0736Singapore soft palate clefts, problems health and welfare education for animal lovers, excerpts from The Glamorous Vets, Singapore, sponsored by  AsiaHomes Internet.  September 01, 2002

The kitten with two holes in the palate 

"The kitten's four siblings had just died, with pus in the eyes, after suffering from an illness," the samaritan said." This stray kitten stopped eating. Yellowish green pus trickled down her nostrils. She sneezed and coughed for a few days at the food court. She cannot meow too"

The kitten had lost her voice and she was wiping flowing mucus off her nostrils.  Life as a stray kitten is harsh on the streets of Singapore as there are cruel boys who would harm the strays.  


I opened her mouth. There was a deep tongue ulcer at the back of her tongue, towards the right edge.  A rotting fishy breadth wafted into my nose, but it was not over powering. The mouth was not infected. 

I palpated the voice box. The kitten felt the pain and started to cough. Would there be a fish bone lodged deep inside the throat? This looked much like a classical case of cat flu with upper respiratory tract infection.  Stray kittens get exposed to viruses. They get infected and they die as their immunity was insufficient to protect themselves. This was a simple common case taking five minutes as the long queue was waiting outside.


Flea dirt was present in her tail and face. These fleas must be removed later.  Now, she needed antibiotics to kill the bacterial infections and dextrose saline injections to prevent dehydration and death. 

"What would you do with the kitten after 3 days of being boarded at the surgery for observation and treatment?" I asked the kind lady. "Put her back at the food court," she said. "Nobody would want to adopt her, especially a sick kitten. My dad does not allow me to bring the kitten home." Many over 50-year-old Singaporean families prohibit the keeping of pets. A waste of money and the thoughts of animals dirtying the apartment and a culture of not being used to keeping pets as this pre-baby boomer generation grew up in harsh and troubled economic times of the second World War.   

The kitten had only 3 days to recover and would be back to the hawker centre unless somebody adopted her.  The ulcer healed the next day and the kitten was lively after the antibiotic injection. The nose had dried up.  She opened her mouth to greet me with a soft "ha" when she should "meow" as her throat was not normal.

Definitely, this was not a viral infection. This was an unusual case. The kitten showed "choking sounds" now and then. As if there was a fish bone inside the throat. She ate little from the dry kitten pellets and drank little of the water. She was active though.

The lady samaritan brought milk and canned kitten food on day 3. On day 5, the yellowish greenish nasal discharge, thick and sticky, presented copiously. Now, if there was a fish bone inside the throat, there should be no runny nose. There would be the "choking" and "gurgling" sounds from the throat.  However, such sounds should not present themselves when the kitten was not eating or drinking. The throat area near the voice box was less painful now.

The kitten lost weight and became dehydrated. "Is it going to die?" the lady samaritan asked me. "Yes," I said. "Unless I can find out the cause of this upper respiratory tract infection. An X-ray of the throat would be most helpful, but it would cost money."

This was a stray kitten and the least cost to the samaritan would be best as her pragmatic mother would be very angry if she was aware of money spent on a stray. A stray with no outstanding features and markings. No chance of being adopted as there are many of her type. Besides, this case was not the typical fish bone in the throat case based on observations.

The return of the pus in the nose was the presenting sign. The mouth was normal. The hard palate which is the roof of the mouth was normal too.  How did this kitten get infected again after five days of confinement. Were the antibiotic injections not effective? Maybe, there was a small fish bone. The kitten was trying to cough out the bone as I cough hear her loud gurgling occasionally.

I needed to check the deeper part of the throat by pulling out the tongue fully but the kitten would not permit that.  Her claws of her front feet extended out to stop me from further probing.

I asked permission from Ms Tan to tranquilise her kitten and anaesthesized by gas to see the inner throat . There is a possiblility of death from the tranquiliser and gas as the nose was blocked by thick pus and the kitten could not breathe well.

I could give an anaesthetic injection via the jugular vein, but this would be extremely risky. The small heart might just stop beating after the injection.

The kitten had great difficulty breathing the anaesthetic gas and clawed at the mask. It took over an hour and yet she was still alert.  I pulled out the tongue with a pair of forceps and looked for any sign of a fish bone.  The back of the throat was not red or inflamed. There was no smell of rotting flesh and this would be there if the fish bone had pricked the throat.

The kitten struggled a bit as I pulled out her tongue fully. The hard palate was normal. It continued to become the soft palate which is a piece of flap which closes the back of the nostrils as the kitten swallows water or feed so that there will be no backflow of water and feed into the nose. 

Two holes on each half of the soft palate, of around 3 mm in diameter showed that the soft palate was punctured. The milk and feed must have gone through into the nostrils. Bacteria loved milk and must have started multiplying. The yellowish green nasal discharge formed. It was a lengthy examination taking over an hour. I could see yellowish brown granules mixed with mucus below the holes and this could be the food which had slipped through. The granules could have blocked the whole nostrils and the kitten would not be able to breathe easily. That was why she kept sneezing out the granules.

What caused the two holes? Was it a fish vertebra bone as there was a small tongue ulcer which could be caused by the bone perforating the tongue surface. Was it congenital, being inherited from birth? What should I do with this kitten? Was this the end of a young life? Many questions have no answers when a stray kitten is involved. 

The kitten recovered quickly after an antibiotic and dextrose saline injection and said a soft "huh" to me.

If she could grow up, the soft palate would grow bigger and the holes may become smaller relatively. But would she have the opportunity to do so? Who would bear the expenses? There was no welfare aid for strays. It would be up to the lady samaritan.

At least, I now know the cause of the gurgling sounds. It was either feed, water or saliva by passing the normal channel into the gut and entering the nostrils or the upper respiratory system, provoking a reflex life saving action of the body. Was it possible to stitch up the two holes in this kitten? It was not as if there was a lot of tissue to stitch up. The two punctures cover around half of the soft palate!  Clefts in the soft palate are uncommon although clefts in the hard palate are common.

I put her on dry feed and plain water. No more milk. It did not have any upper respiratory infection nor runny nose.  It had fewer sneezes. It loved crushing the dry feed. Will it survive to old age as the feed or drink still fall into the two holes into the soft palate and enter the breathing system causing infection.   It is hard to predict. A good home would be important as this kitten would die of aspiration pneumonia as food gets inside the lungs when she eats.  Who will adopt her since she is a common stray kitten. You can find hundreds of them in the hawker centres and wet markets and in the animal shelters.

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