The cause of the disease is open. Historically, a bacteria has been suspected, in particular streptococcus species. However, bacterial cultures never confirm any bacterial infection. Antibiotic therapy alone is ineffective and helps to rule out a bacterial cause. More recently, immune reactions have been suspected.
Research suggests a hypersensitivity reaction possibly to a previously eliminated bacteria.
More importantly, the disease seems to respond to immunosuppressive therapy with consistency. Additionaly, oral corticosteroids are used for 1-3 weeks on a reducing schedule. Oral antibiotics are frequently prescribed over 2 weeks for ancillary therapy. The coarse of the disease is usually less than 2 weeks but can last 4-6 weeks on more severe cases. The prognosis is usually very good but some pups may require special nursing to insure adequate hydration and nutrition.