Highrise Syndrome in Cats

This occurrence has been termed “highrise syndrome”, greatly due to the fact that most of these falls happen from city apartment buildings-- out of windows or off of fire escapes. Damage to the cat’s internal organs may be extensive after a fall from an extreme height. The organs may bruise or swell and, in some cases, may rupture. Broken bones are often seen on the limbs or in the mouth and jaw. The cat may suffer from internal bleeding and be in shock. Emergency veterinary care is needed and can be essential to the survival of the cat. 

Cats have incredible balance and an overall aversion to falls. When they do fall, their bodies can survive the drop from over 20 stories high. This is due to their ability to expand their flexible spines and correct their positioning in the air, somewhat like a flying squirrel. Even if a cat survives a fall from extreme heights, serious injury may be present although not always visible. Increased accounts of injury happen from falls between two and seven stories high because the cat does not have enough time to correct its positioning. 

The symptoms that arise will vary greatly depending on what injuries have occurred within the cat. The delay of symptom onset is common, so if no severe issues are obvious in your cat after a fall it is still necessary to bring it to a veterinarian for a full assessment. Symptoms may show as follows:

• Painful abdominal mass
• Abdominal distention
• Vomiting
• Visible wounds
• Blood loss
• Jaundice
• Bleeding or swelling of the mouth
• Malaligned limbs

Most instances of highrise syndrome are preventable by humans. Often, the cat falls out of a window or off of a balcony of its owner’s home. Kittens may be more prone to falls due to their inexperience and curiosity. Known causes include:

• Being startled (often by a vacuum or other mechanical noise)
• Too strong of a prey drive (cat fails to note surroundings because of extreme focus on a fly, bird, etc.)
• Leaving windows open without appropriate screening
• Involuntary REM movements while sleeping at great heights

In most cases, the owner will be aware of the cat falling as it will be absent from the apartment or it will not be able to return home. If you witness your cat fall, bring it to an animal hospital or veterinary clinic immediately. Take great care when moving an injured cat so that you do not damage it any further. It is necessary to bring your cat to a veterinarian even if the cat seems initially fine. The sooner it is assessed, the more likely the cat will survive serious injuries. 

The veterinarian will perform a complete physical examination of the cat to identify all injuries present. X-rays and ultrasounds, including a transabdominal ultrasound, may be needed to see the extent of internal damage. These images can help identify organ ruptures or the presence of pancreatitis. The vet will determine if any abnormal abdominal fluid exists, and what it is composed of. Full blood work will be taken, including a complete blood count to monitor the number of white blood cells and a biochemical profile to look for increases in creatinine or potassium. 

The appropriate treatment for the cat will depend on what kind of injuries are present. Certain circumstances require emergency stabilization before any other treatment can be administered.

Emergency Surgery 

If any of the internal organs have ruptured from the fall and are leaking blood, urine or other fluids into the abdomen, they will need to be repaired immediately. Any bones that have been severely broken will need to be realigned, sometimes with pins or other implantations being added for support. A splint may be needed while the bone recovers. Surgery requires general anesthesia and does carry risks, especially when vital organs are involved.

Supportive Care 

A cat who has suffered a fall from great heights may be in shock from the trauma. Supplemental oxygen, a feeding tube, and intravenous fluids may help to stabilize the cat’s condition so it can begin to recover. 

If your cat has undergone emergency surgery, you will be given specific instructions for at-home care. The incision site will have to be monitored daily to watch for signs of infection. Certain painkillers or antibiotics may have to be administered. All activity will have to be limited for some time. Complete bed rest is necessary for severe bone fractures and for organ bruising. If carried out properly, this can work wonders for a cat suffering from life-threatening injuries. While a fall can be fatal, the majority of cats do survive with appropriate care.

Highrise syndrome can be prevented. Ensure that you have safe windows installed with proper screen fixtures in place. Open only the top section of windows. Do not leave your window open when you are not at home. It may be the safest option to keep your cat off of any balconies or fire escapes. While you may be comfortable with your cat resting on window sills and railings, falls can and do happen and are seen regularly at veterinary clinics.