| Puppy 
                    strangles (Juvenile cellulitis) is a misnamed disease suggesting 
                    respiratory difficulty. The term cellulitis more appropriately 
                    describes the condition. Pups begin to have noticeable skin 
                    trouble at about five weeks of age. One or more pups in a 
                    litter may be affected. What the veterinarian sees at examination 
                    is usually a well fed, otherwise healthy pup that has massively 
                    enlarged lymph nodes, swelling of the skin and often wet oozing 
                    sores. Marked swelling is usually most pronounced around the 
                    head and neck and the ears (pinnas) are thickened, scabs form 
                    and a thin fluid seeps from the pathologic tissues. In some 
                    cases the skin will crack open the swelling is so severe. 
                    The lymph nodes under the jaw (submandibular lymph nodes) 
                    become extremely swollen and painful and may actually drain 
                    to the skin surface. 
                    
                    
 Cultures of these open sores rarely indicate a bacterial component 
                    and newer research seems to point to an immune dysfunction 
                    as the root cause of the puppy’s uncomfortable medical condition. 
                    Since bacterial origins seldom play a role, administering 
                    antibiotics rarely has any effect on the condition. Instead, 
                    treatment with Prednisone, an cortisone-like drug, works very 
                    well if given in higher than usual doses for two weeks, then 
                    the dose is tapered off as the dog matures and the condition 
                    resolves. Sometimes dramatic improvement is noted after just 
                    a few doses of the Prednisone.
 
                    
 Therapy also entails routine cleaning of the skin and hydrotherapy 
                    where the pup is soaked in warm water with just a small amount 
                    of antiseptic added. If a particular case seems to have a 
                    secondary bacterial infection, which might be expected with 
                    such skin stress and exudative material present on the skin, 
                    antibiotics may be needed to assist resolution of the overall 
                    problem.
 
 Fluid therapy and Vitamin administration may be helpful for 
                    pups that are dehydrated and not eating well. And a high quality, 
                    meat-based diet is indispensable in helping the pup to recover 
                    from Juvenile Cellulitis. Almost all pups will recover but 
                    permanent scarring, lack of hair production and pigment changes 
                    can be a reminder of this nasty puppy skin disease.
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