Why would a vet test a healthy dog’s kidneys twice in 3 days?
This is currently the only way of detecting if a dog is at risk of Alabama Rot. This serious condition means a headache (and heartache) from start to finish, because there is no vaccine and no test, the early signs are vague, and yet prompt treatment could be life-saving.
When Alabama Rot is spotted early, aggressive supportive care gives the dog the best chance of recovery. With around 85 percent of cases not surviving, we need the odds tipping in our favor any way we can. Hence why, one Saturday morning, Elsa came in for a second blood test.
A Possible Case of Alabama Rot
Last week, Elsa the Labrador had been for a walk in muddy woodland. The following day, her human noticed an ulcerated sore patch on the top of her paw. The person had no idea how Elsa had hurt herself, and the area was slowly getting bigger.
Alabama Rot is rare but tricky, not least because the early symptoms are vague. Indeed, it’s not possible to tell an innocent skin sore, ulcer or scrape from the early signs of this serious condition. Elsa’s person, being well-informed, was aware of this and eager to do everything possible to check out her dog.
In clinic, the sore paw looked just that: a small patch of hair loss with inflamed skin and a sticky discharge. It was also quite itchy, causing Elsa to lick at every opportunity.
Alabama Rot lesions tend to be itchy (and painful), so there was little reassurance on the physical exam. Neither did the history of recent contact with mud during the winter ease our minds, with both mud and cold weather being known risk factors.
What to do? Test Elsa’s kidney function.
The Current “Best Test”
When the cause of Alabama Rot remains a mystery, there is no diagnostic test. What we do know is that Alabama Rot (more correctly called cutaneous and renal glomerular vasculopathy, or CRGV) damages the kidneys.
The pattern of disease is that it starts with skin ulcers or sores, and then micro-blood clots lodge in the kidney, like a blocked garbage disposal unit, to stop them from working. This progression from normal kidneys to failure can take 1–9 days, with an average being 4 days.
Hence, the first day the dog is seen in clinic, we take a reference blood sample and repeat the test a few days later. Comparing the 2 results can tell us if the kidneys are completely normal or starting to struggle. If the second lot of test results are worse than the first, this flags Alabama Rot as a possibility.
The Signs of Alabama Rot
OK, so sore skin is common, especially in active dogs, so what else should you be alert for?
Again, the signs are vague and relate to skin sores and worsening renal function. Be vigilant for the following symptoms:
- These are usually below the elbow or mid-thigh, with the muzzle, tongue and belly also being common sites.
- The sores are painful, and the dog wants to lick them.
- The lesions are often circular.
- They range in size from pinpoint to around 10 centimeters in diameter.
- Lack of energy
- Increased thirst and passing more urine
- Loss of appetite
- Sickness and diarrhea
Treatment of Alabama Rot
The problem is not so much the skin lesions (which can be managed with antibiotics and dressings) but the kidney damage. Current treatment aims to support the kidneys and keep flushing them through with intravenous fluids. Then other medications are added in to help:
- Reduce nausea
- Protect against stomach ulcers
- Flush the kidneys through
- Control high blood pressure
- Keep the dog comfortable
Specialist centers are trialing new therapies, such as plasma transfusions, but so far, the benefits are largely unproven.
How much better, then, if we could identify a cause and move forward with targeted therapies?
This vet shares that Alabama Rot is being found in dogs all around the UK:
A Possible Cause
Ever since cases first surfaced in Alabama in the 1980s, attempts to find a cause have failed. But, at long last, there is the first glimmer of a clue.
A fish veterinarian, Dr. Fiona Macdonald, was intrigued by a fish disease causing skin ulcers, fin and tail rot, and blood poisoning (similar symptoms to Alabama Rot). It is caused by a bacterium called Aeromonas hydrophilic, which is found in soil and water.
This bacterium produces a toxin called aerolysin, which causes kidney failure in fish, but isolating the bacterium and proving its presence as the cause of Alabama Rot is hugely difficult. So although a suspicion has hung over Aeromonas for a long time, no hard evidence has been found.
But Dr. Macdonald has developed a test looking for antibodies produced by the body’s immune system in its fight against this bacterium. So far, she is collecting data, but she’s found antibody levels are much higher in dogs with Alabama Rot than in normal dogs, which at very least gives researchers a clue.
Another hopeful development is Dr. Macdonald is developing a skin swab test. Suspect lesions can be swabbed and transported in a special growth medium that helps detect Aeromonas. Again, one dog with Alabama Rot tested positive on this swab, which is hugely exciting as a possible means of early detection.
So far, this research is in the early pre-publication stage, with Dr. Macdonald putting out a call to vets to send her samples from suspect cases. This helps build the bigger picture to see if this offers hope for detecting, treating and preventing this awful condition.
And Elsa? Her story has a happy ending. Her skin lesion settled down with antibiotics, and both blood tests came back normal. To this day, her human doesn’t know how she hurt her paw but doesn’t care — because it wasn’t Alabama Rot.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Mar. 2, 2018.