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Puppies With Defects
Puppies that are not born perfect, those with problems such as “swimmer’s” legs or other imperfections are often euthanized at birth. No one talks about them, and breeders would never mention having a “defective” dog in their lines. The truth is that purebred dogs can and often do have “issues” inherent to a breed due to genetics. They can often have congenital defects, those that occur during embryonic development. These can be linked to a gene/s or genetic component, nutrition, environment, or injury, and sometimes they just happen. If you breed dogs long enough you will at some point have one of these “defective” pups. But what if you don’t destroy them? What if you try and find as much information as you can about the condition, and think about saving the pup? I will tell you a story about one special puppy. She proved a Yorkie with a cleft palate can survive!
Sometimes there is a wealth of information on the internet, and sometimes there is none. If you are lucky, research can provide some information. This research can also paint a very bleak
picture of the situation you are facing. The odds can be heavily stacked against the puppy surviving past the first week, let alone growing into a healthy happy dog. But a cleft palate puppy can survive, and they are worth the effort!
This is the situation I encountered in February 2019 with the birth of a litter of Yorkshire Terrier puppies. Three little boys and one tiny little girl made their appearance into the world, and they all seemed perfect, latching on and settling down with their momma. Sport, Chip, Tiger, and Jammy. They all weighed between 4.7 and 5.5 ounces, small but not too small. The little girl, Jammy was the smallest, and simply beautiful. She captured my heart immediately, and I said it would be difficult to get me to let her go. Looking back, I realize just how true those words would be.
Breeding is Not Easy
Breeding dogs is not a simple or easy undertaking. Puppy checks every two hours from birth, making sure momma is well hydrated and fed, a warm cozy whelping box, and the absolute fear that something can go wrong make for very long days for the first 3-4 weeks of life. Prolonged labors, emergency C-sections, retained placentas, mastitis, eclampsia, the list of possible problems and things to watch for is long. The list of supplies to have on hand is even longer.
I am a third-generation Yorkie owner and breeder. I do this on a very small scale, simply for the love of the breed. These dogs are my family, and the puppies are my babies too. I stay home for the first two weeks after the pups arrive. I am on
my hands and knees checking to make sure the puppies are thriving, and momma is
healthy. I didn’t notice anything at first, as all the puppies were latching on, and momma was taking excellent care of them. The boys soon had nice round bellies and were sleeping contently. They were fat little piggies.
Jammy was not. She was losing weight and restless. Within hours I knew there was a problem. I decided to try to bottle feed her because I could see she needed help. Having to bottle feed because puppies are not getting enough milk is one of the unexpected complications can occur and being properly prepared with puppy formula, and a supply of nipples and bottles is necessary. You should also express mother’s milk from the teat to add into any commercial formula as colostrum is vital to newborn puppy health.
Bottle feeding is usually pretty simple. Express some milk from momma into a tube and poor into a bottle. Alternatively, you can warm a small amount of formula Esbilac 1ml/oz of body weight and feed every two hours. but it wasn’t simple for Jammy. She had trouble latching on to the nipple of the bottle. I could tell she wanted to eat because she gummed at it hungrily. I assumed she was weak and needed more help. I adjusted the nipple to let more formula drip to try and induce her nursing. All of a sudden formula came bubbling out of her nose and she started gagging! I tried not to panic, or let my mind go to worst case scenario, but in my heart I knew.
Refusing to give up I kept trying. Maybe a longer nipple would work. So, I got extended nipples-I did mention the list of items to have on hand was long-and tried again. But the results were the same. I was devastated. I knew then that this wasn’t a case of not being strong enough to nurse or having latching issues. Jammy could not nurse because she had a cleft palate.
Worst Case Scenario
Even writing the words all these months later makes me want to cry. This was the worst-case scenario. My perfect, beautiful Jammy has a cleft palate. This is not a“usual” defect in Yorkies. It is not even an “unusual” defect in Yorkies. How or why it happened doesn’t really matter, the reality of the severity of the defect does. I read everything I could find on cleft palates, and I was devastated by what I read. These are the puppies that are almost always put down. Their prognosis is poor. They require tube feeding in place of bottle feedings (in most cases). Repair cannot be attempted until 6+ months of age, it is not always successful, and that is only if the puppies live that long.
