An 8-year-old male castrated Basset Hound presented to the Emergency Service at Cornell University Hospital for Animals (CUHA) for a non-healing neck wound and oral hemorrhage. Prior to presentation the dog had been healthy with no previous medical history. The dog had a six-month history of a swelling along his dorsal neck which his local veterinarian was actively managing. Presumed to be a sebaceous cyst, the swelling was initially drained and systemic antibiotics were prescribed. Despite treatment, resolution of the swelling was never achieved. One week prior to presentation at the CUHA the swelling in the neck became markedly worse and the area appeared red, inflamed and painful to the touch. It was also noted that the patient became anorexic and adypsic. An exploratory surgery of the affected area was performed by the rDVM and revealed a lesion with purulent deep draining tracts and adjacent areas of tissue necrosis. It was remarked that the lesion was similar to an infected bite or puncture wound. A drain was placed and tissue biopsies of the lesion were collected, the results of which revealed pyogranulomatous inflammation. The dog was hospitalized at the local veterinarian for 3 days post-surgery and was maintained on IV fluids and antibiotics, gentacin and metacam. During this time the patient developed bilaterally inflamed, prolapsed third eyelids and oral hemorrhage was observed in his saliva. Given the progressive nature of his disease, he was referred to the Cornell University Hospital for Animals Emergency Service for further evaluation and work up.