Vet School 101 Leeches: “What works and what sucks” in veterinary medicine
Yes, veterinary surgeons use leeches. Mostly, this happens at the highest levels of vet medicine (usually in university settings) where degloving injuries, traumatic amputations, tissue flaps and non-healing wounds are commonly dealt with.
For the average veterinarian and pet owner, leeches might seem like a throwback to the days when George Washington was leeched and bled with regularity by way of alleviating his ills. As far as we can tell, old George died of complications associated with his severe anemia…and never once received any medical benefits for his trials. Now that sucks, never mind the leeches.
In modern America leeches are used for the sublime and the ridiculous, alike. High-tech human and animal medicine employ their anticoagulant, antibacterial and fluid-draining properties to heal wounds, mostly. They're approved by the FDA as "medical devices."
And some Hollywood starlets are similarly convinced of their non-traditional benefits. Demi Moore reportedly attaches leeches to her abdomen in some strange health-related ritual apparently reserved for the rich and eccentric among us.
I prefer to stick with the former approach, unconvinced as I am of the supposed cosmetic benefits of leeches. But I’ve never yet used them. My vet surgeon boyfriend thinks they do great work, but even he’s steered clear of them since leaving the university setting.
This is less a matter of principle than of logistics, however, given that leeches don’t exactly lend themselves to ready availability in a traditional hospital setting. After all, leeches require maintenance, clients don’t readily accept their use, the cases in which they might do their best work are relatively few and far between for most of us, and they must be disposed of once they’re used.
Ultimately, leeching is expensive. At $10-20 per leech according to leechusa.com (a wonderfully informative site for those of you interested) it might not sound like much but consider the husbandry issues: Leeches must be maintained at 42 to 45 degrees, their water must be changed every other day, special salts must be added to their water, and you might not see a worthy and willing patient for over a month.
That’s why each leech application reportedly costs $100 and up.
Nonetheless, I’m finally intrigued enough to order a few for my next ear hematoma patient. I’ve heard great things about how well leeches can drain a pocket of blood in the ear. Though most veterinary surgeons consider the surgical approach perfectly adequate, I disagree. I’ve always thought there should be a better way. It’s the potential for this alternative that gives me reason enough to place an order courtesy of Carolina Biological.
In case you’re wondering, not all leeches are created equal. Medical grade leeches are required for our patients, though I’m not sure I know what goes into producing these creatures. I imagine they’re laboratory bred and therefore as “sterile” as any living organism can be. But still…
So what do you think? Am I crazy to want to attach a slimy creature to the ears of my patients? Will they sit for it? How many leeches will I have to apply? How long will it take? Will my clients go for it? These are all open questions. But the spirit is willing and the will is not weak on this one. I think I’ll have a go at it.
January 3rd, 2009
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Add Comment49 Comments
I wonder why the guys who fight in MMA (mixed martial arts, aka cage matches) don't use these things on their ear haematomas. The resulting cauliflower ear looks horrible and I can't imagine it's healthy to allow blood to just pool in one spot like that.
Leeches used to freak me out (traumatized by Stand By Me and the leeches down the tighty-whiteys) but their use in medicine to increase bloodflow is intriguing and I've since gotten over the queasy feeling. All things considered, I'd rather have a leech treatment than a medical maggot treatment, although I think I have enough mind over matter control to not freak out at either.
Any other freaky use of another living animal as a treatment that you know of? I've seen a program about dead sea fish that peck off dead skin which helps with exema. Any others?
Christopher January 3rd, 2009 11:12:24 AM
Interesting but just goes to show you that every animal, regardless of classification, is of value. Personally, I am all for alternative therapies--but wonder if most of the pet loving population would be open to this.
As for the special sites--thanks for the links. All animals require care--maybe they could be put under the category of high maintenance...:-)
Find me blogging at Ark Animals.
Ark Lady January 3rd, 2009 11:17:26 AM
@ Christopher Just saw your post. Yes, there are fish being used for pedicures--an odd sort of idea and not for health purposes but amusing just the same.
Ark Lady January 3rd, 2009 11:34:42 AM
And just think...years ago when I was at summer camp, the counselors kept a coffee can of salt on the dock of the swimming area to pop leeches into when they attached themselves to a swimmer. I'm not sure I'd care to deal with them even today.
Ellie January 3rd, 2009 11:56:09 AM
And just think...years ago when I was at summer camp, the counselors kept a coffee can of salt on the dock of the swimming area to pop leeches into when they attached themselves to a swimmer. I'm not sure I'd care to deal with them even today.
Ellie January 3rd, 2009 11:56:34 AM
Yikes! Apologize for the duplicate posting.
