Cleft Palate

Titus @16 wksTitus is a Chinese Shar-Pei, one of those dogs with all the wrinkles and blue-black tongue.  Here he is at 4 months of age.  Like many Shar-Pei, he has some unique medical concerns due to all those skin folds: eye lids that roll in, small ear canals, small nostrils, and skin problems.  Shar-Peis can also develop “Shar-Pei fever,” where they suddenly spike a fever that can go over 106F, which is very dangerous.

Titus had all of these problems, although his owner did a great job keeping his skin clean, his ears treated, and his eyes lubricated.  As he grew bigger, he started “growing into” his wrinkles, eliminating the need for eye or ear surgery.

One thing Titus always seemed to have was an upper respiratory problems–discharge from his nose, reverse sneezing, and snorting, which then often caused a fever.  He responded well to antibiotics, but his fevers were a concern for all of us.

When Titus was 7 months old, he came in to be neutered.  We finally got a good look at the inside of his mouth as he was intubated:

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 We could stick our finger in the cleft.  There was also a small opening on the mid-line of his hard palate.

This cleft opens into the sinus cavity and explained why he got upper respiratory and lung infections.  When the cleft is this far in the back of the mouth, there is a much higher risk of nasal discharge and pneumonia.  This wasn’t a surgery I was prepared to repair, so he was neutered with no complications and the soft palate repair scheduled for a month later.

Titus started getting bigger in that next month and really grew into his wrinkles.  He is such a handsome boy. SAMSUNG CAMERA PICTURESYou can even see his eyes now!

His cleft palate surgery was performed by Elizabeth Laing, DVM, a board-certified mobile surgeon that comes to veterinary clinics to perform more complicated surgeries.

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Before the surgery, Dr. Laing assessed his nostrils.  They are narrow, but didn’t seem to be causing him any issues with breathing, so she decided they didn’t need any surgical correction at this time.

 

 

SAMSUNG CAMERA PICTURES SAMSUNG CAMERA PICTURESAfter Titus was anesthetized, Dr. Laing positioned him on his back, which gave her the best approach to repairing the cleft.  This is a fairly common problem in bulldogs, so she had built the frame to help hold the mouth open during surgery.  Interestingly, when doing this repair on bulldogs they are usually on their chests, instead of their back.

 

Here is the view of the cleft, once he was in position.  He had a mouth gag inserted to keep his mouth open and his tongue was taped out of the way.  The syringe on the right side of the picture is just keeping his endotracheal tube properly inflated.

 

 

Dr. Laing “freshened” the edges along the cleft and closed the defect in two layers, using absorbable suture material.  She also closed the small defect in the hard palate.

SAMSUNG CAMERA PICTURESAt the end of the surgery, everything was closed up nicely and the end of his soft palate ended before his epiglottis–right where it was supposed to be.

For the next month, Titus is on a strict canned food diet while his palate heals.  No bones, no treats, nothing hard at all.  Hopefully he heals well with no complications and has no further upper respiratory infections!

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3 thoughts on “Cleft Palate

  1. Titus's human

    Thank you for sharing Titus surgery! I hope in some way it helps others! We are so incredibly grateful to Dr. Scarlett, dr Laing, Allison, Chelsey, Jamie & Cassie for your loving care and for helping us through Titus’s unique challenges so that he can get back to living his happy, playful, perfect, lazy, treat-filled life 🙂
    Thank you,
    Amber & Brandon and Titus & Nova

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