Floss an article by Jane Bellas

The first time I saw Floss, she was wagging behind her kennel door with her nose pressed against the bars - the first three inches of which were pointing to her left!
  She was a five year old working Border Collie who had done that "crazy collie attack fast moving objects" thing.  It just happened to be a milking machine belt that she had clamped her jaws on, so the promptly did a flying circuit and was deposited on the floor with her nose snapped in half.
  Since she was such a good worker, her owner was keen to try and fix her up; he went straight back to the farm to make a guard for the milking machine as well.
  She was put on a drip to treat shock, filled with painkillers and antibiotics, and hospitalised for two days whilst the swelling subsided.  During this time she endeared herself to everyone who met her, constantly wagging and shuffling up to anyone who passed.
  On the third day she was anaethetised (propofol as she was quite thin) and her mouth examined.  She had a horizontal maxillary fracture between pre-molars 2 and 3, and her nasal septum had separated slightly.
  Kate, one of the vets who operated on her, used a technique she'd read about to repair multiple fractures of the maxilla  (A guide to canine orthopaedic surgery, H.R.Denny, published by Blackwell, 1985).
  Intramedulary pins were placed through the maxilla, two either side of the fracture, and methylmethacrylate was scavenged from a cow clog kit to make "sausages", which kept the pins in place and stabilised the fracture (picture 2).
  We had to keep flushing the pins and the side of her face with cold saline to stop them getting too hot as the "sausages" set; the last thing she needed was tissue necrosis in an already ravaged nose.
  The inside of her mouth was still a ragged maw, so what could be stitched back in place was, and her upper canines were wired together to stabilise the septum.
  Teeth each side of the fracture were also wired together to increase stability.  Her lower jaw was intact apart from some broken teeth.
  She'd been anaesthetised for nearly three hours by now, so the hard palate was left for another day.  As there was a deficit 0.5cm wide across the hard plate, a pharyngostomy tube (cunningly disguised as a lamb feeder!)  was placed to reduce contamination of her wounds and nasal cavities and for her comfort.
  Free passage of a urinary catheter indicated her nostrils were patent (picture 3).
  The next day she was amiable as ever and over the next week she was tube-fed and medicated without complaint.  We found Waltham Convalescence Support the easiest liquid food to use; not too large a volume was needed and it passed easily down the pharyngostomy tube.  The tube was flused with water after each feed to keep it patent and for her hydration.
  We regulary cleaned the entry sites of the pins and tube entry sites of the pins and tube with saline and applied antibiotic cream and/or Vaseline as appropriate.  Amoxycillin clavulanate and xlindamycin 11mg/kg twice daily helped keep infection at bay, and carporfen and buprenorphine kept Floss reasonably comfortable.  Two days post-op she began to lap water voluntarily.
  Eight days after her first op, she was anesthetised again and the deficit in her hard palate repaired.  Two sliding grafts were taken from her cheek lining to cover the hard palate mucosa was undermined a little to effect closure.
  Some broken teeth were removed and dead tissue debrided and sutured.
  We continued to tube feed her for a couple of days, then removed the pharynogostomy tube and stapled the wound.
  We reduced the medication to carprofen and clindamycin at 11mg/kg once daily and started to give small amounts of Hill's a/d orally.  She was keen to eat and managed very well.
  The next day it was time to go home, on another 10 days of clindamycin and a week of carprofen.  Her owner continued to feed her on Hill's a/d and Convalescence Support and she was strictly rested.
  She maintained her weight on her feeding regime, in fact becoming a little plump towards the end!
  Five weeks post-op the sausages were sectioned with a plaster saw, the pins cut with bolt cutters and the whole lot removed.  The maxilla was stable and the gratts had taken well.  Her nose was a little mis-shapen but doing its job.
  A month after pin removal, she was back on her usual dog food and rounding up sheep again.
  Anyone who regulary nurses farm collies knows how difficult it can be.  Unused to handling and often terribly injured, they can be very aggressive.
  We were all appreciative of Floss's gentle temperament and what she went through to get well.  Without her co-operation, we would never have reached our goal of getting her back to work, something farm collies seem to desperately need.
  So here's to kind-natured collies and innovative vets.

This was an entry in Category 3 of the 2003 Vetoquinol Literary Award.