Exposure to toxins or infectious diseases during the 25th to 28th day of pregnancy may also induce cleft palates. Primary cleft palates are obvious as they cause the typical "harelip" appearance that people think of with cleft palate. These are less common in dogs than clefts of the secondary (hard) palate. These are usually noticed when a puppy starts to nurse and milk exudes from their nose or they gag when nursing. Clefts of the secondary palate also can affect the soft palate. These may cause less clinical signs but dogs with this problem may have stunted growth or chronic respiratory conditions. These can almost always be fixed surgically but the techniques are often complicated if the cleft is even moderately severe and it may be best to seek a surgical specialist if repair is contemplated. If your vet feels competent to do the surgery, he or she probably is. Just ask and see whether or not your vet feels better about referring these or fixing them. Mike Richards, DVM