Any newborn that is not thriving will be given a thorough physical examination by the attending veterinarian, who also will take a good history of the health of the bitch and of all of the littermates. A cursory examination of the upper lip and oral cavity by a veterinarian or knowledgeable breeder usually reveals a cleft palate, with the occasional exception being if the midline defect is isolated far back in the soft palate. This is not especially common in companion dogs. The normal initial database of blood work (a complete blood count and serum biochemistry profile) and a urinalysis may or may not be abnormal. If the puppy develops aspiration pneumonia as a result of a cleft palate, the preliminary blood work may identify an infection. Thoracic radiographs (chest X-rays) may be recommended if the puppy is showing signs of respiratory distress.
The best way to definitively diagnose a cleft palate is to conduct a thorough oral examination under general anesthesia. During that procedure, the veterinarian will be able to get a good look at the puppy’s hard and soft palates and evaluate the precise nature and extent of the defect.