Ellie January 3rd, 2009 11:57:33 AM
Yeesh. I wasn't aware that leeches were so pricey!
Should any of my boys ever require treatment for an aural hematoma, I would be more than happy to fork over $100 for a "leeching" in lieu of surgery if there were any possibility the leeches might prove effective. No messy post-op care, and I would imagine that the pain involved would be virtually nil.
I grew up in an area where leeches were quite common, and I was fond of the water, so I've had some encounters. They were gross, to be sure.. but I don't recall ever associating any pain with the things. (I seem to remember something about leech saliva having anesthetic properties, but I could be wrong.)
So, yeah.. if I were a client, I would absolutely be up for it.
Ramen Connoisseur January 3rd, 2009 12:25:27 PM
(Whether or not you could get the cats to cooperate, however, might be another story.)
Ramen Connoisseur January 3rd, 2009 12:27:29 PM
I've seen leeches used a couple of times on my hand therapy patients but never thought of using them in a veterinary setting. And I wouldn't have thought of using them for aural hematomas - but it sounds like a fabulous idea! Certainly safer - and almost certainly more comfortable - than surgery and the result could well be cosmetically superior. Count me among the clients who would jump at the chance to try it.
We'll be eagerly waiting to hear how it works if you get to use them!
Barb January 3rd, 2009 12:36:30 PM
I had a dog with an injured ear; I bandaged (vetwrap) it to her head while it was healing. She hated it and shook her head, flapping the other ear. I'm sure you can guess what happened to the other ear: she burst vessels, the ear became huge. I knew she was going to keep flapping that ear as long as the other was healing.
I applied pressure to the 2nd ear to press the excess blood out of it, then bandaged it flat to her skull. I used a little pressure for the first few days, to keep the burst vessels from swelling back up. After that, I did it just to keep the ear from flapping around when she shook it. It worked really well. Keeping pressure on it from both sides until it healed did the trick so well.
Perhaps not something that most owners will be able to follow up on, I suppose, but I do think it was a better option than leeches. Grin.
~ ~ ~
This summer, we had a dog with a compromised immune system, sick and miserable and getting infection after infection. We were doing everything we could to get it under control, and nothing was working. Suddenly both his ears blew up with a painful infection; he was frantically shaking his head and flapping his ears. I was sure he was going to end up with a pair of cauliflower ears before the antibiotics kicked in. I used a T-shirt sleeve to hold his ears to his head so that even when he shook his head, they didn't flap. Pics of the poor guy with his hematoma preventer: http://lady-of-lothlorien.com/dogs/etc/ear_protector/
Galadriel January 3rd, 2009 12:42:47 PM
Christopher, another example of "freaky use" of living animals in medicine is maggots, used to remove dead tissue from wounds, burns, etc. Maggots eat only dead tissue, not living tissue, so they can do a great job of cleaning up, better even than can be done with surgery. Like leeches, they've been approved by the FDA.
http://news.nationalgeographic.com/news/2003/10/1024_031024_maggotmedicine.html
http://www.msnbc.msn.com/id/5580825/
I think I could deal with leeches better than with maggots, although the idea of using either makes me queasy.
Mary Straus January 3rd, 2009 03:22:14 PM
Mind over Maggots. Nyuk, nuyk!
Christopher January 3rd, 2009 03:40:05 PM
If/When you use leeches for aural hematoma's I would love to hear how it works. Has anyone used them for this purpose? I think my only concern would be would the ear swell up again after the leeches are removed. I find that those things (aural hematoma's) continue to ooze after being opened up for at least a few days. I have had owners who initially refused surgery and just wanted me to 'drain it' with a needle/syringe. I have complied but explained that it will likely fill up again which they have and owner is still left with choice of let it resolve on its own (which I don't advicate by the way) or surgery and subseqent bandageing. So unless the leeches somehow conteract that I would be a bit skeptical that they would avoid the ultimate surgical intervention. However, if they did work I am not sure I could get over some of my unease of using them...but if animals tolerated it okay then I would sure try!!
J.C. January 3rd, 2009 06:12:22 PM
I'd love to hear more about how it turns out working. I'm curious as to how many you need for a certain surface area, how well they stay on & how long, and if the pet tolerates it without sedation
Could end up being the ultimate treatment for particular problems, clean, no incisions or sutures, maybe no irritation or itching??
Barbara A./NH
Pocket's Story from NH January 3rd, 2009 06:38:07 PM
"...and they must be disposed of once they’re used." Dr. K., I'm guessing that you can't just put them out in the nearest stream or pond, so do they just get squashed, and put in the biohazard container or...? And is it a problem of them transferring any blood-borne pathogens or parasites tat precludes them being kept for use on another patient?
