D o ğ u Anadolu Bölgesi Araştırmaları; 2004
İ b r a h i m C A N P O L A T ve Nairn S A Ğ L A M
TREATMENT OF AURAL HEMATOMAS IN DOGS WITH
THE MEDICINAL LEECH, HIRUDO MEDICINALIS
Ibrahim CANPOLAT.
Nairn S A G L A M
*Fırat Ü n i v e r s i t e s i , V e t e r i n e r F a k ü l t e s i C e r r a h i A n a b i l i m D a l ı - E L A Z I Ğ .
* * F ı r a t Ü n i v e r s i t e s i , Su Ü r ü n l e r i F a k ü l t e s i - E L A Z I Ğ
ABSTRACT
In this s t u d y , h e m a t o m a s w e r e i n d u c e d w i t h t r a u m a to t h e arteries a n d v e i n s of the e x t e r n a l s u r f a c e of the
ears o f five h e a l t h y adult d o g s . T h e f o l l o w i n g d a y , t h r e e m e d i c i n a l l e e c h e s (H. m e d i c i n a l i s ) w e r e a t t a c h e d to
the a r e a o f the h e m a t o m a in u n a n e s t h e t i s e d d o g s a l l o w e d t h e m s t a y until t h e y w e r e full and s e l f d e t a c h e d .
T h i s t r e a t m e n t w a s c o n t i n u e d d a i l y for three d a y s . In m o s t c a s e s , thV l e e c h e s a t t a c h e d to h e m a t o m a q u i c k l y
and d e t a c h e d t h e m s e l v e s w h e n t h e y c o m p l e t e d the b l o o d s u c k i n g , u s u a l l y a f t e r 1 0 - 1 5 m i n u t e s . In all case,
aural h e m a t o m a of the ear r e s o l v e d s o o n after the c e s s a t i o n o f the t r e a t m e n t w i t h o u t c o m p l i c a t i o n s .
Keywords: Aural Hematoma, Leech Therapy, Dog.
ÖZET
KÖPEKLERDE DENEYSEL OLARAK OLUŞTURULAN
KULAK HEMATOMUNUN TIBBİ SÜLÜK İLE SAĞALTIMI
Bu ç a l ı ş m a d a , e r g i n ve sağlıklı 5 k ö p e k t e k u l a ğ ı n dış y ü z ü n d e k i arter ve veııalar t r a v m a t i z e e d i l e r e k k u l a k
h e m a t o m u o l u ş t u r u l d u . B i r g ü n s o m a k ö p e k a n e s t e z i e d i l m e d e n o l u ş a n h e m a t o m ü z e r i n e 3 T ı b b i sülük
( H i ı n d o medicinalis) uygulanarak d o y u p kendiliğinden bırakıncaya kadar emmeleri sağlandı. Bu
uygulama
üç g ü n s ü r e y l e d e v a m etti. Ç o ğ u o l g u l a r d a , s ü l ü k l e r ç a b u c a k h e m a t o m b ö l g e s i n e t u t u n u p 10-15 d a k i k a
s ü r e s i n c e k a n e m d i k t e n s o n r a d o y u n c a , k e n d i l i k l e r i n d e n t u t u n d u k l a r ı b ö l g e y i bıraktılar. B ü t ü n o l g u l a r d a
uygulama sonrasında hiçbir komplikasyon oluşmaksızın kulak h e m a t o m u n u n rezorbe olduğu gözlendi.
Anahtar Kelimeler: Kulak H e m a t o m u . , Sülükle Sağaltım, K ö p e k
1. INTRODUCTION
In r e c e n t years, m e d i c i n a l l e e c h e s are u s e d
m a i n l y f o r t w o p u r p o s e s . T h e first is t h e classical
blood-letting therapy, which has experienced a
c e r t a i n r e v i v a l in r e c e n t y e a r s in the c o n t e x t of the
revival of natural remedies and tradional curing
p r a c t i c e s . T h e s e c o n d is the p r o d u c t i o n of r e m e d i e s
c o n t a i n i n g an e x t r a c t o f M e d i c i n a l l e e c h e s . T h e
m a i n a r e a s o f a p p l i c a t i o n are for b l u n t i n j u r i e s
( t r a u m a s ) w i t h or w i t h o u t h a e m a t o m a s , s u p e r f i c i a l
i n f l a m m a t i o n s o f the veins, h a e m o r r h o i d s , p e r i a n a l
thromboses and anal eczemas (Halton,
1989;
K a s p a r e k et al., 2 0 0 0 ; S a w y e r , 1986.). M e d i c i n a l
leech, H. m e d i c i n a l i s is u s e d in h u m a n s for
h e m a t o m a s o f the t o n g u e ( G r o s s m a n a n d K a r l o v i t z .
1998), testis ( G o e s s l et al.. 1997; Isear and T u r n e r .
