Puppy Strangles or Juvenile Pyoderma
Thank you very much, Debbie Brussaard, for letting us reprint
your article on Juvenile Pyoderma. We believe it would be of
big help to many breeders, no matter which (dog)breeds they
Thank you Anette & Christian, for letting us use youre
picture of Chi-Meiling.
1998 and much to my regret I have become familiar with the illness
Puppy Strangles, or as it is known officially Juvenile
Pyoderma. For the sake of ease I will use the abbreviation
PS in the rest of this essay. On August 20, 1998 Gwendy had
6 healthy puppies: 3 bitches and 3 dogs. Everything went very
well and nothing warned me for what happened a couple of weeks
later with one of the puppies.
picture was taken on September 20th.
As you see, this was a beautiful and healthy puppy. This would
This is the story of Ezra, a little sable Sheltie-lady, in whose
body suddenly everything went wrong.
20-09-98: It looks like Ezra was stung by an insect in her
left upper-eyelid. In the evening, the lower eyelid swells enormously
as well. This is definitely not caused by an insect!
27-09-98: The left eye is infected and full of pus. Because
my own vet is on vacation, I called his substitute to ask whether
I may use Terramycin on such a young puppy. This is affirmed.
28-09-98: Terramycin doesnt help and the right eye is
becoming infected as well. Ezras behavior changes drastically:
She is phlegmatic and sick. Called the vet who tells me to come
by. Against my better judgment I take Ezra. In my opinion she
is too young and too sick to take her outside, but I have no
choice. Because Ezra is too ill for a normal eye
infection, I suspect that she has contracted PS. She eats well,
but has diarrhea and dark urine. I informed the vet of my suspicion,
but he has never heard of it!!
I return home disappointed and a little angry, armed with only
29-09-98: Ezras condition is deteriorating rapidly. Called
a fellow breeder. He came by the same afternoon and confirms
my suspicion. Called the vet, who reacts a little annoyed. Its
clear he does not like it that I have come to my own diagnosis.
He tells me to come by again so he can see it for himself. When
he sees Ezra, he proposes to put the her out of her misery!!!!
After a lot of talk, he agrees to help and orders Antirobe for
30-09-98: Ezras condition deteriorates further. She has
acute diarrhea, pimples on her lips, around her nose and on
her chin. Called the vet to ask when the medicine is due: tomorrow!
Took Ezra to the practice again and on my explicit wish, the
vet gives Ezra a shot of antibiotics (equal to Antirobe) to
counter the diarrhea and to tamper the possible PS. Ezra still
eats well. Her temperature is 38,5 degrees.
The diarrhea is gone, but Ezra is still very sick. I clean her
eyes with boiled water every hour, but the flow of pus only
seems to grow. She cant open her eyes despite the Vaseline
I put on her eyelids. Her left ear is starting to get infected.
Finally the medicine arrives. Ezra should take 1 capsule of
Antirobe per day for the next 16 days.
02-10-98: Ezra is really very ill and the pus is flowing from
her eyes. Her ear is now very swollen, red and dirty.
03-10-98: It looks like Ezra is shaping up somewhat: Her behavior
is becoming more normal. The eyes look better, but there is
still a lot of pus.
04-10-98: Behavior is becoming better. In the afternoon, I
find a swelling in the left part of her neck: A swollen lymph
In the evening this is joined by a swollen one on the right.
The eyes look somewhat better.
05-10-98: The swellings in the neck look somewhat smaller.
The pimple on the chin looks likes its drying up and the
others look less infected. She was even able to open her eyes
this morning. Her behavior keeps on improving: She even looks
06-10-98: The swellings in the neck are clearly present again.
Additionally Ezras vulva is swollen and in her right lower
belly, another swelling appears. The eyes still look quite good,
but she is getting more phlegmatic again.
The right ear is now infected as well and both ears look dirty.
The pimples around nose and lips have grown and look fiery.
The vulva is still swollen. Two large swellings on either side
of the neck and one on the belly. I de-wormed Ezra today. Worms
are the last things she needs now. In the afternoon I took Ezra
to the vet for an examination. It took me a lot of trouble to
convince the vet to administer Prednisolon.