I, too, think that hematomas would be the best place for them, and wonder about a case that came in last year of a young dog that got its paw stepped on. Two toes were broken and the owners didn't realize it, so it wasn't until several days later, when the whole paw was swollen (the dog kept licking and nibbling at the painful toes), and infected, that we saw it. We ended up lancing and draining, bandaging and antibiotics, but it still took a week before things started looking good. Would leeches have helped with that kind of problem, either before or after infection started?
KateH January 3rd, 2009 06:58:39 PM
ooooh, I visited the site, the case studies were dramatic! I'd give it a try. It was creepy reading them referred as animals, when they are related to the worm.
I wonder how hard it could be to start your own colony? And what makes one or two varieties better out of the 320? I would think that they become "clean" by the environment....although no mention of how to keep them alive in their "mobile home" without use??
great subject. Barbara A
Pocket's Story from NH January 3rd, 2009 07:06:29 PM
My Eli has a cauliflower ear as a result of a hematoma. It wasn't a huge one and not painful so the vet suggested monitoring it and letting it heal on it's own. She thought taht would result in a more cosmetic outcome, among other things. It did heal eventually, but its not pretty and I worry there may still be some pooled blood in that twisted mass that could get infected sometime. I would have bbn happy to be offered the use of leeches. I'm in a town with a veterinary school. I wonder if they offer leech therapy.
Linda H January 3rd, 2009 10:09:10 PM
KateH: That's the issue...cross-comtamination, blood-borne pathogens. I still haven't found any literature on their reuse on the same patient because most of the lit is geared to human use where 70% isopropyl and a biohazard bag is the upshot for all one-time-use leeches. I'd be willing to re-use them on the same patient but I don't yet know how long it takes a leech to digest its meal and be willing to feed again.
Dr. Patty Khuly January 4th, 2009 08:30:03 AM
btw, I dedicated one of our a small fridges and ordered my first leech kit. It's a relatively expensive setup for my little experiment but I'm sooo excited! If this works out I'll be getting a paper out of this. Trouble will be finding more ear hematoma patients. I have lots of connections with my local colleagues so maybe they'll play...
Dr. Patty Khuly January 4th, 2009 08:33:13 AM
How do you get the dog to hold still for this?
Airedalelover January 4th, 2009 01:42:36 PM
Airedalelover: If it's a reasonably quiet dog or cat it's no big deal. For fractious pets we'd use sedatives tailored to their age and concurrent disease processes. I plan to have clients sit with their pets during the process to cut down on the cost of technicians--if they're willing, of course. For squeamish clients it'll just cost more. The entire process for a patient should take 1 1/2 hours of mostly unattended time.
But several leechings will almost certainly be required for most..wondering how many leeches I can apply at once...wondering if I'll have to see the patient for several days in a row. Still, that beats the pain and stress of surgery and rebandagings even in the worst of cases. After all, leeching is reportedly pain-free.
Dr. Patty Khuly January 4th, 2009 02:36:46 PM
dr. patty: I read in one of the leech sites that they can take 1-3 months to finish a meal. If I lived in FL, I would offer my lab for your "trial run" but alas, I live in Canada :) Please do keep us posted though, as I would love to present that option to my vet as a treatment (she was unfamiliar with the drain treatment for aural hematomas until I requested it)!
charliebear22 January 7th, 2009 12:27:45 PM
My 6 year old retriever has an aural hematoma currently and aside from the cost, the recovery looks awful. I'm currently considering waiting it out (its been two weeks and has not seemed to bother him). My mother mentioned leech therapy for hematoma and I would really like to find out how I can access the therapy or even do home treatment. Any resources would be appreciated. I'm also located in Canada, (Vancouver, BC ) if anyone knows a supplier or practitioner I'd appreciate the referral.
Jane February 19th, 2009 12:13:12 AM
I am very interested. My dog underwent surgery last month on her right ear for a hematoma. It was a very tramatic experience for he and there is a lot of scar tissue. Now she has one developing on her other ear and since the last one have been looking into other methods that where not as dramatic or invasive. I remembered a national geografic program about the use of leeches in medical practices and immediately called my veteranary clinic to see if this procedure could be facilitated any where local to be informed that it was not. I am now doing more research to see if I could perform this myself. I will if I can be sure that I have all the information. As in he report above I have yet to find out the number of leeches that will be needed. If anyone has anymore information or has perfomed this for a large 97 lbs dog with a hematomas the size of two tea bags wet please let me know.
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