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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 35490
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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We are looking forward a second opinion, our puppy has come

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Hello, we are looking forward a second opinion, our puppy has come out in sore around his face and him glands around his neck are very big. Our vet is unable to identify the problem and wondered if you could help?
Customer: replied 3 months ago.
He has a couple of sores on his nose that are oozing and bleeding, around his mouth he has bumps on the lips. He is fine in himself eating and drinking. It would be best to send you pictures, is there a way o can do this?
Customer: replied 3 months ago.
I have added some photos
Customer: replied 3 months ago.
Sorry another photo too

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Holly, I'm sorry that your question wasn't answered in a timely manner. Thank you for the photos. The confluence of lymphadenopathy (swollen lymph nodes) and "sores" about the face strongly suggest puppy pyoderma (puppy strangles, juvenile cellulitis) which is a sterile skin disease of the face, pinnae (ear flaps), and submandibular lymph nodes primarily affecting dogs less than 4 months of age. Treatment consists of early and intensive immunosuppressive systemic therapy with prednisolone or dexamethasone to prevent secondary scarring. Concurrent systemic antibiotics are recommended if secondary pyoderma (bacterial skin infection) is found cytologically or marked fistulation is present. Feel free to share our conversation with your vet. Please respond with further questions or concerns if you wish.

Customer: replied 3 months ago.
Thank you for you response. Our vet has mentioned Alabama rot and said it’s something to be aware of? Have you seen this before? We have obviously gone into panick mode. She also mentioned puppy strangles but said they Usually have more sores in the face but she has only even seen one episode. He is currently taking antibiotics.

It sounds as if your vet is on the ball. Yes, it would be a mild case of strangles but nonetheless should be treated with a steroid such as prednisolone. Alabama Rot is a hemolytic (red blood cell breakdown)-uremic (kidney failure) syndrome whose initial symptoms are skin lesions on the legs, chest and abdomen followed by renal involvement. Please respond with further questions or concerns if you wish.

Customer: replied 3 months ago.
We did do a full blood test the other day and his kidneys were clean but showed signs of slight anemia.. could this be related to puppy strangles. He is full of energy in himself, eating and drinking and running around. Ah yes she has been good just difficult as she has been unable to confirm what it is

Mild anemia isn't unusual in puppies and not expected with uncomplicated strangles. The diagnosis of strangles is usually done visually recognizing the age and presentation of my patient. Confirmation would require cytology and skin biopsy which is rarely needed in these cases. A positive response to a steroid can be confirmatory. Please continue on in our conversation if you wish.

Customer: replied 3 months ago.
That’s great! Thank you much, it defiantly puts our mind at ease. Are steroid ok for puppies to have? We have been provided with piriton will this help?
Customer: replied 3 months ago.
What is it that causes puppy strangles? He has a plastic slow feeder and we wonder if that’s caused any of this?

Yes, when prescribed prudently. An antihistamine such as Piriton isn't indicated. Strangles may have a hereditary component. There's no evidence that it's of an allergic etiology but appears to be immune-mediated (over-excited immune system) such as an allergy.

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Customer: replied 3 months ago.
Perfect thank you so much for your help. We are due to take him back to the vets tomorrow, so will ask to start the steroids, she did mention, but wanted to see how the antibiotics went first. Hopefully he will be free from this very soon.

It's my pleasure. Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.