As I write, January is rapidly approaching. It has been a very difficult and distressing Winter so far. Flooding of homes, businesses including farms, loss of livestock…will it be snow next? With such a big worldwide problem, every little energy-use or dietary decision we make at home, travelling or at work can make a positive difference to the seemingly-inexorable global warming phenomenon.
Spring flowers are catching up with the season, having been lured under false pretences to flower earlier than normal – welcome though it is. But just a little disturbing, perhaps.
As a local practice, we have had a great number of dogs with a seasonal canine illness (SCI) – vomiting, diarrhoea and lethargy but free of any skin lesions.
Currently, the concern is the Winter/Spring seasonality of a serious illness named “Alabama Rot”. Only dogs can be affected – at a very, very low incidence. 56 confirmed cases across the UK between November 2012 and May 2015. Any age, sex or breed. The disease gives skin lesions, occasionally in the mouth, which can look like bites, sores, wounds and stings. Some dogs go on to develop life-threatening kidney failure. Many possible causes, infectious, plant…have been ruled out. However, no proof of an environmental cause has yet been found and research is ongoing.
This research is being co-ordinated and collated by the specialist team at the Anderson Moores Referral Practice near Winchester, Hampshire. They are helped by the New Forest Dog Owners Group and the Animal Health Trust, Newmarket, along with other national authorities. Private and corporate veterinary practices are also feeding back information and whenever necessary, case work. Three possible local cases are yet to be confirmed but are being treated as I write. I wish for full recovery with all the excellent professional care that they are getting at their great practices.
Most cases have occurred between November and May. Professionally known as CRGV (Cutaneous and Renal Glomerular Vasculopathy), it IS a serious disease but cases have only just been recognised across the UK since November 2012. In the USA, it has been recognised initially mainly in greyhounds since the late 1980’s. CRGV is a disease caused by damage to blood vessels of both skin and kidney by enabling blood clots to form. Affected blood vessels will block and this ultimately leads to damage of that area of skin or kidney tissue. Ulceration of the skin and kidney failure may then follow. Not all clinical signs go from skin to kidney – it can be kidney failure before skin ulceration.
As the cause is, as yet, not fully understood, it’s difficult for Anderson Moores to give specific advice about prevention. You may wish to consider regularly bathing any area of your dog that becomes particularly wet or muddy but at this stage, no-one knows if this is necessary or indeed if of any benefit.
I am grateful to Anderson Moores for their very informative fact sheets, for clients and for veterinary surgeons, on CRGV. I will give links in a moment but the key message is that there are no particular areas to avoid in the UK. Although CRGV can be very serious, the number of dogs affected with skin lesions AND kidney failure remains LOW. Also, please remember that even if the skin is ulcerated due to CRGV, many dogs will NOT develop kidney problems and WILL recover FULLY.
More links are shown in the link pages themselves.
So, what can I advise myself and fellow dog owners?
Unexplained reddened, sore or swollen areas of the skin (paws, legs, body, face, tongue or mouth) are often the first sign. Please remember that most of the time, such skin lesions will NOT be caused by CRGV. However, as the info sheet says, CRGV lesions aren’t easy to distinguish from cuts, wounds, stings or bites, so IF IN DOUBT, please seek veterinary attention. Your veterinary surgeon will decide what treatment is suitable or appropriate, with dogs developing acute kidney injury needing much more intensive management and possible specialist referral.
At initial presentation, if caused by CRGV, skin lesions present asymptomatically but within one to nine days, acute kidney injury develops. Sometimes, remember, kidney injury is seen first BUT the fact is that the majority of kidney injuries are caused by causes other than CRGV. Practices are recommended to ask permission for routine urine and blood tests to be carried out in-house, even on day 0. These will at least act as baseline data when repeated testing is carried out over the next two to four days. We have access to specialist advice for case management, which will involve 24 hour care and, often, referral.
I hope that this sets this CRGV issue in better perspective and please contact your own veterinary practice for any more information that you may require.
May I then sincerely wish for a happy, healthy New Year again for both your companion pet and yourself over the coming year.
Robert Elliott MRCVS