Pancreatic rupture in four cats with high-rise syndrome

Abstract

Pancreatic trauma and rupture are rare after feline high-rise syndrome; however, should it happen, pancreatic enzymes will leak into the abdominal cavity and may cause pancreatic autodigestion and fatty tissue saponification. If not diagnosed and treated, it can ultimately lead to multiorgan failure and death. In this case series, 700 records of high-rise syndrome cats that presented between April 2001 and May 2006 were analysed, and four cats with pancreatic rupture were identified. Clinical signs, diagnosis using ultrasonography and lipase activity in blood and abdominal effusion, and treatment modalities are reported. Three cats underwent surgical abdominal exploration, one cat was euthanased. Rupture of the left pancreatic limb was confirmed in all cases. Two of the operated cats survived to date. High-rise syndrome can lead to abdominal trauma, including pancreatic rupture. A prompt diagnosis and surgical treatment should be considered.

Feline abdominal ultrasonography: What’s normal? What’s abnormal? The pancreas

“…On ultrasound, the pancreas in four affected cats appeared hyper-echoic and was surrounded by hyperechoic peripancreatic mesenteric fat. 86 Additional findings in all affected cats included ascites and hypomotility of the gastrointestinal tract. It is thought that the left pancreatic lobe may be particularly vulnerable to rupture and, in the four cases described, the diagnosis of pancreatic rupture was confirmed either at surgery or at post-mortem examination.…”

“…Pancreatic rupture is a very rare event that has been documented in cats with high-rise syndrome. 86 Leakage of pancreatic enzymes into the abdominal cavity ensues, resulting in pancreatic autodigestion and saponification of JFMS CLINICAL PRACTICE 255 adjacent fat. Without the correct diagnosis and treatment, the condition can lead to multiorgan failure and death.…”

High‐rise syndrome in cats and dogs

“…Of the larger retrospective studies of cats with HRS, the prognosis is generally excellent once treatment is initiated, with survival exceeding 90% in treated cases. [1][2][3][4]22,23 None of the papers identified prognostic factors associated with survival.…”

“…High-rise syndrome (HRS) is defined as a fall from a height of 2 or more stories that results in a constellation of injuries in small animals, the classic triad of which are epistaxis, hard palate fracture, and pneumothorax. [1][2][3][4] In recent years, multiple veterinary studies have added to the body of knowledge pertaining to HRS, reporting additional injury types that include other thoracic trauma (eg, pulmonary contusions, rib fractures), abdominal trauma (eg, traumatic pancreatitis, splenic or hepatic fracture and associated hemoperitoneum), and limb fractures. 1,3,5,6 Cats are the most commonly reported species with HRS and often fall from windowsills or balconies when chasing prey or playing.…”

Thoracic and Abdominal Trauma

“…7 Pneumothorax and pulmonary contusions were regularly diagnosed, being documented in 60% and 40% of cats with thoracic trauma, respectively. 7 However, a separate study described pancreatic rupture in four cats, 8 and treating clinicians should be aware of abdominal trauma that cannot be externally visualized. Although injury to the chest and bones was common, nearly 97% of cats survived the fall.…”