I have a 7.5 week old puppy with strangles which presented itself almost two weeks ago in the very early stages and I started treatment on him immediately. The first vet who saw him gave me liquid amoxicillin with prednisone sprinkled in, and the puppy was back to himself within a few hours. I continued this treatment for a week and his sores (which at the time only affected his ears) were simply kept at bay. I took him to a different vet who told me he was being treated incorrectly and sent me home with Clavamox and Prednisone and told me only to use the pred if he got worse. One day went by and his ears got pretty inflamed, so I started him on 10mg of prednisone once daily as instructed by my vet. His symptoms have now progressed and his glands and neck are swollen and sores have just today developed on his face. He is a 15 pound puppy and I am assuming that he needs to be treated a little more aggressively with a higher dose of prednisone. I do plan on taking him back to yet a different vet on Tuesday but in the mean time I'm hoping someone who has dealt with strangles before can give me some insight. I am thinking of doubling his dose tomorrow (10mg twice daily) to see if that makes a difference, the poor guy is just looking miserable. Thanks in advance for any advice, private replies are fine too!

OK first of all I went through bloody hell last summer with 6 of 8 puppies getting this horrid illness. I saw the very early beginnings of it at 4 weeks, but the vet didn't believe me. My vet did the same thing with Clavamox and no Pred. initially which I knew was wrong from what friends were telling me. When she finally agreed to put the poor puppies on Pred. it was much too low a dose and the same thing happened...it allowed the Strangles to aggressively take hold. Not only that, but she switched the Pred. to Dexamethasone and the pups got even worse. After a few weeks of Dex I demanded she change them back to Pred. Long story short 4 of the 8 were on Dex/ Pred. and Clavamox/Ceph for 4+ months! Let me tell you this is NOT what you want. Find a vet, or better yet a breeder that can tell you what dosage of Pred. to use because it will be a fairly high dose( more than what you said) which will be very gradually tapered. Keep that puppy on Cephalexin rather than Clavamox. I did 250mg. 3x a day, and I got it free with a prescription from the vet/ at Wegman's. Keep on Ceph. for the duration of the Pred. useage and for a couple of weeks after the Pred. is done. This is very important! I can email a vet that I know has a regimen for how she nurses a Strangles pup...only wish I could have used her advice when I went through it. Because your pup is already into the disease so far you will have to be prepared for it to get ugly. Don't want to scare you, but I won't sugar coat it. If you need someone to talk to, or just a shoulder to lean on I'd be happy to lend an ear. Hang in there. I will email the vet I know and she breeds Labs too. I spent $2,000+ in vet visits and medications for the 6 sick puppies. It would have been a lot less if I had known about Ceph. being just as good as Clavamox and free at a food store! The Pred. was also cheaper through the food store pharmacy.

We had a puppy last year that was about 6 or 7 weeks, diag. with HOD - very painful joints. We believe that diag. was wrong, so ended up seeing 3 vets and finally settled on Clavamox and Pred. My notes aren't that good, but the Pred was 5.0 - 2 X a day along with the Clavamox. The initial treatment day was 7.5 Pred - 2X a day for only 3 doses.

Initially, pup was on Clindamycin, Buprenex, Metacam and who knows what else. The Clavamox/Pred meds worked much better, but I think pup was on it for a few weeks.

I had it a few years back. My notes say. 1 mg of pred per lb for pup. And Cephalexin 2x500 twice a day. My pups were about 5/8 weeks. Going through this. Keep on meds for 10 days it says. They all cleared up. Had 3, one more than the other two. That other stuff won't touch it. Jump on it and good luck.

Breeder too....Do you mean you gave your pup 1000 mg of Cephalexin 2 times a day ? In your post it says you gave your pup or pups Cephalexin 2 X 500 twice a day. That seems like alot of Cephalexin for a puppy. Do you mean 500 mg in the morning and 500 mg in the evening ?

