Category Archives: Cases

For dog owners & vets: noticing signs & treatment of CRGV; CRGV-like diseases in humans.

Cutaneous and renal glomerular vasculopathy lesions present on the muzzle.
Cutaneous and renal glomerular vasculopathy lesions present on the muzzle.

Laura Holm of Anderson Moores Vet Specialists wrote “Noticing signs of CRGV in dogs to diagnose disease presence” in the Vet Times (March 21st 2016).

Cutaneous and renal glomerular vasculopathy lesion affecting forelimb digits.
Cutaneous and renal glomerular vasculopathy lesion affecting forelimb digits.

Laura Holm said that only a quarter of dogs with skin lesions go on to get acute kidney injury:

“Evidence suggests the median time from the onset of a skin lesion, to development of azotaemia [high blood Nitrogen levels], is 3 days (range 0 to 10 days) … There does, however, appear to be a subset of dogs that develop skin lesions without azotaemia (non-azotaemic CRGV) … with about 75% of cases remaining systemically well following development of skin lesions and only about 25% developing clinical signs attributable to AKI [Acute Kidney Injury].”

Blood clots result in skin ulcers and kidney failure:

“When microthrombi [small blood clots] occlude [obstruct] blood supply in dermal [an area below the skin] vessels, dermal cell death occurs and cutaneous ulceration [skin ulcers] develops, whereas microthrombi in the glomeruli [kidney capillaries] reduce glomerular blood supply and glomerular filtration rate, potentially causing azotaemia [high nitrogen levels in blood] and oliguria [production of small amounts of urine] or anuria [failure of kidneys to produce urine].”

Cutaneous and renal glomerular vasculopathy lesions on the body and limbs.
Cutaneous and renal glomerular vasculopathy lesions on the body and limbs.

Of the 75% dogs that have skin ulcers without kidney injury, the prognosis is excellent. Of the other 25% of dogs that have skin lesions and kidney injury, 85% die when treated at vets whilst slightly fewer (75%) die when treated at referral centres [eg Anderson Moores Vet Specialists in Winchester]:

“For CRGV cases that remain non-azotaemic [normal blood nitrogen levels], the prognosis is excellent. Although skin lesions may take weeks or months to heal, a full recovery should be expected. Unfortunately, the prognosis is significantly less favourable in dogs with CRGV that develop AKI. Overall, more than 85% of CRGV cases with azotaemia have been euthanised or died… The outlook may be slightly better for cases managed in referral centres. Approximately 25% of azotaemic-suspected CRGV cases managed in referral centres have survived. However, no single therapy has been used more commonly in surviving cases and this figure is likely to reflect the more intensive monitoring and management generally possible in the referral setting.”

Laura Holm says that CRGV has not been reported in species other than dogs but CRGV-like diseases do occur in humans:

In humans a group of diseases exist that are characterised by thrombotic microangiopathy (TMA) [blood clots inside blood vessels] which bear some similarities to CRGV, namely: haemolytic uraemic syndrome (HUS) [anemia caused by destruction of red blood cells, acute kidney failure, and low platelet counts], atypical haemolytic uraemic syndrome (aHUS) [uncontrolled activation of the complement immune system that removes foreign particles] and thrombotic thrombocytopenic purpura (TTP) [microscopic clots that form in the small blood vessels].

But even in humans, the causes of CRGV-like diseases are poorly understood:

“Even in humans, the aetiopathogeneses [cause] of TMA illnesses are still relatively poorly understood. Definitive diagnosis can be challenging and treatment is not always successful.”

Reported by Chris Street BSc MSc at Alabamarot.co.uk (May 26th 2016)

References

Vet Times (March 21st 2016) article by Laura Holm.

Notes

Text in [ ] is by alabamarot.co.uk

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Fetcham Surrey – dog dies of confirmed CRGV.

Today Anderson Moores Vet Specialists report that sadly, one dog has been confirmed as having died as a result of cutaneous and renal glomerular vasculopathy (CRGV). The dog was from Fetcham, Surrey.

Our two Alabama Rot maps have been updated. The confirmed cases map gives the Fetcham, Surrey location (red drop). The all cases map includes the Fetcham location (red drop) and the three areas – Bookham Common, Polesden Lacey and Norbury Park (orange drops) where the dog was walked, according to Pet Doctors Fetcham.

