Title: Alabama rot

{{Globalize|article|United Kingdom|date=March 2018}}
{{short description|Often fatal condition in dogs}}
'''Alabama rot''', '''Greenetrack disease''', or '''cutaneous and renal glomerular vasculopathy''' (CRGV)&lt;ref name=&quot;BBC-uk-25820926&quot;&gt;{{cite web|url=https://www.bbc.co.uk/news/uk-25820926|date=21 January 2014|title=Signs warn dog owners of killer disease|work=[[BBC Online]]|access-date=27 March 2015}}&lt;/ref&gt; is an often fatal condition in [[dog]]s. It was first identified in the US in the 1980s in greyhounds.&lt;ref name=&quot;DT-WiAR&quot;&gt;{{cite news|url=https://www.telegraph.co.uk/health/petshealth/10586732/What-is-Alabama-rot.html|archive-url=https://web.archive.org/web/20140122070250/http://www.telegraph.co.uk/health/petshealth/10586732/What-is-Alabama-rot.html|url-status=dead|archive-date=22 January 2014|title=What is Alabama rot?|work=[[The Daily Telegraph]]|date=21 January 2014|access-date=27 March 2015}}&lt;/ref&gt;&lt;ref name=&quot;Carpent et al 1988 401–407&quot;&gt;{{Cite journal|last=Carpent|display-authors=etal|first=J. L.|date=1988|title=Idiopathic Cutaneous and Renal Glomerular Vasculopathy of Greyhounds|journal=Veterinary Pathology|volume=25|issue=6|pages=401–407|doi=10.1177/030098588802500601|pmid=3212884|s2cid=29887065}}&lt;/ref&gt; The high number of affected dogs at the Greenetrack Racing Park, Alabama, led to the initial pseudonyms of Greenetrack Disease and Alabama Rot.&lt;ref&gt;{{cite journal |last1=Carpenter |first1=J. L. |last2=Andelman |first2=N. C. |last3=Moore |first3=F. M. |last4=King |first4=N. W. |title=Idiopathic Cutaneous and Renal Glomerular Vasculopathy of Greyhounds |journal=Veterinary Pathology |date=November 1988 |volume=25 |issue=6 |pages=401–407 |doi=10.1177/030098588802500601}}&lt;/ref&gt; The initial symptoms are skin lesions on the legs, chest and abdomen followed by renal involvement.&lt;ref name=&quot;DT-WiAR&quot; /&gt;&lt;ref name=&quot;Carpent et al 1988 401–407&quot;/&gt;

In November 2012 the first cases were suspected in the UK.&lt;ref&gt;{{cite book|author=Walker, D|publisher=Anderson Moores Veterinary Specialists|title=Important information regarding dogs with acute kidney injury ('Alabama Rot')|date=23 March 2015|url=http://www.andersonmoores.com/vet/news|access-date=27 March 2015}}&lt;/ref&gt; In January 2014, the outbreak in England was identified as having the same or similar histological and clinical findings as Alabama rot, though this could not be classified as Alabama Rot as the histological results from the UK lacked the relation to ''E.&amp;nbsp;coli'' that was present in all the cases in the US,&lt;ref name=&quot;BBC-uk-25820926&quot; /&gt;&lt;ref name=&quot;DT-WiAR&quot; /&gt; although a wide range of breeds were affected.&lt;ref name=&quot;BBC-uk-25820926&quot; /&gt; The suspected disease has been possibly identified across England and Wales, with a case being reported as far north as [[North Yorkshire]] in March 2015. A map posted online shows confirmed (with post-mortem) and unconfirmed (without post-mortem) cases of CRGV since December 2012 in the United Kingdom.&lt;ref&gt;{{cite web|title=UK Map of Alabama Rot|url=https://www.google.com/maps/d/edit?mid=zIJgTtl9x6zk.kif7awTR9hAA|date=6 February 2015|access-date=27 March 2015}}&lt;/ref&gt; In May 2017 it was reported that 98 suspected deaths from the disease have occurred in the UK, including 15 in 2017.&lt;ref&gt;{{cite news|work=BBC News|date=10 May 2017|title=Alabama rot: The dog disease with no cure|author=Jennifer Scott|url=https://www.bbc.co.uk/news/uk-39859678|access-date=29 November 2017}}&lt;/ref&gt;

==Signs and symptoms==
The disease is characterized by cutaneous and sometimes renal changes with the latter frequently being ultimately fatal.&lt;ref&gt;{{Cite journal|last1=Holm|first1=L. P.|last2=Hawkins|first2=I.|last3=Robin|first3=C.|last4=Newton|first4=R. J.|last5=Jepson|first5=R.|last6=Stanzani|first6=G.|last7=McMahon|first7=L. A.|last8=Pesavento|first8=P.|last9=Carr|first9=T.|date=2015-04-11|title=Cutaneous and renal glomerular vasculopathy as a cause of acute kidney injury in dogs in the UK|url= |journal=Veterinary Record|language=en|volume=176|issue=15|pages=384|doi=10.1136/vr.102892|issn=0042-4900|pmc=4413843|pmid=25802439}}&lt;/ref&gt;&lt;ref name=&quot;Carpent et al 1988 401–407&quot;/&gt;

Common symptoms of CRGV include, but are not limited to:&lt;ref&gt;{{Cite web | url=http://www.arrf.co.uk/symptoms.html | title=Symptoms |website= www.arrf.co.uk Alabama Rot Research Fund (ARRF) |access-date= 26 May 2020}}&lt;/ref&gt;
* Cutaneous lesions involving erythema, erosion, ulceration occurring mainly on extremities such as distal limbs, muzzle and ventrum
* Pyrexia (fever)
* Lethargy or malaise
* Anorexia
* Vomiting or retching

