Anestesia en gatos con comorbilidades: Consideraciones en pacientes con enfermedad cardíaca, enfermedad renal, enfermedad hepática y pacientes geriátricos

Autores/as

DOI:

https://doi.org/10.33448/rsd-v14i10.49645

Palabras clave:

Evaluación del riesgo anestésico, Complicaciones perioperatorias, Manejo anestésico individualizado, Analgesia multimodal, Monitorización anestésica.

Resumen

Este trabajo tiene como objetivo, mediante una revisión bibliográfica, presentar y discutir las consideraciones anestésicas asociadas a pacientes con comorbilidades como cardiopatías, nefropatías y hepatopatías, así como la anestesia de riesgo en gatos geriátricos, elucidando su influencia en las decisiones durante el procedimiento anestésico, con el fin de reducir complicaciones perioperatorias. La anestesia en gatos con comorbilidades representa un desafío significativo para el médico veterinario, debido a la mayor susceptibilidad de esta especie a complicaciones perioperatorias. Los estudios demuestran que la tasa de mortalidad anestésica en felinos es superior a la observada en perros, especialmente cuando se asocia con cardiopatías, nefropatías, hepatopatías o senilidad. La individualización del protocolo, basada en la clasificación de riesgo anestésico de la American Society of Anesthesiologists (ASA) y en exámenes complementarios específicos, es fundamental para reducir riesgos y optimizar la seguridad del paciente. Las evaluaciones cardíacas, renales y hepáticas, así como el manejo cuidadoso de gatos geriátricos, son determinantes para la selección de fármacos y para la monitorización intra y postoperatoria. Esta revisión narrativa reúne las principales consideraciones anestésicas en gatos de riesgo, destacando la importancia de una evaluación previa rigurosa, la selección racional de agentes anestésicos y la adopción de estrategias de monitorización que minimicen complicaciones. Se procuró ofrecer al médico veterinario herramientas prácticas que apoyen la toma de decisiones y la conducción segura de la anestesia en felinos con condiciones clínicas complejas.

Referencias

Abbott, J. A. (2010). Feline hypertrophic cardiomyopathy: an update. The Veterinary Clinics of North America. Small Animal Practice, 40(4), 685–700. https://doi.org/10.1016/j.cvsm.2010.04.004

Ambrósio, A. M., & Fantoni, D. T. (2024). Manual de anestesia veterinária: procedimentos e condutas - serviço de anestesia da FMVZ USP. Editora Manole.

AVMA U. s. pet ownership and demographics sourcebook. (2022). American Veterinary Medical Association.

Barros, C. M., & Stasi, L. C. D. (2012). Farmacologia Veterinária. Editora Manole.

Bednarski, R., Grimm, K., Harvey, R., Lukasik, V. M., Penn, W. S., Sargent, B., Spelts, K., & American Animal Hospital Association. (2011). AAHA anesthesia guidelines for dogs and cats. Journal of the American Animal Hospital Association, 47(6), 377–385. https://doi.org/10.5326/JAAHA-MS-5846

Bomassi, E., Misbach, C., Tissier, R., Gouni, V., Trehiou-Sechi, E., Petit, A. M., Desmyter, A., Damoiseaux, C., Pouchelon, J.-L., & Chetboul, V. (2015). Signalment, clinical features, echocardiographic findings, and outcome of dogs and cats with ventricular septal defects: 109 cases (1992-2013). Journal of the American Veterinary Medical Association, 247(2), 166–175. https://doi.org/10.2460/javma.247.2.166

Brodbelt, D. C., Pfeiffer, D. U., Young, L. E., & Wood, J. L. N. (2007). Risk factors for anaesthetic-related death in cats: results from the confi-dential enquiry into perioperative small animal fatalities (CEPSAF). British Journal of Anaesthesia, 99(5), 617–623. https://doi.org/10.1093/bja/aem229

Brown, D. C., Boston, R. C., & Farrar, J. T. (2013). Comparison of force plate gait analysis and owner assessment of pain using the Canine Brief Pain Inventory in dogs with osteoarthritis. Journal of Veterinary Internal Medicine, 27(1), 22–30. https://doi.org/10.1111/jvim.12004

Carroll, G. L. (2012). Anestesia e Analgesia de Pequenos Animais. Editora Manole.

Chetboul, V., Pitsch, I., Tissier, R., Gouni, V., Misbach, C., Trehiou-Sechi, E., Petit, A. M., Damoiseaux, C., Pouchelon, J.-L., Desquilbet, L., & Bomassi, E. (2016). Epidemiological, clinical, and echocardiographic features and survival times of dogs and cats with tetralogy of Fallot: 31 cases (2003-2014). Journal of the American Veterinary Medical Association, 249(8), 909–917. https://doi.org/10.2460/javma.249.8.909

Cote, E., MacDonald, K. A., Meurs, K. M., & Sleeper, M. M. (2011). Feline Cardiology (1o ed). Wiley-Blackwell.

