Hirudotherapy (medicinal leeches) for treatment of upper airway obstruction in a dog
Trenholme HN, Masseau I, Reinero CR (2021) · Journal of Veterinary Emergency and Critical Care · n=1
Study Profile
- Design
- single veterinary case report of medicinal leech therapy as ancillary treatment for upper airway obstruction caused by sublingual and cervical soft-tissue swelling in a Mastiff (University of Missouri College of Veterinary Medicine, USA; Université de Montréal, Canada)
- Sample size (n)
- 1
- Intervention
- Application of Hirudo verbana medicinal leeches to sublingual and cervical regions of a 10-month-old female Mastiff intubated for upper airway obstruction from soft-tissue swelling; leeches applied as adjunct to standard supportive care
- Comparator
- Not applicable - single-patient veterinary case report; within-subject pre/post timeline
- Primary endpoint
- Time to extubation; resolution of soft-tissue swelling and airway patency; demonstration of leech therapy applicability to veterinary upper-airway congestion analogous to human flap salvage
- Primary result
- Continued slow bleeding from leech detachment sites enabled gradual reduction of sublingual hematoma and resolution of airway obstruction; the dog was extubated at 44 hours after intubation and discharged from hospital; first veterinary case report of medicinal leeches (Hirudo verbana) as complementary treatment for sublingual hematoma contributing to upper airway obstruction
- Follow-up duration
- 44 hours intubation period plus discharge
- PMID
- 34252261
Key Findings
- First reported use of medicinal leeches (Hirudo verbana) for sublingual hematoma in a dog
- Successful extubation at 44 hours following leech therapy adjunct to standard airway management
- Demonstrates that the venous-drainage mechanism of leech therapy is operative across species
- Adds Hirudo verbana species data to the predominantly Hirudo medicinalis veterinary literature
- Provides translational rationale for considering leech therapy in human sublingual hematoma airway compromise
Limitations
- Single case (n=1) - cannot establish veterinary efficacy or safety profile
- Veterinary species (Mastiff) - not directly applicable to human anatomy or coagulation profile
- Concurrent multiple therapies (propofol/fentanyl infusion, supportive care) confound attribution to leech therapy
- No randomized comparator or alternative treatment arm
- Long-term outcomes not reported in abstract
Clinical Implications
Trenholme 2021 is a single veterinary case report extending hirudotherapy applicability to canine upper-airway obstruction from sublingual hematoma. For ASH editorial purposes, the trial provides cross-species mechanistic context supporting the venous-drainage rationale of leech therapy. For US clinicians, the report does not change practice but does illustrate that the basic mechanism translates across mammalian species. The veterinary case is included in the registry to document the breadth of the hirudotherapy evidence base, including its extension beyond standard human plastic-surgery indications.
Related Trials
Medicinal leech therapy in venous congestion of microsurgical flaps: a randomized comparison with heparin pinprick scarification
Merlino G, Carbone S, Servillo G, Marletta DA (2020)
Adjunctive medicinal leech therapy for venous congestion in free flaps: a German multicenter randomized trial
Lehnhardt M, Daigeler A, Behr B, Schmidt SV, Wallner C (2021)
Medicinal leeches and the microsurgeon: a four-year study, clinical series and risk benefit review
Whitaker IS, Josty IC, Hawkins S, Azzopardi E, Naderi N, Graf J, Damaris L, Lineaweaver WC, Kon M (2011)
Medicinal leeches for surgically uncorrectable venous congestion after free flap breast reconstruction
Pannucci CJ, Nelson JA, Chung CU, Fischer JP, Kanchwala SK, Kovach SJ, Serletti JM, Wu LC (2014)