==Causes==
Some veterinary experts theorize the disease is caused by a parasite, while others believe it is bacterial. It is more widely believed that Alabama rot is caused by toxins produced by ''[[E. coli]]'' but, as there has been no presence of ''E. coli'' in histological examination in UK cases, the disease is described there as suspected CRGV rather than Alabama rot ''per se''. Because the exact cause has not been found, developing a vaccine is not possible. The cause of Alabama rot in the UK is under study as of 2013 at Anderson Moores Veterinary Specialists in Winchester, Hampshire.&lt;ref name=Anderson&gt;{{cite web|title=Important information regarding dogs with acute kidney injury ('Alabama Rot')|url=http://www.andersonmoores.com/vet/news|publisher=Anderson Moores|access-date=28 March 2015}}&lt;/ref&gt; A podcast on Alabama rot was published in April 2014 by the [[Royal Veterinary College]].&lt;ref&gt;{{cite book|author=Jasani, S.|publisher=Royal Veterinary College|date=14 April 2014|title=Alabama Rot-like Syndrome in UK dogs (and podcast)|url=http://www.rvc.ac.uk/small-animal-referrals/news-events/clinical-podcasts/15-alabama-rot-like-syndrome-in-uk-dogs|access-date=28 March 2015}}&lt;/ref&gt; As of February 2015 the [[Forestry Commission England]] will only publish specific site location details if &quot;cases are confirmed as CRGV and a scientific connection to the dogs walked on the site is made&quot;.&lt;ref&gt;{{cite web|title=Cutaneous and Renal Glomerular Vasculopathy (CRGV or 'Alabama Rot')|url=http://www.forestry.gov.uk/alabamarot|publisher=Forestry Commission England|access-date=28 March 2015|archive-date=15 February 2018|archive-url=https://web.archive.org/web/20180215083621/https://www.forestry.gov.uk/alabamarot|url-status=dead}}&lt;/ref&gt;

A comprehensive report on CRGV was published in March 2015 by the [[British Veterinary Association]], concluding that it is a disease of unknown cause &quot;carrying a poor prognosis when [[azotaemia]] develops&quot;.&lt;ref name=BVA&gt;{{cite journal |author=Holm, L. P. |display-authors=etal |journal=Veterinary Record |date=March 2015 |title=Cutaneous and renal glomerular vasculopathy as a cause of acute kidney injury in dogs in the UK |url= |volume=176 |issue=15 |page=384 |doi=10.1136/vr.102892 |pmid=25802439 |pmc=4413843 }}&lt;/ref&gt; However, an association has been linked to dogs walking on muddy ground.&lt;ref name=&quot;KC&quot;&gt;{{cite web |title=Alabama rot |url=https://www.thekennelclub.org.uk/health/for-owners/alabama-rot/ |website=www.thekennelclub.org.uk |access-date=26 May 2020 |language=en}}&lt;/ref&gt;

==Treatments==
Treatment is primarily symptomatic involving wound management of skin lesions and aggressive supportive therapy when renal compromise occurs. Some UK dogs with Alabama rot have been successfully treated since 2013.&lt;ref name=Anderson /&gt; A webinar on Alabama rot by the Royal Veterinary College on 11 February 2015 was tutored by David Walker of Anderson Moores Veterinary Specialists.&lt;ref&gt;{{cite web|title=Webinar: Understanding 'Alabama Rot'|date=11 February 2015|url=http://cpd.rvc.ac.uk/courses/webinar-understanding-%E2%80%98alabama-rot%E2%80%99|publisher=Royal Veterinary College|access-date=28 March 2015|archive-url=https://web.archive.org/web/20160304234839/http://cpd.rvc.ac.uk/courses/webinar-understanding-%E2%80%98alabama-rot%E2%80%99|archive-date=4 March 2016|url-status=dead}}&lt;/ref&gt;  As the disease is widely believed to spread via dogs' feet and legs, due to the current lack of treatment the best action is to avoid infection by not walking dogs in a suspected infected area.{{citation needed|date=March 2018}}

In August 2018 sources reported that [[plasmapheresis]] (therapeutic plasma exchange) resulted in survival of 2 out of 6 dogs with advanced disease.&lt;ref&gt;[https://www.vettimes.co.uk/news/rvc-announces-alabama-rot-breakthrough/ RVC announces Alabama rot breakthrough] 1 August 2018 ''www.vettimes.co.uk'', accessed 26 May 2020&lt;/ref&gt; This finding offers hope that such blood filtering could result in better survival rates, particularly if caught early before vascular and renal damage occur.{{citation needed|date=April 2021}}

==Epidemiology==
The number of cases in the US is not known, but it was confined to greyhounds and in many cases was not fatal; however, as of 2017 there had been 103 suspected cases in the UK.&lt;ref&gt;[https://www.bmj.com/company/newsroom/uk-alabama-rot-risk-may-be-linked-to-certain-types-of-dog-breed-and-habitat/ UK Alabama Rot risk may be linked to certain types of dog breed and habitat], ''BMJ Newsroom'', accessed 26 May 2020&lt;/ref&gt;

Analysis by Felcana found that between 2018 and 2020, South West and South East regions had the highest proportion of Alabama Rot cases per 100,000 dogs in the UK.&lt;ref&gt;{{Cite web | url=https://felcana.com/blogs/blog/alabama-rot | title=UK distribution of Alabama Rot cases by region|website= www.felcana.co.uk. Felcana |access-date= 1 March 2021}}&lt;/ref&gt;

== References ==
{{Reflist|2}}

[[Category:Kidney diseases]]
[[Category:Dog diseases]]
[[Category:Idiopathic diseases]]