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The single most practical predictor of clinical performance is whether a leech is properly fasted. It determines whether the animal attaches and draws when you need it to.

Leeches feed infrequently and can take a large meal relative to body size. After feeding they are sated and uninterested in attaching for days to weeks. A clinical leech must arrive in the hungry, ready state.

What fasting delivers

• Prompt, reliable attachment at the target site
• A meaningful draw rather than a token bite
• Predictable behaviour for the clinical team

Why it depends on the supplier

Correct fasting is a husbandry outcome — it depends on feeding cycles, holding conditions and timing of dispatch. It cannot be improvised at the bedside, which is why it belongs in the supply chain, not the clinic.