Yorkies with Cleft Palates
The information on Yorkies with cleft palates was scarce. But what I did read was more of the same, with only 1-2 instances where anyone had attempted to raise one of these special pups. At the end of almost every article, even those where they opted to try and save the pups, the advice was to put the pup down, the chances of survival were slim. I don’t know the odds, I don’t think anyone does, as there just aren’t many stories or numbers to share. It is important to note that there are different types of palate clefts, those that affect the lip only, lip and front of hard palate, open down the midline of the hard palate, part of the hard and soft palate, or some variation of those. The “usual” ones I read about were open mid-line clefts and were almost always fatal within a couple days.
Call for Help
My first call was of course my vet. She is amazing. I told her what I suspected and brought her in for an exam. My squiggly little pup may have been small, but she sure didn’t want us to look in her mouth! We finally got a good look inside, and of course my worst fears were confirmed. She had what appeared to be an upside-down V shaped cleft extending from the back of her hard palate into her soft palate.
My vet asked what I wanted to do. I just smiled and asked if she had any 5 fr. feeding tubes. She laughed and told me she knew that would be my answer. She gave me a couple feeding tube but suggested I get the clear tubes to see which worked better for me. I was determined to prove a Yorkie with a cleft palate can survive!
My decision had been an easy one. There was no way I would put the puppy down. But the thought of tube feedings scared me. I had seen my father do it many times with the very tiny pups that had a hard time nursing. He made it look easy. But my father has been gone for many years, and the truth is, tube feeding is anything but easy. One wrong placement of the tube can cause fluid to go into the lungs of the pup and this can lead to “drowning” the pup, aspirating pneumonia and death. Having the correct size tubes and syringes is critical in a situation like this. These are the supplies you may think you don’t need on hand, but unfortunately, I did.
In some ways, I am luckier than most people in this situation because I work with small animals, and have extensive experience handling them. The fear of holding and feeding her wasn’t the problem but potentially doing it wrong was. I was already captivated by this tiny little pup with her fighting spirit and will to live. I didn’t want to fail her. I gathered all the things I needed, correct size tubing and syringes, scale, notebook and pen to record before and after weights. Keeping good records is critical so you don’t overfeed or underfeed the puppy. Then I did some research to find a protein rich formula that would be optimal for her growth and development.
Because I wanted to give Jammy formula that contained close to as many grams of protein per ml as mother’s milk (10.5) as possible, I chose to make my own formula:
fresh goat’s milk
eggs yolks only
full fat Greek yogurt,
clear karo syrup
I heated these ingredients together on the stove and poured aliquots it into breast milk bags for freezing.
I then took a feeding tube and ran it along the outside of Jammy’s head from her mouth down to the bottom of her rib cage and marked off the length with a permanent marker. This would be how long I would need to put the tube in to reach her stomach. I then began a regiment of tube feedings. I won’t tell you I was very good at first, but I must have done it right, because little Jammy began to gain weight! I Fed her 7x a day for the first 5 days then 6x a day for the next week, adjusting amounts per feedings higher and numbers of feeding per day decreased. Jammy was slowly continuing to gain day after day. I looked for ways to optimize the
feedings and purchased additional supplies such as clear tubes with markings already on them, and larger syringes. I developed a way to heat the formula for each feeding so that the temperature was perfect. I just wish Jammy didn’t hate the tube so much!
Being a research scientist has its advantages in situations like this as I have access to publications that others may not. While I was doing my research, I came across a lot of information about the development of palates during gestation, which gave me a better understanding of the absolute randomness (and Super Star status) of Jammy’s cleft, as well as a very interesting article Cleft palate prosthesis paper.pdf by Teresa Conze about a prosthetic made to aid cleft palate puppies. The prosthetic is designed to covered the roof of the pup’s mouth and allow them to suck on a bottle and avoided tube feedings. That sounded like a great idea! The prosthetic was ingeniously made from pieces of melted down football mouth guards. I contacted the original authors of the paper who are in Germany-I did mention that being a scientist had its advantages- and they responded right away. They said all the info I needed was in the paper, although they did admit that their pups were a lot bigger than Jammy.
