Trauma/Automobile Injury in Cats

Overview of Trauma & Automobile Injuries in Cats

Automobile injury or trauma is defined as an injury sustained when a cat is struck by a moving vehicle such as a car, truck, snowplow, train or motorcycle. Injuries may also occur as the result of human abuse, falling from a height, or animal attacks.

The impact of traumatic injuries ranges from minor to life threatening and any body system may be affected. Common injuries include but are not limited to:

• Shock
• Skin bruising, abrasions and lacerations
• Head and facial injuries
• Spinal cord injuries
• Broken bones
• Pulmonary contusions (bleeding into the lungs)
• Pneumothorax (air in the chest cavity)
• Internal bleeding due to a liver, spleen or kidney injury
• Ruptured bladder

What to Watch For

• Abnormal behavior
• Inactivity
• Hiding
• Crying, whining
• Bruising
• Skin abrasions
• Lacerations
• Pale gums
• Increased respiratory rate
• Difficulty breathing
• Lameness or obvious broken bones

Diagnosis of Trauma/Automobile Injuries in Cats

Diagnostic tests are necessary to recognize trauma/automobile injury, and exclude other diseases. Tests may include:

• Complete medical history and physical examination
• Complete blood count (CBC)
• Serum chemistry profile
• Chest radiographs (X-rays)
• Abdominal radiographs
• Electrocardiogram (EKG)

Treatment of Trauma/Automobile Injuries in Cats

Treatments for trauma/automobile injury depend upon the extent of the injury and may include the following:

• Hospitalization
• Intravenous fluids
• Oxygen therapy
• Pain medication
• Antibiotics
• Anti-arrhythmic drugs if the heartbeat is irregular
• Blood transfusions if there is significant blood loss
• Surgery

Home Care and Prevention

If you suspect your pet has been struck by a motor vehicle or has suffered any other type of trauma, you should seek veterinary care immediately. The lack of external wounds does not rule out substantial injury.

Your veterinarian will likely recommend exercise restriction during your pet’s first few days to weeks at home depending on the injuries sustained. Animals with chest injuries require one to two weeks of exercise restriction. Animals with fractures of the extremities require four to six weeks of limited and supervised exercise. Animals with mandibular (jaw) fractures must be fed soft food until the fracture heals.

Your veterinarian may want you to cage rest your pet to allow some fractures (such as those of the pelvis) to heal. This means that you will need to confine your pet to a small area containing a bed and food.

Keep bandages clean and dry. Check wounds for redness, swelling or discharge. See your veterinarian if you have any questions or problems.

Return to your veterinarian for follow-up or suture removal if needed.

Animals with spinal cord injuries and hind limb paralysis may require assistance with a sling or harness to walk outdoors.

In-depth Information on Trauma/Automobile Injuries in Cats

Trauma may result from other accidents unrelated to moving vehicles. Other causes of trauma include:

• Falling from heights like apartment buildings, roofs, trees and decks. Pets can sustain injuries that are identical to those caused by automobiles. Veterinarians describe this type of trauma as “High Rise Syndrome.”
• Humans can maliciously induce trauma when they purposely strike, kick or shoot an animal with a gun or arrow. Injuries can include head injuries, spinal cord injuries, broken bones, pulmonary contusions and internal bleeding.
• Humans may inadvertently cause trauma when they step on a small cat or kitten. This is very common. Head trauma, broken bones, spinal cord injuries, pulmonary contusions and internal bleeding may result.
• Other, usually larger, animals may attack pets causing serious trauma or injury. Common injuries include bite wounds, lacerations, facial injury, neck and spinal cord injury (particularly when a smaller animal is shaken by the larger animal), perforation of the abdominal cavity and underlying organs and perforation of the chest cavity.Injuries that result from bite wounds, falls from heights, or other accidents may cause similar signs to those caused by an automobile accident. Signs of injury include:
• Shock is very common following trauma and results from an inability of the heart to pump enough blood to the internal organs. Symptoms of shock include pale gums, increased respiratory rate and heart rate, weakness, low blood pressure, weak pulses, low body temperature and collapse. Shock must be treated quickly before damage to internal organs occurs.
• Head trauma is a common injury seen in animals struck by moving vehicles. Signs of head trauma may include swelling of the nose or around the eyes, bleeding from the ears, mouth or nose, bleeding into the eye, unequal pupil size or fractures of the skull. A cat may be knocked unconscious or may be completely responsive following the injury. Head injuries can result in coma, dementia, seizures or death. Several days may be required before your veterinarian can accurately assess your pet’s prognosis for recovery from head injury.
• An eye can be displaced from the socket (proptosis) and may occur with a blow to the head.
• A tracheal tear (tear in the windpipe) can occur if the animal is struck in the neck region. As a result of this injury, air will accumulate under the skin primarily in the head and neck region but may extend all over the pet’s body and cause difficulty breathing.
• Pneumothorax is the abnormal presence of air in the chest cavity (air is normally confined to the lungs). Pneumothorax results from a tear in an airway and often accompanies rib fractures. This injury causes difficulty breathing and can be life-threatening.
• Pulmonary contusions (bruised lungs) result from blunt trauma to the chest and bleeding into the lung tissue, cause difficulty breathing and can be life-threatening.
• Hemothorax is the accumulation of blood in the chest cavity and results from lacerated blood vessels, often in conjunction with rib fractures.
• A diaphragmatic hernia is the presence of abdominal organs (stomach, liver, spleen, intestines) in the chest cavity. Organs normally confined to the abdomen move into the chest cavity through a tear in the diaphragm (muscle that separates the abdominal and chest cavity). The pet may exhibit no symptoms or may have difficulty breathing. This injury can be life threatening. Surgery is delayed for 24 hours following trauma to allow time for stabilization unless the cat is experiencing respiratory distress.
• A body wall hernia may result when a tear occurs in the muscles of the abdominal cavity and internal organs move into the space between the muscles and the skin. An external swelling may be visible on the animal’s side or between his hind legs.
• Internal bleeding due to laceration of the kidney, spleen or liver is also common. Shock that is unresponsive to treatment, abdominal pain, distension and bruising are signs associated with internal bleeding.
• Uroabdomen is the accumulation of urine in the abdomen and results from a disruption of the urinary tract (kidneys, bladder, ureter, urethra). The pet may or may not pass urine, and is generally very depressed and dehydrated.
• Fractures of the extremities are common and may cause shock.
• Vertebral fractures (back fracture) may cause lack of coordination or paralysis.
• Degloving skin wounds occur when the cat is dragged on the street surface by a car. The skin is completely removed from the underlying tissues, exposing tendons, muscle or bones.
• Traumatic myocarditis. Approximately 50 percent of traumatized animals develop an abnormal heart rhythm (arrhythmia) beginning 24 to 48 hours after the initial trauma. The arrhythmia may result from direct bruising to the heart muscle or from the effect of substances that are released during shock and circulate in the blood.

In-depth Information on Veterinary Care for Feline Trauma Injuries

Veterinary care should include diagnostic tests and subsequent treatment recommendations.

Diagnosis In-depth

A complete medical history and physical examination will be performed to evaluate for broken bones and/or internal chest or abdominal injuries. Most traumatic injuries are self-evident; however, the diagnosis of trauma may be difficult if the owner does not witness the traumatic event and the cat does not have external injuries.

Your veterinarian will likely ask whether you witnessed the accident to determine where your cat was struck.

Tests other than the physical examination often are necessary to rule out the presence of internal injuries. These may include:

