Sterile Nodular Panniculitis: Understanding and Treating an Uncommon Condition

Panniculitis, the inflammation of fat-containing tissues just below the skin, is a condition that affects dogs. While primarily caused by bacterial or fungal infections, there is also a rare, sterile form of panniculitis. This sterile form, known as “sterile nodular panniculitis,” is believed to be the result of various underlying diseases, such as pancreatitis, autoimmune disorders, cancers, and even vitamin E deficiency. It can also be triggered by drug reactions. However, the majority of cases of sterile nodular panniculitis remain “idiopathic,” meaning we still don’t fully understand the cause.

Identifying Sterile Nodular Panniculitis

In dogs with sterile nodular panniculitis, single or multiple nodules of varying size and consistency develop under the skin. These nodules typically appear on the head, neck, back, and trunk. While the nodules may break open and release a clear fluid, they do not seem to cause the animal any discomfort. However, affected dogs may experience episodes of fever, loss of appetite, and lethargy that coincide with the appearance and resolution of these nodules.

To diagnose sterile nodular panniculitis, veterinarians perform skin biopsies and cultures to rule out any infections. It is also crucial to evaluate the pet for any recent drug administration or underlying diseases, such as pancreatitis or autoimmune conditions, which could potentially contribute to the development of this condition.

Breeds at Risk

While sterile nodular panniculitis can affect any breed, Dachshunds and Weimaraners appear to be more predisposed. The mode of inheritance for this condition remains unknown.

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Treatment Approaches

Treating the infection or underlying disease is crucial in non-idiopathic forms of panniculitis. However, for idiopathic cases, treatment options may involve administering vitamin E megadoses and other supplements. Reports suggest that drugs such as tetracycline, niacinamide, cyclosporine, prednisone, and tacrolimus have been used with varying levels of success. In cases with a single lesion, surgical excision is considered an acceptable approach.

Veterinary Care Costs

Since diagnosing and treating sterile nodular panniculitis often requires the expertise of dermatologists and may involve long-term specialized care for underlying diseases, the associated costs can be quite high. The diagnostic process alone can range from $1,000 to $2,000, depending on the degree of certainty needed to rule out any underlying conditions. Treatment costs depend on the underlying cause, if any, and in cases where the cause is idiopathic, the expenses will depend on the selected drugs and the possibility of surgical interventions.

Preventing Sterile Nodular Panniculitis

Given the presumed hereditary nature of this disease, it is strongly recommended to remove affected dogs and their first-degree relatives from the breeding pool to prevent its further spread.

For further information about sterile nodular panniculitis and the importance of its prevention, please visit Katten TrimSalon.


  • Alexander F. Koutinas, DVM, Dr. Vet. Med., DECVD; Professor M. Saridomichelakis, DVM, DrMedVet; The Skin As a Marker of Internal Disease; Clinic of Internal Medicine, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki.
  • Cross, J.R. et al. Bartonella-Associated Meningoradiculoneuritis and Dermatitis or Panniculitis in 3 dogs. Journal of Veterinary Internal Medicine. 2008; 22: 674-678.
  • Ackerman, LJ. Canine Nodular Panniculitis. The Compendium on Continuing Education Vol 6, No 9, September 1984, pp. 818-823.
  • Mellanby, RJ, et al. Panniculitis associated with pancreatitis in a Cocker Spaniel. Journal of Small Animal Practice 2003; 44: 24-28.
  • Kano, R, et al. Systemic Treatment of Sterile Panniculitis with Tacrolimus and Prednisolone in Dogs. Journal of Veterinary Medical Science 2005; 68(1): 95-96.
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