Cleft lip and palate

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Sections available in full article Introduction, Presenting signs, Age predisposition, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Prevention, Control, Sequelae, Prognosis, Reasons for treatment failure, Sources, Vetstream contributor(s),
Contributors Mr David Crossley BVetMed FAVD MRCVS
Dr Elisa Mazzaferro MS DVM PhD DipACVECC

Introduction

  • Congenital defect or traumatic separation of primary (cleft lip) and/or secondary (cleft palate) palate.
  • Cause : stress, genetic, environmental, drug induced or trauma (adult).
  • Signs : rhinitis +/- pneumonia.
  • Treatment : surgical closure.
  • Prognosis : reasonable, variable surgical success rates, fatal if not able to suckle.

Diagnosis

Clinical signs

  • Cleft palate  Mouth: cleft palate   Cleft hard palate: severe   Palate: defect - soft   Palate: defect - hard  .
  • Persistent nasal discharge.
  • Inhalation pneumonia  Pneumonia  .

Diagnosis

Differential diagnosis

  • Other causes of nasal discharge, tachypnea/dyspnea, failure to thrive  Fading kitten syndrome  .

Sequelae

Prognosis

  • Poor - usually euthanased as neonates when cleft recognized.
  • Requires careful nursing to allow subsequent surgery.
  • Fair - following surgery.

Reasons for treatment failure

  • Sepsis/aspiration pneumonia.
  • Surgical wound breakdown is common.
  • Trauma to surgical site at a later date   →   high risk of fistulation.

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