Highrise Syndrome in Cats
Dr. Dawn Ruben
To a cat, a window may look like a path to freedom, but to many it leads to injury and death from upper story apartments. Each year, many cats fall from windows and balconies. The trauma sustained from a fall of over two stories (24 to 30 feet) is known as "high-rise syndrome." Chest trauma – pneumothorax (air in the cavity outside the lung), lung bruising, and rib fractures
As you would guess, high-rise syndrome is more common in urban settings. Studies done on cats that have fallen from 2 to 32 stories show that the overall survival rate is a surprising 90 percent. Strangely, cats that fall from a height under 6 stories have more severe trauma than those that fall from over 6 stories. One theory is that cats reach terminal velocity at about 5 stories, and at this point they relax, allowing a more distributed force of impact and less severe injuries. When cats land before reaching top speed, they are rigid and flexed and prepared for the landing. This results in most of the force impacting the parts of the body that hit initially.
Cats that fall from a height over 24 feet usually sustain significant injuries. The most common cause of death is due to severe chest trauma. Injuries most commonly seen are in order of occurrence:
Facial/oral trauma – fractured jaw, broken teeth, fractured palate, and head trauma
Limb trauma – fractures of the bones in the arms and legs
Spinal fractures – broken back, broken neck, dislocated spine (although uncommon in cats)
Abdominal trauma – bleeding, damage to the liver or spleen or kidney, ruptured urinary bladder
The diagnosis of high-rise syndrome is not difficult. Typically, the cat is found outdoors, several stories below, and a nearby window or patio door is open. It is difficult, however, to detect all the injuries. Your veterinarian will need to do several tests to determine the types and severity of injuries.
Chest x-rays. Even if your cat seems to be breathing normally, chest x-rays should always be done to determine if there is a collapsed lung, pneumothorax, bruising of the lungs or rib fractures.
Examination of the face and mouth. Cats usually land on their chest and face, which can result in a fractured jaw, split hard palate and broken teeth. These need special attention.
Orthopedic examination. Your veterinarian will examine your cat to detect fractures of the legs or pelvis. The most common forelimb fracture occurs below the elbow, while a fractured thigh bone (femur) is most common in the rear legs. The force of impact often causes bone fragments to pierce through the skin creating an open fracture.
Additional x-rays. If your veterinarian suspects more injuries, it may be necessary to do x-rays of your cat's abdomen, skull, or spine.
Blood tests. Initially, blood tests are not too helpful. However, during treatment they may help to determine the overall health of your cat and make sure that the organs have continued to function.
Treatment will depend on the types and extent of your cat's injuries. If your pet shows signs of shock – collapse, weakness and pale gums – your veterinarian will start intravenous fluids. Other treatment will include:
Chest trauma. Oxygen support may be needed to help your cat breathe. Rib fractures are painful and require pain medication, and chest taps or a chest tube may be needed to remove excess air from the chest.
Facial trauma. A fractured jaw may need to be pinned or wired, although fractured hard palates usually heal on their own. Fractured teeth may need root canal, capping or removal, and head trauma is treated with fluids, diuretics and steroids.
Limb fractures. Your veterinarian may initially just clean the wound and place temporary dressings on limb fractures. Later, when life threatening injuries are under control, surgical repair can be done.
Abdominal trauma. Pressure wraps will control bleeding, and surgery may be necessary to repair internal organs.
There is no home care for cats affected with high-rise syndrome. Your cat should be examined by your veterinarian, even if s/he appears normal.
Take care when picking up and carrying an injured cat. Some injuries associated with high-rise syndrome are extremely painful and your cat may bite and scratch as a reflex. Wrap the cat in a heavy towel or blanket and place in a carrier or box when transporting to your veterinarian.
The best way to prevent high-rise syndrome is to make sure there are no open windows without heavy screens in your home. Make sure screens are intact and strong – cats insistent on going outside have been known to slash through thin screens. Unscreened balconies and upstairs porches should be off-limits to your cat.