Diagnosis and Treatment of Juvenile Cellulitis in an English Cocker Spaniel Puppy

Introduction. Juvenile sterile granulomatous dermatitis and lymphadenitis (JSGDL), also known as juvenile cellulitis, is a rare but severe immune-mediated skin disease of puppies. Despite its characteristic clinical presentation, the disease poses a diagnostic and therapeutic challenge. Difficulties arise both at the early stages of differential diagnosis with angioneurotic edema, deep pyoderma, or demodicosis, and during the treatment process. High doses of glucocorticosteroids (GCS), which are the mainstay of therapy, do not always lead to rapid resolution of the process and carry the risk of secondary infections, while also raising the question of the safety of routine vaccination. The prolonged course of the disease and the formation of cosmetic defects, such as scars and skin hyperplasia, significantly reduce the patient's quality of life and necessitate the development of clear protocols for the management of such animals, which underscores the relevance of analyzing each clinical case. According to the literature, JSGDL affects puppies between 3 weeks and 4 months of age, with a predisposition in breeds such as the Golden Retriever, Dachshund, and English Cocker Spaniel. The etiology of the disease remains unknown, but a hereditary nature of immune dysfunction is suspected. Classic signs include acute facial edema followed by the formation of papules, pustules, and lymphadenopathy. The standard of treatment is immunosuppressive therapy with prednisolone. However, current research points to the possibility of a protracted course, the development of resistance to GCS monotherapy, and the need for combination regimens, for example with cyclosporine, in complex cases. A number of authors emphasize the importance of cytological monitoring for the timely detection of secondary bacterial infection, as well as the need for a cautious approach to vaccination during immunosuppression, in accordance with WSAVA guidelines.

Case presentation. This report describes a clinical case with an atypically prolonged course lasting 13 weeks, which allowed us to demonstrate the limits of the effectiveness of standard prednisolone therapy and the stages of secondary infection acquisition. The practical significance lies in illustrating the need for regular cytological monitoring for timely therapy adjustment, as well as in discussing the complex choice of vaccination strategy in puppies receiving immunosuppressive therapy.

Discussion. The subject of the study was a 2-month-old male English Cocker Spaniel puppy at the time of initial presentation. The diagnosis was established comprehensively based on history and clinical findings: acute onset of the disease, the classic triad of symptoms (acute edema and erythema of the face, including the lips and eyelids), the presence of papulopustular eruptions, pronounced bilateral lymphadenopathy (submandibular and parotid lymph nodes), and concurrent otitis externa. The methods used included clinical examination, otoscopy, cytological analysis of skin and ear canal impression smears, as well as analysis of the patient's clinical dynamics during therapy.

Conclusion. The materials of this article can be used by practicing veterinarians to optimize the diagnostic and therapeutic process for this disease. When juvenile cellulitis is suspected, comprehensive diagnostics should be performed, including cytological examination of pustule contents and ear canal smears to rule out an infectious etiology and monitor for possible secondary infection at all stages of treatment. Immunosuppressive therapy with prednisolone at a dose of 2 mg/kg should be initiated immediately upon diagnosis, as a delay in starting treatment may contribute to a protracted disease course. The GCS dose should be adjusted at each visit, taking into account the puppy's rapid weight gain. If no positive dynamics are observed within 2–4 weeks, or if relapse occurs, the addition of cyclosporine or a change of the GCS preparation should be considered. Systemic antibiotic therapy should be prescribed only when secondary infection is cytologically confirmed. To minimize scarring and skin hyperplasia, early and aggressive initiation of anti-inflammatory GCS therapy is critical. Regarding vaccination, it is recommended to follow WSAVA guidelines: vaccinate only after the patient's condition has stabilized or immunosuppressive therapy has been completely withdrawn, giving preference to inactivated vaccines and minimizing the patient's exposure to infection during the treatment period.

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