My 13 week old Lab puppy was first diagnosed with a Staph infection in his ears about 10 days ago, and then started to present lameness (wouldn’t walk) and Hypertrophic Osteodystrophy (HOD) was added to the diagnosis. At this point he was prescribed antibiotics for the infection, and Non-steroid anti inflammatory for his joints, and Tramadol for the pain. This seemed to resolve the lameness, but the ear infection persisted. After about three days of this, he started to present swollen lymph nodes and a few bumps on his muzzle and lips and back to the vet we went, and they added Puppy Strangles to the list of diagnoses and stopped the anti-inflammatory and started 5mg of Prednisone once per day for my 21 lb puppy. After three days of this, there was no improvement on the ears, and the bumps around the lips and muzzle were a little worse, so back to the vet we went. This visit resulted in an increase to 20mg per day of the Prednisone and that was Monday. It is now Wednesday, and there is still no noticeable improvement in the ears and the lips and muzzle may be slightly worse, but certainly no better. At this point I think we have really been dealing with Puppy Strangles all along because it is the only diagnosis of the three that has ear bumps, face bumps, and lameness as symptoms. If there is no improvement by tomorrow, we will be back at the vet and they are planning to increase the Prednisone dosage. Another fact that also supports the Puppy Strangles, is that my puppy's sister from the same litter, was also diagnosed with Puppy Strangles the same day we were at the vet the first time. Her lameness was only slight, but the bumps on the face were much worse than our puppy, and she also had the same bumps in the ears.
Can anyone think of anything we haven’t done or have any suggestions at this point?
Additional information on the tests that have been done:
Cytology was done on the ears and it was positive for Staph (i think this is a secondary infection that came after the bumps, and not the cause of the bumps.
Ears tested negative for ear mites
Test for Lyme came back negative
X-Rays were takes and sent to a specialist for review and they indicated HOD
An ultrasound of the stomach was done early on because an x-ray take at two different times showed what looked like a "back-up" of gas in the stomach that could've indicated a blockage. The ultrasound was normal and it was assumed the gas was caused by the antibiotic.
Additional information on the puppy:
The breeder is a new breeder, but the female has a pretty good pedigree and is from a reputable breeder in Buffalo New York, and the father, has an extremely good pedigree is from a very well know breeder here in Texas.
I have read that one possible long term side effect of Prednisone could be hip dysplasia, and I have read somewhere that we should give Glucosamine to help with this. Does anyone know of a reason why we should do this?
Hi Sam.. very sorry to read of your puppy and what is going on. I can pretty much guarantee you what your puppy has is ONLY puppy strangles. Puppy Strangles is not fully understood and we can only hypothesize where and how it forms. What you are describing is many times exactly how it presents itself and in the order of presentation. Sometimes you will find a puppy that has very red ears, are quite swollen and start to present puss in them before anywhere else. Other times the ears will be ok, the puppy will limp, and then all of a sudden the lymph nodes swell and the nose is a mess. Sometimes just the nodes and the muzzle and then it spreads. PS can go from mild to very severe in days when it's not immediately recognized and treated properly. As well, even when it is diagnosed and treatment begins it can get worse before it gets better. Based on your description 5mg is not going to do anything, by the time you started the 20 it had proceeded to get worse and that's why you are not seeing it help immediately. It will. I understand you were told HOD and of course I am not a vet but I can tell you for sure that vets will often times confuse the issue when the Strangles is presenting like HOD and it happens!! Once you get this all under control you may want to discuss that.
The pred is going to be so incredibly important. Your pup will most likely be on it for quite a while because this became serious. Please be aware you can not just take the puppy off of it, he will need to be tapered off slowly!! I do mean slowly. You are correct in that the infection in the ear is simply secondary and should be treated like an infection in the ear is treated. Did I miss or did you say you were also using an antibiotic? If so which and how much? There is also something else you can get in any drug store. It's called Dumboro and it's a rinse that comes in separate packages. You can just ask the pharmacist where it's located. Take a packet out and mix it with nice warm water. Take a cotton ball and squeeze the mixture onto the infected areas. This will also help.
