American Society of Hirudotherapy

Leeching as initial treatment in a cat with polycythaemia vera

Research article published in The Journal of small animal practice (2001)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsNett et al. · The Journal of small animal practice, 2001

Abstract

Polycythaemia vera was diagnosed in a three-year-old domestic shorthaired cat referred because of seizures and a high packed cell volume (PCV). Laboratory examination revealed severe erythrocytosis (PCV 79 per cent). Diagnosis was reached by excluding causes for relative and secondary absolute polycythaemia. As phlebotomy proved impossible for initial treatment due to hyperviscosity, four leeches were used to suck blood and the PCV was consequently reduced to 64 per cent. A further 24 hours later, when bleeding at the sites of sucking had stopped, the PCV was 56 per cent. Long-term management of the condition was achieved with hydroxyurea (100 mg/cat once daily) and intermittent phlebotomy. Initial treatment using leeches in cases of polycythaemia vera is a simple, non-invasive, well tolerated and effective method where phlebotomy is not possible.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article
Indexed MeSH termsAnimalsCat DiseasesCatsEnzyme InhibitorsFemaleHydroxyureaLeechingPhlebotomyPolycythemia VeraSeizures

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This veterinary case report describes a three-year-old cat with polycythaemia vera and severe erythrocytosis (PCV 79%) presenting with seizures, in which conventional phlebotomy was impossible because of hyperviscosity; four medicinal leeches were applied to draw blood, lowering the PCV to 64% and then to 56% over the following day, with long-term control achieved using hydroxyurea and intermittent phlebotomy. This is a genuine, directly relevant example of hirudotherapy: it documents leeching used deliberately to reduce blood volume and viscosity when standard venesection failed, illustrating a niche mechanical role for medicinal leeches. Caveat: it is a single feline case report, not a clinical trial and not in humans; the authors' favorable description of leeching as simple and well tolerated reflects one animal's course and cannot be generalized to human patients or treated as controlled evidence.

Citation

Leeching as initial treatment in a cat with polycythaemia vera.

Nett et al. · The Journal of small animal practice, 2001

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.