Please keep in mind to also give the puppies while treating them (calcium and yogurt) The meds do deplete the calcium and kills good bacteria. About the dose ask the Vet. Calcium comes in a vitamin for dogs and are chewable.
What is going on with all the Strangles!? I think we might be over vaccinating our dogs but that's another thread for later on.

Well I had mine on Ceph. 250mg. 3x a day. I should have mentioned that I also had them on Nature's Farmacy Probiotics; both the Digestive Enzymes and the Immuno Gard as well as Phytoflex for their joints. As they got older I added Fish Oil to the mix. Occasionally a couple of pups vomited from all the meds and a fewx a couple puppies' eyes became very bloodshot and bulgy...that scared me. I assume that was from the steroid. Their growth was stunted without a doubt; some more so than others and their heads stopped growing which threw their bites off. They became a somewhat underbite with a crossbite too. Those bites over time have straightened out to almost perfect. Their bodies are still showing a hint from the long term Pred. I hope that will disappear too. The puppies turned 1 year May 6th. The Strangles cases last summer were off the charts on the east coast. It was similar to this summer's weather; very wet, sticky hot and loads of biting insects. I chose to have a winter litter because of what happened to my pups and all was well...same dam, different sire. There were no whelping issues with either litter.

Okay, take this for what it is worth and maybe there is no relationship at all:
I had mild strangles here in two summer litters. I also had some sort of staph infection that was systemic in a couple of puppies. In one litter, all the males had it.
For my last litter, I treated the puppies with Baycox for coccidia at three weeks, before they were started on solid food. I ALWAYS get coccidia in puppies and I always have to treat with Albon. This was by far the healthiest litter that I have had in a long time. I think coccidia which is so prevalent in puppies, really stresses the immune system and opens the door to some of these immune problems (strangles) that we see so often.

Please, please take your puppy to a vet. Do not follow the advice given by anonymous posters. People are recommending huge doses of antibiotics that I might use for an adult male dog but not as much corticosteroids as recommended in Blackwell's 5-Minute Veterinary Consult (often used by vets). Steroids have very powerful effects on the whole body, please don't double the dose without veterinary consult.

Please. Kate

And it makes sense Coccidia would be much more of an issue in the summer. I had NO intestinal problems with my winter litter and no Strangles. Last summer was my first Strangles experience and what a whopper it was! I did have pups with some vomiting at about 3 weeks and one in particular with off and on runny poop. Hmmmmm.

As I mentioned, I have taken the puppy to two different vets and plan to take him to a third tomorrow. I am not looking for anonymous posters to diagnose or treat my puppy. However he is worsening very quickly and something needs to be done about the swelling around his neck, because he doesn't want to swallow and is very uncomfortable.

Thank you to those of you who have shared your experiences, it has been helpful.

Let me restate that as the note says 2 ceph 500 give 2 times a day. That would mean 1 500 morning and 1 500 night and it came from a vet. I did not just make it up. The second time I had this years later, it started in the ears and I quickly did this and it did not go all over face. Was over quickly. But you do have to do Pred. others don't seem to touch it. And Ceph. for healing and scaring.

I did email Kristin a private email but in short I did say....strangles does get worse even with treatment till it reverses.

If you are worried, take your puppy to a veterinary specialty vet today. 5-minute Vet Consult says that juvenile cellulitis (strangles) is an immune dysfunction with a heritable cause suspected. 5-minute Vet Consult recommends aggressive treatment with steroids for at least 2 weeks with a very slow taper for several weeks. Antibiotics are used if there is evidence of secondary bacterial infection or as an adjunct therapy with immunosuppressive doses of steroids.

Kristin,

I would strongly recommend making an appointment with a veterinary dermatologist. They deal with cases like your puppy's on a daily basis. The Vet Derm will have the most current protocal for treatment of the pups condition. Best of luck! Please let us know how you make out....

