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High-Rise Syndrome, Orofacial 469.e5

VetBooks.ir Diseases and Disorders

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A B
HIGH-RISE SYNDROME, OROFACIAL A, Open-mouth clinical image of the dorsal aspect of the oral cavity (rostral
is toward the bottom of the image) shows traumatic cleft palate in a cat after falling from a height. Note separation
of left and right incisive bones (arrow), fractured left maxillary canine tooth (asterisk), and midline defect in hard and
soft palates. B, Postoperative image of the same patient. Repair of traumatic cleft palate was accomplished by means
of approximation and suturing of medially positioned flaps after creation of bilateral releasing incisions (arrows) into
palatal mucoperiosteum along dental arches. Note interarch splinting (composite resin reinforced with underlying twisted
wire) between maxillary canine teeth. (Copyright Dr. Alexander M. Reiter, University of Pennsylvania.)

is extensive, interarch splinting may be • Malocclusion Client Education
required. Very narrow and short separations • Temporomandibular joint ankylosis in very Close windows and balcony doors in the
may sometimes heal spontaneously in 2-4 young animals with difficulty or inability to presence of animals.
weeks with conservative management, but open the mouth
the benefit of initial surgical management • Chylothorax SUGGESTED READING
outweighs the risk of developing a persistent Bonner SE, et al: Orofacial manifestations of high-
oronasal communication. Recommended Monitoring rise syndrome: a retrospective study of 84 cats
• Temporomandibular joint luxation: conserva- • In-patient monitoring until discharge (2000-2010). J Vet Dent 29:10-18, 2012.
tive reduction with a wooden dowel (pencil • Repeat exam and removal of skin sutures in
in a cat) 2 weeks ADDITIONAL SUGGESTED
• Removal of cerclage wire around mandibles READINGS
Chronic Treatment and wire-reinforced splint in between maxil- Gordon LE, et al: High-rise syndrome in dogs:
• If response to emergency treatment is poor, lary canines in 4 weeks 81 cases (1985-1991). J Am Vet Med Assoc
visceral injury (abdominal and thoracic) with 202:118-122, 1993.
possible hemorrhage should be considered PROGNOSIS & OUTCOME Papazoglou LG, et al: High-rise syndrome in cats: 207
and pursued diagnostically. cases (1988-1998). Aust Vet Pract 31:98-102, 2001.
• Chronic oronasal communication: medially Good prognosis for survival and return to Vnuk D, et al: Feline high-rise syndrome: 119 cases
positioned flaps with releasing incisions along normal function for ≈90% of cats (1998-2001). J Feline Med Surg 6:305-312, 2004.
dental arches or overlapping double flaps Whitney WO, et al: High-rise syndrome in cats. J
• Temporomandibular joint injury (chronic PEARLS & CONSIDERATIONS Am Vet Med Assoc 191:1399-1403, 1987.
luxation or ankylosis): unilateral or bilateral
condylectomy Comments RELATED CLIENT EDUCATION
• Extraction or endodontic therapy of teeth Number and severity of injuries increase with SHEET
with pulp exposure increasing height of fall; others report that the
association between injuries and height of fall Consent to Perform General Anesthesia
Nutrition/Diet follows a curvilinear pattern. AUTHOR & EDITOR: Alexander M. Reiter, DVM, Dr.med.
Nutritional support: soft food is appropriate. vet., DAVDC, DEVDC
An esophagostomy tube is rarely necessary. Technician Tips
Gently offering soft food during the healing
Possible Complications period can be the cornerstone of nutritional
• Chronic oronasal communication support.

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