Davis, H., Jensen, T., Johnson, A., Knowles, P., Meyer, R., Rucinsky, R., Shafford, H., American Association of Feline Practicioners, & Ameri-can Animal Hospital Association. (2013). 2013 AAHA/AAFP fluid therapy guidelines for dogs and cats. Journal of the American Animal Hospital Association, 49(3), 149–159. https://doi.org/10.5326/JAAHA-MS-5868

Dyson, D. H., Maxie, M. G., & Schnurr, D. (1998). Morbidity and mortality associated with anesthetic management in small animal veterinary practice in Ontario. Journal of the American Animal Hospital Association, 34(4), 325–335. https://doi.org/10.5326/15473317-34-4-325

Fantoni, D. T., & Cortopassi, S. G. (2009). Anestesia em Cães e Gatos. 2a edição. Roca.

Fox, P. R., Liu, S. K., & Maron, B. J. (1995). Echocardiographic assessment of spontaneously occurring feline hypertrophic cardiomyopathy. An animal model of human disease: An animal model of human disease. Circulation, 92(9), 2645–2651. https://doi.org/10.1161/01.cir.92.9.2645

Freeman, L. M., Rush, J. E., Stern, J. A., Huggins, G. S., & Maron, M. S. (2017). Feline hypertrophic cardiomyopathy: A spontaneous large animal model of human HCM. Cardiology Research, 8(4), 139–142. https://doi.org/10.14740/cr578w

Gaspri, Í. G., & Flôr, P. B. (2022). Anestesia em pacientes geriátricos: Relato de caso. PubVet, 16(11), 1–9. https://doi.org/10.31533/pubvet.v16n11a1267.1-9

Grimm, K. A. et al. (2015). Lumb & Jones, Anestesiologia e Analgesia em Veterinária. 5th ed. Roca.

Grubb, T., Sager, J., Gaynor, J. S., Montgomery, E., Parker, J. A., Shafford, H., & Tearney, C. (2020). 2020 AAHA anesthesia and monitoring guidelines for dogs and cats. Journal of the American Animal Hospital Association, 56(2), 59–82. https://doi.org/10.5326/JAAHA-MS-7055

Gruen, M. E., Lascelles, B. D. X., Colleran, E., Gottlieb, A., Johnson, J., Lotsikas, P., Marcellin-Little, D., & Wright, B. (2022). 2022 AAHA pain management guidelines for dogs and cats. Journal of the American Animal Hospital Association, 58(2), 55–76. https://doi.org/10.5326/JAAHA-MS-7292

IBGE. (2023). Censo Brasileiro de 2023. Instituto Brasileiro de Geografia e Estatística.

IBOPE Inteligência, & Waltham Research Center. (2016). Perfil e padrão de comportamento dos brasileiros na interação com seus pets. IBOPE Pesquisa.

INTERNATIONAL RENAL INTEREST SOCIETY (IRIS). (2023a). IRIS Staging of CKD. IRIS.

INTERNATIONAL RENAL INTEREST SOCIETY (IRIS). (2023b). Treatment Recommendations for CKD in Cats. IRIS.

Johard, E., Tidholm, A., Ljungvall, I., Häggström, J., & Höglund, K. (2018). Effects of sedation with dexmedetomidine and buprenorphine on echocardiographic variables, blood pressure and heart rate in healthy cats. Journal of Feline Medicine and Surgery, 20(6), 554–562. https://doi.org/10.1177/1098612X17720327

Julião, G. H., & Abimussi, C. J. X. (2019). Uso de dexmedetomidina em Medicina Veterinária: revisão de literatura. Revista de Educação Conti-nuada em Medicina Veterinária e Zootecnia do CRMV-SP, 17(1), 26–32. https://doi.org/10.36440/recmvz.v17i1.37840

Klein, B. G. (2021). Cunningham Tratado de Fisiologia Veterinária. (6th edição). Grupo GEN.

Lamont, L. A., Tranquilli, W. J., & Grimm, K. A. (2000). Physiology of pain. The Veterinary Clinics of North America. Small Animal Prac-tice, 30(4), 703–728, v. https://doi.org/10.1016/s0195-5616(08)70003-2

Lamont, L., Grimm, K., Robertson, S., Love, L., & Schroeder, C. (Orgs.). (2024). Veterinary anesthesia and analgesia, the 6th edition of Lumb and Jones (6o ed). Wiley-Blackwell.

Lamont, Leigh A., Bulmer, B. J., Sisson, D. D., Grimm, K. A., & Tranquilli, W. J. (2002). Doppler echocardiographic effects of medetomidine on dynamic left ventricular outflow tract obstruction in cats. Journal of the American Veterinary Medical Association, 221(9), 1276–1281. https://doi.org/10.2460/javma.2002.221.1276

Little, S. E. (2016). O Gato - Medicina Interna. Grupo GEN.

Marino, C. L., Lascelles, B. D. X., Vaden, S. L., Gruen, M. E., & Marks, S. L. (2014). Prevalence and classification of chronic kidney disease in cats randomly selected from four age groups and in cats recruited for degenerative joint disease studies. Journal of Feline Medicine and Sur-gery, 16(6), 465–472. https://doi.org/10.1177/1098612X13511446

Pereira, A. S., et al. (2018). Metodologia da pesquisa científica. [e-book]. Ed. UAB/NTE/UFSM.

