Soft Palate Disorders in Dogs

Overview of Canine Soft Palate Disorders

Soft palate disorders are usually congenital defects of the fleshy tissue at the back of the throat that separates the oral and nasal cavities. The most common disorders are a defect or “cleft” in the palate or an elongation of the palate. The soft palate can be traumatized and lacerated, such as following a penetrating stick injury.

Puppies born with palate defects, as in the case of cleft palate, may have problems early on in their development. Dogs with elongated palates frequently do not have clinical signs until 2 or 3 years of age.

Cleft soft palate and elongated soft palate are predominantly seen in brachycephalic, short-faced breeds of dog such as English bulldogs, Boston terriers and pugs. There is no sex predilection.

Untreated cleft soft palate can cause difficulty nursing, failure to thrive, pneumonia and death. Untreated elongated soft palate causes increased airway noise, difficulty breathing when excited and in hot weather, and secondary upper airway diseases such as laryngeal collapse.

What to Watch For

Signs of soft palate disorders in dogs may include:

• Puppies that dribble milk from their noses when feeding
• Coughing and gagging
• Thin and poorly nourished pups
• Excitable young brachycephalic dogs with lots of airway noise emanating from the back of their throat, as though they are gagging

Diagnosis of Soft Palate Disorders in Dogs

• The diagnosis of a cleft soft palate is usually made from the history; information about the dog’s age, sex and breed (signalment); and physical examination. A defect exists between the two sides of the palate leading to a split, which often involves the hard palate, the bony separation between mouth and nose.
• Anesthesia or sedation may be necessary to visualize the tissues in a young squirming puppy.
• The diagnosis of an elongated soft palate is made from the history, signalment and physical examination; thorough visualization of the soft palate almost always requires anesthesia.
• In cases of traumatic injury to the soft palate, a history of running onto, or chasing a stick is most common, together with a sudden onset of oral tenderness, reluctance to eat or drink and bleeding from the mouth. Anesthesia can be most helpful to visualize the damaged region of the palate.
• Chest X-rays are useful in newborn puppies to assess for pneumonia, and, in older dogs with elongated palates, to assess for concurrent diseases such as a narrowed trachea and heart abnormalities.
• There are no blood abnormalities specific for soft palate disorders.

Treatment of Soft Palate Disorders in Dogs

• Young puppies with a diagnosis of cleft soft palate should be tube fed until at least three months of age before undergoing corrective surgery to close the defect.
• Young dogs with elongated soft palates should be treated surgically between 4 and 24 months of age, by shortening the palate to a more normal length. This can be achieved using a scalpel or a laser.
• Traumatic injuries to the palate should be repaired shortly after the injury, ensuring that any perforating material is not left behind in the throat or neck to cause future problems.

Home Care

• Whatever the nature of the surgery on your pet’s soft palate, your animal will have been closely monitored for respiratory difficulty in the immediate postoperative period. Your pet will probably stay at your veterinary hospital for a day or two after the procedure.
• Once at home your dog should be kept quiet and rested, avoiding excitement and should be watched closely when eating or drinking. Small, easily digested food should be offered initially. Avoid chew toys and rawhide.
• All sutures used at the time of surgery will be absorbable, so suture removal will not be necessary. Your veterinarian may suggest you return some two weeks after the procedure for a check-up.

Preventative Care

• Since cleft soft palate is a congenital problem, it is usually detected by breeders, and the sire and dam should be avoided in a breeding program.
• Elongated soft palate is seen in slightly older animals and is a common problem in certain brachycephalic dogs. When choosing these breeds, dog owners should be aware of this disorder and how early surgical intervention can minimize future respiratory disorders later on.
• Avoid throwing sharp objects for your dog to chase and catch; use a ball or a Frisbee instead.

In-depth Information on Soft Palate Disorders in Dogs

Clefts of the soft palate should be distinguished from clefts involving the hard palate alone (although they can be in conjunction with hard palate clefts) and clefts involving the lips and nostrils, a primary cleft or harelip. The latter is usually easy to define on physical examination.

Traumatic clefts should be distinguished from congenital clefts. Traumatic clefts may not have a defined history of trauma, but they usually occur in older, active, outdoor animals.

Since congenital clefts of the soft palate are frequently associated with nasal discharge, other causes of rhinitis, or inflammation of the mucus membrane of the nose, should be considered, such as bacterial or viral disorders or inhalation of a foreign body.

Dogs suspected of having an elongated soft palate must also be evaluated for concurrent airway problems such as stenotic or narrowed nostrils, everted laryngeal saccules and laryngeal collapse.

In theory, upper airway noise from an elongated soft palate may be similar in nature to the noise associated with the disorder of laryngeal paralysis. For the most part, the affected breeds of dog and age groups are quite different, with laryngeal paralysis being uncommon in younger brachycephalic dogs and most common in geriatric medium to large breeds of dogs such as Labradors and golden retrievers.

The presence of a mass like an abscess or tumor on the soft palate, the larynx or the trachea can mimic the noise of an elongated soft palate and should be considered, especially in an older dog or non-brachycephalic breed.

