Cat fell from a window:jaw, palate and tooth injuries

High-rise syndrome in cats: what injuries a fall causes

Vets call the injuries cats sustain after falling from windows and balconies high-rise syndrome. In mid-air a cat turns its feet towards the ground, so the impact is taken by the front legs, the chest and the head, and the chin strikes the ground hard. That is why the injuries usually fall into three groups:

• the chest — pneumothorax (air between the lungs and the chest wall), bruised lungs, rib fractures; this is the most dangerous part of the injury;
• the limbs — fractures, dislocations, joint injuries;
• the face and mouth — nosebleeds, a split hard palate, separation of the lower jaw at the chin, jaw and tooth fractures, wounds to the lips, tongue and chin.

There is no safe height: cats are injured in falls from low floors too. And a cat that walked off and hid after a fall may still have chest injuries — breathing difficulty sometimes worsens over several hours.

Cat fell from a balcony: what to do in the first minutes

Your job is to get your cat to a vet as quickly and as gently as possible. Here is what to do:

1. 01

   Do not wait for your cat to “recover”

   Have your cat examined on the day of the fall, even if it is walking and has no visible wounds. Go immediately if it is breathing fast or with its mouth open, its gums are pale or bluish, it cannot stand or it responds poorly to you.

2. 02

   Move your cat into a carrier carefully

   Drape a towel over it, slide your hands under the chest and hips and lift it into a hard carrier, ideally one with a removable top. Do not lift it by the scruff and do not squeeze the chest. A frightened, injured cat may bite even its owner.

3. 03

   Keep it warm and calm

   Cover your cat with a towel or blanket and drape a cloth over the carrier to reduce stress. Do not put a hot-water bottle directly against its body, and do not hold your cat in your arms during the journey.

4. 04

   Call the clinic ahead

   Phone on the way to say your cat has fallen from a height, and give the floor and the approximate time of the fall. Choose a clinic that provides emergency care around the clock.

What jaw, palate and tooth injuries cats get after a fall

The impact on the chin spreads through the whole head, so one cat may have several injuries at once. Some are visible straight away, others only under anaesthesia and on radiographs. This is what I assess after a fall from height.

Split palate in a cat

The hard palate is the bony “roof” of the mouth that separates the mouth from the nose. The impact can split it along the midline, where the left and right halves meet. In the mouth you may see a lengthwise gap or a tear in the lining down the middle of the palate, and the nose often bleeds.

A narrow split can be hidden under a blood clot, so it is easy to miss. If it does not heal, an opening between the mouth and the nasal cavity may remain — an oronasal fistula: food and water get into the nose, the cat sneezes and develops nasal discharge.

Separation of the lower jaw at the chin (symphysis)

A cat's lower jaw is made of two halves joined in the middle, at the chin — this joint is the symphysis. After an impact the halves can separate: the lower canines and incisors sit at different heights or splay apart, the chin moves, and the teeth no longer meet properly. There may also be a wound or torn soft tissue under the chin.

Jaw fracture in a cat

Besides the symphysis, the body of the lower jaw and the bones of the upper jaw can break. Signs include an asymmetrical face, displaced teeth, a mouth that does not fully close, bleeding from the mouth and pain on touch. The fracture line may run through tooth roots, and the condition of those teeth determines how the jaw is stabilised. I describe the fixation methods in more detail on the page about jaw fractures in cats and dogs: stabilisation and splinting.

Jaw joint injury

The temporomandibular joint (TMJ) connects the lower jaw to the skull. A fall can dislocate the joint or fracture the condylar process of the lower jaw. With a dislocation the mouth usually will not close, the jaw is shifted to one side and the teeth do not meet — just as with the other causes described on the page cat cannot close its mouth. Fractures near the joint may be hard to spot from the outside but can later limit how wide the cat opens its mouth, so follow-up after the injury matters.

Broken teeth

The canines take the impact first: they are the longest teeth and stick out the furthest. If you see a pink or dark dot on the broken surface, the pulp (the nerve and blood vessels inside the tooth) is exposed: the tooth hurts and becomes infected over time. Sometimes a tooth does not break but becomes loose, displaced or darkens later. What a fracture looks like and what it means is covered on the symptom page broken tooth.

Signs of jaw and tooth injury in a cat

After a fall, watch for these signs — even one of them is a reason to have the mouth examined:

• bleeding from the mouth or nose, blood-tinged saliva;
• the mouth does not close fully, or the cat holds it slightly open;
• the teeth do not meet as before, the lower jaw is shifted to one side;
• heavy drooling, frequent licking of the lips or swallowing;
• refusing food, or approaching the bowl and walking away;
• swelling of the face, the chin or under the eye, a wound under the chin;
• a broken, loose or displaced tooth;
• sneezing, nasal discharge, food or water coming out of the nose — a possible palate injury.