You can probably guess what came next, lol. I called up one of my besties, one of my partners’ in crime who was immediately all in. She went straight to Wally World and bought every mouth guard they had and came straight over. We read the paper over and over and got to work. Well, it sure wasn’t as easy as it sounded or looked in the pics. After about an hour and 15 failed but hilarious attempts, we came up with a couple viable models-or so we thought. Can you picture two grown women trying to insert a piece of rubbery clear plastic the size of flattened quarter into the roof of a puppies’ mouse without choking her, holding it in place, holding the puppy, and then trying to feed her with the bottle? Epic fail! I definitely give us the A for effort. Unfortunately, this was not going to work for us. Back to tube feeding I went. At least I know that I tried. And I got to spend a couple hours laughing til I cried playing mad scientist in my kitchen with my beautiful friend.
Jammy is Stubborn
You would think Jammy knew how much I loved her after a week or two, right? You would think she would know how I only wanted to help her. Nope, not a chance. That little scamp hated tube feedings. I mean she hated them. She fought me every single step of the way. Momma dog was wonderful. She never abandoned Jammy. She never pushed her away. She let her continue to try and nurse and her brothers continued to cuddle her. She was only upset when I put her on the scale and the tube into her stomach. Once the feeding was over, she would calm down again. She would go cuddle with her brothers and momma would clean her and take care of her. She may have preferred the tube to the awful prosthetic experiment, but not by much!
It was very hard to feed the puppy when she was mewing and agitated because I would worry about the tube going into her lungs instead of her stomach. When they are that small, not even half a pound, the distance is very slight. There were several times when I had to reinsert the tube a couple times. I was also fortunate to have my daughter Mads around for most of the feedings. One to gently hold her steady, one to put the tube in her tiny belly. After a few aborted tubing attempts I decided I needed to make sure her lungs stayed clear, so my next purchase was a stethoscope. Of course, I got on that was suitable for both adults and children, because she was smaller than the bell!
I Spoke too Soon
Did I jinx myself or what? Sure enough, there came a feeding when I was alone and Jammy pulled away before I had finished emptying the syringe of formula. Bubbles started coming out her nose and she was gasping. I panicked. I mean really panicked. She was only 4 weeks old! I “burped” her and wiped her nose and helped her as best I could. I tried to suck the formula out of her nose, then blow out the rest. Anything to prevent her from further chance of aspirating the formula.
Fluid in Lungs
The problem with getting the formula in her lungs is two-fold. First, she could essentially drown if too much liquid got into her lungs. Another problem is pneumonia caused by bacteria that would grow from the formula that got into her lungs. I don’t have to tell you those choices are both horrible. As there didn’t seem to be too much fluid in her lungs, my biggest worry was going to be possible pneumonia. To check for this, I would need to listen for the telltale rattle. Out came the stethoscope (I had jinxed myself with) to listen to her lungs. But honestly, I didn’t really know what I was supposed to hear. I mean I knew it would be a rattle, but puppy lungs can be noisy places. So, I listened to each of the boys and then to Jammy. I did this for hours. I didn’t hear anything different, until I did. My heart dropped, and I prayed I was wrong as I waited until the morning to call the vet. Unfortunately, I wasn’t wrong. Our special girl got some antibiotic. To administer this to her I had to add it to her feedings. I would prime the feeding tube with some formula, then draw the antibiotic, then draw the rest of the formula to make sure she got the full dose. I did this every feeding for a week. On her return visit with the vet our perfect princess was given the all clear! It worked! What an amazing little dog!
Somehow the weeks passed and little miss Jammy grew and grew. In fact, she thrived. She (and her brothers) captivated everyone she met with her huge personality.
She surpassed all expectations in terms of growth and size. At around 6 weeks I put a hamster water bottle in the crate so Jammy could start to try drinking water. Drinking with her head tilted back would let the water slide down her throat and this should not cause it to come out her nose-I hoped. I knew that even if it did it would not really hurt her it would act more like it was cleaning her nose out. She would learn. And she did, but boy was it funny at first. I would tap the end and the water would drop on her face and she would give me the look. The I’m a princess what are you doing to me look. She was truly a joy!
