Q: I have a 6-month-old Appendix filly who was born with a cleft palate. Our veterinarian has told us that the hole (about two inches long and a half-inch wide) can’t be fixed because it is in the back of her mouth in the hard palate. When she was 2 months old, our filly got pneumonia because her mother’s milk got down into her lungs. She lost a lot of weight and we thought she was going to die. Thankfully, she is past her illness and has put her weight back on. Is there any type of special care that can make her life easier? Also, can anything be done to repair her palate? Celia Lobato-Luna; Bloomfield, New Mexico

A: Cleft palate is a congenital condition in which the roof of the mouth does not form properly in utero. I have seen clefts in the hard and soft palates of horses, but never the lips. Defects in the palate allow anything ingested by mouth to pass into the nose and from there into the lungs, a process known as aspiration, which is likely why your foal developed pneumonia.

There are surgical treatments for cleft palates in horses, even those affecting the hard palate. Essentially, the two edges of the palate are sutured together. However, these procedures have a high failure rate and may need to be repeated, even two or three times, to get enough closure to prevent aspiration. The prognosis is guarded because of the repair failure and the problems associated with general anesthesia on an animal whose lungs are already compromised. This is why some veterinarians feel that cleft palates are not amenable to surgical treatment.

Because this foal has already developed pneumonia once, we can surmise the cleft is fairly disabling to her. If the opening is not closed, you can expect her to continue to develop pneumonia repeatedly, grow poorly and develop pulmonary abscesses.

I know of no special feeds or feeding techniques that would prevent aspiration through the cleft other than nasogastric intubation. I would recommend you take her to a university or referral hospital that has experience in repairing this defect and consult on the feasibility of surgery for her specific condition.

Norm Ducharme, DVM
Cornell University
Ithaca, New York