Soft Palate Disorders in Cats

Overview of Feline 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.

Kittens born with palate defects may have problems early on in their development, in the case of clefts. Untreated cleft soft palate can cause difficulty nursing, failure to thrive, pneumonia and death.

What to Watch For

• Kittens 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 Cats

• The diagnosis of a cleft soft palate is usually made from the history; information about the cat’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 kitten.
• 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.
• Chest X-rays are useful in newborn kittens to assess for pneumonia, and to assess for concurrent diseases such as a narrowed trachea (tracheal hypoplasia) and heart abnormalities.
• There are no blood abnormalities specific for soft palate disorders.

Treatment of Soft Palate Disorders in Cats

• Young kittens 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.
• 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 cat 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.
• 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.

In-depth Information on Soft Palate Disorders in Cats

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. Traumatic clefts can occur after falling from a height.

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.

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.

Cats with nasopharngeal polyps can exhibit upper airway noise similar to an elongated soft palate due to the presence of a polyp in the back of the throat.

Diagnosis In-depth

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 kitten.

• Kittens 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.
• 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 may include:

• Chest radiographs are useful in small kittens 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.

Treatment In-depth

• 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.
• 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.
• 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.

Home Care of Cats with Soft Palate Disorders

Your pet 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

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.