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.