Summary

Cleft palate is a relatively common condition that results from the failure of the roof of the mouth (hard and soft palates) to close during normal embryological development, thereby leaving a “cleft” in the roof of the mouth.

The result is a puppy or kitten whose oral cavity communicates with their nasal passages. This leads to problems eating, swallowing, and receiving enough nutrition, but has respiratory implications as well.

While environmental factors during gestation may theoretically yield cleft palates, this is generally regarded as an inherited condition. As such, purebred pups are far more likely to suffer these defects. This is especially the case for brachycephalic (short-headed) breeds and bulldogs in particular.

Symptoms and Identification

A cleft palate typically looks like what it sounds like: a hole in the roof of the mouth. That hole may be larger or smaller and it may vary in location (closer to the front or back of the mouth), but most are readily identifiable at birth. Some cleft palate defects may extend so far forward as to affect the lip as well.

If the presence of a cleft palate isn’t identified by visual inspection of the pups’ individual oral cavities immediately after birth, the most typical sign that one or more pups in the litter may have a cleft palate involves difficulty suckling and swallowing.

Coughing, gagging, and milk bubbling from pups’ noses is typical of cleft palate defects, as is sneezing and snorting. Other signs (usually in less obvious defects) may include failure of a pup to grow normally, a sudden onset of pneumonia (typically from aspiration), or sudden death.

Affected Breeds

In one study, bulldog breeds appeared to be thirty percent more likely to suffer from cleft lips and cleft palates than other breeds. Another found that bulldog breeds were at “exceptional risk” for cleft palates while German shepherds and mixed breeds were at lowest risk.

It’s interesting to note that Nova Scotia Duck Tolling Retrievers have a genetic mutation in a gene known to be involved in normal palate development. This so-called CP1 mutation appears only in this breed.

Treatment

Sadly, many cleft palate pups are euthanized immediately after their defects are detected. If handled with sufficient care and diligence, however, many of these puppies will survive.

If elected, treatment of cleft palate depends largely on the size and location of the defect, and the degree to which the affected puppy is currently affected (some pups may already suffer from pneumonia or malnutrition).

Bottle or tube feeding small quantities of milk every two hours is a typical recommendation for neonates. Older pups may be transitioned to solid foods as early as four weeks of age.

Assuming no serious complications ensue and pups are healthy enough, surgical correction may be advisable after four weeks of age. Each patient’s individual health concerns and palatal defect details will inform the ideal timing of surgery and the technique elected. Several surgical procedures may be necessary as these pups grow and their palates expand.

For this reason, as well as for reasons related to anesthetic risk, surgery is considered a last resort best undertaken later in puppyhood, when the palate is closer to its adult size.

Note: Cleft palate surgeries have historically suffered a low success rate. When performed by a board-certified surgeon or board-certified veterinary dentist, however, puppies tend to enjoy a far higher rate of success.

It’s important to note, however, that even after successful surgical correction, long-term complications as a result of the cleft palate defect are possible, even likely. These dogs are at higher risk of upper respiratory infections. Some will suffer a chronic nasal discharge that may or may not be definitively treatable.

Veterinary Cost

The veterinary cost of a cleft palate depends on the severity of the defect, the skill and diligence of the human caretakers, and the need for surgical correction. If surgery is not deemed necessary and no complications arise, few veterinary costs will be incurred.

If surgical treatment is deemed advisable, expenses can run to $5,000 or even higher, especially if a board-certified surgeon or board-certified veterinary dentist is elected to perform the repair.

Long-term complications of cleft palate defects significant enough to require surgery will almost certainly occasion the need for follow-up veterinary care. These future expenses should not be ignored by prospective owners.

Prevention

Prevention involves breeding more diligently for traits that will minimize the risk of cleft palate defects. In general, breeding for exaggerated traits related to a shortened head, snub nose, and compressed airway structure will increase the risk of cleft palates.



References

Hoskins JD. Veterinary pediatrics—dogs and cats from birth to six months. 3rd ed. Philadelphia, Pa: WB Saunders, 2001.

Lawler DF. Neonatal and pediatric care of the puppy and kitten. Theriogenology 2008;70(3):384-392.

Macintire DK. Pediatric intensive care. Vet Clin North Am Small Anim Pract 1999;29(4):971-988.

Merck Veterinary Journal. Merck & Co. Inc., Whitehouse Station, NJ. 2005:Online Version (Ninth Edition).

Mulvihill JJ, Mulvihill CG, Priester WA. Cleft Palate in Domestic Animals: Epidemiologic Features. Teratology. 1980;21:109-112.

Plunkett SJ. Fading neonatal syndromes. In: Emergency procedures for the small animal veterinarian. 2nd ed. Philadelphia, Pa: WB Saunders, 2000;213-215.

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