What is cleft palate in dogs?

A cleft palate is an opening between the mouth and nose that occurs when the tissues separating the two cavities do not fuse properly. This in turn causes problems that include feeding, difficulty breastfeeding and poor growth.

This birth defect can occur in two forms:

• primary cleft palate - cleft lip

• secondary cleft palate - affects either the hard palate or the soft palate or both

Purebred dogs and cats have a higher incidence of cleft palate, and brachycephalic breeds with a short, round face are most commonly affected. Although genetics is believed to be the main cause of this problem, nutritional deficiencies, viruses and toxins that affect the mother during pregnancy can also increase the risk of cleft palate.

What are the symptoms of cleft palate?

The symptoms of cleft palate in dogs are relatively easy to recognize and often even visible. Cleft palate in dogs can also cause various health problems:

• Difficult intake of milk and food - Puppies and kittens with cleft palate are unable to create sufficient suction (vacuum) when nursing because the oral cavity is open to the nasal cavity. Milk or food that is successfully ingested goes from the mouth into the nose and causes sneezing, nasal irritation, nasal discharge, regurgitation and retching.

• Poor Growth - Without the ability to suckle and eat normally, many puppies and kittens with cleft palates are not getting the proper nutrition, which results in poor growth rates.

• Sneezing and blowing your nose - Food and saliva enter the nose during food intake, where it irritates the nasal mucosa. This results in sneezing and blowing your nose, and nasal discharge can be observed after eating. Sometimes the runny nose is permanent.

• Aspiration pneumonia - Milk and food can enter the lungs from the nose, resulting in a lung infection. Depending on the age of the puppy or kitten, this can result in coughing and difficulty breathing, fever with lethargy, and in the worst cases, death.

• Facial Deformity -  Occasionally, dogs with cleft palate may also have a facial deformity such as a cleft lip (primary cleft palate).

• Other problems -. Although not always apparent at first and depending on the extent of the cleft palate, problems with the inner ear, middle ear, swallowing, nasal septum, sinuses and teeth may develop.

What are the causes of cleft palate?

Congenital cleft palate is already present at birth, if the palate during the 25th-28th day of gestation will fail to fuse properly. This can happen for a variety of reasons:

• Genes - Most congenital cleft palates are genetic. Therefore, dogs with any level of cleft palate should be neutered and not used for breeding purposes.

• Nutrition - Cleft palate can occur with excess vitamin A intake or folic acid deficiency during pregnancy

• Medications - Especially steroids, aspirin, griseofulvin and some anti-seizure medications during pregnancy can cause cleft palate in puppies and kittens.

• Viruses - If the mother is exposed to certain viruses at certain times during pregnancy, her puppies or kittens may be born with a cleft palate.

An acquired cleft palate is a new defect that appears in a previously normal palate. Causes may include:

• Trauma such as gunshot wounds, bites, thermal/electrical burns or blunt force trauma, especially falls from heights in cats

• Dental disease - periodontal disease, malocclusion, specifically liquoversion of the lower canines, where the lower canines are tilted towards the tongue and injure the hard palate (read more here)

• Foreign bodies in the mouth

• Cancer

What is the treatment for cleft palate?

Most cases of congenital and acquired cleft palate require surgical correction. A small number of acquired clefts may heal on their own. Most dogs with cleft palate may require more than one surgery. Different techniques are used depending on the size, location (hard vs. soft palate), and severity of the cleft. The goal of the operation is complete separation of the oral and nasal cavity and reconstruction of the floor of the nasal cavity. This is most often done with flaps, which involves repositioning existing healthy tissue in the mouth to cover the deformity.

Because the surgery is performed on young animals with underweight and respiratory problems, anesthesia and recovery from surgery can be risky. Many pets have swelling of the soft palate after surgery, which can cause breathing problems.

Newborn cleft palate puppies normally require tube feeding before they are old enough for surgery, usually they should be no more than 8-12 weeks old. Tube feeding will reduce the chance of aspiration pneumonia and ensure that the puppy receives adequate nutrition.

All infections such as chronic rhinitis or pneumonia must be treated before surgery. Antibiotics should be administered for another 14 days after surgery, longer in case of pneumonia.

A soft, blended diet must be given for 2-4 weeks after surgery. Chew toys should not be present for 1 month either.

Dehiscence - the breakdown of the surgical wound - is a common postoperative complication. Many surgical wounds open due to tension at the surgical site, lack of space in the mouth, intraoperative trauma, and postoperative trauma from eating or chewing.

However, after successful surgery and a healed palate, the prognosis for these dogs is positive.