days, your pup’s facial swelling should resolve, she’ll start feeling more energetic, and begin to eat more. However, it can take several weeks to resolve the skin pustules and swollen lymph nodes, thus the need for a long course of prednisone.

It’s important to note that the relatively high dose of prednisone needed to resolve strangles will increase your puppy’s appetite and thirst. She’ll drink more water than usual and will need more frequent outdoor access to relieve herself.

Most puppies with strangles make a complete recovery from their illness and do not have a recurrence of the disease.

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