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Secondary Cleft Palate Repair in a 15 Week Old Pit Bull Puppy

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A 15-week old intact female pit bull terrier was presented to Cornell’s Dentistry and Oral Surgery Service for the surgical repair of a congenital cleft of the secondary palate. The patient was initially evaluated at 10-weeks of age; at that time, it was diagnosed with a unilateral primary and complete secondary cleft palate, in addition to aspiration pneumonia. The dog was prescribed oral doxycycline and surgery was delayed until the aspiration pneumonia was resolved. One week prior to presentation for surgery, the primary care veterinarian performed thoracic radiographs, confirming resolution of the pneumonia. Preoperative bloodwork (complete blood cell count and a serum biochemistry profile) on the day of surgery revealed no significant abnormalities. A computed tomographic scan of the head was performed to characterize the osseous defect in the secondary palate, and to aid in surgical planning. The patient’s oral cavity was prepared for surgery and bilateral infraorbital nerve blocks were performed with articaine. The soft palate was surgically apposed in three layers. The hard palate defect was repaired using a double-layer mucoperiosteal flap. The patient recovered uneventfully from surgery and was admitted to the intermediate nursing care unit for postoperative analgesia and supportive care, and was discharged the following day with a course of oral doxycycline, meloxicam, and tramadol. At the time of writing this report the outcome of surgery was unknown. This report discusses the suspected causes, clinical signs, and prognosis for a patient with a congenital cleft of the primary and secondary palate. The most common surgical repair techniques for cleft palate are discussed.

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2015-10-21

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