I am sure like very where else in America no vet will be open today, especially a specialist. the only thing she will find is an ER vet who will not have a clue how to deal with strangles.

keep up with the prescribed treatment, make sure the pup is drinking fluids or SQ. Get into your vet first thing in the morning, once it gets in the neck it can become deadly..."strangles"

Maybe I am just lucky, but I have three veterinary specialty hospitals within an hour of me. All are open on Memorial Day as well as providing nighttime services. True, often they are staffed by general vets outside regular business hours, but all the vets can consult the specialists and one hospital has vets trained specially in emergency medicine.

If you are really worried, why not call the veterinary specialty hospitals in your area to see what the staff knows about treating strangles. Advanced strangles qualifies as an emergency, and for those who do not know how to treat strangles, they can read the 5-Minute Vet Consult or the Merck Manual.

How is your little guy today?

Yes please let us know how puppy is doing?

Dear Kristen,

So sorry for your strangles. I had a puppy with them a year ago...my Vet diagnosed immediately. In my situation, puppy was fine in the morning and when I went home at lunch was not well and I ran her in. I'm happy to say she's over a year now and no lasting effects post treatment. I will say that it is not very common and if a Vet doesn't have breeder clients, they may have never seen it before.

My Vet is a breeder-Vet and has seen it quite a few times. Yes, treatment is Clavamox & pred, but they may need a shot to begin and then pred is given for a total of about 10-14 days starting with a higher dosage and weaning down. Feel free to call me if you want my Vet's info or whatever...

Best,

Leslee Pope
Huntcrest

Listen to Leslee. She's right on.

In my experience, if you catch it soon enough and start treatment immediately, there may be no scaring at all. The catching it soon enough part means noticing swelling in the area of their cheeks (glands). The trick is convincing a vet that your pup actually has strangles. Most have never seen it and have no idea how to treat it.

I think "catching it" is actually before the glands start swelling. I was able to see the earliest signs after learning from the first puppy that came down with it. The tiny little pinpoint pimple that begins to enlarge each day is the earliest sign and it could be just one pimple that begins on an eyelid, near the nose,lip, or inside the ear flap...or a slight red rash inside the ear flap could be an early warning sign. This could linger for a couple to a few weeks before BAM!...the full blown Strangles hits. If you start antibiotics at that very first sign of a pimple, or rash and keep them up for even a few weeks Strangles can be avoided. It worked with one puppy! No Pred. was needed with him. I think once the neck glands have swelled and the pup is lethargic, the pup and you are in for a rough ride. IMO from my experience. Each situation can be very different. I agree that Leslie had good advice.

I guess you must believe that Strangles is primarily a bacterial infection. From what others have written, I presume some vets are treating the puppies as if they have a very bad bacterial infection and giving large doses of broad-spectrum antibiotics, such as Clavamox.

Surely this is an effective strategy for any bacterial infection that develops secondary to the Strangles. But all the things I read suggest that Strangles is first an immune system dysfunction.

Corticosteroids at very high doses seem to be the leading recommendation for dealing with the immune system issue. The 5-minute Vet Consult actually recommends 2.2 mg for every kilogram of weight of the puppy (divided twice daily) for at least two weeks, a startlingly large dose for one so small, and then a long taper.

In fact, it appears that Kristen's first vet must not haved recognize the puppy Strangles, giving primarily an antibiotic, and the second vet recommended a much lower dose of steroids than recommended by the Vet Consult. I sure can understand why the dose of steroids recommended would give any vet pause, but the Vet Consult does says that aggressive early treatment with high doses of steroids to avoid scarring.

