Surgical repair of a cleft soft palate in a 3 month old Fell Pony foal; a case review
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A three month old Fell Pony filly presented for definitive diagnosis and surgical correction of a congenitally cleft soft palate. Since birth she had copious amounts of mucoid nasal discharge bilaterally, hypersalivation, and after nursing, milk was visible from both nostrils. An endoscopic examination of her oral and nasal cavities revealed a large and wide, central, soft palate defect extending the entire length of the palate. Thoracic radiographs showed an increased diffuse airspace pattern in her cranioventral lungfields consistent with pneumonia. Bloodwork revealed a mature neutrophilic leukocytosis, with no left shift or toxic changes noted. The soft palate defect was surgically corrected using a combination of two techniques; a laryngotomy and a lip sparing mandibular symphysiotomy, in an effort to get maximum exposure and repair of the defect. Immediately after surgery she began to nurse showing little evidence of milk regurgitation, but she retained a mild serous nasal discharge. Her surgical pain was managed via transdermal fentanyl patch, and her aspiration pneumonia was treated with a course of chloramphenicol. Post-operatively she continued to have a mild serous nasal discharge and occasional regurgitant nasal reflux. Her aspiration pneumonia resolved and she continued to do well despite these persistent problems. She recently required a second surgery to repair a one inch dehiscence of the previous repair in the caudal most aspect of her soft palate. Congenitally cleft soft palates in horses are rare and pose a serious challenge to correct surgically due to lack of adequate exposure, and high complication rate.
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Seminar SF610.1 2006 M33