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[[Image:Cleft-palate.gif|right|thumb|300px|<small><center>A congenital cleft palate defect (Courtesy of Alun Williams (RVC))</center></small>]]

[[Image:Cleft-palate.gif|right|thumb|300px|<small><center>A congenital cleft palate defect (Courtesy of Alun Williams (RVC))</center></small>]]

==Description==

==Description==

An abnormal communication between the [[Nasal cavity - Anatomy & Physiology| nasal]] and [[Oral Cavity - Oropharynx - Anatomy & Physiology| oral]] cavities involving the [[Soft Palate - Anatomy & Physiology| soft palate]] , [[Hard Palate - Anatomy & Physiology| hard palate]], premaxilla and or [[Lips - Anatomy & Physiology|lip]] . Abnormalities arise during foetal development where there is incomplete closure of the primary palate, secondary palate or both.  

An abnormal communication between the [[Nasal cavity - Anatomy & Physiology| nasal]] and [[Oral Cavity - Oropharynx - Anatomy & Physiology| oral]] cavities involving the [[Soft Palate - Anatomy & Physiology| soft palate]] , [[Hard Palate - Anatomy & Physiology| hard palate]], premaxilla and or [[Lips - Anatomy & Physiology|lip]] . Abnormalities arise during foetal development where there is incomplete closure of the primary palate, secondary palate or both.  

==Diagnosis==

==Diagnosis==

==History and Clinical Signs==

===History and Clinical Signs===

Failure to thrive with signs such as nasal discharge, nasal milk regurgitation, gagging, coughing or sneezing during nursing, and respiratory infection due to aspiration pneumonia or rhinitis.  

Failure to thrive with signs such as nasal discharge, nasal milk regurgitation, gagging, coughing or sneezing during nursing, and respiratory infection due to aspiration pneumonia or rhinitis.  

Affected animals often have other concurrent congenital abnormalities and hence a thorough physical exam should be undertaken.

Affected animals often have other concurrent congenital abnormalities and hence a thorough physical exam should be undertaken.

==Laboratory Tests==

===Laboratory Tests===

Often normal unless aspiration pneumonia is present.

Often normal unless aspiration pneumonia is present.

==Radiography==

===Radiography===

Radiographs of the skull are unnecessary however thoracic radiographs are useful to check for the presence of aspiration pneumonia.

Radiographs of the skull are unnecessary however thoracic radiographs are useful to check for the presence of aspiration pneumonia.

Aspiration pneumonia should also be treated with appropriate antibiotics, expectorants and oxygen.

Aspiration pneumonia should also be treated with appropriate antibiotics, expectorants and oxygen.

Surgery should be delayed until the animal is 12-14 weeks old or longer if possible in order to get the best possible post surgical outcome. More mature tissue is less friable and holds suture better.   

Surgery should be delayed until the animal is 12-14 weeks old or longer if possible in order to get the best possible post surgical outcome. More mature tissue is less friable and holds suture better.   

Surgical correction is normally only carried out if the defect is small and owners must be warned that more severly affected animals may need multiple procedures.

Surgical correction is normally only carried out if the defect is small and owners must be warned that more severely affected animals may need multiple procedures.

===Closure of Primary Clefts===

===Closure of Primary Clefts===

===Closure of Secondary Clefts===

===Closure of Secondary Clefts===

====Hard palate defects====

====Hard palate defects====

Three procedures have been described firstly, the Lagenbeck or sliding pedicle technique whereby longitudinal strips of mucosa are released from the hard palate and slid together at the midline. Hard palate bone is exposed laterally however granulation and epithelisation occur quickly.

Three procedures have been described firstly, the '''Lagenbeck''' or '''sliding pedicle technique''' whereby longitudinal strips of mucosa are released from the hard palate and slid together at the midline. Hard palate bone is exposed laterally however granulation and epithelisation occur quickly.

The second technique is the Sandwich or overlapping flap technique where by a recipient bed is created by splitting the mucous membrane at the edge of the defect. A donor bed is created by releasing strips of mucosa from the opposite mucous membrane which is then sutured into place.  

The second technique is the '''Sandwich''' or '''overlapping flap technique''' where by a recipient bed is created by splitting the mucous membrane at the edge of the defect. A donor bed is created by releasing strips of mucosa from the opposite mucous membrane which is then sutured into place.  

Thirdly a combination technique can be applied where both of the above tecniques are used to produce a double layer of mucosa over the cleft.

Thirdly a '''combination technique''' can be applied where both of the above techniques are used to produce a double layer of mucosa over the cleft.

====Soft Palate defects====

====Soft Palate defects====

==Prognosis==  

==Prognosis==  

Historically surgical correction of these conditions had a low success rate. More recently new surgical techniques can result in a good prognosis however multiple surgeries may be required and aspiration pneumonia must be treated.

Historically, surgical correction of these conditions had a low success rate. More recently new surgical techniques can result in a good prognosis, however, multiple surgeries may be required and aspiration pneumonia must be treated.

==References==

==References==

[[Category:Nasal Cavity - Developmental Pathology]]

[[Category:Nasal Cavity - Developmental Pathology]]

[[Category:Respiratory System - Developmental Pathology]]

[[Category:Respiratory System - Developmental Pathology]]

[[Category:Cattle]][[Category:Horse]][[Category:Goat]][[Category:Pig]][[Category:Sheep]]

[[Category:Cattle]][[Category:Alimentary Disorders - Horse]][[Category:Goat]][[Category:Pig]][[Category:Sheep]]

[[Category:Cat]][[Category:Dog]]

[[Category:Cat]][[Category:Dog]]

[[Category:To_Do_-_Review]]

[[Category:Expert_Review]]