Cleft Palate

Question 1

What is a cleft palate

Answer 1

Cleft palate is an abnormal opening in the roof of the mouth.

Question 2

What will affect animals do if they have a cleft palate

Answer 2

Affected animals will regurgitate their food and water into the nose.

Question 3

When should puppies and kittens be checked for a cleft palate?

Answer 3

When puppies and kittens are born, they should be checked for this straight after birth.

Question 4

How does a cleft palate cause difficulty in an animal

Answer 4

Difficulty during feeding for the neonate, as they are unable to suck well, develop rhinitis, and they are at risk of aspiration pneumonia.

Question 5

Pre op

Answer 5

Prior to the operation, the patient is given antibiotics. During intubation the endotracheal tube is secured to the lower jaw, to allow proper visualisation of the palate.

Question 6

Patient Prep

Answer 6

No clipping is required. The pharynx should be packed with swabs and the oral cavity is flushed with diluted chlorhexidine. This should be done with the patient’s head lower than the feet, to avoid the fluids entering the glottis. Alcohol based solutions must be avoided as these are harsh on the mucous membranes.

Question 7

Patient Positioning

Answer 7

The patient is placed in dorsal recumbency with the limbs secured to the table appropriately. You may need to secure the maxilla to the table with lastotel.

Question 8

Instruments / Materials

Answer 8

A mouth gag is required to keep the oval cavity open throughout the procedure. A general surgical kit and Polydioxanone suture material will need to be made ready. A fenestrated drape is usually selected.

Question 9

Surgical Procedure

Answer 9

The defect is repaired using PDS. This suture material has a high tensile strength, has delayed absorption, is a monofilament, and is absorbable. After the cleft palate has been repaired, an oesophagostomy or a gastrostomy tube is usually placed. This allows the oral cavity to heal without food accumulating at the surgical site.

Question 10

Post op

Answer 10

Care of the feeding tube is required postoperatively. The patient will be sent home on antibiotics and a revisit will be organised 10-14 days post-surgical repair to assess healing. The patient will require an Elizabethan collar, to prevent them from pawing at their face. Wound dehiscence is a common post-operative complication; multiple surgeries may be required for complete closure.