Some diseases occur worldwide, as we’ve learned all too well from the COVID-19 pandemic. But many diseases occur in specific geographic locations or are restricted to certain populations of humans and animals. For example, Valley Fever or coccidioidomycosis, a fungal infection that can affect dogs and people, occurs predominantly in the southwestern United States due to that region’s soil conditions. Veterinarians and physicians in NYC would not suspect this disease unless their patient had travelled out west. Another example: Boxer cardiomyopathy, or arrhythmogenic right ventricular cardiomyopathy, is suspected in any Boxer with an abnormal heart rhythm because it is a disease occurring frequently in, you guessed it, Boxers!

High rise syndrome in dogs and cats is another example. Specific to urban areas, high rise syndrome, or animals falling from tall buildings, is a common cause of traumatic injuries in pets. High rise syndrome was first described by AMC veterinarians in the 1980s studying falling cats and dogs leading to the publication of two scientific papers detailing a triad of injuries common injuries seen in these patients: chest, limbs and skull.

With the recent warm weather in New York City, the Schwarzman Animal Medical Center has seen a number of pets with injuries related to falls. Using 2 dogs – both Chihuahuas – and 6 cats that recently fell and were cared for at AMC, today’s blogpost will focus on high rise syndrome.

High Rise Syndrome and Lung Injuries

One of the falling Chihuahuas and three of the falling cats injured their lungs in the fall. The force of impact on the ground causes bruising in the lungs. In some cases, the bruises are severe enough to compromise breathing and land the pet in an oxygen cage. The x-ray below shows broken ribs in a cat — AMC veterinarians suspect one of the broken ribs tore some blood vessels, so the cat required a blood transfusion in the Intensive Care Unit (ICU).

High Rise Syndrome and Broken Bones

In high rise patients, the most common fractures are of the front legs, especially the forearm, or radius and ulna. But the patients featured in this blog post suffered multiple fractures: radius, ulna, ankle, shin bones and femur. In addition, the Chihuahua that fell 13 floors had an unusual fracture: a chipped lumbar vertebra.

High Rise Syndrome and Head Trauma

Skull fractures are another common injury in falling dogs and cats. Veterinarians believe injuries to the head occur when the pet lands and the head bounces on the ground. AMC’s emergency room veterinarians see fractured teeth and hard palates, as well as fractures of the upper and lower jaw in high rise syndrome patients. The CT image below shows the head of a cat. The ears are on top. The dotted arrow points to the brain inside the while boney skull. The joints between the lower jaw and the skull are fractured on both sides (solid arrows) with the fractured piece on the left side severely displaced from its normal position.

Preventing High Rise Syndrome

Some of the recent high rise syndrome patients were unexpectedly found on the ground when their owners came home. I can’t imagine anything worse. All pets, but especially those home alone, should have the windows closed or, if they are left open, with a well secured screen in place. Window guards, required in many large cities to prevent children from falling, have bars that are too far apart to protect cats and small dogs from a fall.

All the falling pets mentioned here were a year or less in age, except for one of the Chihuahuas. That piece of information suggests that a curious puppy or kitten is more likely to explore a window ledge and accidently fall. Moving furniture away from window ledges will prevent a dog from accessing an open window but will absolutely not divert an agile cat. Again, tight fitting screens or windows that are only open crack are required if you have a cat.

Finally, don’t feed birds or squirrels on your windowsill, terrace or fire escape. The AMC study on high rise syndrome in dogs found a majority of dogs jumped off the building, and the jump was often incited by one of these creatures. In the AMC study of high rise syndrome in cats, one cat reportedly fell when jumping after an insect, and AMC’s emergency room commonly cares for cats who have fallen when lunging for a pigeon.

On a lighter note – have your ever wondered how cats can fall and suffer so few injuries? The Washington Post has an excellent piece explaining cats’ “righting reflex” in words, photos and video.