Cutaneous and renal glomerular vasculopathy / Alabama rot – Veterinary Information Sheet (unedited source)
Cutaneous and renal glomerular vasculopathy (CRGV) is a disease of unknown aetiology, often characterised by ulceration of the distal extremities in dogs. It is variably associated with clinically significant renal azotaemia secondary to acute kidney injury (AKI). CRGV has previously been reported in a case series of greyhounds in the USA, a Great Dane in Germany and a greyhound within the UK.
Since November 2012, more than sixty dogs across the UK have been identified with clinicopathological findings similar to those reported in greyhounds in the USA in the 1980’s. Skin lesions, typically appearing as ulcers or erosions on the distal limbs, ventrum or oral cavity/muzzle, commonly appear less than a week before clinical signs attributable to AKI.
The major renal histopathological lesion reported in CRGV is thrombotic microangiopathy (TMA). Thrombotic microangiopathies are characterised by inflammation and damage to vascular endothelium, leading to widespread formation of microthrombi and resultant consumptive thrombocytopaenia.
A range of breeds have been identified with CRGV in the UK suggesting the disease does not solely affect greyhounds. There does not appear to be a breed, body weight, sex or age predilection. Cases have been identified across the whole of UK and there may be a seasonal distribution with cases being identified between November and June.
Thrombocytopaenia has been identified in approximately half of the affected dogs and is thought to be the result of widespread microthrombi. Mild anaemia, neutrophilia and hyperbilirubinaemia have also been seen in around a quarter of affected dogs. A significant proportion of dogs affected by CRGV are non azotaemic at presentation, if you are presented with a dog with a skin lesion of unknown cause and you or the owner are concerned about CRGV please refer to our ‘non azotaemic cutaneous and renal glomerular vasculopathy – advice sheet for vets’ for further information.
A definitive diagnosis of CRGV is made by histopathological assessment of the kidneys +/- skin. The aetiology of CRGV remains unknown at this time and common causes of AKI should be considered and excluded when presented with a dog that may be suffering from CRGV.
Current knowledge suggests management should be as for any dog presenting with AKI of unknown cause. Advice should be sought when presented with a patient with suspected CRGV.
If you are concerned that a case you have been presented with may be suffering from CRGV please feel free to contact Anderson Moores Veterinary Specialists (01962 767920; firstname.lastname@example.org). We continue to collate data on all cases nationally. We can provide histopathology free of charge on suspected cases but please contact us prior to sending tissue.
Please see Anderson Moores Facebook page for regular CRGV updates.