From what I observed with my litter I believe something bacterial came into contact with the puppies first. I am aware this is an immune system dysfunction, but I think something either bacterial, viral, or perhaps even stress from being too hot (a "perfect storm") puts the puppy's immune system into overdrive. It happens most often after vaccines from what I understand, but one of mine became ill 3 weeks before and the other 5 a few days to 2 weeks after the first vaccine. I really hemmed and hawed about doing the vaccines on the seemingly well pups. It was a gamble and they lost. If the puppy has a predisposition to it either by heredity, or just a slower to mature immune system, then I think that's when Strangles occurs, but I firmly believe the pup's immune system is struggling to fight off a germ of some kind. That is my opinion and there are no clear answers. From my experience one puppy started early with the Ceph. and kept on it for a few weeks did NOT develop the Strangles. He had a pimple on his eyelid as did the others when they started, but he left the litter and was kept on the Ceph. only, and after a few weeks the pimple just faded away and no Strangles. His Ceph. was started at the very first miniscule sign of a pimple. Once the signs are more obvious such as Kristen's puppy the Prednisone is a must. The puppy was well into the illness and her vet missed the boat on that one unfortunately. Mine did too. I have learned more than I wanted to know about Strangles and if it weren't for breeder friends and this forum I would have lost it. Kate, I think you need to be more open to others' points of view. Even so called experts don't agree on what causes Strangles.

Sorry I can't take any credit for the recommendations. I'm just telling you what I read in the vet resource manuals I have, and they pretty much all agreed with the 5-Minute Vet Consult stuff that I posted.

I have no experience treating strangles. Sounds like you have a lot--for an uncommon disease--but you post anonymously so I don't know much about your expertise other than your anonymous posts. I'd love to read any of the sources you have found for treating strangles as you describe. Who knows when I may need the information that is not in the books I have available.

There is a huge amount of veterinary information available online. Below is a quote from the American Canine Association, Inc., which is a veterinary health tracking organization:


"Puppy strangles (Juvenile cellulitis) is a misnamed disease suggesting respiratory difficulty. The term cellulitis more appropriately describes the condition. Usually puppies contract the condition early from 4 weeks to 4 months of age. There is no predisposition to breed or gender. Not all puppies are affected in the litter, but the entire litter can be involved. Early signs include redness around the outside of the ear associated with edema (fluid under the skin). The disease quickly progresses to ulcerations of the skin and deep tissues around the ear, followed by draining tracts that can extend into the adjacent lymph nodes of the face and upper neck.
The cause of the disease is open. Historically, a bacteria has been suspected, in particular streptococcus species. However, bacterial cultures never confirm any bacterial infection. Antibiotic therapy alone is ineffective and helps to rule out a bacterial cause. More recently, immune reactions have been suspected. Research suggests a hypersensitivity reaction possibly to a previously eliminated bacteria. More importantly, the disease seems to respond to immunosuppressive therapy with consistency.
Treatment for strangles consists of support by keeping the areas clean and dry with diluted hydrogen peroxide and astringent (Burow¹s solution) washes several times a day. Additionally, oral corticosteroids are used for 1-3 weeks on a reducing schedule. Oral antibiotics are frequently prescribed over 2 weeks for ancillary therapy. The course of the disease is usually less than 2 weeks but can last 4-6 weeks on more severe cases. The prognosis is usually very good but some pups may require special nursing to insure adequate hydration and nutrition."

I have to say I treated the puppy that recovered without full blown under my own direction. Did I experiment...in a word, "yes". I felt it was worth trying. Wish I had just put them all on the Ceph. at the first sign from that first puppy and kept them all on it until after at least the first vaccine. Who knows, maybe they all would have dodged the bullet. I can't call myself an expert, but being thrown into so many with it at once sure made me have a working knowledge of it...one I care not to repeat. After reading about the different opinions from various sources(on the internet, some overseas breeders and different breeds too) and how most believe it to be an overreaction to a bacteria, I figured why not see what keeping this pup on the antibiotic(250mg. 3x a day) will do? All I can say is it worked. I know one source I read up on was a Sheltie hit very hard and wouldn't get better. I believe that case was in England. I will try to dig up and find the articles.