1989), orbit ( M e n a g e and W r i g h t , 1991.) and t o e
( H a l t o n , 1989.). T h e leech p r o d u c e s a n u m b e r o f
d i v e r s e s a l i v a r y s e c r e t i o n s that i n c l u d e a n e s t h e t i c ,
anticoagulant
(hirudin),
local
vasodilator
(histamine), and enzyme (hyaluronidase) (Sawyer.
1986, A n o n y m o u s 2 0 0 3 , Y u r e v i c h , 2 0 0 3 ) .
Leeches have been used for medicinal
p u r p o s e s for c e n t u r i e s , w i t h the earliest r e p o r t s
c o m i n g f r o m India. In t h e R o m a E m p i r e , the
s y s t e m a t i c f o u n d a t i o n f o r the t r e a t m e n t of p a t i e n t s
w i t h l e e c h e s w e r e laid. L e e c h e s e x p e r i e n c e d a
c o n s i d e r a b l e b o o m p a r t i c u l a r l y in E u r o p e in the 19 th
century, when they virtually became a fashion.
R e s e a r c h e r s have c a l c u l a t e d that l e e c h e s w e r e
a b s t r a c t i n g in Paris a l o n e a total o f 84 0 0 0 L b l o o d
p e r year at the b e g i n n i n g o f the 19 th century. T h e
u t i l i z a t i o n o f l e e c h e s , h o w e v e r , d e c r e a s e d in the
e a r l y 20 l h c e n t u r y w i t h the a d v e n t of m o d e r n
m e d i c i n e s . E v e n b y the 18 th a n d 19 th centuries, the
populations
of the
medicinal
leech
(Hintdo
medicinalis)
in C e n t r a l E u r o p e w e r e u n a b l e to m e e t
the c o n s i d e r a b l e d e m a n d .
L e e c h e s were
then
i m p o r t e d into C e n t r a l E u r o p e a n states f r o m the
O t t o m a n E m p i r e ( A n a t o l i a ) , N o r t h A f r i c a and
R u s s i a ( K a s p a r e k et a l . , 2 0 0 0 , S a g l a m , 1998).
67
D o ğ u A n a d o l u B ö l g e s i Araştırmaları; 2 0 0 4
İ b r a h i m C A N P O L A T ve N a i r n S A Ğ L A M
T h e aural h e m a t o m a s of d o g s is a important?,,
p r o b l e m and results f r o m bluni i n j u r i e s (traumas;-,
bites, itchs and frictionals. T h e aural h e m a t o m a is
f o r m e d w i t h laceration of a r t e r y s a n d v e i n s o f the
ea: ( D u b i e l z i g et a:. 1 9 8 4 ) .
T h e h a e m a t o m a s is
treated medically and s u r g i c a l l y . If it is not treatee.
w i t h e h r o n i c i t y . f i b r o s i s and c o n t r a c t i o n t h i c k e n and
d e f o r m the ea: ( C o w l e v F.1976K
In
this
study,
alternative
treatment
o!
e x p e r i m e n t a l l y f o r m e d aural h e m a t o m a m d o g s with
m e d i c i n a l ieech, w a s i n v e s t i g a t e d
2. MATERIAL AND METHODS
In this study, ten ears f r o m f i v e h e a l t h y
adult d o g s (2 m a l e s and 3 f e m a l e s , w e i g h t b e t w e e n
16-35 k g ) were u s e d . In e a c h c a s e , s u b c u t a n e o u ; .
aural h e m a t o m a o f 5-7 c m in d i a m e t e r w a s i n d u c e d
by t r a u m a t i n g its vessels w i t h a spinal n e e d l e ( 1 4
g a u g e , 8 c m ) In the n e x t d a y . three m e d i c i n a l
l e e c h e s w e r e a t t a c h e d ( F i g u r e 1) t o t h e h e m a t o m a of
the a w a k e d o g . T o atract f u r t h e r a t t a c h m e n t t h e are:,
w a s s o a k e d with s u g a r e d w a t e r . T h e t r e a t m e n t
c o n t i n u e d daily for three d a y s .
T h e aural h e m a t o m a s are treated m e d i c a l l y
or surgically. L a r g e h e m a t o m a s are not e a s i l y c u r e d
with t h e r a p e u t i c s . Ir; this h e m a t o m a s
surgical
t h e r a p y is u s u a l l y u s e d In tiie s u r g i c a l t h e r a p y arc
w a i t e d f o r b e c o m e c o a g u l a t e d o f b l o o d f o r 8 - 1 0 day
Medical and surgical therapies sometimes cause
fibrosis, i n f l a t i o n and d e f o r m a t i o n o n the eai
( D u b i e l z i g et al., 1984. C o w l e y F.19761. In this
study, no c o m p l i c a t i o n
w a s not o b s e r v e d in t h e
t h e r a p y o f h e m a t o m a with leech (hi. mea'icinciUs)
l i s
m m m
janttı
it has b e e n r e p o r t e d that leech t h e r a p y m a y
sometimes
be
complicated
by
Aeromona:nyarophilo in m a n . T h i s G r a m - n e g a t i v e b a c t e r i u m is
a n o r m a l enteric o r g a n i s m ol the leech. T h e r e f o r e , in.
the leech therapy to patients an a n t i b i o t i c as
p r o p h y l a c t i c are g i v e n ( E l d o r et al. 1996). In this
study, n o i n f e c t i o n w a s seen on the d o g s a f t e r leech,
therapy.
