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AFGHANS ARE US -HEALTH
Juvenile Pyoderma (Puppy Strangles)
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In any young puppy presenting with any noticable swelling of the lymph nodes
together with spots and pustular lesions about the face,JP should be
considered as a possible diagnosis. I have recently been told by a vet, who
has treated this condition, that the pustular lesions (like blisters) may
also be found on the body particularly the abdomen, the pads of the feet,
and the genitals and the anus. (Please note a puppy could have one small
unbroken pimple on an eyelid and it could be JP, check all of your puppies
eye rims closely)
If anyone cares to look at the 1981 AFGHAN HOUND YEAR BOOK there is specific
reference to research then being undertaken at the Cambridge Vet school on
this condition. At this time whilst MANY breeders WERE aware of this
disorder, little was known about WHY it happened and what treatments were
appropriate, indeed some puppies, severely affected were euthanised, others
less so severely affected, breeders thought the condition may be related to
proprietary milk products and adverse reaction on the part of the individual
puppy to such. (Hence Hazel mentioning the term frequently used "milk spots"
further down the page)
We have come a long way since then because we we are now more tuned into the
health problems that may result from the reactions of the IMMUNE system and
the implications, viz: This IS an IMMUNE RELATED DISORDER.,and as such must
be treated with appropriate Immune suppressive doses of corticosteroids
PROMPTLY! In addition , specific ANTIBIOTICs (not synolox) also to deal with
secondary infection from the lesions .Quite an aggressive approach is
necessary for a relatively short period and it would appear that most
puppies now do very well and make a good recovery with the minimum (or no)
scarring.
The use of an immunosuppressive medication must be undertaken with the
CORRECT dose being given, too little and it will NOT suppress the immune
system and the destruction will continue, too much and this can result in a
variety of other serious problems, particularly for a developing puppy.
The general doses that appear to be recommended are 2--- 4 mg of
prednisilone per kg body weight daily .
Still some owners/ breeders, and even some vets in practice may say they
know little about this disease. This is where the SHARING of information
amongst us as owners/breeders is so VERY relevant so that the Lines of
Communication" are available to help and assist in times of need....however
it is important that factual data and information to support any advice on
treatments is given and also in the relaying of personal experiences, to
avoid any confusion and misunderstanding.
Sylvia Evans
Juvenile Pyoderma / Cellulitis (often misleadingly termed "Puppy Strangles")
is a fairly common, but alarming disorder that can be seen in many breeds
including Afghan puppies from 3 weeks to 4 months of age. It appears
initially as acute swelling of the face, primarily of the lips, eyelids,
chin, and muzzle. It may easily be confused, early on, with a sudden
allergic reaction typical of a bee sting or a vaccine reaction. However,
untreated it can progress rapidly into bumps and pustules which drain and
scab. The lymph nodes under the neck may enlarge dramatically, which is what
precipitated the term "puppy strangles." Half of the cases are lethargic. Up
to one quarter of the cases may show fever, appetite loss, and joint pain.
The cause of Juvenile Pyoderma is unknown, although an immune basis is
postulated, because of the rapid response to immune-suppressive doses of
steroids. Early, aggressive steroid treatment is needed to avoid excessive
scar formation. If evidence of concurrent bacterial infection is present,
then antibiotics are indicated. It takes a great leap of faith, but the only
really good way to treat juvenile Pyoderma is with the use of
corticosteroids in combination with antibiotics. If corticosteroids are not
used early in this disease permanent scarring of the affected areas can
occur and if they are never used death is not uncommon. The swelling of the
lymph nodes cuts off the puppy's ability to breath, hence the common name of
"puppy strangles". In it's mildest form and before it became more understood
some people used to think of it as 'milk spots'. It could be only a single
pup from a litter or a whole litter that are affected.
It is really scary to use immunosuppressive medications in the face of what
appears to be a really severe infection but it is essential IF the condition
is in fact juvenile Pyoderma. Diagnosis of this can be confirmed by skin
biopsy but it is usually best for your vet to make an educated guess and
start treatment while waiting for biopsy reports and hope for the best if
the symptoms are severe, since biopsy results usually take a while to get
back.
Many vets want to try Synulox at the first signs of the problem, this
usually has proved to be a waste of valuable time on it's own and puppy
should be put onto a course of Prednisolone 2--4 mg per kilo bodyweight and
Ceohalexin 250mg half tablet twice daily. If the problem does not rapidly
respond to treatment or is a severe case then Antirobe 75mg one tablet twice
daily and Cephalexin 250mg half tablet twice daily. If the problem is severe
around the eyes Fulcithalmic cream can help soothe the eyes.
