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Originally Posted by bchgirl  I see most of the cleft babies described in this thread have not needed surgerical intervention to thrive and grow...leads me to believe the condition of the severity must be something to be considered.
Perhaps when Bombo is evaluated he won't need surgery afterall....seems he's come very far in his first year. If he does need surgery...I hope for much success and a speedy recovery. |
I think most vets would recommend surgery even with a small cleft, since the danger of respiratory infection is always there, and in a small dog with little reserves, respiratory infections can turn into pneumonia. Even in humans with weakened immune systems, pneumonia can be difficult to overcome once it sets in.
The oral surgeons have already seen the photos, read the history I provided, and talked to the dental veterinarian who first evaluated his cleft, and all strongly recommend surgery, and in fact, are surprised he is still alive. One specialist had advised surgery at 5 months, which is when he first saw Bombo. The other recommended waiting until his permanent teeth were in--and they were late in coming in. The evaluation at UC Davis is only to see if he's healthy enough for surgery, to see the nature of the cleft (a full midline graded a 3, which is major) and to allow the veterinary students to see a dog with this type of deformity. We may be there for several hours and even half a day as they evaluate him. Then we must stay overnight and if all checks out with his heart, kidney function, and so forth, he will have the surgery the next day. He will stay another two days or more for recuperation.
I do think people may not want to attempt surgery if an experienced vet is not available. A veterinary dentist is one option, as is a veterinary surgeon who does only surgery. The failure rate of this surgery is around 40%--not to be confused with mortality, although there is some risk of that when the puppy is sick or does not take well to anesthesia over a long period. The failure rate is even higher with additional surgeries. I think the overall failure rate includes clefts that run from the hard palate through the soft palate, and thus, the additional potential failure for the repaired cleft, if wide and performed when the puppy is still quite, to tear apart as the puppy's mouth continues to grow. Contributing to that percentage is, I think, the number of surgeries on serious clefts attempted by vets who have never seen a cleft. From what I understand, the usual procedure is for the tissue on both sides of the cleft to be cut, "roughed up along the edges," and then laid over the opening and stitched together. If it later tears, there is also a chance that the cleft can be left even larger.
It goes without saying that surgery of any kind is very, very expensive. In the case of veterinary specialists, such as oral surgeons in urban areas such as ours, it runs into the thousands. We also have to pay for our travel and our stay in a hotel for several anxious days, and then post-care over the following month. I am guessing Bombo's surgery at UC Davis, which includes all kinds of advanced equipment, a special surgical unit, and lots of intensive post-care will cost somewhere around $5000 to $7500--if there are no complications.
Although we would do almost anything for our babies, I don't think we can expect people to run into enormous debt and thus sacrifice their family's welfare when there are still high risks that the surgery won't even succeed. I am fortunate that I can afford the surgery. That is why I chose to take on this special needs puppy. His breeder loves him very much and gave him her all for 4 months. She said I was the only one she would ever give him to, knowing I had the time 24 hours a day, the experience with very small yorkies, resources among a network of yorkie breeders, and the means to pay for whatever he needed. The cost has already added up to a lot -- about $1700 in vet bills for routine care, early evaluations, and emergencies.
I do think that it's possible to keep some cleft palate puppies alive if one can establish a careful regimen and willingness to take on a lot of worry and thus keep the puppy relatively healthy. There is a website created by a lab breeder, Hennwood, I think, who does not recommend surgery. She feels that many clefts will close down naturally and that the dogs do well on a regimen of dry food and water. Much of my information on care--such as antibiotics, feeding, and such-- come from that advice. I think, however, her experience comes from raising bigger dogs, like labs. However, I was happy to read that another Yorkie puppy, Joker, has remained healthy, in spite of a cleft that was not corrected So it is possible to do!
Good luck to all the Cleft Palate Puppies and their Loving Humans
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