Cats hide pain and may hide themselves, so the absence of obvious complaints does not mean there is no injury. Why blood in the saliva needs attention is explained on the page blood from the mouth or in the saliva.

Diagnosis: anaesthesia, dental radiographs and possibly CT

We carry out the dental examination only once the cat has been stabilised: breathing is normal, pain is controlled and its general condition allows anaesthesia. Anaesthesia is given and monitored by a separate veterinary anaesthetist — which is especially important after a chest injury.

A full examination of an injured cat's mouth is impossible without anaesthesia: it hurts, and some injuries can only be seen on careful examination and on radiographs. The work-up includes:

• examination of the mouth — the palate, gums, tongue and lips, assessment of the bite and of how mobile the jaw fragments are;
• **dental radiography** — fracture lines, the roots and the teeth in the fracture line, root fractures that cannot be seen in the mouth;
• CT (computed tomography) — may be needed if a jaw joint injury, multiple fractures or upper jaw fractures that are hard to see on standard radiographs are suspected;
• chest radiographs and other tests — usually done at the emergency care stage.

If radiographs or a CT scan were already taken at another clinic, bring them with you — they help plan treatment.

Treatment: stabilising the jaw, closing the palate, treating the teeth

The main goal is to restore the correct bite so that the cat can close its mouth and eat, and to remove pain and sources of infection. I plan treatment individually after radiographs; it is carried out under inhalational anaesthesia with local anaesthesia.

• Symphyseal separation — the two halves of the lower jaw are brought together and fixed, for example with a thin wire around the jaw behind the canines, sometimes with a composite splint. The fixation is removed once healing has been confirmed by examination and a follow-up radiograph.
• Jaw fractures — the fragments are put back in the correct position and stabilised so that the teeth meet as they did before the injury: with intraoral composite splints anchored on the teeth, wire constructions or a combination. Sometimes the jaws are temporarily fixed to each other in the correct bite — then the cat is fed through a tube.
• Jaw joint injury — a dislocation is reduced under anaesthesia and jaw movement is temporarily limited if needed; the approach to a fractured condylar process is chosen based on radiographs or CT.
• Split palate — a narrow split with stable fragments sometimes heals on its own under a vet's supervision; a wider one is closed surgically by suturing the lining of the palate, so that no opening between the mouth and nose remains.
• Broken teeth — the dental radiograph decides: a fresh fracture with exposed pulp may allow vital pulpotomy, an inflamed or dead pulp calls for root canal treatment, and if the tooth cannot be saved it is extracted. All of this is done when clinically indicated.

Teeth in a jaw fracture line are kept if they help stabilise the jaw and do not interfere with healing; otherwise they are extracted. A broken canine should not be left “for later”, even if the cat is eating: in the case of a cat with a broken canine, the tooth went untreated for more than three years — the cat refused dry food and toys, and its appetite returned after treatment.

All types of mouth injuries are covered on the page dental and jaw trauma.

Feeding and recovery after a jaw injury

Once the jaw has been stabilised, your cat needs soft food: pâté or wet food mashed into a smooth paste, without hard pieces. Dry food, treats and toys your cat chews on come back only when the vet says so.

If your cat will not eat on its own or its jaws are temporarily fixed together, a feeding tube may be needed — it is placed under anaesthesia, for example through the neck into the oesophagus. A tube allows feeding and medication without pain and without loading the jaw. Going without food for long is dangerous for cats, including for the liver, so waiting for the appetite to come back on its own is not a good idea.

• pain relief and other medicines — only as prescribed by the vet;
• check the splint or wire every day: if the fixation loosens or breaks, or bad breath appears, contact the vet;
• a protective collar may be needed so that your cat does not paw at its face;
• follow-up examinations and radiographs — on the schedule the vet sets.

Recovery time depends on the type of injury, the cat's age and how the bone heals, so I give specific timelines only after radiographs.

Prevention: how to protect your cat from falling out of a window

Cats do not fall because they are “clumsy”: they get distracted by birds and insects, slip off the windowsill or jump when startled. So reliable protection means a physical barrier, not just supervision.

• fit sturdy cat-proof nets on every window that opens and on the balcony — an ordinary insect screen will not hold a cat;
• secure the net so that your cat cannot push it out with its paws or body weight;
• do not leave tilt-and-turn windows in the tilt position without protective inserts: a cat can get stuck in the gap and be injured;
• do not leave windows ajar when you are out, whatever floor you live on;
• check the protection after a move, when visiting and at a holiday home — in a new place cats explore everything.

What the cost of treating a jaw injury depends on

The cost cannot be quoted in advance: it depends on the number and type of fractures, the fixation method, whether CT and a feeding tube are needed, how many teeth are broken and how they are treated, and the number of follow-up visits. That is why I give the exact amount after diagnostics.

If your cat has already been stabilised at another clinic or you are not in Kyiv, start with an online consultation: I will review photos, radiographs or CT and suggest the next steps.

Frequently asked questions