Alabama Rot

Dr Linda Simon (MVB MRCVS, University College Dublin)

 

A condition that has seen much attention in the media in recent years, Alabama Rot, also known as Cutaneous and Renal Glomerular Vasculopathy, continues to cause worry and frustration for many owners. Despite research, we are still unsure what the actual cause of this disease is and, while there has been a lot of promising developments when it comes to the therapy, the majority of dogs continue to pass away not long after contracting the disease.

It was in the 1980s in Alabama, that the first cases were reported in Greyhounds, though we now know that many other breeds can be affected. Due to the high fatality rate, the unexpected outbreak in the UK roughly seven years ago caused a great deal of panic and we are still unsure as to why a country previously free of the disease has started to see cases.

What Is Alabama Rot?

So, what is Alabama Rot exactly? While the term ‘Alabama’ refers to the state in which the first case was diagnosed, this name is not very informative. In medical circles, the term Cutaneous and Renal Glomerular Vasculopathy is far more enlightening.

Small clots start to develop within the blood vessels and it is the skin (‘cutaneous’) and kidneys (‘renal’) that show the most obvious effects of this. Tissues are damaged and the skin will ulcerate, while the kidneys will struggle to function due to the lack of blood supply and will start to fail.

What Causes Alabama Rot & Are There Any Risk Factors?

Inevitably, there have been a number of theories as to what causes the disease, including parasites, certain bacteria and toxins, but no-one has yet established the causative agent. Though no-one knows what the actual cause of Alabama Rot is, we are getting closer to finding out and have established a number of risk factors. Recent studies have shown a link between the development of the disease and living in particular areas.

Indeed, there seems to be a higher number of cases in certain parts of a country, especially those with a large amount of woodland. On top of this, cases become more prevalent at certain times of the year, with cases occurring far more frequently between December and May within the UK. Furthermore, researchers now know that specific dog breeds are at a higher risk of developing Alabama Rot than others. The Gun Dog breeds, such as the Spaniels and Retrievers seem to be hit the hardest.

Whether this is a genetic predisposition or due to the work that they do or the areas in which they are more likely to find themselves, is as of yet unknown. Those least likely to be affected include those, such as the Jack Russell Terrier and Staffordshire Bull Terrier. While knowing the above has not brought us closer to determining the cause of Alabama Rot, it can help a veterinarian to be aware of these risk factors when suspicious they may be presented with an affected dog.

What Are the Symptoms?

Skin Ulcers (Photo Credit: RVC)

Symptoms of Alabama Rot can progress rapidly and the first thing that owners notice is usually the development of skin sores for no apparent reason. Generally, these sores will develop on the paws, lower legs and belly, as well as occasionally on the face. The overlying fur is lost and the wounds may weep and bleed. Of course, there are many other causes of skin sores, including allergic skin disease and parasitic infections, so it is important to rule out the obvious first and not jump to a diagnosis of Alabama Rot the minute an animal develops skin lesions!

Typically, skin lesions will appear a few days before the dog becomes unwell. On top of the dermatological issues, dogs will develop symptoms of acute kidney failure, which can include vomiting, lethargy and a markedly increased thirst. It may take up to a week for these signs to develop. Again, these symptoms are not specific to Alabama Rot and there are many diseases which can present similarly and would need to be ruled out.

How Common Is It?

Though anxious owners may begin to worry their pet has been affected at the first sign of a new skin sore, the good news is that this condition is exceedingly rare and there have only been a small number of cases (roughly 200 in total) diagnosed within the UK since it first emerged as a disease almost a decade ago. Despite this, it is natural to worry and owners should always seek veterinary attention if they are concerned.

Frustratingly, there is no definitive test for Alabama Rot other than renal histopathology, which is not something that can be carried out in an alive animal and must be done at post-mortem. Due to this, vets will have to establish their diagnosis based on a clinical suspicion, as well as the characteristic lesions seen on dermal histopathology and the biochemical blood changes.

How Can You Prevent It?

Many will wonder if there is anything they can do to prevent their dog becoming affected. It is possible to check for recently diagnosed cases online and to avoid walking dogs in the area in which the disease was recently reported.

Some experts also recommend washing mud and other debris off as soon as possible after a walk in the countryside (though there is no evidence that this helps). Paws and legs should be checked regularly and any unexplained skin lesions should prompt an immediate vet visit. However, even if treated promptly, the prognosis is grave.

What Treatments Are Available, If Any?

TPE Treatment (Photo Credit: RVC)

Sadly, the treatment for Alabama Rot is quite limited and many dogs will pass away, despite intensive care. Supportive care is key, and dogs will need to be hospitalised and kept on a drip. They will receive medication to reduce nausea and may require nutritional support. Dogs may also have their wounds cleaned and treated, to prevent secondary bacterial infections from setting in.

The Royal Veterinary College

Certain specialist centres and teaching hospitals are working hard to develop more specific therapies that may help improve prognosis. The Royal Veterinary College in London currently offer a potential treatment known as Therapeutic Plasma Exchange (TPE) whereby the animal’s blood is filtered in the hopes that the causative organism (whatever it may be) can be removed from the animal’s system. After the blood has been filtered, it is simply pumped back into the patient. Though only one cycle of therapy may be required for some, others may need more than this.

This therapy is not without complications and there is the potential for side effects including a low body temperature and low blood pressure. While the number of dogs contained in the university’s initial study was small, it has shown somewhat promising results and means that vets should consider referring their patients for the treatment. Not unexpectedly, this pioneering technology comes with a high price tag, which may make it prohibitive to some.

While a potentially devastating disease that is tricky to diagnose and exceptionally difficult to successfully treat, thankfully, Alabama Rot is not a common condition and should not deter owners from walking their animals in woods. It’s important to be aware of early symptoms so that animals can be brought to the vet as soon as possible and any necessary treatment can be started.