In-depth Information on Diagnosis

The diagnosis of a cleft soft palate is usually made from the history, signalment and physical examination. A defect may exist between the two sides of the palate leading to a split down the center of the soft palate. The cleft may be asymmetrical and off to one side. Anesthesia or sedation may be necessary to adequately visualize the tissues in a young squirming puppy.

• Puppies with cleft soft palates tend to be thin, stunted and often have harsh lung sounds upon auscultation with a stethoscope.
• The noise of an elongated soft palate tends to come during inspiration as the palate gets sucked into the opening of the larynx, restricting normal breathing. During excitement or panting in hot weather, the problem gets worse.
• Some dogs with elongated soft palate may gag or retch. Some may turn blue and collapse.
• Owners may also report snoring or restlessness when sleeping.
• Traumatic injury to the soft palate is usually associated with a history of trauma, bleeding from the mouth, blood tinged water when drinking, reluctance to chew or swallow, and sometimes difficulty breathing.

Diagnostic Tests

• Chest radiographs are useful in small puppies to assess for aspiration pneumonia. They are helpful in cases of elongated soft palate to assess for other thoracic abnormalities such as tracheal hypoplasia and heart disease.
• Radiographs of the neck may be useful in cases of a stick injury, to look for a foreign body and/or air pockets where damage to the upper airway may have occurred. Endoscopic evaluation of the pharynx, trachea and esophagus can be useful where a stick has lacerated the palate and may have injured other nearby structures.
• There are no specific laboratory abnormalities for soft palate disorders. Blood work may be useful prior to general anesthesia.

In-depth Information on Treatment

• Congenital soft palate defects are best repaired surgically when the pet is at least 8 to 12 weeks of age. The older the animal at the time of repair, the better the chance that the surgery will be successful since the tissues in the mouth are stronger and hold stitches better. Owners should be aware that multiple surgeries may be necessary in some cases, to get the defect repaired.
• To get to this age the animal will require either tube feeding or placement of a feeding tube, as oral intake of nutrition will be inefficient and dangerous with regard to aspiration pneumonia.
• Traumatic injuries to the palate should be repaired as for any other soft tissue injury, by cleaning and debriding the affected tissue and closing the wound. Any pockets or punctures should be explored to ensure that any material, a stick remnant, for example, is not left behind.
• Medical management of an elongated soft palate is limited to rest, restriction, avoiding exercise and hot weather, and using steroids and sedatives when necessary. It does not address the underlying problem; in fact, delay in surgical treatment usually exacerbates other airway disorders such as laryngeal collapse.
• Surgical resection of the excessive palate is usually performed anywhere from 4 to 24 months of age. The elongated palate can be shortened using a scalpel blade and oversewing with absorbable sutures or using a laser, which does not require sutures. Concurrent airway problems such as stenotic nares or everted laryngeal saccules may be addressed at the same time.
• All animals, regardless of their type of palatal surgery will be closely monitored in the postoperative period for difficulty breathing or swallowing.
• Corticosteroids may be given around the time of surgery to reduce postoperative inflammation.
• Your veterinarian may be sufficiently worried about the postoperative recovery and suggest the use of a temporary tracheostomy tube, a tube going directly into the trachea to by-pass the upper airway, to ensure control of the airway in the postoperative period. This tube can be pulled a few days after the procedure and the remaining hole left to heal on its own.
• Dogs and cats should be carefully monitored when offered food and water to ensure there is no coughing and gagging before they go home. Water is offered first, usually the day following surgery, and if drinking goes well, small amounts of food can be offered on the second day of recovery.
• Postoperative antibiotics may be required, particularly in young animals with a degree of aspiration pneumonia.

Follow-up Care for Dogs with Soft Palate Disorders

Your dog will need to stay quiet and rested for the next few weeks, avoiding too much exercise and excitement. Monitor feeding and drinking carefully. For some animals a canned type of pet food is more easily consumed, but for others, dry food is fine. Be prepared to experiment to see what works best for your pet.

In the case of a congenital soft palate defect, break down of sutures may occur. This normally takes place around three to five days following surgery. If nasal discharge occurs around this time, or you happen to see a break down, perhaps when your pet yawns, consult your veterinarian.

Recheck with your vet in 10 to 14 days following surgery, so that he or she can try to evaluate the surgical site, or at least check that your pet’s recovery is on track.

Prevention of Soft Palate Disorders in Dogs

Most puppies and kittens with a cleft soft palate are put to sleep or they die instead of receiving surgery. It is uncommon to purchase a puppy with this defect and then want to nurse the pet to a point at which surgery can be performed. Then, too, the procedure itself is costly.

Some less than scrupulous breeders may euthanize the affected animals before selling the remaining animals in a litter and not alter their breeding program to avoid breeding from the dam and sire of affected offspring.

Because untreated elongated soft palate can contribute to other airway disorders, in particular laryngeal collapse, early surgical intervention with elongated soft palate is recommended. The prognosis for this surgery is good, when undertaken before two years of age.