Complications of cleft palate repair in large animals

Seven foals, 2 horses, and 2 calves were presented to the George D. Widener Hospital for Large Animals at New Bolton Center and the Large Animal Clinic at Auburn University for surgical repair of cleft palate. All animals had preexisting pneumonia. Initial repair of cleft palate in 6 foals, 2 horses, and 2 calves was performed via mandibular symphysiotomy. Primary repair of cleft soft palate in a foal was attempted through a pharyngotomy incision after fracture of the basal hyoid bone; however, exposure was inadequate and mandibular symphysiotomy had to be done. Dehiscence of a portion of the cleft palate occurred in all cases (10 of 11) that survived the immediate postoperative period. A 2nd repair was attempted in 3 foals; however, dehiscence of the palate recurred. Osteomyelitis of the mandibular symphysis developed in 6 animals; dehiscence of the lower lip occurred in 3 animals. Serious complications after surgery led to euthanasia or death of 5 animals. Of the 6 surviving animals, 4 did not grow normally. All survivors experienced chronic nasal discharge often contaminated with food material. Although mandibular symphysiotomy provided adequate exposure for surgical repair of cleft palate, serious complications have not been overcome.