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[RC] Fw: Neonatal Cleft Palate......Not - Maggie Mieske

This is a note from my friend who wrote to me seeking advice on a scary situation with a new foal.  I immediately forwarded it to all of my horsey friends including Ridecamp.  This letter is a report from her and a thank you note.  I also would like to thank everyone who shared their experiences and advice!!!  Ridecamp is a special group of people!!!
Maggie

We had a somewhat scary few days with our newborn bay filly, Mashallah Mujadra (by Talimm BA out of Mashallah Mujhara, by Arabest El Hasan x a *Tuhotmos daughter).  The filly's birth was normal and she seemed healthy and normal in every way, a pretty and much-hoped-for filly from our all-time favorite mare.  Halfway through her first day, I was watching her nursing, and when she stopped, a flood of milk came pouring back out of both nostrils.  Anxious and apprehensive, I watched for for the rest of the day and the next, and whenever she quit nursing, milk would regurgitate back out of her nose, sometimes a trickle, sometimes a stream with enough force to resemble the bleeding from a punctured artery. 
   I turned to my usual standby reference, "Veterinary Treatments and Medications For Horsemen", which mentioned neonatal cleft palate in newborn foals and said that euthanasia was usually recommended.  Seriously worried, I searched the internet and found an article on "Congenital Cleft Palate In Horses",  written by Stacy A. Semevolos, DVM, and Norm Ducharme, DVM, MS, etc., on the site "My HorseMatters.com", which described exactly the symptoms I had observed in my foal, and went on to describe a grim and gloomy prognosis, that surgery for the condition was difficult, with greater than 85% complications, often requiring more than one surgery to correct, with special care and long-term antibiotic treatment needed, and that as many as  50% of surgically-treated horses have had complete healing (not very good odds).  The article stated that horses with this condition repaired still may have poor muscle tone of the soft palate, leading to early fatigue and upper airway noise.  While a genetic heritability has not been proven in horses, a strong correlation is true in humans, so it would be prudent not to use such a horse for breeding.  Untreated, the condition generally leads to death due to aspiration pneumonia caused by feed being aspirated into the lungs.
   As you may imagine, this rather upset me.  I reported the matter to several horse breeding friends, one of whom forwarded the letter on to her large and extensive ride group, asking for advice, and whether anyone had any experience with this.  I thought it might be one of two things; the dreaded cleft palate, or simply a matter of more milk at more pressure than the foal could handle.  I have had several heavy milking mares, and this filly's dam is one of those, but never in 30 years and 80 or so foals had I seen one regurgitate milk back out its nose.
   I received a gratifying number of emails, two from vets, one suggesting the cause might be malformed or weak soft palate, both advising the foal should have an endoscopy done to determine the extent of the problem.  One lady said she had worked at a mare-foaling farm where she saw many foals and never one that couldn't handle the milk flow, so she suspected cleft palate.  A number of others said they had had foals with the same symptoms, and it was simply a matter of too much milk to swallow, and the problem would resolve itself as the filly got older.  Several said they had adult horses with cleft palates who did aspirate food back out their noses but hadn't died of it yet.
   In the meanwhile, the filly learned to gallop, found she could outrun her mother, and dribbled less milk out of her nose every day.  By day 5 it was an occasional trickle.  By 7 days she was able to handle her dam's heavy milk flow with no problem, and now, at two weeks old, is normal, active and healthy in all respects. 
   I offer thanks to all who sent me advice, and should any of you have a newborn gushing milk from her nose, don't panic; it's likely to be just a case of too much milk  too soon.  (Whew!)
                 Barbara Ward