He rather sees her go to the specialized clinic in Utrecht and
again proposes to put the puppy out of her misery. Got a 21-day
Prednisolon program in the end. Once home, found a new swelling
on her breast between the front paws. The pimple on the chin
has grown to double its original size. Ezra is improving what
her behavior is concerned. She eats well, she weighs 1755 grams
and her droppings and urine look normal.
08-10-98: Ezra is exactly 7 weeks old today. We are halfway
through the Antirobe and in the second day of the Prednisolon.
I start giving Ezra warm baths to counter the pimples faster
(tip from a Finnish breeder). In the evening, the pimples in
her neck have decreased in size. Her eyes and ears look good:
She even has a couple of eyelashes left.
09-10-98: Constipation!! Ezra has great pains in trying to
relieve herself, even though nothing happens to this extent.
Gave her an enema of 5ml Microlax, but this doesnt help.
The left ear is very dirty. The right ear is clean and looks
good. The eyes are reasonably clean but am continuing the balm
treatment. The swelling on the breast is bigger and harder,
just like the swelling on the belly. Found a new one on the
right flank and one next to the larynx. The swelling in the
neck has disappeared. The lips are now fully swollen and red.
Pimples on the chin are unchanged; Those around the nose are
fiery and swollen. Ezras temperature is 37,9 and thank
goodness my own vet has returned from vacation!! He pays a house
call: The left ear is literally full. The constipation is caused
by the antibiotics; a few licks daily of paraffin should help.
Absolutely no bathing! This causes the skin to remain wet for
too long. I may try this in the case of multiple open abscesses,
but not yet. The Prednisolon program is extended to 5 weeks
as follows: first week full dose, 2 weeks half dose (half a
tablet per day), last 2 week a quarter dose (half a tablet per
two days). My own vet is fully aware of the illness and is helping
me in the battle with and for Ezra! Im regaining confidence
10-10-98: Ezras temperature is 38,5 and has no new swellings.
Her existing swelling are however becoming bigger and bigger.
Her droppings are halfway normal, but she has problems getting
rid of it.
11-10-98: Ezra is not running a fever anymore and her droppings
are reasonable thanks to the paraffin. The eyes look fine, but
the ears are still full of pus. In the evening Ezra really took
a giant shit. No wonder she was in pain!
12-10-98: Called my vet: the swelling on the breast burst open.
His advice is to fiddle around with it as little as possible.
If the mother wants to take care of it, this is fine, but do
not clean it with corrosive (cleansing) substances. This wont
help and would only cause scars if the abscess closes up again.
I should keep in mind that swellings under the skin will burst
I ask if the Prednisolon has a negative influence on calcium
levels. This seems to be true, but it is useless to supplement
calcium. A new swelling on the breast appears and the one next
to the larynx is getting bigger. The swelling on the belly is
even bigger and has a soft top; this one wont be closed
much longer. In the afternoon, the opening in the abscess on
the breast has grown bigger and is losing more fluid. The swelling
between the shoulder blades has become ENORMOUS; micro-chipping
her was only just possible, as the skin has become very tight.
In the evening, a new, small swelling appears on the right side
of the neck.
13-10-98: Under the skin a large blood clod appears above the
swelling on the belly: will try to make it mature quicker with
camphor. I got Otifin P.D. gel from Apharmo for the ears. New
swellings on the left of the neck. Her temperature is 38,5.
14-10-98: The abscess on the belly has opened, the one on the
breast is starting to heal. Shaved the two swellings between
and to the right of the shoulder blades and treated them with
camphor balm. The ears are still very irritated, but less swollen
and dirty; Ezra now has an ear-complex. Stopped treating the
eyes with gel. They look fine (just like pig eyes). Temperament:
she is becoming happier by the day, plays more and is cheekier!
15-10-98: The lips and vulva look better, for the rest no change.
Decided together with my vet to extend the Antirobe treatment
for another 16 days. Ezra weighs 2,4 kilos.
16-10-98: Switching to a half a tablet of Prednisolon per day
for the next two weeks (until 30-10-98).
