Mind the Gap: Palatoschisis in a Labrador Retriever

An approximately 1-year-old male neutered Labrador retriever was referred for evaluation of a previously diagnosed congenital cleft palate. Prior to referral, the primary care veterinarian had performed two unsuccessful attempts at repair. A complete physical examination at the time of presentation revealed a defect in the rostral secondary and mid-­‐secondary hard palate, mild generalized calculus, severe halitosis, class I malocclusion with linguoversion of both mandibular canines, mild discharge from the left eye and a periorbital swelling ventral to the left eye. Select preoperative diagnostics included point-­‐of-­‐care bloodwork, computed tomography of the skull and full-­‐mouth radiographs; intraoperative aerobic, naerobic, and fungal cultures were obtained from the nasal cavity via the palatal cleft. Based on the history, physical examination, and diagnostics performed, a congenital, non-­‐syndromic, complete secondary cleft palate was diagnosed. A combination two-­‐flap and modified von Langenbeck palatoplasty was performed to reconstruct the secondary palatal defect; the soft palate was reconstructed using a 3-­‐layer direct apposition technique. Recovery from surgery and anesthesia was uneventful and the patient was discharged the following day. Approximately 5 weeks post-­‐operatively, a recheck examination under general anesthesia revealed three 1-­‐2mm palatal defects at the hard-­‐soft palate junction; all preoperative clinical signs had resolved and the pinpoint palatal defects did not appear to be causing clinical signs. The palatal defects were corrected by incising and apposing the palatal mucosa. The class I malocclusion was corrected by partial coronal pulpectomy of the mandibular canines. Surgical outcome was considered excellent.