The disease is spread by an infected horse when nasal discharge or pus from the draining lymph nodes contaminate pastures, feed troughs, brushes, bedding, tack etc.

Equines of any age may contract the disease, although younger and elderly equines are more susceptible. Young equines may lack immunity to the disease because they have not had prior exposure. Geriatric equines may have a weaker immune system.

A horse with strangles will typically develop abscesses in the lymph nodes of the head and neck causing coughing fits and difficulty swallowing. Clinical signs include fever up to 106 °F and yellow coloured nasal discharge from both the nose and eyes.

Abscesses may form in other areas of the body, such as the abdomen, lungs and brain. This is considered a chronic form of strangles called "bastard strangles" and can have serious implications if the abscesses rupture. Horses develop this form of strangles when their immune systems are compromised or if the bacteria rapidly invades the body.

Strangles has a 8.1% mortality rate. Mortality is lower in cases without complications than it is in cases of bastard strangles. The disease is very contagious and morbidity is high. Precautions to limit the spread of the illness are necessary and those affected are normally isolated. An isolation period of 4–6 weeks is usually necessary to ensure that the disease is not still incubating before ending the quarantine.

Only 8% of infected horses have this form of pigeon fever, however, it has a 30-40% fatality rate. Organs that are commonly affected are the liver, spleen, and lungs. For a successful recovery, long-term antimicrobial therapy is essential.

The disease can occur in horses of any age, breed or gender. In the US, it occurs throughout the country and at any time of year. The disease was traditionally thought to occur mainly in dry, arid regions, but from at least 2005, its range has been increasing into areas where it was not previously seen, such as the Midwestern US, and Western Canada. Environmental risk factors include over 7 days of a weekly average land surface temperatures above 35 °C, and drier soils; these factors were implicated in an outbreak in Kansas in 2012.

Purpura hemorrhagica may be prevented by proper management during an outbreak of strangles. This includes isolation of infected horses, disinfection of fomites, and good hygiene by caretakers. Affected horses should be isolated at least one month following infection. Exposed horses should have their temperature taken daily and should be quarantined if it becomes elevated. Prophylactic antimicrobial treatment is not recommended.

Vaccination can reduce the incidence and severity of the disease. However, horses with high SeM antibody titers are more likely to develop purpura hemorrhagica following vaccination and so these horses should not be vaccinated. Titers may be measured by ELISA.

Prognosis is good with early, aggressive treatment (92% survival in one study).

The cause of juvenile cellulitis is unknown. Cytologic examination of aspirates of affected lymph nodes, pustules, abscesses, and joint fluid rarely reveal bacteria, and culture results of intact lesion are always negative for bacterial growth, suggesting a nonbacterial etiology. As signs resolve following treatment with glucocorticoids, the cause is likely to be an immune disorder.

Juvenile cellulitis, also known as puppy strangles or juvenile pyoderma, is an uncommon disease of dogs. Symptoms include dermatitis, lethargy, depression and lameness. When puppies are first presented with what appears to be staphylococcal pyoderma, juvenile cellulitis, a relatively rare condition, may not be considered.

Strangling involves one or several mechanisms that interfere with the normal flow of oxygen into the brain:

- Compression of the carotid arteries or jugular veins—causing cerebral ischemia.

- Compression of the laryngopharynx, larynx, or trachea—causing asphyxia.

- Stimulation of the carotid sinus reflex—causing bradycardia, hypotension, or both.

Depending on the particular method of strangulation, one or several of these typically occur in combination; vascular obstruction is usually the main mechanism. Complete obstruction of blood flow to the brain is associated with irreversible neurological damage and death, but during strangulation there is still unimpeded blood flow in the vertebral arteries. Estimates have been made that significant occlusion of the carotid arteries and jugular veins occurs with a pressure of around , while the trachea demands six times more at approximately .

As in all cases of strangulation, the rapidity of death can be affected by the susceptibility to carotid sinus stimulation. Carotid sinus reflex death is sometimes considered a mechanism of death in cases of strangulation, but it remains highly disputed. The reported time from application to unconsciousness varies from 7–14 seconds if effectively applied to one minute in other cases, with death occurring minutes after unconsciousness.

Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hanging may cause death (alongside breaking the victim's neck).

Strangling does not have to be fatal; limited or interrupted strangling is practised in erotic asphyxia, in the choking game, and is an important technique in many combat sports and self-defence systems.

Strangling can be divided into three general types according to the mechanism used:

- Hanging—Suspension from a cord wound around the neck

- Ligature strangulation—Strangulation without suspension using some form of cord-like object called a garrote

- Manual strangulation—Strangulation using the fingers or other extremity

Some systemic diseases can become symptomatic as a skin disorder. These include many endocrine (hormonal) abnormalities, such as hypothyroidism, Cushing's Syndrome (hyperadrenalcorticism), and tumors of the ovaries or testicles.

Some diseases are inherent abnormalities of skin structure or function. These include seborrheic dermatitis, ichthyosis, skin fragility syndrome (Ehlers-Danlos), hereditary canine follicular dysplasia and hypotrichosis, such as color dilution alopecia.

Juvenile cellulitis, also known as puppy strangles, is a skin disease of puppies of unknown etiology, which most likely has a hereditary component related to the immune system.