WmamSmm
F i g . 1 : M e d i c i n a l leeches a t t a c h e d t o t h e h e m a t o m a
; 'If
ffff
ffî&y-
Ü
-IIS
^.yp^-i'; '
A d v a n t a g e s o f leech t h e r a p y a r e q u i c k l y
p o s i t i v e r e s p o n s e to t r e a t m e n t and n o n e e d to
a n a e s t h e s i a w h e n c o m p a r e d to o p e r a t i v e t r e a t m e n t .
ÂM-^ÎÂ"- i •iSSSpwF' '""r'JiVt:'
-
> ••A
- YI'>N
A t t a c h e d l e e c h e s w e r e d e f i n e d to b e c o m e
distant l i o n : h a e m a t o m a area T h i s w a s p r e v e n t e d
with use a g l a s s c o v e ; A t t a c h e d l e e c h e s w e n
o b s e r v e d s u c k i n g b l o o d with peristalsis, in m o s :
cases, the l e e c h e s attached to the area o f h a e m a t o m a
q u i c k l y and self d e t a c h ed when they c o m p l e t e d the
b l o o d meai, u s u a l l y aftei 1 0 - 1 5 m i n u t e s
Alte;
l e e c h e s d e t a c h m e n t , the h a e m o r r h a g e c o n t i n u e d ir
the bitter; ear:- f o r 60 s e c o n d (Figure 2). Tlie a u r a l
hematoma
r e d u c e d g r e a d u a l l y and r e s o l v e d a f t e first day the t r e a t m e n t . A f t e r three a p p l i c a t i o n s
h e m a t o m a r e c o v e r e d all case w i t n o u t c o m p l i c a t i o n
After
treatment
fibrosis,
enfiamation
and
d e f o r m a t i o n on t h e ear w e r e not d e f i n e d .
T h e a p p l i c a t i o n of leeches are o n e o f t h e
oldest r e c o r d e d m e d i c a l t r e a t m e n t s w i t h the first
a c c o u n t d o c u m e n t e d a p p r o x i m a t e l y 2 5 0 0 y e a r s ago.
Until the a d v e n t of n e w e r t h e r a p i e s in t h e n n c
ISOO's the a p p l i c a t i o n of l e e c h e s w a s c o n s i d e r e d as
s t a n d a r d m e d i c a l p r a c t i c e for a variety of ılinesse.( E l d o r et al. 1990. S a ğ l a m . 1998)
ÎÎ-
,< X
3. RESULT AND DISCUSSION
4. REFERENCES
if'-. .
•
A n o n y m o u s . 2 0 0 3 a . M e d i c a l U s e of L e e c h e s .
http://www.amonline.net.au.
•
Anonymous. 2003b. Medical Use of Leeches.
http://www.austmus.gov.au
F i g . 2 : H a e m o r r h a g e at the b i t t e n l e e c h e s ear
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1. C o w l e y F 1976. T r e a t m e n t of h e m a t o m a o f the
c a n i n e ear. V e t . M e d S m a l l A n ı m . C l i n 7 1 : 2 8 3 .
2.
D u b i e l z i g R R , W i l s o n J W and S e i r e g A A . 1984
P a t h o g e n e s i s of c a n i n e aural h e m a t o m a s . J A V M A
185(8):873
3.
E l d o r , A., O r e v i , M . , a n d R i g b ı , M . 1996. T h e
r o l e of the leech in m e d i c a l t h e r a p e u t i c s . B l o o d
R i v i e w s , 10, 2 0 1 - 2 0 9 .
4.
G o e s s l C, S t e f f e n - W i l k e K. and Miller K „
1997. L e e c h t h e r a p y for m a s s i v e scrotal h e m a t o m a
following percutaneous transluminal angioplasty. J
U r o l . , 158(2), 5 4 5 .
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8. K a s p a r e k , M . D e m i r s o y , A. A k b u l u t , A.
A k b u l u t ( E m i r ) , N . Ç a l ı ş k a n , M . and D u r m u ş , Y.
2 0 0 0 . D i s t r i b u t i o n a n d status of
the m e d i c i n a l
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(Hirudo
medicmalıs
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in
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9.
M e n a g e M.J, and W r i g h t G „ 1991. U s e of
l e e c h e s in a c a s e o f s e v e r e p e r i o r b i t a l h a e m a t o m a . B r
J O p h t h a l m o l , 75(12), 755-6.
10. S a ğ l a m ,
N„
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Tıbbı
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m e d ı c i n a l i s 'in ( L , 1758, H i r u d i n i d a e ) İ n c e l e n m e s i ,
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and
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treatment of aural hematomas in dogs with the