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HEAD TRAUMA IN CATS

Head Trauma

Cats commonly suffer various degrees of head trauma after being hit by a car or suffering other traumatic injury such as a high fall or being struck by a bat. Trauma to the head can cause skull fractures, crushed sinuses, jaw fractures, bleeding within the brain (hematoma formation), brain contusions (bruising), seizures, concussions, and worst of all herniation of the brain. The degree of head trauma is assessed by examining the cranial nerves reflexes, or the nerves supplying the brain. Often veterinarians have to take a "wait and see" type of approach when treating head trauma. Some cats recover rapidly, others decline over time. Each cat is different and both doctors and owners must be patient.

Symptoms:

  • Unequal pupil size-constricts with light (good prognosis)
  • Fixed pinpoint size pupils (guarded prognosis)
  • Fixed dilated pupils (grave prognosis)
  • Constant repetitive rapid eye movement (nystagmus)- up and down or side to side
  • Bleeding from nostril(s) (epistaxis)
  • Mental dullness / unaware
  • Labored / frantic breathing
  • Seizures
  • Coma
  • Death

Diagnosis:

Based primarily on physical exam and neurologic assessment of the cranial nerves. The cat is assessed daily (sometimes more frequently) to look for either an improvement or decline in neurologic function. Veterinarians try to identify a trend over several days to help owners decide whether to continue treatment or euthanize the cat. Head trauma often takes several days to weeks, sometimes even months to resolve. Some cats never recover fully, however, most times cats adapt easily to the neurologic impairment. Radiographs can be taken to look for skull, sinus, and jaw fractures. The majority of cats however primarily have a brain injury which does not show up on films. Advanced imaging techniques to assess the brain include MRI and CAT scan. Additional diagnostics such as blood work, chest and abdominal, and skeletal radiographs, blood gasses, etc. are used to assess /identify injury to the rest of the body.

Treatment:

Treatment is based on supportive care and stabilizing the cat. Cats with head trauma often present with other injuries. Head trauma is treated with a variety of drugs including steroids, mannitol (a drug used to decrease brain inflammation and swelling), supplemental oxygen., antibiotics (if bleeding from the nose is present, and other anti-inflammatory medications. Injury to other body systems is addressed as well as shock. Treatment should be continued for at least 48 hours unless the animal shows signs of severe trauma that carries a grave prognosis (i.e. coma, fixed dilated pupils).

Prognosis:

Depends entirely of the form and extent of the head trauma. Cats in a coma, or who present with repetitive seizures or breathing difficulty carry a grave prognosis as well as do cats with fixed dilated pupils. Cats with fixed non-responsive pinpoint size pupils or fixed pupils of two different sizes carry a guarded prognosis. Treatment should be attempted for all animals with unequal sized pupils that respond to light by constricting. These cats carry a good prognosis for recovery with proper treatment along with sinus injuries and jaw fractures. As long as the cat is not in pain or compromised by severe injuries to the rest of the body, one should always try medical therapy for at least 48 hours. Many cats respond dramatically to this form of treatment.