At 5 weeks old, Ivy the Springer spaniel’s litter of lovely puppies were growing well and all had homes lined up to go to in a few weeks. Then one morning, the owner noticed that one of the puppies (Ralph), had an issue with one of his eyes.

They brought him in to see me later that morning. Ralph was quite well, but his right eye had several little swollen glands (Meibomian glands) on the eyelid. These are important in producing part of the tear film that lubricates the eyes. There was a similarly swollen gland affecting the left eye as well.

His lymph nodes under his jaw were also swollen, but other than that all seemed fine.

I was instantly suspicious that Ralph had an uncommon condition that can go by several names but is most commonly known as ‘puppy strangles’. Unlike strangles in horses, it isn’t caused by bacterial infection and isn’t contagious, in fact, the cause hasn’t been identified. It does appear however, that the immune system is involved, meaning that the puppy’s immune system is attacking its own skin.

The first sign is usually a sudden swelling of the face or muzzle (with Ralph it was his eyelids).  This can be followed by raised bumps and pustules over the face and ears, which may rupture and lead to scarring which can be permanent.  Other areas of the body can be affected as well if it is not treated quickly. The swollen lymph nodes are also typical – these can also rupture. Affected pups often feel unwell and have a high temperature. We only tend to see cases in puppies between the ages of one and four months.

As this is an immune-mediated disease, the treatment involves suppressing the immune system with high doses of a steroid (prednisolone). I always have to take a deep breath when I do this, because I can have a sick puppy with discharging abscesses and a high temperature! We also give antibiotics to treat secondary bacterial infections in these patients.

Because Ralph’s observant owners had caught the disease so early, I was hoping that he would respond rapidly to medication and not progress to more severe disease. Over the next few weeks, we kept a very close eye on him. Initially, it did appear to be clearing up, but then it became more severe.  Ten days later his face was more swollen, and he had some lumps around his mouth and muzzle. A couple of days after that, I saw Ralph at his worst. His eyes and ears were swollen, sore and discharging, his muzzle was crusty, his lymph nodes were more enlarged, and his temperature was raised. It is a very sad sight to see a gorgeous young puppy like this, but despite everything, he was eating well and growing rapidly, partly due to the steroid. His owner was weighing him every few days so they could accurately calculate his doses of steroids and antibiotics.

Ralph very gradually improved and after a whole month on steroid treatment, he was well enough for us to start to cautiously reduce his steroid dose.

I’m happy to say that Ralph has now been off medication for over a week, and I was very pleased to give him his first vaccination. He is a delightful, laid-back character who has borne all his trials with very good spirit. His face now looks perfect as you can see from his ‘before and after’ pictures, with no scarring visible and just one tiny pink spot where we are waiting for his fur to grow back.

His breeder has put an enormous amount of love and care into his recovery. Although Ralph’s prospective new owner decided that they were not able to take him on, his breeder is so bonded to him after all they’ve been through that he is very happily staying put for now!