Juvenile cellulitis, often called puppy strangles, is an uncommon skin and lymph node disease of young puppies. It causes a swollen face, pimple-like bumps and big lymph nodes under the jaw.
A puppy with a swollen face needs a vet now. Have any new lump or swelling on a young puppy’s face or ears looked at. Some affected puppies also become dull and tired, run a fever or go off their food [3][6]. Do not wait to see if it clears up.
Never lance, squeeze or pop the bumps at home. Leave the swellings and pustules alone, and let your vet examine them.
What juvenile cellulitis is
Vets also know it as juvenile pyoderma [3] or sterile granulomatous dermatitis and lymphadenitis [5]. The University of Minnesota dermatology handbook groups it with the immune-mediated diseases [2] and calls it sterile, meaning germs do not cause it, although sores can pick up an infection later [1]. In other words, the puppy’s immune system seems to overreact. The exact trigger is still unknown: researchers who followed an affected litter found no bacteria, fungi or viruses in the swollen lymph nodes [4].
Despite the name, it is not the same as strangles in horses.
Which dogs get it
- Age: it usually shows up in puppies younger than about four months [1]. In the litter study, cases came in clusters of pups aged one to four months [4].
- Breeds: our sources do not give a reliable breed list for puppies, so any puppy with these signs should be checked.
- Adult dogs: a review of 90 adult dogs found that the adult form looks and behaves much like the puppy form, so vets should keep it in mind at any age [5]. Havanese, Australian Shepherds, Irish Setters, Dachshunds, Bichons Frises and Maltese turned up more often than expected in that study [5].
Signs
- Bumps on the face and ears: swelling, small raised spots, firmer lumps and draining sores, mostly on the muzzle and chin and around the eyes [1]. The inner side of the ear flaps and the edges of the lips and eyelids are often involved too [1][2]. The skin can lose hair, turn red and crust over [2].
- Swollen lymph nodes under the jaw: big lymph nodes are the hallmark of the disease, mainly under the jaw and sometimes in front of the shoulders [1][2]. In a study of 15 dogs, swollen jaw lymph nodes were sometimes seen without skin lesions [3].
- Ears: the problem often spreads from the ear flaps into the ear canal, giving an outer ear infection with bumps and a lot of discharge [2].
- Feeling unwell: in the 15-dog study, more than half the dogs were lethargic, and some had a fever or a poor appetite [3].
- Sore joints: in the same study, four dogs showed pain when their joints were moved [3].
How vets diagnose it
Your vet will examine your puppy and may take samples from the bumps and lymph nodes. Under the microscope, fluid from the pustules usually shows many inflammatory cells but no bacteria [3], and tissue samples show a typical pattern of inflammation [4]. Your vet will also want to rule out demodectic mange with deep skin infection, which can look similar [2]. For bacterial skin infections, see pyoderma in dogs.
Treatment
Your vet treats the immune reaction and any infection that sets in on top of it. Because the disease comes from the immune system but the sores can pick up germs, treatment usually has to deal with both [1][2]. Only your vet can choose the medicines and how long to give them.
At home, as directed by a vet:
- give all medicines exactly as prescribed, and do not stop them early on your own;
- keep the face and ears clean only in the way your vet shows you;
- do not squeeze, lance or pick at the bumps;
- watch for eating, energy and fever, and tell your vet about any change.
Outlook
Outcomes vary between studies:
- A 7-week-old puppy described in one case report had much less swelling, and its pustules were healing, a week after it was first seen [6].
- In the 15-dog study, one dog relapsed once its treatment was stopped [3].
- In the study of adult dogs, 30 of the 35 dogs with records went into remission and the status of the other five was not known. Of the 30, 19 stayed in full remission and 11 had the signs come back during follow-up [5].
These are figures and statements about groups of dogs in particular studies. They do not prove that a treatment caused an outcome, and they cannot predict how one dog will do. Your vet can explain what this means for your dog.
When to see your vet
See your vet now if your puppy has:
- a swollen face, muzzle or eyelids;
- bumps, pustules or crusts on the face or ears [1];
- swelling under the jaw [1];
- is not eating, is sluggish or has a fever [3];
- limping or seems sore when moved [3].
See your vet again if signs come back after treatment ends [3].
FAQ
Is puppy strangles contagious?
It is treated as an immune-mediated disease, not an infection [2]. In the litter study, researchers could not pass it on to newborn puppies using tissue from affected dogs [4]. Ask your vet whether littermates should be checked.
Can adult dogs get juvenile cellulitis?
Yes, though rarely. It mostly affects puppies [1], but a review of 90 adult dogs showed it can appear at any age [5].
Can it come back?
Sometimes. Signs returned in some dogs after treatment ended [3][5], which is one reason to finish the course your vet sets and to keep follow-up visits.
Can I pop the pustules?
No. Do not squeeze, lance or pop them. Your vet will decide how to treat them.
Is it the same as strangles in horses?
No. The name is shared, but juvenile cellulitis in dogs is a separate condition.
The bottom line
Juvenile cellulitis, or puppy strangles, gives young puppies a swollen face, bumps and pustules, and big lymph nodes under the jaw. It is thought to come from an overreacting immune system. A puppy with a swollen face needs a vet now, and treatment works best when it starts early and is finished as prescribed. Never squeeze or lance the bumps.
This article is for general information only and does not replace advice from your veterinarian. If your puppy’s face is swollen, contact your vet now.
Sources
- Torres SMF, et al. 1.1 Canine Pyodermas. Small and Large Animal Dermatology Handbook, Vol. 1. University of Minnesota Libraries Publishing, 2025 (CC BY 4.0). https://open.lib.umn.edu/animaldermatology/chapter/canine-pyodermas/
- Torres SMF. 2.10 Otitis Externa: Dogs and Cats. Small and Large Animal Dermatology Handbook, Vol. 1. University of Minnesota Libraries Publishing, 2025 (CC BY 4.0). https://open.lib.umn.edu/animaldermatology/chapter/otitis-externa-dogs-and-cats/
- White SD, Rosychuk RA, Stewart LJ, Cape L, Hughes BJ. Juvenile cellulitis in dogs: 15 cases (1979-1988). J Am Vet Med Assoc. 1989;195(11):1609-1611. https://pubmed.ncbi.nlm.nih.gov/2599949/
- Reimann KA, Evans MG, Chalifoux LV, et al. Clinicopathologic characterization of canine juvenile cellulitis. Vet Pathol. 1989;26(6):499-504. https://pubmed.ncbi.nlm.nih.gov/2603330/
- Inga A, Griffeth GC, Drobatz KJ, Goldschmidt KH, Mauldin EA. Sterile granulomatous dermatitis and lymphadenitis (juvenile cellulitis) in adult dogs: a retrospective analysis of 90 cases (2004-2018). Vet Dermatol. 2020;31(3):219-e47. https://pubmed.ncbi.nlm.nih.gov/31789433/
- Martens SM. Juvenile cellulitis in a 7-week-old golden retriever dog. Can Vet J. 2016;57(2):202-203. https://pubmed.ncbi.nlm.nih.gov/26834274/