17-10-98: The abscess on the breast is almost closed, now the
skin has to follow suit (like the swelling on the belly). The
swellings on the shoulders are big and hard and cannot be moved.
The swelling next to the larynx is almost gone. The one on the
right side of the neck is hard, but not as big. The ears are
looking better, the eyes look fine! The lips look more appeased,
dried crusts on the chin. Excrements are fine, but Ill
administer the paraffin for the time being. The vulva looks
No new findings. She went into the garden for the first time
and loved it!
19-10-98: Abscesses between the shoulders and on the right
flank are becoming soft. I expect them to open one of these
days. The eyes are slightly irritated again (balm); the ears
are still going strong.
20-10-98: Found another big swelling on the left side of the
neck. A number of smaller swellings appear under the abscess
on the breast.
21-10-98: The abscess on the breast is open again. There is
a second small opening just under the original one. The abscess
on the belly has another bloodstain under the opening, which
has almost closed in the meantime. Everything is becoming very
painful for Ezra!
There is a new swelling between the anus and the vulva. The
three swellings on and between the shoulders are enormous and
still closed (Ezra cannot lie on her back anymore), will start
applying camphor balm twice per day to make the mature quicker.
The abscess on the belly has grown and opened again. On the
breast, the two holes have united into one big one, started
to apply camphor balm around and wound spray in the wound twice
a day. The ears are better, but the eyes remain irritated. Balm
twice per day. At 10.45 the swelling on the shoulders opens:
A LOT of pus. Try to push out as much as possible.
23-10-98: Swelling between the shoulders does not open further;
it remains a small hole. The ears and eyes are slowly getting
24-10-98: The swelling on the shoulder has closed already and
is starting to shrink. Will treat the eyes and ears with balm
only once a day.
25-10-98: Ezra looks like she is really shaping up, the swellings
are stablising. Stopped applying the camphor balm on the abscess
on the breast.
Ezra is stable and the eyes are looking better all the time:
also the connective tissue (eyes) is nice and pink. At 11.30
pm, the swelling on the right part of the shoulder bursts open
as well, again an enormous amount of pus. Pushed out as much
as possible again. It's clear that this is a relief for Ezra.
This is the start of the period of healing. Toned down the balm
treatment on eyes and ears according to intuition. Stopped the
camphor balm and the paraffin. Ezra is becoming fatter by the
day, but acts more normally by the day as well: cheeky and playful.
She goes outside a lot and plays a lot with her brothers and
sisters and the grown-up shelties. The last phase of the Prednisolon:
half a tablet on 01-11, 03-11, 05-11, 07-11, 09-11 and 11-11.
My vet will give Ezra her first shot on 16-11-98.
10-11-98: The abscess on the breast is gone, save for a little
crust. The eyes have fully recovered including hair, eyelashes
and pigment. The ears look fine, but are still a little dirty.
The lips are still a little crusty, but are healing nicely.
The swellings are small or have vanished.
16-11-98: My vet declares Ezra for 100% healthy!! She gets
a full shot, despite of her having missed the first two. She
is allowed to move to her new owners in 10 days. Having a mind
of my own, and also knowing how much her new owners want to
have her, she may go to the them on 22-11 on condition that
they regard Ezra as "quarantine-case" until 26-11:
they may not walk her where she can come into contact with other
dogs. Ezra looks beautiful! The abscess on her breast is just
a fine, pink line of approximately 1 cm, where hair is beginning
to grow again. The abscesses are almost gone and the lymph glands
are small and appeased. One needs to be careful in combing and
brushing as Ezra is still very sensitive. You can hardly recognize
the eye infections, the ears look great. The same goes for the
lips and nose. She weighs 4,5 kilos, which is too heavy for
her size. I dont really care about this: should she have
a lapse or contract some kind of virus, shell have enough
reserves to take care of that herself. Agreed with the new owners,
that they will put have Ezra on a diet by the time shes
6 months in case she hasnt become slimmer naturally (at
that time the Prednisolon has lost its effect). At the time
Ezra turned one year old, the new owners had X-rays taken to
check whether the Prednisolon has not harmed the bones (especially
the joints). Happily, everything looks fine and she may start
doing doggy-agility exercises J
On the picture you see Ezra on the left together with her half-sister
Jacky. Didnt she become a beautiful lady?
no damage is visible, except for a number of tiny scars where
she had open abscesses. Only someone who knows where to look
will notice a couple of small scars on the eyelids. For the
rest she became a great, beautiful lady. Also her seasons started
normal and at this moment (May 2000) she started agility. Hopefully
she will become as successful as her half-sister.
