Cutaneous lesions may be the only clinical feature of this syndrome, or cutaneous lesions may precede or follow the onset of azotemia. Severe peracute renal failure may occur in these dogs or the renal involvement may be minimal. The precise pathogenesis of this syndrome is unknown, although histologic changes are found in blood vessels of the kidney and skin. A bacterial toxin has been suspected as a pathologic mechanism. Lesions are most frequently seen on the tarsus, stifle or inner thigh.
Lesions procede to ulcerate to the level of the subcutaneous tissue.
Treatment is supportive and symptomatic for the ulceration and for renal failure, if coexistent. Healing and full recovery may take several weeks. Dogs may not return to previous levels of racing performance.