Study finds ATTS beats VetCOT score in cats with high-rise syndrome
Bottom line
A new retrospective study in the Journal of Small Animal Practice suggests the Animal Trauma Triage Score, or ATTS, predicts mortality in cats with high-rise syndrome better than the Veterinary Committee on Trauma, or VetCOT, score. The study reviewed 60 cats and found the feline-applicable ATTS had significantly better prognostic performance than the canine-derived VetCOT score, adding to a growing body of evidence that species-specific trauma scoring may be more useful in feline emergency care. Earlier feline trauma registry work and prior high-rise syndrome studies had already shown ATTS can track injury severity and outcome in cats, but this paper directly compares it with the VetCOT score in this specific syndrome. (pubmed.ncbi.nlm.nih.gov)
Why it matters: For veterinary professionals, the finding is less about replacing clinical judgment and more about choosing the right triage framework at admission. High-rise syndrome can involve thoracic, orthopedic, neurologic, and facial trauma, and rapid prognostic assessment helps guide monitoring intensity, client communication, and referral decisions. If ATTS continues to outperform broader or canine-derived tools in feline patients, it strengthens the case for using cat-appropriate trauma scoring in ER workflows, teaching, and future research. (pmc.ncbi.nlm.nih.gov)
What to watch: Watch for follow-up validation in larger, multicenter feline cohorts, and for whether trauma centers begin favoring ATTS over VetCOT-based scoring for cats with high-rise injuries. (onlinelibrary.wiley.com)
Key facts
- Study type
- Retrospective study
- Journal
- Journal of Small Animal Practice
- Sample size
- 60 cats
- Condition
- High-rise syndrome
- Comparison
- Animal Trauma Triage Score (ATTS) vs. Veterinary Committee on Trauma (VetCOT) score
- Main finding
- ATTS predicted mortality better than VetCOT
- Study takeaway
- Species-specific trauma scoring may be more useful in feline emergency care
- Limitation
- Small, retrospective study
A new study in the Journal of Small Animal Practice reports that the Animal Trauma Triage Score outperformed the VetCOT score for predicting mortality in cats with high-rise syndrome. In a retrospective cohort of 60 cats, the authors found significantly better prognostic performance from ATTS, supporting the broader argument that feline trauma patients may need species-specific scoring tools rather than systems adapted from dogs. (pubmed.ncbi.nlm.nih.gov)
That conclusion fits with the direction of recent feline trauma literature. The American College of Veterinary Emergency and Critical Care’s VetCOT registry was built to standardize trauma data collection across dogs and cats, including variables such as ATT score and neurologic assessment. Subsequent registry analyses in hundreds of injured cats found ATT score was associated with outcome, while a 2022 prospective study in 25 cats with high-rise syndrome also supported the prognostic value of ATTS in this exact presentation. (pmc.ncbi.nlm.nih.gov)
High-rise syndrome remains a distinct and clinically important feline trauma pattern. Reviews and retrospective studies describe frequent thoracic, facial, oral, orthopedic, and sometimes neurologic injuries after falls from buildings, with presentation severity shaped by factors such as landing surface and fall circumstances. A 2025 study of 373 cats with high-rise syndrome found nonsurvivors had markedly higher mean ATTS values than survivors, reinforcing the score’s practical link to outcome even before this newer head-to-head comparison with VetCOT. (pmc.ncbi.nlm.nih.gov)
The scoring issue matters because the two systems are built differently. ATTS is a structured trauma triage tool that grades perfusion, cardiac, respiratory, eye/muscle/integument, skeletal, and neurologic status. VetCOT, by contrast, is best known as the trauma registry and has also supported development of scoring tools that were not originally tailored to feline high-rise injury patterns. The new study’s takeaway, based on the abstracted findings available so far, is that a score already used and validated in cats performed better than the canine-derived comparator in this feline syndrome. (vetcot.org)
Direct outside commentary on this specific paper was limited at the time of reporting, but the broader field has been moving toward better feline-specific trauma assessment. Published reviews of feline ATT literature describe it as the most widely used system-based injury severity scale in small animal emergency medicine, and VetCOT-linked studies have repeatedly tied higher ATT scores to worse outcomes in cats with trauma, including bite wounds and mixed-injury populations. Taken together, that makes the new result feel evolutionary rather than surprising. (veteducation.com)
Why it matters: For emergency and critical care teams, this is a workflow story as much as a research story. A triage score that better predicts mortality in feline high-rise cases could improve early risk stratification, help standardize handoffs, and support clearer conversations with pet parents during the first hours of care. It may also influence how hospitals train interns and technicians, design trauma protocols, and select variables for quality improvement or research databases. Importantly, it reinforces that cats shouldn’t always be assessed with tools borrowed from canine populations without direct validation. (pmc.ncbi.nlm.nih.gov)
There are still limits to keep in mind. The new paper was retrospective and relatively small at 60 cats, so it adds signal rather than settling the question. High-rise syndrome itself is heterogeneous, and prior literature shows outcomes can be shaped by age, landing surface, injury mix, and the quality of early stabilization. That means no score should be interpreted in isolation from imaging, serial examination, and response to treatment. (thieme-connect.com)
What to watch: The next step is external validation: larger multicenter comparisons, ideally across different emergency settings, to see whether ATTS consistently outperforms VetCOT-based scoring in feline trauma subsets beyond high-rise syndrome. If those data hold, the field could move toward more formal recommendations for feline-specific trauma scoring in both practice and registry design. (vetcot.org)