Mika, a 6-month-old, female Rhodesian ridgeback, was presented to the Dentistry and Oral Surgery Service at the University
of Pennsylvania for evaluation of a cleft palate. Mika's defect was noted at birth. The breeder tube fed the puppy for the
first eight weeks, and then Mika was placed in a new home. She suffered from several episodes of aspiration pneumonia, which
responded to antibiotics. The results of a preoperative laboratory work-up were normal, and she was deemed a good surgical
In order to ensure the flap would be big enough to cover the defect, Mika had surgery the day of her initial exam to extract
three premolars on her right maxilla. Four weeks later, she returned for palatal surgery.
Photo 1: Mika at her initial exam. (PHOTOS COURTESY OF THE UNIVERSITY OF PENNSYLVANIA)
Mika was anesthetized, and her bilateral secondary hard and soft cleft palate defect was surgically corrected. The mucoperiosteum
of the hard palate was incised to create a releasing or elevating flap on the right side of the palate. This flap was folded
over so that the connective tissue surfaces were in contact and sutured closed. This technique allowed for coverage of the
midline defect. Note the difference in the rugae folds of the palate in Figure 3.
An Elizabethan collar was placed, and Mika was sent home with antibiotics and analgesics and instructions to feed soft food
only for two to four weeks. No toys or chewing were allowed.
Photo 2: The missing teeth and the healed extraction site are visible. The palatal defect extends the length of the hard and
soft palate. (PHOTOS COURTESY OF THE UNIVERSITY OF PENNSYLVANIA)
Mika recovered well. At her recheck exam four weeks later, a small area of tissue on the rostral maxilla, just caudal to the
incisive papilla, had retracted and opened. The owner was given the option for another surgical procedure to close the small
defect. The owner elected to postpone another surgery.
At last report, Mika is a happy, healthy adult, and the small open area on the rostral palate does not seem to be causing
any issues at this time.
Palatal defects may be acquired—due to trauma or severe periodontal disease—or congenital, as in this case. Congenital palatal
defects may have a hereditary component or may result from metabolic disorders or vitamin imbalances in the dam or exposure
of the dam to teratogenic chemicals or drugs. These defects are classified as either primary (involving the rostral region
on the lateral aspects of the palate) or secondary (affecting the areas of the caudal palate along the midline). Affected
neonates typically have difficulty nursing and swallowing, often regurgitating and aspirating. This can progress to pneumonia
and eventually death.
Photo 3: The palate surgery site. The left side is normal tissue with rugae folds. The right side is smooth, because it is
the underside of the palatal tissue that was folded over to create a flap and repair the defect. The rugae folds are now on
the inside. (PHOTOS COURTESY OF THE UNIVERSITY OF PENNSYLVANIA)
Surgical intervention is almost always necessary. Most oral surgeons will wait until a patient is 4 to 6 months old, as in
this case, to ensure that the palate is growing properly and that the tissue has sufficient strength to withstand the surgical
A dental technician must know the anatomy of the palate, what causes the defects and how they can be repaired. If technicians
and doctors aren't aware of surgical options, pets with palatal defects might be euthanized.
Technicians may need to teach clients how to tube feed puppies and kittens until they are able to have surgery.
Dental technicians assist during surgery, handing instruments, retracting tissue and cutting suture. After surgery, they monitor
the pet's recovery.
At checkout, a dental technician will discuss possible complications with the owners as well as an appropriate feeding schedule
and medication use.
Patricia March, CVT, VTS (Dentistry), is a dental technician at Animal Dental Center in Baltimore, Md., and the past president
of the Academy of Veterinary Dental Technicians.