All the times she was learning her special ways she was still with her brothers and momma and they were doing things their way. It was fun to watch them each adapt to different ways as if they knew they were supposed to do things differently. The boys used a water bowl and Jammy used a water bottle. The boys also started a transition to semi-solid and wet food that Jammy did not. But she didn’t seem to mind. She knew she was special and had a different path to take.
Transition to Solid Food
Jammy was now approaching 8 weeks old and it was time to wean her off tub feedings and onto solid food. Yay! No more tubes! But another scary moment because I didn’t want her to choke on kibble. The trick would be to find pieces small
enough. Back to the internet I went for the best brand with the smallest kibble and the most protein. I decided to use a very slightly softened-and I mean slightly, puppy food (Diamond Natural Small Breed Puppy) that I had heated with water for a first attempt. I gave her a few pieces from my hand. That girl ate every last piece and looked at me for more! So, I gave her more. Before I knew it, she was eating her food just as it was, no issues. She just put in in her mouth, gave it a crunch and threw her head back to swallow. My little warrior had it all figured out.
During this time, I had been doing research on the next step in the process, the palate repair. In theory, it doesn’t “have” to be repaired, but for the safety and longevity of the dog’s life, it should be done. Here was another case of the more I read, the more depressing and negative the news. You need a specialist, the costs are prohibitive, there is no guarantee it will work, the dog may not survive the surgery, you may need two surgeries. There are more but let’s not continue to depress ourselves. But Jammy’s wouldn’t be like that I thought, hers was getting smaller, I could tell from the pictures we have been taking along the way.
Let’s face it, there is only one person I trust to take care of my pup. Jammy is now 15 weeks old and 3.5 lbs. It was time to go back to the vet for the “talk”. As I mentioned earlier, my vet is the best. Not only is she great with the animals, she is a skilled animal surgeon. Although she had never done this exact procedure, I had total confidence that Jammy was going to be just fine. We talked about what needed to be done, how it could be done, and set the date.
Surgery day was an eye-opening experience. First, there was a camera crew for the tv show Pet Me by Dr. Karen Hamilton from Zadco Media). They happened to be filming the day Jammy was born so they wanted to come film her palate surgery. It was very hard to see how tiny she looked once she was under anesthesia on the table. One forgets how small a 3.5lb 15-week-old puppy really is until they are laying so still. And then we saw inside her mouth fully for the first time. Both the vet and I gasped in shock. The “small” “closing” v-shaped cleft at the back of her throat was in fact a fully open mid-line cleft from the front of her mouth all the way through to her soft palate.
Instead of being discouraged, the vet turned to me and shook her head with a smile and said she was even more amazed than before. Completely open, the worst-case scenario, and Jammy had thrived. But now was not the time to pat ourselves on the back. We still had to close the cleft.
Working her skilled hands, our wonderful vet repaired Jammy’s cleft by nicking each side of the opening and pulling them together so they would knit themselves together as they healed. With precise tight stitches and careful recovery, the palate should close beautifully.
We also spayed her at the same time, as I did not want her to go under anesthesia again because she was so small. She recovered throughout the day and came home that evening. She lay in my lap looking up at me. She was quiet, not her usual happy self of course.
By the next morning I wondered if something was really wrong. The little stinker was her usual self! I mean completely normal! I had to make her rest! Of course, it was back to tube feeding for the next two weeks as the repair healed. She didn’t fight me any less than she had when she was younger, but she liked food, so we reached a compromise. I would not put the cone of shame on her and she would not struggle like a crazy chicken when I tried to feed her. I figured it was a fair trade off.
After two weeks we went back to get the stitches removed and get a good look at the repair. Tears were running down my fact. It worked!!! My perfectly imperfect puppy was perfectly perfect!
We had beaten the odds and done what they said was near impossible. I don’t say this because I am special. No, Jammy is special. My vet, Dr. Karen Hamilton of Annapolis Veterinary and Wellness is special. I am just stubborn. I could not put her down. I could not give up on her. She defied the odds. She is amazing. She persevered. She is a stubborn little girl. She is the one who proved a Yorkie with a cleft palate can survive. After all, it is Jammy’s World.