High-rise syndrome in cats (part 2): injury patterns and survival rate

Objectives This two-part study investigates the relationship between risk factors, injury patterns and survival rates in cats affected by high-rise syndrome (HRS). By identifying key prognostic and predictive factors, such as age, fall height and impact surface, we aim to enhance veterinarians’ ability to provide accurate prognoses and optimise patient management. In addition, this study seeks to address inconsistencies in the literature by re-evaluating the influence of these factors on injury severity and survival outcomes.
Methods We analysed medical records and radiographs from 1125 cases of feline HRS treated at the Freie Universität Berlin’s small animal clinic between 2004 and 2013. All cases involved falls from a minimum height of 4 m. Data collected included sex, age, body weight, fall height, impact surface, injury details, prior treatment, time to veterinary presentation (>4 h or <4 h), radiographic findings and survival outcome.
Results Among the 1125 HRS cases, circulatory shock was observed in 48.6%, craniocerebral injury in 2.8%, thoracic trauma in 58.3%, orofacial lesions in 51.1% and blunt abdominal trauma in 14.6%. Musculoskeletal injuries were common, with limb fractures occurring in 47.2% of cases and pelvic fractures in 11.1%. The overall survival rate was 87%, while 13.3% of cats died or were euthanased as a result of trauma severity or poor prognosis. Significant correlations were found between injury severity, age, impact surface and fall height.
Conclusions and relevance This study includes the largest sample of HRS cases in cats to date, providing essential insights for veterinarians and pet owners regarding prognosis and treatment protocols. Although survival rates are high, euthanasia as a result of severe trauma and financial constraints remains a concern. The identified risk factors and injury patterns can help veterinarians provide more accurate and individualised prognoses, ultimately improving patient care and opening new avenues for future research, such as the importance of preventive measures at home and the role of treatment protocols for initial stabilisation before referral.
© The Author(s) 2025.