A 3-month-old, male, intact, Domestic Long Hair cat presented to Cornell University Hospital for Animals’ Dentistry and Oral Surgery Service for evaluation of a mandibular malformation that was causing difficulty eating and drinking. The kitten was recently adopted after being found in a barn as a young kitten. He was not being cared for by his mother and the rest of the litter did not appear to have any facial abnormalities. Upon adoption and living in his new home, the kitten was having difficulties eating and drinking. The client reported the recent development of excessive salivation as well as bad breath. On physical exam, the kitten had an asymmetric skeletal malocclusion characterized by unilateral left mandibular brachygnathia with deviation of the mandibles to the left, ptyalism, halitosis, a severely enlarged left mandibular lymph node, and several small, ulcerative lesions on the soft tissues of the hard palate. His vital parameters were within normal limits and the remainder of his physical exam was unremarkable. The kitten’s problem list included: dysphagia, ptyalism with halitosis, ulcerative lesions of the hard palate, left mandibular brachygnathia, and left mandibular lymphadenopathy. The differential diagnoses for this kitten were significant trauma to the skull and its growth plates early in life, hemifacial microsomia, or another congenital abnormality of the skull. The diagnostics pursued were a left mandibular lymph node fine needle aspirate, full mouth intraoral radiographs, and a computed tomography scan of the head. Treatment at the time of presentation involved extraction of deciduous left mandibular canine, deciduous left mandibular 3rd premolar, and deciduous left maxillary 4th premolar teeth with post-operative pain management of buprenorphine.