- 1 week ago
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00:01One, two, three.
00:04Hello, mate. You understand Irish?
00:07Animals from all over the world
00:09Ah, bonjour.
00:11Come to see one extraordinary man
00:13who's known as the Bionic Vet.
00:16High five. Yes!
00:18Professor Noel Fitzpatrick.
00:20You only get one shot at this. Here we go.
00:23Noel and his team offer some of the most advanced treatments available anywhere.
00:28It's the perfect marriage of mechanics and biology.
00:31This is what we have now, a brand new knee.
00:33Oh, wow!
00:35For some, it's a last chance.
00:38It is a life or death situation because we cannot leave him like he is.
00:42I just want you to do anything you can for him, really.
00:45Sorry.
00:46As Noel continues to devise new ways of healing...
00:49You're going to be Bionic. Thank you so much.
00:52He transforms the lives of his patients.
00:55That is just unbelievable.
00:57He's raring to go.
00:59Against all the odds.
01:00Boom!
01:01One small step for a dog, one giant leap for mankind.
01:04Well done.
01:09Scooby, please.
01:11Now, Nibbles folks, please.
01:13Spengie.
01:14Each week, Fitzpatrick Referral sees more than 150 pets.
01:20Scrabble.
01:21Okay.
01:22Princess, please.
01:23Noel will see around 20 of them personally.
01:28His first patient today is a one-year-old Labrador called Simba.
01:33He's been referred for surgery with severe arthritis in both hips.
01:38Oh, Lordy.
01:39Look at those hips.
01:41They're not even in the sockets.
01:44That's really bad.
01:46Sophie and her partner Costas first noticed Simba had problems when he was six months old.
01:54When we took him for walks, he was hopping like a bunny and we thought it was just because he was a puppy and we thought it was cute.
02:01But then when he was crying in bed, we thought there's something not quite right.
02:06We booked a vet's appointment and they did an x-ray and they said it's one of the worst cases they've seen and that they would refer him here to get us sorted.
02:16It's not just a dog for us. It's kind of like part of the family.
02:22Sophie grew up with Labradors.
02:24Simba.
02:25Simba, come on.
02:26Simba is the family's third.
02:28Wait.
02:29I've loved Labradors all my life.
02:31Miss.
02:32But with Simba, I feel like maybe as close as it gets her to having a child.
02:37And I put his needs before mine, which is insane because he's a dog, but he just brings me so much happiness.
02:47When we found out that Simba had been diagnosed with hip dysplasia, I just felt like my world had ended.
02:53I'd got like the perfect puppy who was so stunning, who was so lovely and cuddly.
02:58And then to look at him thinking that inside him is damaged and not right, it just made me want to cry all the time.
03:05I just can't describe how heart-wrenching it was.
03:09As the disease worsened, Simba's puppyhood came to an abrupt end.
03:15Before, we'd come home from work. He'd be sprinting around the house.
03:18We'd have to walk him for ages on a night.
03:20Now, he'll stand at the bottom of the stairs and cry because he wants you to carry him up the stairs.
03:25And then he'll cry at the side of the bed because he wants you to put him on the bed.
03:30And he just won't move all night.
03:33So I've just been, like, trying to massage his hips on the bed.
03:38His hip dysplasia is so bad, even euthanasia was suggested as an option.
03:43Just having him since he was eight weeks old and watching him develop like a little child growing up.
03:50And then when somebody just says, well, you might have to get him put down and lose him.
03:55It's as if, why? Like, I love you so much and I've done so much for you.
04:06Surgery is really the only resort for me.
04:09Because if that doesn't work, then at least we've done all that we could do.
04:22Right, Simba, please. Simba.
04:26Hi. How are you? I'm Noel. Hello, Simba.
04:29Hi. How are you?
04:30Hi. How are you doing? Nice to see you.
04:31Hello. How are you?
04:32Grab a seat there.
04:33So listen, I've been looking at your notes. It isn't good, is it? It doesn't paint a great picture.
04:39They did the x-ray and said that he would need a full hip replacement.
04:44I see. First things first, let me have a look.
04:46Because everything we do has to be in the patient's best interest.
04:50All right, mate. Come on then, bud.
04:53Let's just see what we got here. Hold tight.
04:55Hold tight.
05:01Yes, okay, sorry about that. Right, so he's in quite a lot of pain.
05:05And I can feel rubbing when I do that.
05:07All right, let him go. Thanks, girls. It's fine.
05:10Well, he's in a lot of pain.
05:14In this case, hip dysplasia has produced two very loose hips.
