Alabama rot

Lore & Background

Alabama rot was first identified in the US in the 1980s in greyhounds, with a cluster at the Greenetrack Racing Park in Alabama giving the disease its common names. Initial symptoms are cutaneous lesions on the legs, chest, and abdomen, followed by renal involvement, which is frequently fatal. In November 2012, the first suspected cases appeared in the UK, and by January 2014, the outbreak in England was found to have similar histological and clinical findings to the US cases, though the E. coli association previously suggested in US cases was never definitively proven, leading to the term 'suspected CRGV' rather than Alabama rot per se.

Reader's Guide

Alabama rot remains a significant concern in veterinary medicine due to its high fatality rate and unknown cause. The disease was first noted in US greyhounds in the 1980s, but its emergence in the UK since 2012, affecting a wide range of breeds, has prompted ongoing research. Veterinary experts theorize causes ranging from parasites to bacterial toxins, with E. coli toxins widely believed in the US, but UK cases lack this link. Treatment is primarily symptomatic, with wound management and aggressive supportive therapy for renal compromise. In August 2018, plasmapheresis showed promise, with survival in 2 of 6 advanced cases. The disease's association with muddy ground and the lack of a vaccine mean avoidance of suspected areas is recommended. As of 2017, 103 suspected cases and 98 deaths were reported in the UK, with highest proportions in South West and South East regions between 2018 and 2020.

Did You Know?

• The disease was first identified in the 1980s in greyhounds at Greenetrack Racing Park, Alabama.
• UK cases since 2012 have been compared to US cases, but the E. coli association in US outbreaks was never definitively proven.
• As of May 2017, 98 suspected deaths from the disease had occurred in the UK.
• Plasmapheresis has been explored as a treatment, but its effectiveness in advanced disease is not widely established in the known literature.

Origins and the Birth of a Name

Alabama rot first surfaced in veterinary records during the 1980s in the United States, where it struck greyhounds with particular severity. The condition was not immediately given a formal medical name; instead, the cluster of affected animals at the Greenetrack Racing Park in Alabama gave rise to two informal labels—Greenetrack Disease and Alabama Rot—that stuck in both clinical and public discourse. The full medical designation, cutaneous and renal glomerular vasculopathy (CRGV), captures the dual attack on skin and kidneys that defines the pathology. Unlike many canine illnesses that affect a broad range of breeds, the American presentations were confined to greyhounds, and in numerous instances the disease did not prove lethal. This relative containment, however, would not hold when the condition crossed the Atlantic. The naming history reflects a broader pattern in veterinary medicine: when a disease appears in a concentrated, geographically linked population, the location becomes shorthand for the condition itself, even as the underlying biology remains only partially understood.

The UK Outbreak and Geographic Spread

The first suspected cases in the United Kingdom emerged in November 2012, and by December of that year an online map began tracking both confirmed (post-mortem verified) and unconfirmed cases across the country. A turning point came in January 2014, when the English outbreak was recognised as sharing the same or very similar histological and clinical hallmarks as the American condition. Yet a critical distinction emerged: the UK tissue samples lacked the E. coli association that characterised every American case, meaning the disease could not be formally classified as Alabama rot and was instead termed suspected CRGV. Unlike the greyhound-limited American presentations, the UK epidemic affected a wide range of breeds. The geographic footprint expanded steadily—by March 2015 a case had been reported as far north as North Yorkshire—while the toll mounted. By May 2017, 98 suspected deaths had been recorded, including 15 in that year alone, and the total suspected case count reached 103. A 2018–2020 analysis by Felcana identified the South West and South East regions as bearing the highest proportion of cases per 100,000 dogs.

Clinical Presentation and Prognosis

The disease announces itself through a characteristic sequence of signs that progress from the skin inward. The earliest and most visible markers are cutaneous lesions—patches of redness, erosion, and ulceration—concentrated on the extremities, the muzzle, and the ventral surface of the body. In the American descriptions, these lesions appeared on the legs, chest, and abdomen before the kidneys became involved. Accompanying systemic signs include fever, marked lethargy or general malaise, loss of appetite, and vomiting or retching. The truly dangerous phase arrives when renal compromise sets in; once azotaemia develops, the British Veterinary Association's March 2015 comprehensive report concluded that the prognosis becomes poor. The renal involvement is what frequently renders the condition ultimately fatal, distinguishing it from a purely dermatological problem. Because the precise aetiology remains unresolved—some experts suspect a parasitic agent, others a bacterial one, while the prevailing view points to toxins produced by E. coli—there is no targeted therapeutic or preventive strategy. The BVA report characterised CRGV as a disease of unknown cause, a description that still holds and that leaves affected dogs and their owners largely at the mercy of supportive care.

Treatment, Prevention, and Emerging Hope

Because no definitive aetiological agent has been isolated, a vaccine remains out of reach, and clinical management is symptomatic. The standard approach involves wound care of skin lesions and aggressive supportive therapy once renal function begins to deteriorate. Encouragingly, some UK dogs have been successfully treated since 2013, and the Royal Veterinary College has contributed to public understanding through an April 2014 podcast and a February 2015 webinar tutored by David Walker of Anderson Moores Veterinary Specialists. In the absence of a cure, prevention takes centre stage: the disease is widely believed to spread via contact with contaminated mud on dogs' feet and legs, and a recognised association with walking on muddy ground has prompted the Forestry Commission England to restrict publication of specific site locations unless a confirmed CRGV case and a scientific link to the dogs walked there are established. The most cautious advice for owners is simply to avoid suspected infected areas. A glimmer of new hope emerged in August 2018, when reports indicated that plasmapheresis—therapeutic plasma exchange—enabled two of six dogs with advanced disease to survive. This finding suggests that blood-filtering techniques, applied before vascular and renal damage becomes irreversible, could improve survival rates.