Pereira, F. G. (2015). Fisiologia, fisiopatologia e manejo anestésico de pacientes com doença hepática. Em K. A. Grimm, L. A. Lamont, W. J. Tranquilli, S. A. Greene, & E. Robertson SA (Orgs.), Lumb & Jones, Anestesiologia e Analgesia em Veterinária. 5th ed. Roca.

Pypendop, B. H., & Ilkiw, J. E. (2015). Anestesia e Cuidados Pericirúrgicos. Em S. E. Little (Org.), O Gato: Medicina Interna. Roca.

Rezende, L. R., Aidar, E. S. A., Gering, A. P., Souza, E. E. G. de, Andrade, C. R. de, Sousa, B. B. de, Mendonça, C. de C., & Diniz, R. R. F. (2021). Particularidades da anestesia em felinos. Research, Society and Development, 10(5), e37610514994. https://doi.org/10.33448/rsd-v10i5.14994

Roberts, R., & Sigwart, U. (2005). Current concepts of the pathogenesis and treatment of hypertrophic cardiomyopathy. Circulation, 112(2), 293–296. https://doi.org/10.1161/01.CIR.0000146788.30724.0A

Rodan, I., Sundahl, E., Carney, H., Gagnon, A.-C., Heath, S., Landsberg, G., Seksel, K., Yin, S., & American Animal Hospital Association. (2011). AAFP and ISFM feline-friendly handling guidelines. Journal of Feline Medicine and Surgery, 13(5), 364–375. https://doi.org/10.1016/j.jfms.2011.03.012

Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta Paulista de Enfermagem. 20(2): 5-6.

Sano, H., Barker, K., Odom, T., Lewis, K., Giordano, P., Walsh, V., & Chambers, J. P. (2018). A survey of dog and cat anaesthesia in a sample of veterinary practices in New Zealand. New Zealand Veterinary Journal, 66(2), 85–92. https://doi.org/10.1080/00480169.2017.1413959

Sartorelli, M. de M., Kerchener, A., Moraes, J. V. de, Feder, G., & Vanzella, L. (2022). Defeito do septo ventricular em cães e gatos, uma revisão / Ventricular septal defect in dogs and cats, a review. Brazilian Journal of Animal and Environmental Research, 5(2), 2091–2097. https://doi.org/10.34188/bjaerv5n2-050

Scarparo, V. A., Gorczak, R., & Valandro, M. A. (2020). Anestesia em pacientes de risco: um abordagem anestésica aos pacientes cardiopatas, nefropatas, hepatopatas, pediátricos e senis. Veterinária em Foco, 17(2), 12–26.

Souza Spinosa, H., Górniak, S. L., & Bernardi, M. M. (2023). Farmacologia Aplicada à Medicina Veterinária. (7th edição). Grupo GEN.

Spinosa, S. H., Górniak, S. L., & Bernardi, M. M. (2023). Farmacologia Aplicada à Medicina Veterinária. (7th edição). GEN.

Tidholm, A., Ljungvall, I., Michal, J., Häggström, J., & Höglund, K. (2015). Congenital heart defects in cats: A retrospective study of 162 cats (1996-2013). Journal of Veterinary Cardiology: The Official Journal of the European Society of Veterinary Cardiology, 17 Suppl 1, S215-9. https://doi.org/10.1016/j.jvc.2014.09.004

van Beusekom, C. D., Schipper, L., & Fink-Gremmels, J. (2010). Cytochrome P450-mediated hepatic metabolism of new fluorescent substrates in cats and dogs: Biotransformation cats and dogs. Journal of Veterinary Pharmacology and Therapeutics, 33(6), 519–527. https://doi.org/10.1111/j.1365-2885.2010.01199.x

Vilela, P. C. R., Silva, A. F. de F., De Medeiros, J. M. Q., Gomes, D. I., Pimentel, M. M. L., Cruz, R. K. S., De Cerqueira, L. V. F., De Almeida, B. K. C., De Araujo, K. V. C., & Oliveira, A. C. de J. (2024). Uso de opioides em cães e gatos: revisão de literatura. Brazilian Journal of Health Review, 7(1), 7457–7471. https://doi.org/10.34119/bjhrv7n1-608

Zwicker, L. A., Matthews, A. R., Côté, E., & Andersen, E. (2016). The effect of dexmedetomidine on radiographic cardiac silhouette size in healthy cats: Dexmedetomidine and radiographic heart size in cats. Veterinary Radiology & Ultrasound: The Official Journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association, 57(3), 230–236. https://doi.org/10.1111/vru.12346

Publicado

2025-10-03

Número

Sección

Revisiones

Cómo citar

Anestesia en gatos con comorbilidades: Consideraciones en pacientes con enfermedad cardíaca, enfermedad renal, enfermedad hepática y pacientes geriátricos. Research, Society and Development, [S. l.], v. 14, n. 10, p. e14141049645, 2025. DOI: 10.33448/rsd-v14i10.49645. Disponível em: https://www.rsdjournal.org/rsd/article/view/49645. Acesso em: 9 dec. 2025.