• A complete blood count (CBC) is often performed to look for evidence of blood loss (anemia) and a low or high white blood cell count, which can indicate infection or inflammation. The white blood cell count is particularly important if the injury is suspected to be older than 24 hours or if the cat has a fever.
• A serum chemistry profile allows evaluation of the internal organs such as the liver, pancreas and kidneys. The liver enzymes are usually elevated in a traumatized patient due to direct trauma. Increases in pancreatic enzymes could indicate a traumatic pancreatitis (inflammation of the pancreas). Elevations in kidney blood values could indicate direct injury to the kidneys, rupture of the ureters (ureters carry urine from the kidneys to the bladder), rupture of the bladder or rupture of the urethra (connection between the bladder and the outside). A disruption of the urinary tract is life threatening and requires surgical intervention.
• Chest radiographs (X-rays) are essential in a traumatized animal regardless of the animal’s appearance. Chest X-rays identify pulmonary contusions (bleeding into or bruising of the lungs), pneumothorax (air in the chest cavity) and diaphragmatic hernia (abdominal organs in the chest cavity). These conditions may be missed with auscultation (listening to the chest with a stethoscope).
• Abdominal radiographs are indicated if the cat has abdominal pain, bruising or distension. Abdominal X-rays are used to identify fluid or gas in the abdomen, which could indicate the accumulation of blood or urine or a rupture in the intestinal tract. These X-rays are also used to identify whether the bladder is visible and intact.
• An electrocardiogram (EKG) may be run to identify the presence of an abnormal heart rhythm.Additional diagnostic tests may be required on an individual pet basis, including:
• Plain X-rays of the abdomen are not always sufficient to identify a leak in the urinary tract. If your veterinarian suspects a rupture to the bladder or urethra that cannot be identified on plain X-rays, a contrast cysto-urethrogram may be recommended. A contrast cysto-urethrogram is an X-ray taken of the bladder and urethra after a dye has been injected into the bladder. The injected dye outlines the contour of the bladder and urethra and is used to identify urine leakage from the bladder or urethra due to a tear or rupture. This procedure requires general anesthesia.
• An IVP (intravenous pyelogram) is a radiographic study to identify the kidneys and the ureters. This study is done when your veterinarian suspects the kidney or ureter has been damaged. This study requires general anesthesia.
• Radiographs of the skull are necessary if your cat has suffered severe head or facial injuries. These x-rays help identify fractures that may require surgical repair.
• Surgery is considered a diagnostic and therapeutic tool when a wound appears to penetrate the chest or abdominal cavity. These wounds must be explored and repaired to prevent an infection in either cavity.
• Thoracocentesis (inserting a needle in the chest to withdraw fluid or air) may be performed to diagnose a pneumothorax or hemothorax if your animal is in respiratory distress.
• Abdominocentesis (inserting a needle into the abdominal cavity to withdraw fluid) is often used to diagnose the presence of internal bleeding or urine in the abdomen.

Treatment In-depth

Treatments for trauma/automobile injury may include the following:

• Hospitalization of several days duration may be necessary to treat traumatic injuries; however, if your pet does not have external injuries and radiographs appear normal, he/she may be released after the examination. Despite a normal physical examination, your veterinarian may recommend one night of hospitalization for observation in the event of late developing problems.
• Intravenous fluids are administered to treat or prevent shock.
• Supplemental oxygen is given to animals in shock and to those with injuries such as pneumothorax, pulmonary contusions, head trauma, and blood loss.
• Animals with head trauma may receive drugs to reduce brain swelling after they have been treated for shock. These drugs may include mannitol. Anticonvulsants such as diazepam or phenobarbital are used to control seizures.
• Pain medication such as butorphanol,buprenorphine, fentanyl or oxymorphone is administered to animals with fractures and muscle bruising. Additional pain relief may be provided with non-steroidal anti-inflammatory drugs such as aspirin, carprofen or Etogesic®. Anti-inflammatory drugs may be contraindicated in some animals so check with your veterinarian before giving any medications to your pet.
• Antibiotics are given to animals with skin wounds, lacerations and open fractures (the fractured bone punctured through the skin to the outside).
• Anti-arrhythmic drugs such as lidocaine or procainamide are administered intravenously or orally to control an abnormal heart rhythm that may result from trauma. The arrhythmias are usually transient (last less than 3 to 4 days) and animals are rarely discharged on heart medication.
• If your pet experiences serious blood loss, your veterinarian will administer a blood transfusion or give a blood substitute (e.g., Oxyglobin®). A wrap may be applied to the animal’s abdomen to limit bleeding into the abdominal cavity.
• Thoracocentesis. During this procedure, a needle is place into the animal’s chest to withdraw air or blood that is restricting his/her ability to breathe. If thoracocentesis is not sufficient to deal with the volume of air or fluid, a chest tube may be inserted for several days.Surgery may be necessary for some injuries; however, it is usually delayed until the patient has been stabilized. Types of wounds/problems that may require surgery include:
• Skin wounds and lacerations.
• Fractures involving the legs or back. Occasionally a leg fracture may heal with application of a cast. Fractures of the pelvis that do not involve weight-bearing surfaces may heal with 4 to 6 weeks of cage rest.
• Bleeding. If your pet experiences internal bleeding that cannot be controlled with blood transfusions and other medical support, your veterinarian may need to do an abdominal exploratory to locate and stop the source of bleeding.
• Urinary tract trauma. Surgery is required if any part of the urinary system (kidney, ureter, bladder, urethra) is disrupted and is causing leakage of urine into the abdomen.
• Any wound that appears to penetrate the chest or abdominal cavity must be explored to prevent pyothorax (pus in the chest) or peritonitis (infection in the abdominal cavity) from developing.
• Hernias (diaphragmatic or body wall) must be repaired surgically. Surgery is delayed for the first 24 hours to allow stabilization of the cat’s condition.

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