High-Rise Syndrome and Bilateral Mandibular Fracture in a Feline

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Case study:

A very important case was referred to UVAS Pet Centre Lahore recently. It was that of a white cat that fell from a considerable height, a syndrome which is called "High-Rise Syndrome" in veterinary terms. This incident had resulted in a very serious injury to the facial area.

Location: Pet Center, UVAS Lahore

Date: April 4, 2026

Patient: White Cat (Adult)



Clinical Presentation and Physical Exam

​On admission, the patient presented with hypovolemic shock caused by blood loss and pain. These were the main clinical manifestations of this patient:

​Epistaxis (Nasal Bleeding):

 Profuse bleeding from the nose.

​Hemorrhage from the Mouth: 

Profuse bleeding from the mouth.

​Dislocation of the Mandible:

 Malpositioning of the lower jaw.

​Hypovolemic Shock:

 Paleness of mucous membranes, palpitations, and unresponsiveness.

​Imaging (X-Ray Results)

​The X-ray films helped confirm that the trauma was very severe. The X-rays (Right Lateral and Right D-V view) showed:

​Fractured Bilateral Mandible: 

Fracture of both sides of the mandible (jaw bone).

​Swelling in Soft Tissues: 

Inflammation of soft tissues in the area of the jaw and nose.



Plan for Emergency Stabilization & Treatment

The objective here was stabilizing the cat before thinking about surgical repair. The following measures were taken:

IV fluids for combating shock & raising BP.

Hemostatics: 

Inj. Tranexamic Acid for arresting the internal bleed.

Pain management: 

Inj. Tramadol HCL (an opioid medication) was provided to alleviate the excruciating pain due to trauma.

Supplementary calcium and broad spectrum antibiotics for preventing infections.

​Surgery Recommendation

In cases of bilateral mandibular fractures, surgical fixation using interfragmentary wiring/symphysial wash is the best procedure that allows the patient to chew, eat & drink. While at the moment the owner is contemplating this procedure, we will continue monitoring him/her and providing support.

Conclusion

Cases of high rise syndrome require prompt action. Our main focus as veterinarians should always be on stabilizing the patient (ABC-Airway, Breathing and Circulation) prior to performing any orthopedic surgeries.



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