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High-rise syndrome and the feline pancreas

Zimmermann E, Hittmair KM, Suchodolski JS, et al. Serum feline-specific pancreatic lipase immunoreactivity concentrations and abdominal ultrasonographic findings in cats with trauma resulting from high-rise syndrome. J Am Ved Med Assoc 2013;242:1238-1243.

High-rise syndrome (HRS) is defined as a fall from a second floor or higher that leads to trauma, including shock, facial, thoracic, and orthopedic injuries. Cats have the ability to survive falls that kill most humans because they have a special gyroscopic righting reflex and use limb flexing on landing. Abdominal injuries, including pancreatic trauma, have been reported to occur although not frequently. This study was a prospective case series looking at 34 client-owned cats with naturally-occurring HRS and evaluating serum feline-specific pancreatic lipase immunoreactivity (fPLI) and abdominal ultrasonographic findings. Measurement of serum fPLI was performed within 12 hours of the fall and 24, 48, and 72 hours later. Pancreatitis was diagnosed with an fPLI concentration of greater than 5.4 µg/L. Each cat had abdominal ultrasonography performed twice 48 hours apart, and pancreatic trauma was determined by detection of a number of pancreatic and peripancreatic abnormalities. Each cat was assigned 1 point for each abnormality noted, and a cumulative score of greater than or equal to 3 was suggestive of traumatic pancreatitis. 
Traumatic pancreatitis was diagnosed in 9 cats on the basis of the serum fPLI concentration and in 8 cats on the basis of ultrasonographic findings. The results showed that serum fPLI increased within 12 hours after the fall, but decreased dramatically between 24 and 48 hours later. Therefore, the evaluation of serum fPLI in cats with HRS more than 48 hours after a fall may have limited or no value in determining traumatic pancreatitis. There was significant agreement between the use of serum fPLI and abdominal ultrasonography for diagnosis of traumatic pancreatitis. This agreement suggests serum fPLI and repeated abdominal ultrasonography are clinically useful for diagnosis of traumatic pancreatitis following HRS in cats. [VT]
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