It is essential that hygiene and very good feeding are practised as poor
management could escalate the problem. The good news is that once
successfully treated a relapse is extremely unlikely. Although not thought
to be hereditary (unproven either way ) it is now considered by some vets
unwise to breed from a dog who has been affected. It is very advisable to
delay any innoculations after the condition has totally cleared up to
prevent any possible further complications. |
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Showing puppy's head swollen and sticky eyes |
Clearly showing the pustles around the face |
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Showing the pustles around the eyes |
I am delighted to say these puppies made
a total recovery and went on to win well in the showring. What a
lovely Afghan:-)
Many thanks to all the caring owners of the puppies shown and for
their case histories. |
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 Showing
hair loss and small pimples |
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CASE HISTORIES
Puppy 1 case history
Very healthy puppy, birth weight 1lb 2 1/2 oz who did very well up until 7
weeks. Developed two small spots on eye lid and was taken to vet for check
up. Put on Synulox for one week but condition was worsening rapidly and
spreading to lips. At 8 weeks was put onto Prednisolone 5mg 1/2 tablet once
daily and ceohalexin 250mg 1/2 tablet twice daily, condition not improving
quickly and pup's lips and eyes very swollen and sore and glands swelling
but pup seemed happy throughout. Medication changed to Antirobe 75mg 1
tablet twice daily and continued with the Cephalexin as before.
1 week later although glands still very swollen the spots were lessening and
pup was put back onto Prednisolone along with the Antirobe and Cephalexin,
Puppy began to make rapid progress and left for new home aged 10 weeks and 5
days fully recovered armed with a full progress chart for the new owners
vet. There was no scarring. Innoculation was delayed until puppy was totally
cleared, this pup was never bred from.
Hazel Cranham
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sorry but not very clear -
starting round lips |
Showing bottom lips badly affected |
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 Becoming worse - Pustles forming |
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Puppy 2 case history
Healthy puppy birth weight 15oz at 6 weeks. She was from a litter of 10 pups
with 2 affected. A small pimple type spot appeared on one upper eye rim and
hint of others on the lower rim (puppy milk spots?) vet suspected early
Pyoderma and a skin biopsy was taken confirmed our suspicion, pup had a
short course of Prednisolone, puppy never appeared ill and there were no
further developments. Inoculation was delayed until 12 weeks to be on the
safe side. This pup later did a lot of winning but was never bred from, a
sibling produced a single Pyoderma pup from an otherwise healthy litter.
Hazel Cranham |
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 One confirmed JP spot |
 Hint of others coming-due to early treatment they didn't develop further |
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Puppy 3 case history
Healthy puppy birth weight 1lb 5oz did extremely well up until 6 weeks when
a small spot appeared on eyelid, was thought to have been a scratch from a
puppy nail and vet was treating as such. Eyes worsened rapidly and pup was
on Synulox and eye cream, by eight weeks puppy was covered on it's face with
open sores and antibiotics were changed, owner very worried, pups head was
becoming very swollen. Puppy was still being treated for infection and
swelling was so bad in glands that the puppy was very close to death at this
point as pup was having severe breathing difficulties, stud dogs owner told
the breeder to ask the vet if it could be puppy strangles! treatment was
immediately changed to Prednisolone and Antirobe and puppies health started
to improve dramatically. Puppy left home at 3 months continued a further
weeks treatment from new owners vet fully armed with all the relevant
information. Inoculation was delayed until the condition was totally
cleared. There was no scarring and this pup later became a multiple BIS
winner but was never used at stud. This was the only puppy in a litter of 11
to be affected.Hazel Cranham |
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 Showing first tiny pimples appearing around the eyes |
 Closer view of the nose and pustles appearing on his muzzle |
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A very sick puppy - showing the foreface becoming affected and head starting
to swell as his glands became very swollen |
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Puppy 4 case history
Jared was born at the beginning of November 1996, one of a litter of eight
puppies - 6 boys, 2 girls. The birth was easy with no stress for Emma, the
mother, at all and she doted on the pups as soon as they were born. All were
normal births and normal weight for afghans - Jared was the third puppy to
be born and he weighed 18 oz.
All went well with the litter with no problems at all until they were
approaching six weeks of age and I went into them on that particular morning
and was horrified to see Jared with a swollen face and a rash on his muzzle.
There had been no sign of anything untoward until then, no spots or pimples
- they had been checked by me every day, played with constantly, several
visitors and potential owners came to look at the litter, and at no time did
he look any different to the others.