You do not need Glucosamine or any of that.. it's Puppy Strangles.
Now, I am not your breeder but I happen to live where you do. If you would like to message me privately I am more then willing to assist you further and perhaps even send you to my vet who will immediately be able to help you with this and will see you immediately with my referal tomorrow. He knows Puppy Strangles and is outstanding. Strangles is NOT about breeding at all, it has nothing to do with your breeder so new or not please don't think that. It's thought to be an immunity problem and many times happens after a booster is given. Did your puppy by chance get a booster soon before developing this?
Anything more I can do please let me know.. Susan
Danika & Eva
The only reason I mentioned Glucosamine was because I heard that high doses of Prednisone can lead to hip issues. The hips of both the sire and dam of my puppy have hip clearances, but if the Glucosamine will help or at least not hurt, I would give it to him.
The Antibiotic he is on is Clindamycin 150mg twice a day. We are also using Mupirocin inside his ears which is a topical antibiotic ointment.
My understanding is that Prednisone is the correct treatment for Strangles, but the dosage seems to be debatable. I agree the 5mg dosage was a waste of time as it doesn’t reach the level of being an immune system suppressant. 20mg is, but seems to be at the low end. I obviously don’t want him to have any more than is necessary because of the potential short and long term side effects, but I wonder what the impact is of taking too long to get on top of this.
Sam you really do not have a choice. frankly you are right it can have a long term affect.. not necessarily a hip issue but rather stunting growth. You just do not have a choice right now. This is what is going to take care of the strangles and you can't rush it. Clindamycin is ok and the Mupirocin is ok, too. Again, if you are not sure with the veterinary care you are getting because they may not be as familiar with Strangles and were not able to diagnosis to begin with, certainly you can visit my vet who knows this stuff inside and out. Unfortunately your puppy got severe and therefore doses are so much higher then what they would have been. I do suggest getting the Domeboro (spelled it wrong above) that will help too.
Danika & Eva
Check your private message :-)
Danika & Eva
Thanks for the Domeboro recommendation. We will go out and get some this evening.
I realize there is still not much know about Puppy Strangles, but it seems like there is a consensus that it is a autoimmune issue. If so, do you not think this is a genetic issue? At least two puppies from the same litter came down with it at the same time and I havent seen anyone suggest that PS is contagious.
I have also heard that a possible trigger is the vaccine booster shot, and yes my puppy had his second set of shots right at two weeks before the symptoms started.
My personal opinion is there are things in the canine world that are either.. genetic, environmental, or just happens. We never know. Even HD in my opinion can be genetic, environmental or the number is up and it just happens.
You certainly have done your homework and are very knowledgeable, that's going to benefit you tremendously on this. I will say again, I seriously doubt you have HOD... it's all manifestations of the PS and EVERYTHING you posted is exactly what happens. I have known some to have REALLY serious cases and I mean bad, where the pup had to stay on Pred for a couple of months. It did stunt this one particular pup I know of (not mine) but otherwise he was fine.
Danika & Eva
Hang in there SamD... You are doing everything you can for your pup right now. Mine pup was diagnosed very early with lameness being the presenting symptom, progressing to swollen lymphs and beginning of pustules in the ears. Others are definitely correct that it gets worse (looks wise) before it gets better. I was lucky that my breeder is super vigilant and she knew what it was before the vet came in the room so it was caught early. That being said, the ear pustules still became horrendous, with pus flying from drippy ears when he shook his head (gross, I know). He was placed on the high dose of pred and clindamycin and it took a good month or so to completely go away. The prednisone is absolutely crucial... you have to block the immune response. He's now 7 months old and shows no signs of ever being affected (diagnosed at 10 weeks). Its horrible to watch and hell to experience, but it does get better.
Melissa's (Luvmydog2much) puppy Nola had puppy strangles. She is very knowledgable, and would be a good source for info. Hopefully she'll see this thread, but if she doesn't I would send her a PM.
Debi and Bauer
Some people are like slinkies. Not really good for much, but bring a smile to your face when pushed down the stairs.