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The hard bony structure on the front of your dog’s mouth is the hard palate, it separates the oral and nasal cavities. During fetal development, defects of the hard palate may arise. When they do, the hard palate does not adequately form to separate these two cavities. These defects are more common in certain breeds including shih tzu, bulldogs, pointers and Swiss sheepdogs. In addition to congenital defects, injuries to the oral cavity through trauma can compromise the hard palate.
When the hard palate is not completely formed in newborn puppies, fluid enters the nasal cavity when the puppy nurses, leading to aspiration, choking, and even death. Defects in the hard plate that allow food and fluid to enter the nasal passages and airway cause rhinitis that results in sneezing and gagging when the animal feeds. This condition must be surgically corrected or the animal will develop a life-threatening condition with the respiratory system becoming compromised. In the case of congenital defects, the puppy must reach two to four months of age certain age before surgery can be performed. It is important to ensure that the puppy does not aspirate food or fluid during this waiting period as aspiration pneumonia could result that would make surgery extremely risky and prognosis for recovery would be poor. It may be necessary to tube feed the puppy until they are old enough to have corrective surgery in order to avoid this. Surgical correction to close hard palate defects in dogs is performed by a veterinarian under general anaesthetic.
In the case of congenital defects, surgery will have to wait until there is enough tissue present for surgical manipulation to close the hard palate gap, which usually exists at two to four months of age. The puppy will need to be maintained with a feeding tube or special feeding techniques until they reach an appropriate age for surgery.
The closure of hard palate defects involves harvesting tissue adjacent to the cleft defect and using it to cover the gap in the hard palate. There are several techniques available for this and the method chosen will depend on the position and size of the defect and the tissue available.
Prior to surgery, you will need to fast your dog in order to avoid aspiration during anesthesia. As intubation tubes may interfere with ability to access the surgical site, intravenous anesthesia may be preferable.
Your veterinarian will make incisions to acquire skin flaps and tissue to cover the defect. Skin flaps will be as large as possible and blood supply will have to be maintained to the tissues. The flap will be sutured in place and bleeding at incisions controlled with pressure. In some cases where a large gap exists, bone grafts or synthetic prosthesis may be utilized. Multiple procedures may be required in order to adequately reconstruct the tissues in the oral cavity to cover the defect. Your dog will be observed post surgery to ensure recovery from anesthesia and that bleeding does not occur.
Surgery to repair hard palate defect will resolve the gap in the palate, although this may take multiple procedures. However if aspiration pneumonia has occurred or chronic rhinitis is established these conditions may continue to be problematic and can result in a chronically ill dog. Also, if the defect is especially large, closure may be problematic and euthanasia may need to be considered.
Antibiotics will be administered to prevent infection post-surgery. The pet owner will need to monitor the surgical site to ensure that repair does not become damaged or infected. Ensure your dog does not have any toys or foreign objects available to chew on for three to four weeks post surgery. Soft food will need to be fed for three to four weeks post surgery and, in some cases, a feeding tube will be inserted and feeding maintained via the tube while the oral cavity and palate recover. A basket muzzle may be used to keep your dog from eating or chewing on objects while they recover. Follow-up with a vet for subsequent procedures, to monitor healing, and to remove stitches if necessary will be required.
The cost of hard palate repair will depend on the degree of repair needed and the number of procedures required and can vary from $500 to $2,000 or more.
If aspiration pneumonia has occurred, anesthesia becomes a serious risk and prognosis for recovery is guarded.
Wound rupture (dehiscence) is a common complication and if it occurs, additional surgery to repair the wound will be required.
Rhinitis and pneumonia that has occurred may result in chronic nasal infections that can be ongoing.
Any dog that has experienced hard palate defect should be removed from a breeding program in order to prevent the defect from occurring in future generations.
Monitoring your dog and removing hazardous objects that could cause oral trauma from your dog’s environment will reduce the likelihood of oral trauma from foreign objects occurring.
Keeping your dog in an enclosed area or on a leash at all times will reduce the likelihood of them experiencing an accident, for example motor vehicle accidents, that cause hard palate damage.
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