I had vaguely heard of juvenile pyoderma but had no real idea what it looked
like and my first reaction was to burst into tears as I thought he was
dying! Fortunately for me, at that very moment a friend visited whose mother
was Beryl Formstone whom some of you will remember for showing afghans in
the 70’s and 80’s. Beryl was then into dachshunds, and the minute Steve saw
Jared he rang his mother. She confirmed instantly that it was JP, she knew
of several people in dachshunds who had had the problem and instructed me to
get to the vets instantly and insist the vet put him on Antirobe immediately
as no other antibiotic dealt with the problem as effectively - Synulox
doesn’t touch it!
I instantly took him to the vets - our vet, Richard, had almost no knowledge
of JP but was more than willing to go along with the information given me by
Beryl and Jared was put onto Antirobe and Prednisolone. Unfortunately before
long the swelling had spread to his eyes and ears - the eyes streaming with
discharge and the ears so swollen they appeared almost totally blocked. It
was an exceedingly worrying time as gradually every gland in his body
swelled before finally reacting to the various treatments he was having. In
fact he looked at that time more like a shar pei than an afghan. His face
was bathed three times a day and this had to be fairly hard to remove the
crusting of the sores and Panalog ointment then applied, he had Lincocin
drops for his eyes and Canaural for his ears - but throughout all this he
never once complained and carried on eating and playing absolutely normally.
Rather than keep him separated from his siblings I was told to keep him with
them unless he showed signs of distress - which he never did. None of the
other pups ever showed any signs of the disease.
He carried on with the various prescriptions for almost two months, weaning
gradually off all of them, though he had a blip during this time (when his
penile glands swelled up) and briefly he went back onto two Antirobe a day.
Once he had been declared fit Richard felt he could be safely vaccinated and
his course of vaccinations started. He was never able to be socialised until
well after he was eighteen weeks and we felt he missed out on this. He was
shown with success once he was six months old with only the very faintest
scarring on his muzzle which with age has disappeared.
The only sign of anything being slightly wrong is that his tear ducts do
weep occasionally, and I believe that can be a consequence of JP. When he
was declared fit and well by our vet he did warn us that he may suffer later
in life, but at the time I was so pleased that he had recovered so well I
completely forgot to ask Richard what might happen!
Needless to say he has never been bred from for although it isn’t proven to
be hereditary we didn’t want to take the risk of it possibly being so. Jared
is now 10 - and lately he has been having problems with a rash on his tummy.
This could be an allergy to heat or grass but it is just a possibility that
this is what Richard meant as a potential problem as our current vet does
feel that as JP is an auto immune disease his system could be compromised,
hence the rash now.
Di Searle (Salamkhan) - 06-01-07
Puppy 5 case history
Text book birth and all puppies fit and well. Bitch and puppies checked by
vet at six days who commented we had a nice healthy even litter all weighing
within 100gms of each other. Bitch developed a slight touch of Mastitis in
one teat at fourteen days and she was given a Synulox injection and a course
of tablets. Initially this appeared to clear up but after ten days the
dosage was increased. I mention this because this did not really clear until
the pups were fully weaned at around six weeks, so therefore all pups were
getting a low dose of Synulox from early on through bitches milk.
At four weeks of age I noticed a small mark on one of the pups lower right
eye lids, no more than the size of a pinhead. The next morning, Sunday she
had a small amount of rubbish in the corner of this eye, I assumed the
little mark was maybe a blocked tear duct which had cleared and thought no
more of it. During the course of the day the top eyelid began to swell and
by the next morning, Monday, the whole eye was completely closed and the
other eye was beginning to puff up, she also now had one neck gland slightly
swollen. Puppy taken to see vet number one that afternoon who diagnosed an
eye infection and that the swelling in her neck gland was just her immune
system kicking in, she also had a slight temperature. Fulcithalmic eye
ointment was prescribed to be applied twice daily to both eyes. I would like
to point out that at this stage I did ask if this could be a Pyoderma puppy
but somehow she managed to carry on talking and not answer the question. I
do not know why to this day I connected the two as this was something I had
only read about in one of my books. I had not heard of it and I certainly
had no experience of it or tiny puppies in general come to that as this was
my first litter. I wish now I had pushed for an answer and as they say
hindsight is a wonderful thing. Appointment was made to check puppy Friday.
