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Fracture of the Skull in Cats

By: Dr. David Diamond

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Fractures of the bones of the skull occur after head trauma – usually a fall from a height or a motor vehicle accident.

The symptoms of a skull fracture are related to the area of the skull that is affected. Fractures of the nose and upper jaw region can cause difficulties in breathing and chewing. Fractures of the cheek bone can cause difficulties with the adjacent eye. Fractures of the part of the skull that protects the brain can cause neurological deficits due to injury to the underlying brain. Neurological deficits can range from minor to more severe. The potential long-term effects of these fractures range from none to lifelong neurological dysfunction and death.

What to Watch For

  • Ataxia (incoordination)
  • Head tilt and circling
  • Behavioral changes
  • Blindness
  • Coma
  • Seizures

    Diagnosis

    No laboratory tests are required to make the diagnosis, but other diagnostic tests may include:

  • Thorough medical history and physical examination

  • Chest radiographs (X-rays) to rule out injury to the lungs caused by the trauma

  • Complete orthopedic examination for other fractures or joint injuries

  • Complete neurological examination to determine the extent of brain injury

  • Radiographs of the skull once the animal is stable enough for general anesthesia

  • CT scan of the skull to better evaluate the fractures and plan for possible surgery

    Treatment

    Emergency care for concurrent problems caused by the trauma is paramount. Once the pet is stabilized, additional treatment may include:

  • Treatment of concurrent fractures and soft-tissue injuries

  • Fractures of the nose and upper jaw may not need any treatment, but might be addressed with immobilization of the jaws in a restricting muzzle or may require surgery to realign teeth and reopen nasal air passages

  • Fractures of the cheek bone may also not need any treatment, may be surgically removed or stabilized with pins, wires and/or small bone plates

  • Most fractures of the skull do not need surgical treatment. Surgical decompression (by removal of the compressed fragments of the skull) is generally not indicated unless your pet's neurological symptoms are rapidly worsening (indicating possible pressure build-up on the brain due to continued hemorrhage)

  • Injectable analgesics (pain medications) may be given to your pet while being treated in the hospital and may be continued orally once discharged from the hospital

    Home Care and Prevention

    Fractures of the skull usually require confinement and restriction of your pet's activity for several weeks. Bleeding from the mouth or nose may continue for several days after these fractures. If the upper jaw is affected, soft (canned) foods of gruel can be fed.

    Neurological deficits may take many days to several months to recover (if they return at all). Nursing care is very important in order to avoid bedsores from pressure while lying down and skin problems from urinating and/or defecating while lying down.

    A recheck appointment with the veterinarian may occur in several weeks to evaluate how the bone is healing (with new radiographs), to monitor your pet's neurological progress and make sure it is safe to increase your pet's activity level.

    Many traumatic events are true accidents and thus unavoidable. Avoid the chance for motor vehicle trauma by keeping your cat indoors.

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