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92% of all 121 Alabama Rot cases are in Winter or Spring

Of the 121 reported cases of confirmed, unconfirmed and suspected Alabama Rot between December 2012 and April 2016 (at 8th May 2016), 92% were reported in Winter (52%, 63 cases) and Spring (40%, 48 cases). Only 8% (10 cases) were reported in Summer (4%, 5 cases) or Autumn (4%, 5 cases).

75 confirmed cases (confirmed by dog post mortem) were analysed in another post dated 8th May 2016 indicating that 89% cases were reported in Winter or Spring.

This post with 121 analysed cases seems to strengthen the argument for a Winter / Spring seasonality to Alabama Rot. This 121 case analysis has 46 more cases (+60%) than the 75 confirmed cases.

alabamaRot-ALL-by-season
Winter (December, January, February), Spring (March, April, May), Summer (June, July, August), Autumn (September, October, November).

Chris Street of AlabamaRot.co.uk on 8th May 2016 analysed all confirmed UK Alabama Rot cases (between December 2012 and April 2016).

Data sources – Confirmed Cases UK map combined with Unconfirmed & Suspected cases (excludes confirmed cases) and cases-by-month spreadsheet.

Chart of All Alabama Rot cases by month between 2012 and 2016:

alabamaRot-ALL-cases-by-month

The monthly all cases were plotted by year:

alabamaRot-all-cases-by-month-by-year

The above chart shows the vast majority of Alabama Rot cases occur every year in Winter (December – February) and Spring (March – May).

Why donate to AlabamaRot.co.uk?

89% of the 75 confirmed Alabama Rot cases are in Winter or Spring

Of the 75 confirmed cases of Alabama Rot between December 2012 and April 2016, 89% (67 cases) were reported in Winter (51%, 38 cases) and Spring (38%, 29 cases). Only 11% cases (8 cases) were reported in Summer (4%, 3 cases) or Autumn (7%, 5 cases).

alabamaRot-by-season
Winter (December, January, February), Spring (March, April, May), Summer (June, July, August), Autumn (September, October, November).

Chris Street of AlabamaRot.co.uk on 8th May 2016 analysed all confirmed UK Alabama Rot cases (between December 2012 and April 2016).

Data Source – Confirmed Cases UK map and cases-by-month spreadsheet.

Chart of confirmed Alabama Rot cases by month between 2012 and 2016:

alabamaRot-by-month

The monthly cases were plotted by year:

alabamaRot-by-month-by-year

The above chart shows the lion’s share of Alabama Rot cases occur every year in Winter (December – February) and Spring (March – May).

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Midlothian, Scotland: Dog dies of suspected CRGV (Alabama Rot)

On 16th April 2016 ICR Vets posted news of a suspected (confirmed by post-mortem?) case of Alabama Rot / CRGV that was presented early March 2016.

ICR Vets in Edinburgh said:

“We can confirm that we treated a case of Alabama Rot at the start of March. The disease is almost always fatal and our case sadly did not make it…. We are not advising any areas to avoid in Midlothian as we don’t know where the disease has come from – but the best advice is to wash and dry dogs feet after walks, and to be vigilant checking your dogs for new skin lesions. If you see any suspicious lesions please contact us on 0131 440 4229.”

Anderson Moores at Bransgore fundraising event for Alabama Rot research

Laura Holm a vet from Anderson Moores Veterinary Specialists – the UK leading authority on Alabama Rot – will speak at a fundraising event in Bransgore, Dorset on Friday 22nd April 2016.

CRGV fundraiser flyer (pdf, 4MB).

The event is organized by local pet businesses in aid of:

The New Forest Dog Owners Group Alabama Rot Research Fund

&

Hearing Dogs for Deaf People.

Doors open 6.15pm, first speaker (Laura Holm) 7pm. Venue is Bransgore Village Hall Burley Road, Bransgore, BH23 8AY

Speakers

Laura Holm, BVM&S CertSAM MRCVS Veterinary Surgeon from Anderson Moores Veterinary Specialists – The latest findings on CRGV (Alabama Rot).

Mark Pegg and ‘Erin’ South Hants Hearing Dogs – Life with a Hearing Dog,

Raffle

A raffle will be held on the evening. All donations of prizes will be very gratefully received.

Tickets

Tickets £3.50 in advance, £4 on the door. Complimentary refreshments provided.

Tickets available from: Sarah Stephens, Oscar Pet Foods – 07770 601668; Katy Dalton, Wagging Tails Home Dog Boarding – 01425 673 928; Rocky Ranch Pet Food Supplies – 07775 563155