Closure of Soft Palate Defect in Cats

The soft palate is a shelf of elastic tissue at the back of the throat. Its job is to separate the nasal and oral cavities, and facilitate food passing down into the esophagus whilst protecting the entrance to the windpipe. 

A defect in the soft palate allows fluid or food to pass up into the nasal cavity or down into the windpipe. This can infection and the potentially serious complication of aspiration pneumonia in the lungs. 

Most soft palate defects are congenital (the kitten is born with the problem) or traumatic (as a result of a traffic accident or fall). Defects of the soft palate are also linked to defects of the hard palate since both structures are derived from the same cells in the embryo. The palate may be repaired in first opinion practice, but repeat surgeries may be needed.

Surgical closure of the soft tissue deficit is the treatment of choice. However, in severely affected newborn kittens with both soft and hard palate deficits, euthanasia is also a humane option that is appropriate to consider. 

For those cases taken to surgery, the success rate is improves after 12 weeks, and again after 20 weeks, thus the more mature the kitten the higher the chances of recovery. 

Regardless of the cause, it is recommended that a feeding tube is placed. This facilitates giving adequate nutrition but without the risk of aspiration pneumonia developing. Once the patient is old enough for surgery (or stable after a trauma) a general anesthetic is induced. 

The cat's mouth is held open with a gag and the head supported in an upright position. Using sterile surgical instruments, the surgeon uses a scalpel blade to freshen the exposed edges of the soft palate. This promotes better healing once the palate is sutured back together. 

Fine absorbable suture material is used to draw the palate edges back together and support them. Once the surgeon is happy with the repair, the gag is removed and the cat woken from the anesthetic. 

Success rates improve if surgery of congenital problems can be postponed until at least 12 weeks of age. Another step up in success occurs for operations performed on cats older than 20 weeks. 

Corrective surgery is extremely effective, but there is a risk of wound breakdown and the need for revisional surgery. This is because the tongue and the act of swallowing puts a strain on the suture line and can cause it to fail.

The patient requires close observation for several hours after surgery. Handling the soft palate can cause swelling, with the potential to block the airway. In mild cases, the administration of anti-inflammatory drugs may be all that's required. If the patient's breathing is compromised then emergency tracheotomy may be needed (but this is rare). 

It is wise to leave the feeding tube in place for 7 to 14 days, in order to protect the healing soft palate from abrasive food. The clinician will check the visual appearance of the soft palate and if all is well, remove the feeding tube once healing is complete. 

The average cost for treating a soft palate defect in the cat is around $600. However, this can vary widely depending on the location of the clinic, its facilities, and the experience of the clinician. In complex cases that require intensive care, be prepared to pay up to $3,000.

Repairing a soft palate defect is fiddly work and not without complications. In the short term, these can include hemorrhage and swelling (with the potential to cause breathing difficulties). In the medium term, it's possible the sutures won't hold and the wound breaks down, in which case revisional surgery is required. However, in the long term once healing is complete the outlook is excellent. 

The Siamese breed are over represented when it comes to hereditary palate defects. Affected individuals should not be bred from and preferably neutered at an early age (perhaps when under anesthesia for the soft palate repair.) 

Most traumatic causes of soft palate defects are the result of traffic collisions. Keeping an indoor cat or only letting the cat out under supervision can go a long way to reducing the risk.