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Peer-reviewed veterinary case report

High-rise syndrome injuries in cats and dogs explained

By Lefman, Sara & Prittie, Jennifer E·Published in Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)·2022·BluePearl Veterinary Partners, United States·View original on PubMed

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Original publication title: High-rise syndrome in cats and dogs.

Movement & joints

Plain-English summary

A cat or dog that falls from a height of two stories or more can suffer serious injuries, known as high-rise syndrome. These pets may experience a range of problems, including broken bones, lung injuries, and internal bleeding. Treatment often involves stabilizing the pet's condition with fluids and pain relief, and they may need surgery for severe injuries. Fortunately, most cats recover well, with survival rates over 90%, while dogs also have a good chance of recovery but may require more surgical intervention.

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Abstract

OBJECTIVE: To review the current literature pertaining to the pathophysiology, diagnosis, and treatment of injuries sustained from high-rise syndrome in cats and dogs. ETIOLOGY: High-rise syndrome is defined as a fall from a height of 2 or more stories that results in a constellation of injuries, including thoracic, abdominal, orthopedic, and orofacial trauma. Animals often fall after slipping from windowsills, engaging in mating behavior, or chasing prey. Cats suffer less severe injuries than dogs due to their "righting reflex" and smaller body mass. Affected animals are younger, and the frequency of falls is higher in warmer months. DIAGNOSIS: Physical examination coupled with radiographs, ultrasound, and computed tomography can diagnose a myriad of injuries that include pneumothorax, pleural or abdominal effusion, orthopedic fractures, and orofacial injuries. Bloodwork may identify anemia, thrombocytopenia, or increases in hepatic, renal, or pancreatic values consistent with trauma to these organs. Serial venous or arterial blood gas can help determine the severity of respiratory compromise and influence resuscitative efforts. Traditional coagulation tests and thromboelastography can assess trauma-induced coagulopathy and guide transfusion therapy. THERAPY: Animals presenting in shock require hemodynamic stabilization. Initial resuscitation may incorporate crystalloids, colloids, blood products, and analgesics. Thoracic injuries may require oxygen, thoracocentesis, chest tube placement, and mechanical ventilation. Fractures and wounds are decontaminated and splinted/bandaged, with definitive fixation pursued after stabilization. Abdominal injuries are managed medically unless there is severe ongoing bleeding, sepsis, or injury to the urinary tract. PROGNOSIS: In feline high-rise syndrome, the prognosis is generally excellent following treatment, with survival exceeding 90%. Canine literature is sparse. The largest retrospective study reported a >90% survival to discharge and a greater need for surgical stabilization in this species. There are no prognostic factors identified that are associated with survival for either species.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/35650712/