What is PS?
This is not easily explained, but in the course of things,
I have learned the essentials. Simply stated, the immune system
attacks the body. The Antirobe I wanted is a special antibiotic
against specific bacteria that cause the infections during PS.
With the benefit of perfect hindsight, I should have started
with the Prednisolon. This medicine sees to it that the bodys
immune system is suspended, which is of utter importance if
this system goes out of control.
How do you recognize if a puppy has PS?
The first signs can vary. During Ezras illness, I have
talked to a large number of breeders, who had encountered PS
as well (a number of puppies have been put to sleep because
the vet didnt know what it was!), but in most cases it
starts in the mucous membranes of ears, eyes, nose and lips.
This is not surprising, as these are visible.
Swollen lymph glands (in the neck, groin and around the anus)
could also be an indication of PS. I have learned from another
patient that it started with a persistent infection of the spinal
colon. In general, one can say that mysterious infections,
which do not seem to go away, can be an indication of PS.
How does the disease develop?
All kinds of infections appear throughout the body. The puppy
gets swellings like Ezra had in her neck. These are swollen
lymph glands. Swellings under the skin will often burst open,
causes a lot of pus to flow out. Some puppies had 24 abscesses,
which were interconnected by corridors under the skin. Looking
at it in this way, Ezra was lucky!! Genitalia tend to swell
and the noted infections to eyes, ears, nose and lips are visible.
What can you do?
, as you can conclude from my story: find a good
vet! Once you have him/her, you can get to work. If you start
by suspending the immune system quickly, the illness will be
milder. So start directly with a heavy dose of Prednisolon.
Apart from this an Antirobe treatment, as this has proven to
be the most effective antibiotic. Apart from this, you need
good medication for the eyes and ears etc., paraffin to keep
the bowel movement going. You may decide to use camphor balm
to rub on abscesses under the skin to make them mature quicker.
Wound spray may help to treat the open abscesses with. This
does not clean or disinfect, but does stimulate the healing
process and prevents large scars.
Myths about PS
PS is absolutely not contagious for other dogs. The illness
is caused by the bodys own immune system and not by bacteria
or viruses. The puppy is naturally more sensitive to these intruders,
but thats why he takes Antirobe. Its also important
to protect the puppy against secondary infections like worms.
PS is not caused by a lack of hygiene on the part of the breeder.
PS is not lethal, but it can take a lot of time and money to
cure the puppy. If you would leave a PS-infected puppy to his
own devices, it could at long last be overcome by exhaustion
and secondary infections, like worms.
Is PS hereditary?
Good question! In principle, the answer is no. There are however
known cases where an ex-PS patient had a litter where regretfully
a PS patient was present. Personally, I would not breed from
an ex-PS patient
Is PS widely known?
Regretfully no! There are breeders, whove been in the
business for 30-40 years and have never heard of it. The same
goes for vets. When Ezras owners took her to their own
vet and wanted to let him read my diary, this was
dismissed with statements like doesnt exist
and the breeder probably did not adhere to hygienic standards.
Sad, but true! Ezras owners immediately went to another
vet, who showed more interest and offered more help. He also
X-rayed Ezra to establish normal development.
If you ever encounter a puppy with PS I hope you will find
a good vet in time to help you and this puppy.
Because really, puppies with PS are really worth helping!!!
Translated from Dutch by Richard Wulff (Munich Germany) after
the 10 week old Labrador puppy Bibi contracted the
same disease. Also this vet had not heard of PS, but had a healthy
distrust in the diagnosed symptoms and sufficient personal courage
to do literature research and consult a colleague. The vet diagnosed
the illness within 24 hours of first contact and had her on
correct medication immediately after. THANKS, Dr. Hübner!!