CONDITION
Alabama Rot (CRGV)
Alabama rot, formally called cutaneous and renal glomerular vasculopathy (CRGV), is a condition in which small blood vessels in the skin and sometimes the kidneys become damaged and blocked by tiny clots. The cause remains unknown. It is rare: typically fewer than 50 confirmed cases are recorded each year in the UK, though the condition attracts significant attention because of its severity and the uncertainty surrounding it. Owners most often notice unexplained skin lesions, particularly on the legs or paws: areas that can appear red, ulcerated, or swollen without an obvious injury. In some dogs the kidneys are also affected, typically within days of the skin lesion. Most dogs that develop kidney injury do not survive, while dogs whose kidneys stay unaffected usually recover. The pattern and progression can vary, and the condition can resemble other causes of skin wounds or illness. This page explores what is observed in affected animals, what may be happening beneath the skin, how the condition is investigated, and the approaches that may be considered when CRGV is suspected. It also examines what is currently understood, and not yet understood, about how and why it occurs.
Why this matters now
Alabama rot cases in the UK cluster predominantly between November and May, with wet, muddy walking conditions appearing to be a common factor. Dogs of many breeds and ages have been affected, and certain areas report higher case numbers. In a UK study of 101 cases, hounds and gundogs were at higher risk than terriers, and no toy breeds were among the cases.
The condition typically begins with unexplained skin lesions, often on the legs, paws, or face. These may initially resemble cuts, stings, or other minor injuries. In some dogs the disease goes on to affect the kidneys, causing acute kidney injury: in a UK series of 178 dogs the median time from the first skin lesion to acute kidney injury was 3 days, with a range from 4 days before the lesion to 45 days after it. Whether the kidneys are involved cannot be judged from the look of the skin or from the dog's behaviour at home, and early blood results can be normal. Dogs whose kidneys stay unaffected have an excellent outlook. Once acute kidney injury develops the outlook is poor: in the first UK series of 30 confirmed cases every dog died or was euthanised, at a median of 7 days from the first signs, and the specialist centre that tracks UK cases has put mortality at about 90%.
Signals & patterns
Early signals
Unexplained skin sores
Lesions typically appear as red, ulcerated areas, often on the lower legs, paws, underside of the body, muzzle or mouth without known trauma.
Swelling around lesions
The tissue surrounding skin sores may appear puffy or oedematous.
Licking at affected areas
Dogs may show attention to developing lesions before they become obviously visible.
Recent muddy walks
Many affected dogs have a history of walking in wet, muddy woodland areas in the preceding days.
Later signals
Reduced appetite
Declining interest in food may indicate systemic effects as the condition progresses.
Lethargy
Generalised weakness and reduced activity can accompany kidney involvement.
Vomiting
Nausea and vomiting may develop as kidney function becomes impaired.
Reduced urination
Passing little or no urine is a sign of established acute kidney injury. It is hard to judge at home and is measured in hospital.
Click to read about the biological mechanisms
How this is usually investigated
Investigation begins with careful examination of the skin lesions and a detailed account of recent activity, including where the dog has been walked. Because the condition is rare and the early skin changes can resemble many other causes of wounds or ulcers, the diagnosis often becomes clearer only over time. Blood and urine tests help identify whether kidney involvement has occurred, which is the key prognostic factor.
Physical examination
Chemistry panel
Complete blood count
Urinalysis with sediment
Histopathology
Options & trade-offs
Management centres on supporting kidney function and preventing further deterioration, as there is no specific treatment that targets the underlying cause. The approach varies depending on whether kidney injury has developed and how severe it is. Some dogs with skin lesions alone recover without intervention, while others require intensive hospital care.
Intravenous fluid therapy
Fluids are given through a vein to support kidney perfusion, maintain hydration, and help the kidneys eliminate waste products. This is the main treatment for dogs showing signs of acute kidney injury. The rate and composition are adjusted based on blood tests and urine output.
Trade-offs: Requires hospitalisation, often for several days or longer. A minority of dogs with acute kidney injury recover kidney function; in most, damage progresses despite treatment. The cost and emotional impact of prolonged intensive care can be substantial.
Wound care and pain management
Skin lesions may be cleaned, covered, or left to heal depending on their location and severity. Pain relief is provided as needed. Some lesions heal spontaneously, while others may require ongoing attention or surgical debridement if tissue is necrotic.
Trade-offs: Wound healing can be slow and the appearance may be distressing. Pain levels vary between individuals. Wound care alone does not address kidney involvement if it occurs.
Plasma exchange
Plasma exchange (a procedure carried out in specialist centres that removes and replaces the dog's plasma) has been used in an attempt to interrupt the disease process. The rationale is based on the thrombotic microangiopathy mechanism, though no controlled studies have demonstrated benefit. In a published report of plasma exchange in six dogs with CRGV and kidney injury, two survived to discharge and four were euthanised. No drug treatment has been shown to improve the outcome.
Trade-offs: Evidence is limited to a small case series with no comparison group. The procedure needs specialist equipment and trained staff, and carries its own risks: low blood calcium, low body temperature and low blood pressure were recorded during treatment in the published report. The rarity of the condition makes it difficult to assess outcomes rigorously.
Monitoring without intervention
Dogs with skin lesions but normal kidney function may be monitored closely with repeat blood and urine tests. Kidney injury usually appears within days of the skin lesion but has been recorded up to 45 days afterwards, so the length of monitoring varies. If kidney parameters remain stable, intensive treatment may not be needed. The focus shifts to wound healing and observation.
Trade-offs: Progression can be rapid in some cases, so this approach relies on frequent repeat tests to pick up kidney changes early. It suits dogs with mild, localised lesions and stable clinical signs.
Common misconceptions
"Alabama rot is becoming more common and poses a widespread risk to dogs in the UK."
The condition remains rare, with typically fewer than 50 confirmed cases annually in the UK. While the exact number fluctuates year to year and some areas report clusters, the overall incidence is very low relative to the dog population. The prominence of the condition in media and owner discussion often reflects concern rather than frequency.
"Washing a dog's legs after muddy walks will prevent Alabama rot."
No preventive measure has been shown to reduce risk. Rinsing muddy paws is a reasonable hygiene practice for many reasons, but there is no evidence it influences the likelihood of developing CRGV. The association with wet, muddy conditions is observational and the specific trigger has not been identified.
Related conditions
Chronic Kidney Disease in Dogs
Alabama rot causes acute kidney injury through damage to the small blood vessels in the kidneys, while chronic kidney disease involves progressive decline in kidney function over a much longer timeframe. Both conditions can affect waste filtration and fluid balance, though through different mechanisms and time courses.
Atopic Dermatitis in Dogs
Both Alabama rot and atopic dermatitis can cause skin lesions in dogs, though the underlying mechanisms differ substantially: vasculopathy and tissue death in Alabama rot versus immune-mediated inflammation in atopic dermatitis. The skin changes in Alabama rot tend to be more focal and ulcerative, often affecting the limbs.
Acute Kidney Injury
Acute kidney injury is the complication that decides the outcome in Alabama rot. It develops in some affected dogs, usually within days of the skin lesions, through clots in the small blood vessels of the kidneys.
Understanding the early signs of skin lesions and the timeframe in which kidney changes may develop can help inform decisions about monitoring and repeat testing. The broader context of vascular and clotting conditions may offer useful perspective on how the body's systems can be affected by processes that disrupt normal blood flow. Because the condition is rare and the outlook poor once the kidneys are involved, conversations about prognosis and the scope of treatment can be valuable as the clinical picture unfolds.
Last reviewed: 9 October 2026 · Dr Alastair Greenway MRCVS