Leeching as initial treatment in a cat with polycythaemia vera.

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.