Cleft palates: One of the most common congenital defects seen in puppies and kittens
Fact #1: A cleft palate is a defect of the palate (the roof of the mouth) that can occur in newborn kittens and puppies. Part of the palate may only be affected, or the defect may extend the full length. The defect results in direct communication between the mouth and nasal cavity.
Fact #2: A cleft palate is due to a disturbance in the processes that form the face and jaw during embryonic development (Merck Veterinary Manual, 9th edition).
Fact #3: Cleft palate is generally a congenital malformation, which means it is present at birth.
Fact #4: Cleft palates vary in their degree of severity. The defect is usually easily detected, but a very small defect may be missed. After delivery, puppies and kittens should always be examined for the presence of a cleft palate. Should a cleft palate be identified or suspected, speak to your veterinarian.
Predisposition and risk factors
Fact #5: Brachycephalic breeds are predisposed and most commonly affected.
Fact #6: Beagles, Cocker Spaniels, Dachshunds, German Shepherd Dogs, Labrador Retrievers, Schnauzers, Shetland Sheepdogs, and Siamese cats also show an increased incidence.
Fact #7: In most cases, cleft palate is hereditary. The genetic determinism of the disorder is complex and varies from breed to breed. In most breeds, the genetic determinism remains unknown.
Fact #8: Certain drugs can disturb the normal development of the embryo or foetus; these are referred to as teratogenic drugs. Exposure of the bitch/queen to teratogenic drugs during pregnancy can result in cleft palate development. Always speak to your veterinarian before administering any drugs to your pregnant animal.
Fact #9: Nutritional deficiencies have been implicated in the development of cleft palate. Folic acid is important for normal neural tube development in canine and feline embryos. Folic acid deficiency during pregnancy may result in puppies or kittens being born with a cleft palate.
Fact #10: Chemical/toxin exposure, excessive Vitamin A intake and some viral infections during pregnancy have also been implicated.
Clinical signs and treatment
Fact #11: Clinical signs will depend on the extent of the cleft, and may include sneezing, coughing, and nasal discharge. Milk may be observed to be dripping from the nostrils when attempting to suckle. Other signs may include difficulty in suckling, weight-loss or ill-thrift.
Fact #12: Patients with cleft palates are predisposed to chronic rhinitis, laryngotracheitis, and aspiration pneumonia. The latter may result in bronchopneumonia which can be life-threatening.
Fact #13: Surgical correction may be an option in some cases. The procedure is typically delayed until 8-24 weeks of age, when there is enough tissue to close the cleft and when the puppy/kitten anaesthesia is easier to manage.
Fact #14: Surgical correction can be challenging; the surgical technique used will depend on the location and severity of the cleft. In some cases, more than one surgical procedure may be required to achieve a complete repair.
Fact #15: Puppies and kittens with cleft palates require intensive supportive care, such as regular tube feeding, until surgical correction can be attempted. Tube-feeding is not without its risks including regurgitation and aspiration pneumonia.
Fact #16: Most cases have an excellent long-term prognosis following surgical correction.
Fact #17: Puppies and kittens born with cleft palates should not be used for breeding purposes.
Folic acid and cleft palate prevention
Fact #18: In women, folic acid supplementation is recommended during gestation to prevent neural tube defects in newborn infants. In dogs, scientific studies have demonstrated that folic acid supplementation has a preventative effect, especially in predisposed breeds.
Fact #19: As neural tube development stops at approximately Day 30 of gestation, folic acid supplementation needs to be initiated at the beginning of pregnancy.
Fact #20: In cleft palates induced by drugs administered during pregnancy, folic acid supplementation will have no preventative effect
Fact #21: There are two options for supplementing your pregnant bitch with folic acid: feeding a diet already supplemented with folic acid; supplementing a diet with folic acid as recommended by your veterinarian.