Wednesday puppy was not making any progress, both neck glands were up and
both eyes swollen so much that she could hardly open them. I understand now
this to be classic text book signs. Her eyes were obviously very painful as
she fought me each time I had to pry them open to apply the ointment. I had
taken to bathing them several times a day with cooled boiled water as they
were stuck together more often than not. I decided I could not wait until
Friday so took first available appointment that day. Saw vet number two,
senior partner who decided she needed some antibiotics so prescribed a
course of Synulox and to carry on with the ointment. I did not mention
Pyoderma to her because I thought she surely must know an eye infection when
she sees one!
Friday morning she was obviously getting worse, her whole head was now
beginning to swell along with the neck glands and the tell tale pustules
where on her lips and chin. I was now convinced this could not be an eye
infection and started to ring a few Afghan friends seeking advice. One good
friend came up with a horror story of a Pyoderma puppy she had bred years
ago and I was now positive that this was indeed what I was dealing with. A
few more calls and I was given the name of someone who had had a Pyoderma
puppy some months previous and could give me the help I needed,
unfortunately she was not in so I was unable to speak to her until after our
next vets appt. Saw vet number two again and I knew by now that if this was
indeed a Pyoderma puppy she required specific Steroids and antibiotics
quickly as we had already wasted best part of a week. So tongue in cheek
baring in mind this was a senior partner I put the puppy on the table and
declared " If this is not a Pyoderma puppy then what is it because it
couldn't just be an eye infection ? ". I was some what surprised when she
declared she did not know much about Pyoderma puppies and proceeded to check
the Internet. I explained I knew we needed specific Antibiotics and a
Steroid in high doses but couldn't get hold of the one person who could give
me the information. I know you don't just give any old Steroids so on her
suggestion puppy was given a non Steroidal anti-inflammatory injection to
help her in the mean time until I could contact this person. The surgery was
closed over the weekend and vet number two was off anyway so an appointment
was made to see her on Monday. I was assured that if I needed anyone over
the weekend that the vet hospital was open and she would email them so they
were aware what was going on. That evening I had all the information I
needed for her treatment in just one phone call.
Saturday morning came and when she banged her chin and it started to ooze
blood I decided not to wait for Monday and contacted the vet hospital for an
appointment. Vet two had emailed as promised and they had all the details.
The nurse when requested checked that the drugs I required where all
available in the pharmacy and so off we went. Vet number three was seen who
turned out to be an arrogant young man, he led me to believe he had seen
Pyoderma in a Retriever, had heard of it in Boxers and Westies but never in
Afghans ! He gave me the Steroids I wanted but refused to change the
antibiotics, he told me to trust him he was the vet and I would see a change
in a couple of days, he even joked that I could smack his backside if he was
wrong. So she was still on Synulox. My husband will tell you he had to
practically drag me from the surgery and it's not that young mans backside
I'd now like to smack!
Monday morning puppy was still no better so I rang and asked to speak to vet
Number two who at least took me seriously. She rang me straight back and I
told her what had happened and the puppy was still very sick and that if she
was not prepared to give me the antibiotics I wanted she was wasting my time
and I hers and I would go elsewhere. She obviously realised I meant business
and said she would work out the correct dosage for the puppies weight and
they would be ready for me to collect at the appointment already made for
later that day. She even agreed to just check with her vet school that
nothing had changed treatment wise over the last few months.
MEDICATION
Antirobe one 75mg capsule twice a day for five weeks
Rilexine one and three quarters of a 75mg tablet twice a day for two weeks
Rilexine half a 300mg tablet twice a day for remaining three weeks
Prednisolone one 5mg tablet once a day for one week
" " one and a half once a day for one week
" " one once a day for a five days
" " half once a day for five days
" " Quarter once a day for five days
" " Quarter once every other day
Once on the correct treatment it was very straight forward and all she has
to show is a slight bald patch on the end of her nose and slightly watery
eyes occasionally. She was kept with her siblings as far as possible and was
just rescued when it got a bit too boisterous for her, obviously her head
and face were very sore but she would have been more upset by being
segregated.. Jabs were delayed a month to let her immune system recover from
the Steroids. She was having lots of Goats milk which lined her stomach as I
understand this can be damaged with the medication. Since my experience I
have spoken to many people and it would seem it is very common and has been
around for many years not only in Afghans but in all sorts of breeds. Not
long ago at ring training a lady told me she had lost two Westies out of
several in a Pyoderma litter because the vet did not realise what he was
dealing with and she herself did not know at the time. It took me five
visits and three vets to get my puppy the right treatment so my advise would
be if you think you are right argue your case. It might also be worth asking
your vet what they know about Pyoderma puppies when you take your bitch to
be checked over before you mate her, you might not get the answer you want
to hear!
Liz Floyd - 09-01-07
Updated 25-06-09
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