Cleft Palates and Calcium

What is a cleft palate?

A cleft palate is an abnormal opening between the mouth and the nose that occurs when the tissues separating these two cavities do not grow together properly. When this birth defect involves the lip, it is known as a cleft lip or harelip. Separation within the mouth along the bony hard palate on the roof of the mouth or the flexible soft palate used for swallowing in the back of the mouth is described as a cleft palate. Some cleft palates involve both the hard and soft palates.

This relatively common condition results from the failure of the two sides of the hard and/or soft palate to close together during normal embryologic development. Although it is generally regarded as an inherited condition, environmental factors such as nutritional deficiencies, viruses and toxins that affect the bitch during pregnancy increase the risk of cleft palates. Certain medications, especially prednisone, aspirin, griseofulvin used to treat fungal infections, and excessive amounts of Vitamins A and D should not be given to bitches that are in whelp.

While cleft palates can occur in any breed, the brachycephalic breeds, including Bulldogs, Pugs and Boston Terriers, have a higher incidence. It is interesting to note that Nova Scotia Duck Tolling Retrievers have a genetic mutation in a gene known to be involved in normal palate development. This so-called CP1 mutation appears only in this breed.

The result of a cleft lip or palate is a puppy whose oral cavity is open to the nasal passages. This makes it difficult, if not impossible, for the puppy to make a seal around the nipple in order to nurse properly.

What are the signs of a cleft palate?

One of the first signs of a problem is a puppy that is not gaining weight as well as its littermates. Even though the puppy is on the nipple and trying to nurse, the milk will not flow without proper suction. Labored breathing caused by aspiration of milk into the lungs is another symptom of a cleft palate. Some affected puppies will cough and have milk bubbling from their nose.

A cleft palate is usually visible by turning the puppy over and examining the roof of the mouth. There will be a separation that appears as a slit or hole in the palate. Smaller defects are not always obvious. A cleft in the lip is easily seen, but defects further back in the mouth may require sedation to examine.

Is there treatment for cleft palate?

Cleft lips that do not connect the mouth directly to the nose can be left alone if they do not cause any symptoms. However, they are unsightly and most owners prefer to have them cosmetically corrected.

Defects in the roof of the mouth will usually require surgical repair. Without surgery, food can get stuck in the malformed areas and lead to serious infections of the lungs and nasal passages. In severe cases, the puppy cannot eat or swallow properly and will suffer from dehydration and lack of nutrition.

Since the surgical repair is difficult on young puppies and some cleft palates may become smaller as the puppy grows, most surgeons recommend waiting until the puppy is older and strong enough to handle the anesthesia. The preferred time for surgery is three to four months of age, if the puppy is stable enough.

In the meantime, owners can feed cleft-palate puppies with feeding tubes inserted into the back of the mouth, through the nose, or passed directly into the stomach. A veterinarian can place a feeding tube through the side of the neck through which blenderized diets can be fed.

Unfortunately, surgery is costly and may require multiple attempts for complete closure of the opening in the palate. Some puppies have temporary swelling of the soft palate after the surgery, which can cause breathing problems or snoring. Antibiotics are prescribed to prevent post-operative pneumonia and nasal infections. The greatest success rates are seen when the procedure is performed initially by an experienced veterinary surgeon.

However, even after successful surgical correction, long-term complications as a result of the cleft palate defect are possible. These puppies are at higher risk of upper respiratory infections. Some puppies will have a chronic nasal discharge that may not respond to treatment.

Should I give calcium supplements to my dog?

Calcium is a mineral that is essential to your dog’s diet. It is necessary for the formation of bones and teeth, nerve-impulse transmission, muscle contraction and blood coagulation. The amount of calcium your dog requires may fluctuate under certain circumstances, so you may need to supplement. Since too much calcium in the diet can result in kidney failure and too little can lead to weak bones and poor muscle condition, it is a good idea to check with your veterinarian first to determine how much, if any is needed.

One of the biggest problems with feeding raw diets is ensuring there is adequate calcium, especially with diets that encourage the feeding of raw bones or egg shells as the calcium source. Dogs do not readily absorb the calcium from these sources, so although it looks like you are providing enough calcium, these diets may actually be lacking. This is especially true with growing large or giant breed puppies where the balance of calcium and phosphorus is vital for optimal development.

If there isn’t enough calcium in your dog’s diet, a condition called secondary hyperparathyroidism can occur. This is seen in dogs that are fed diets consisting of meat. It results in bone loss, fractures and deformities of the skeleton. Meat and most vegetables and grains are naturally deficient in calcium. For this reason, a calcium supplement is recommended for dogs that are eating a homemade diet. Well-balanced commercially formulated diets already contain the recommended amount of daily calcium, so supplementation is not necessary.

During pregnancy, the demand for calcium increases due to mammary-gland development and the growing fetuses. The need for calcium will continue to increase at whelping and during lactation. The parathyroid gland regulates calcium levels in the blood and will take calcium from the bone to supplement calcium levels as needed. If a dog’s diet is deficient in calcium, this can lead to weak bones and eclampsia.

Eclampsia, sometimes called “milk fever,” is a life-threatening condition associated with low blood-calcium levels. In most cases, it occurs in small-breed bitches that are nursing large litters. The time frame is usually one to five weeks after whelping when the bitch is producing the most milk. The mother is not able to meet the high demand for calcium for the nursing puppies. Signs of eclampsia are weakness, fever, rapid breathing and, in severe cases, seizures and lapsing into a coma.

Treatment for eclampsia in dogs requires intravenous administration of calcium until the bitch is able to maintain her calcium levels on her own. Intravenous calcium must be given slowly to prevent complications like cardiac arrest. The heart rate is monitored during the administration to avoid slowing the heart rate or cardiac arrhythmias.

The puppies should be removed from the nursing mother and bottle-fed until her calcium levels have stabilized. Bitches recovering from eclampsia should be given oral calcium supplements until the puppies are weaned. Her calcium levels should be monitored throughout the nursing period.

It is important to remember that supplementing with calcium before whelping is not recommended, as it can actually increase the risk of developing eclampsia. Giving too much calcium to pregnant bitches can suppress parathyroid hormone production. When the bitch delivers her puppies and starts to produce milk, the demand for calcium suddenly increases and the parathyroid gland is not able to respond quickly enough to meet her calcium needs.

Fast-absorbing calcium, found in yogurt, milk and ice cream, can be given in early labor. It will help to dilate the cervix, strengthen uterine contractions, and give energy to a tired mother. Calcium carbonate is a good choice for supplementation because it has a high percentage of elemental calcium and is not irritating to the stomach. Products that contain calcium bound to lactate, citrate and ascorbate are easily absorbed.

High-quality, nutritionally balanced diets with proper calcium and phosphorus ratio should be fed during pregnancy, lactation and growth. The optimal ratio of calcium to phosphorus is 1.2 to 1.