Juvenile cellulitis, also called juvenile pyoderma, puppy strangles, juvenile sterile granulomatous dermatitis and lymphadenitis) is an uncommon disorder of the face, pinnae, and submandibular lymph nodes, usually in puppies. The condition is presumed to be immune-mediated based on histopathological features and response to immunosuppressive forms of therapy. A heritable nature has been suggested. Dachshunds, Golden Retrievers, yellow Labrador Retrievers, Gordon Setters, Lhasa Apsos, and Pointers are most commonly affected, but any other breed can have this disease. Most affected animals are less than 4 months old, but occasionally the disorder is reported in adults. Several puppies or only one in the litter may be affected. Signs are characterized by vesicles or pustules in the inner surface of the outer ear, on the muzzle, lips, and eyelids which rapidly progresses to extensive facial swelling, abscesses and draining lesions. Occasionally lymph nodes will abscess and drain. A few cases will develop nodules over the trunk, penis and anus areas due to a panniculitis. Puppies usually have fever, are depressed and lose appetite. Permanent areas of alopecia and scarring may result if the lesions are extensive.
Diagnosis is based on history, clinical signs, cytologic examination of draining inflammatory fluid, skin biopsy, and response to therapy. Skin scrapings are performed to rule out demodicosis. Bacterial cultures sometimes reveal organisms, although they are secondary infection. Although juvenile cellulitis has many clinical similarities to pyoderma, it responds to corticosteroid therapy. Antibiotics are used to treat secondary infection. Treatment with bactericidal antibiotics (cephalexin, cephadroxil) and immunosuppressive doses of corticosteroids (prednisolone) is required for several weeks. Once lesions have resolved, the dose is slowly reduced to an alternate day schedule to prevent relapses. The condition usually resolves completely, with little chance of recurrence. Owners should be prepared for scarring which may be permanent.
- Nesbitt G.E. & Ackerman L.J. Canine Immune-Mediated Skin Diseases. In: Canine and Feline Dermatology: Diagnosis and Treatment. Veterinary Learning Systems, Trenton, New Jersey