Correção de hérnia diafragmática traumática padrão combinado em felino geriátrico infectado por FIV: relato de caso

Abstract

Diaphragmatic hernia occurs due to disruption of the diaphragm musculature, allowing abdominal organs to displace into the thoracic cavity. In small animals, it is most frequently caused by trauma, especially automobile accidents. Animals diagnosed with diaphragmatic hernia represent a medical emergency, requiring immediate clinical stabilization and early referral for surgical intervention. Surgical management of diaphragmatic hernia in geriatric cats is challenging due to reduced cardiopulmonary reserve and increased anesthetic risk. Chronic diseases common at this age may impair immunity and wound healing. Coinfection with retroviruses, such as Feline Immunodeficiency Virus (FIV), exacerbates the surgical scenario by promoting immunosuppression, increasing the risk of opportunistic infections, impairing healing, and compromising the inflammatory response. Therefore, prior stabilization, nutritional support, and perioperative monitoring are essential for surgical success. This case report describes the clinical, diagnostic, surgical, and postoperative management of a 14-year-old geriatric cat coinfected with FIV, affected by circumferential and radial traumatic diaphragmatic hernia. On physical examination, the animal showed paradoxical dyspnea, muffled cardiac auscultation, and abdominal pain on palpation. Ultrasonography confirmed the hernia, and surgical correction was successfully performed 24 hours later, followed by regular postoperative care and weekly follow-up visits. Surgery remains the only effective treatment and must be carefully planned and conducted with extreme attention to the pre-, intra-, and postoperative periods, considering the patient’s advanced age and comorbidities to optimize prognosis and reduce complications.