Zebedee's Story

Zebedee had been a perfectly healthy puppy right up until 10 days after receiving his first vaccination. At this point there were signs that he was not as healthy as he had previous presented. Pustules appeared on his face and inside his ears. This was followed very quickly by swelling and discharge from his ears. He became very reluctance to walk, to the point where he needed to be held up in order to go to the toilet. His condition deteriorated very quickly within fours days.

Initially he was taken to the local vet who began treatment but no improvement was evident and a decision was made to get a referral to the Melbourne Veterinary Referral Centre Pty Ltd. [M.V.R.C.]

The following is the complete summary of the first and second visit for Zebedee. Although it includes details of the treatment and contact name for the treating vet, these are only included for information purposes. Do not use the information to treat your dog. Do not attempt to contact the vet as this is a referral centre. This is to mean your regular vet must write a referral to the M.V.R.C. in order to receive treatment/information.

Throughout the two summaries you will note some of the terminology and drugs used in treatment are linked to off site web sites. This is to assist the reader of Zebedee's Story to gain more information about the condition Juvenile Cellulitis, also know as Puppy Strangles.

We further extend our sincere gratitude to Zebedee's owners for allowing us to share their experience.

Visit Summary Tuesday, 9 March 2004

Patient: - "Zebedee", 3 month old male Weimaraner.

Client: - Withheld

Date of Visit: - Tuesday, 9 March 2004

History: -

Weight 8.200 kg

Zebedee is a 3 month old Weimaraner. Zebedee's chief complaint is sudden onset of sterile pustules covering the ear pinnae, nose and periocularly.

Zebedee was initially seen for this 4 days ago, where it was noted that he had a mild rash on his ventral abdomen, and again at different clinic, 2 days ago, where the pustules had extended to the muzzle and face. There was no previous skin problems before this. He seems quite itchy only at the effected sites.

He has been on Clavulox for 3 days so far and the owner says the rash has responded mildly, it is not as angry looking.

The owner is mainly concerned about the fact Zebedee has not been walking, he doesn't get up off the ground very often. If he does walk it is only over very short distances.

Previous Diagnostics and Therapies:

Main Ridge vet 5 March 2004.
Sterile Pustules on ventral aspect - both pinnae, not extending into ear canals. (full of debris) - mild rash ventral abdomen. Suspect sterile puppy pyoderma and advised may require aggressive steroid therapy. Trial topical first. Dispense Fucidermand Surolan.

Dromana Vets 7 March 2004.
Multiple pustules over face, muzzle and ears. Worsening, despite treatment. Not itchy. Skin scrape neg. Cytol Neuts ++, only very rare cocci seen Tx Clavulox 125mg BID (10d).

Environment:

Zebedee is mainly an indoor dog lately, especially after his energy loss. He used to spend more time outside.

Zebedee is currently fed Eukanbua dry, mixed with some canned food. He also has fresh meats and table scraps and puppy porridge on occasion.

Current Therapies:

Clavulox 125mg BID 10d course, been on for 3 days.

Diagnostic tests: - The following tests where performed:

• CYTOLOGY
  Cytology samples were taken from:
  • nose lesions: pyogranulomatous inflammation

• FINE NEEDLE ASPIRATE
  A fine needle aspirate was taken from following location:
  • lymph node

  Smearing, staining and examination of these samples revealed neutrophils (numerous), with occasional lymphocytes seen.

Diagnosis:

Our confirmed diagnoses for Zebedee include Juvenile Cellulitis.

Treatment:

PREDNISOLONE 20 MG Tablets 20Rx: ONE HALF (½) of tablet once daily for the next 7 days and then as directed in your detailed future plan.

VIBRAVET 100 MG Tablets 15Rx: ONE HALF (½) of tablet once daily with a meal until all medication is finished.

Future Plan:

WHAT IS THE CURRENT SITUATION?

This condition is Juvenile Cellulitis. The exact aetiology is not fully understood but we know the following:

1. It is specific for certain breeds (Weimaraner, Lab, Gordon Setter and Dachshund), therefore there is a genetic component.
2. Distemper virus has been demonstrated in lesions in affected Weimaraners.
3. It has occurred post vaccination with Distemper virus and in non vaccinated dogs.

Wild type distemper virus exposure in hyper-immune puppies that are genetically programmed to over-react is the likely cause of the disease. The distribution of lesions (sebaceous glands of the skin and ears, lymph nodes, joint and bones) is associated with viral predilection for these areas.

HOW ARE WE GOING TO DO THIS? WHAT ARE THE DETAILS?

Plan:

1. Start Vibravet 50mg daily
2. Start Prednisolone 10mg daily

Please telephone in 7 days to discuss progress (I may want to increase or decrease the Prednisolone dose depending on the response).

I would like to see Zebedee again in 14 days time for a revisit examination and decide how fast we can wean off the Prednisolone

NOTE:

Scarring is possible due to destruction of hair follicles and reduced growth is possible if we can not reduce the Prednisolone quickly.

Staining of teeth with Vibravet is rare and not expected to be a problem.

Further information: - For Zebedee's owners

Dr Greg Burton, BVSc (Hons); FACVSc (Dermatology)

Visit Summary Wednesday, 24 March 2004

Patient: - "Zebedee", 3 month old male Weimaraner.

Client: - Withheld

Date of Visit: - Tuesday, 9 March 2004

History: -

Weight 11.200 kg, 24.64lb, 0.50m²

Since the last visit, Zebedee has improved. Zeb has been diagnosed with Juvenile Cellulitis and has been on medication for the past 2 weeks.

Zebedee is much more lively and less itchy. He has put on 3 kilos since we saw him last. The lesions have all dried up a lot.

Medication being used included Vibravet 20mg once daily, Prednisolone 10mg once daily and Fuciderm on the itchy areas, which has not been used too much due to the reduction in itch.

Diagnostic tests:

Nil

Diagnosis:

Our confirmed diagnosis for Zebedee include Juvenile Cellulitis.

Differential Diagnoses:

Nil

Treatment:

VIBRAVET 100MG Tablets 10Rx: ONE HALF (½) of a tablet once daily with a meal until all medication is finished.

Future Plan:

WHAT IS THE CURRENT SITUATION?

Zebedee is doing really well. The plan is to try and reduce the Prednisolone slowly without relapse occurring.

1. Stay on the Vibravet ½ tablet ONCE daily
2. Reduce the Prednisolone
   • WEEK 1 - Alternating between ½ and ¼ tablet each day
   • WEEK 2 - Give ¼ tablet each day
   • WEEK 3 - Give ¼ tablet every second day
   • WEEK 4 - Stop

NOTE

If Zebedee seems lethargic at any stage, stops eating or seems unwell as the Prednisolone stops or reduces to every second day, please telephone and let me know and give Zebedee a ¼ tablet of the Prednisolone while waiting for out reply.

I would like to see Zebedee in 6 weeks time but telephone in 4 weeks.

Use Hydraderm if the skin looks dry around the muzzle.

Greg

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