Julian Norton, the Yorkshire Vet, on the miraculous recovery of a hapless collie who had a very nasty farm accident

Pneumothorax is the technical term for a “collapsed lung”. Penetrating injuries to the chest are the usual cause, but the first case, in a young and energetic Kelpie, came out of the blue. In his case, the lung had collapsed due (we think) to a small tear developing in the delicate tissue of the respiratory system. The result, whatever the cause, is that air escapes into the space around the lung, inside the rib cage. Its proper name is a tension pneumothorax, because of the pressure changes within the chest cavity.

The phrase always makes me smile, because “tension” also describes the atmosphere around the staff who have to deal with this emergency. Everyone leapt into action, hardly having time to explain the condition and its seriousness to the worried owner.

But I try not to be tense or stressed, despite the fact that affected patients are acutely ill and dangerously close to death. Panicking, I have come to realise, is not helpful in cases of crisis.

First, we need to diagnose the problem. In theory, this is simple – a dog or cat who can’t breathe, is turning blue and whose heart beats are not audible by stethoscope (the thick layer of air inside the rib cage muffles the usual heart sounds, so the chest is uncharacteristically silent). If we have time, X-rays confirm the diagnosis and then a long needle or tube is inserted into the chest cavity to suck out the extraneous air. We’ve all seen emergency departments on television with medics shouting for chest tubes. It’s more or less the same in a dog, but without the shouting.

Within moments, the Kelpie improved, re-inflated and depressurised. The previously panting, blue-gummed Australian sheepdog was soon pink, wagging, breathing freely and cautiously heading home.

As he was discharged, we finally had a chance to explain what had happened. The condition was termed “idiopathic”, which means that we didn’t really know what caused it or why it had happened.

“A follow-up check the next morning confirmed everything was back to normal.

The next week, our second collapsed lung was definitely NOT idiopathic – the cause was horribly evident.

The hectic and unfortunate border collie called Lucy had run into a farmyard spike and impaled herself, leaving a deep and penetrating wound on her chest. Like the boy in Amsterdam, the collie’s owner held a clenched fist inside the gaping hole, preventing any more air escaping. It was deja vu, as I reached for the required equipment and rushed little Lucy into theatre.

I sucked about four litres of escaped air from her chest cavity. The nurse and veterinary student (who could hardly believe her luck at experiencing such a drama) watched with increasingly large grins as Lucy’s breathing settled and a healthy colour returned to her dark purple gums. Next it was time to investigate the wound.

Exploration revealed that it extended deep inside Lucy’s chest and my fingers felt the unnatural sensation of the inside of the collie’s ribs. I flushed and cleaned the accident zone and repaired it.

Lucy stayed hospitalised for a few days, but the wag of her tail the following morning told us everything we really needed to know.

And, at last, the tension was gone.