As peak season kicks in, internal medicine expert answers all the questions dog owners are asking

It’s peak season for Alabama rot in the UK.

Studies have shown that 95% of all cases of the disease occur between November and May.

While treatment options for Alabama rot remain limited, researchers recently made a ground-breaking discovery on this front. It’s called therapeutic plasma exchange and it can be carried out in our pet emergency hospital in Glasgow.

We sat down with internationally-renowned small animal internal medicine specialist Scott Kilpatrick, who works in the hospital, to ask him to explain what Alabama rot is, how to spot signs of the disease and what owners can do to protect their dog from catching it.

Image of Scott Kilpatrick of Vets Now Glasgow for article on alabama rot treatment
Scott Kilpatrick is a specialist in internal medicine at our pet emergency hospital in Glasgow

What is Alabama rot?

Alabama rot is a disease affecting dogs which causes small clots in blood vessels. These eventually result in tissue damage, skin ulcers and, in many cases, kidney failure. Also known as cutaneous and renal glomerular vasculopathy, or CRGV, the cause of Alabama rot remains unknown although theories put forward have included E. coli-produced toxins to parasites and bacteria.

Is Alabama rot a new disease?

It was first recognised in the 1980s in America. However, as with a lot of conditions, it’s taken time for us to properly understand the disease. Thankfully, this is gradually improving as owners and vets are increasingly recognising the symptoms.

Is it on the increase?

It’s still very rare. The reason we’re seeing it more in the UK now is largely because we’re getting better at recognising it. When veterinary subjects get into the mainstream then, of course, they’re reported more because people recognise the symptoms.

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Why is it called Alabama rot?

It’s a geographical thing. It was first recognised in greyhounds in Alabama. The rot is a descriptive term potentially to do with the effect the disease has on the skin. I don’t know whether it’s a good or bad thing that the name creates an image in your head.

What causes Alabama rot?

We don’t know exactly what causes it, but we do know the first sign of the disease is often unexplained redness, a skin sore or lesion that isn’t caused by a known injury. The good news is there is a lot of work going on in the UK and elsewhere to understand this condition better. I’m reassured by this and pet owners should be reassured, too. There are a number of groups now looking at potential causative agents, most notably Anderson Moores and the Royal Veterinary College, and progress is being made.

What are the symptoms of Alabama rot?

The main symptoms are skin lesions, often ulcerative lesions on the dog’s limbs. We also occasionally see these lesions elsewhere, such as on the tummy or the mouth. Owners will possibly notice their dog become lethargic, lack appetite and have a high temperature. More generally, their dog will become off-colour and poorly. These signs may be quite vague but could be an indication that the disease is progressing and affecting the kidneys.

"There is a lot of work going on in the UK and elsewhere to understand this condition better. I’m reassured by this and pet owners should be reassured, too."

Scott Kilpatrick Internal medicine specialist

What’s the main Alabama rot treatment?

Treatment will depend on the individual pet, the way they present, and what their blood samples tell us. For example, we typically see blood abnormalities in patients with Alabama rot, and around 50% present with a low platelet count. If there are skin lesions, treatment will be based on whether there is a secondary infection, and whether antibiotics or pain relief is appropriate. In more severe cases, notably increases in kidney enzymes, fluid therapy would be our first line alongside other supportive measures. We can also offer what’s called therapeutic plasma exchange or plasmapheresis. This involves filtering the patient’s blood so that toxic substances, including whatever causes Alabama rot, are removed. Once filtered, the blood is returned to the patient. This is a relatively new treatment but, so far, the results have been positive.

Can dogs get it by walking in muddy conditions?

It may be a factor, but it’s not proven. The latest research shows most of the cases have been confirmed in western and southern parts of England. Some of those were diagnosed after being walked in woods. So there is a suspicion there is an environmental trigger — possibly a toxin in the mud dogs are absorbing — but it’s only a suspicion. It’s about a balanced risk assessment of the factors because thousands of dogs walk in muddy, swampy areas every day without being affected by this disease. In fact, as a dog owner myself, I’m not sure there’s such a thing as a non-muddy walk!

What’s the prognosis for a dog with Alabama rot?

It depends on how advanced it is. In cases where the kidneys are affected, the prognosis is, sadly, quite poor. But the good news is the management of this disease is getting better and some dogs with suspected Alabama rot have survived.

Image of Neus and Dan using Vets Now cell salvage machine for article on Alabama rot UK
Specialist Dan Lewis and resident Neus Elias-Santo Domingo using the blood cell salvage machine at Vets Now in Glasgow

What can pet owners do to prevent it?

In all honesty, we don’t know the answer to this. There’s definitely a consensus that if you do go out for a walk and your dog gets muddy, then it’s sensible to wash them thoroughly afterwards. But this advice is not based on any specific evidence, and I think most dog owners would do this anyway. As always, if you notice something unusual on your dog’s skin such as a lesion we’d advise you to get your dog checked out by a vet. In my experience, most dog owners are very good at spotting changes in their dog’s condition or health and acting on these changes.

Is Alabama rot contagious?

We don’t think that there is a dog to dog transmission factor, so that’s not something that we are currently concerned about nor do we think Alabama rot affects other companion animals such as cats.

Is the disease more prevalent in certain breeds?

There are some conditions that affect some breeds more than others and, as I said, initially only greyhounds were believed to be affected by Alabama rot. But we’ve since seen lots of breeds die from the condition so I don’t think we can say one breed is safer than another. Owners of all breeds should be vigilant.

Image of sores on a dog's foot for Vets Now article on alabama rot lesions
The first sign of Alabama rot is often unexplained redness, a skin sore or lesion

Is there a cure for Alabama rot?

Sadly, there’s currently no vaccination for Alabama rot, nor is there a drug that cures the condition. But it’s worth highlighting that there’s a lot of good people in the veterinary community doing a lot of good work to find out more about it. We’re hopeful that as our knowledge improves that side of things will develop significantly.

Where in the country is it most prevalent?

The majority of cases have been confirmed in western and southern parts of England. Far fewer have been reported in the east and in the north, including Scotland. But obviously, there are more people in southern England and therefore more dogs. We have to be very careful about making assumptions about where might be dangerous. It’s worth bearing in mind that there are around eight million dogs in the UK and there have been fewer than 200 confirmed cases of Alabama rot. Yes, it’s vitally important that we’re educated as pet owners and vets but it’s important to keep things in perspective. Having said that it is devastating if your dog is affected, so we’re not underplaying it, but we just have to be sensible.

How do you think the disease and treatment will develop?

It’s important to understand the cause because hopefully, that will allow us to develop better treatment options. Reporting is also really important, we’ve got to be better in the veterinary community at saying ‘I’ve seen this case, we’ve confirmed Alabama rot in this situation’ and making sure that we’re supplying that information to the veterinary community, because the more cases we have, the more cases we understand, the better chance we have of finding treatments and cures.

If caught and treated early, can dogs recover?

There’s absolutely no doubt there are dogs who are treated successfully, especially in some of the centres that are seeing a large number of these cases. But the number is smaller than we would like.

What should pet owners do if they’re concerned their dog has the disease?

You’ll find that dogs get skin lesions for lots of different reasons, and only a tiny proportion are caused by Alabama rot, but it’s best you get these checked out to be absolutely sure. If in any doubt contact your vet because they’re in the best position to provide you with the most up-to-date information for you and your pet.