05:18I mean, I would say they're both as bad as each other.
05:20I can feel grating, which is bone rubbing on bone.
05:23We hear that a lot. Yeah, you hear it. You can hear it, yeah.
05:26Because you've got no sockets left. They've become saucers.
05:29And the other big problem you've got is you've got severe muscle laxity.
05:33He'll lie down a lot after walks like this and stick his legs out backwards
05:37because that's the most comfortable position to put them in.
05:40Because he's grown accustomed to the fact that he's in pain every day of his life.
05:44Pain management will control the signs to some extent, but obviously won't cure it.
05:49So therefore, our only three options are do nothing, chop the femoral head off and throw it away,
05:55try and make a false joint, which is called a femoral head and neck excision,
05:58or do a total hip replacement.
06:00I believe, as does the current scientific literature,
06:03that total hip replacement is superior to femoral head and neck excision in a dog of this size.
06:08And we know that this technology works and has in fact worked for decades,
06:12but you need to understand there's risk associated with that.
06:15The primary complications are dislocation or fracture.
06:19Infections are rare.
06:21Also, when I pull the hip back in, if I have to make it very tense,
06:25then this nerve here may have a palsy temporarily.
06:29This is very rare, but if you get it, don't be scared.
06:32Sometimes they drag the foot for a while.
06:35All right, friends, is this your first child?
06:37Yes.
06:38OK, well, I will do my very best to look after your firstborn.
06:43Expensive child.
06:45Yes.
06:46OK, Mum and Dad, give them a big cuddle there.
06:49I'll ring you later, guys.
06:52Noel will go ahead with hip replacement surgery on both of Simba's hips.
06:56When he was going through the risks of what could happen,
07:00I suppose your heart sinks and you ask yourself,
07:02is it worth it or why me?
07:04Why did I end up choosing one that had this
07:07or why has he got that wrong with him?
07:09But just got to man up and hope for the best.
07:26OK, Baba.
07:29All right.
07:30Oh.
07:31Emergency cases are referred to the practice for specialist treatment
07:34at any time of day or night.
07:39It's early evening and the Richards family and their friends
07:42have brought in Poppy, their three-year-old Cavachon.
07:46Earlier today, she escaped from the garden
07:49and was run over on a busy main road.
07:51Come and slap her in the corner and I'll pop her back down for you.
07:54Poppy has been given painkillers by their local vet.
07:58Do you need a hand there?
07:59This is Poppy?
08:00Yeah, this is Poppy.
08:01OK.
08:02Hello, sweetheart.
08:03OK.
08:04Come on, then.
08:05She seems to respond.
08:06I don't know.
08:07Can you carry her?
08:08Yeah, absolutely.
08:09Yeah, got it.
08:10Good girl.
08:13Come on in, girls.
08:14Come on in.
08:15When did the accident happen, please?
08:16About 10 o'clock.
08:1710 a.m. this morning.
08:19Mum Tina was out at the time,
08:21but daughter Megan was at home.
08:23Did anybody see what happened?
08:25Uh, yeah.
08:26I heard a scream.
08:27There was a lady crying there and she was like,
08:28your dog just got run over and I was like,
08:30it can't be my dog.
08:31And Poppy came in, I was crying,
08:33and I saw her leg and it was like completely broken.
08:36It did not look right at me.
08:37Has the bone come through the skin?
08:38Do you know?
08:39I don't think so.
08:40You just said it was floppy.
08:41It was really floppy.
08:42You were so blurted.
08:43Yeah, I saw blood, but I didn't know where it was coming from,
08:46and she was completely out of breath.
08:47And after that, there was a lovely lady who took me to the vet with Poppy.
08:51Right, so they've not taken x-ray pictures of the leg yet.
08:54Oh, they haven't?
08:55They've taken x-ray pictures of the chest, yeah.
08:57They've just checked for life-threatening internal organ issues.
09:00Okay.
09:01Which they did not find.
09:02Okay.
09:03But we will need to recheck that.
09:04Okay.
09:05And she doesn't seem to be in pain?
09:07Uh, well, they've given her a lot of methadone, yeah.
09:09So she's a lot of happy drugs going on there.
09:11Yeah.
09:12Okay, bubba.
09:13All right, guys.
09:14That's it.
09:15I'll need to establish what's going on and what the prognosis is.
09:18So if you want to give her a big kiss, guys, I'll take her now.
09:23Okay, guys.
09:24There we go.
09:25I'm going to take her through.
09:26I'll call you later.
09:27No worries.
09:28Thanks.
09:29For now, there's nothing more the family can do,
09:33so they're going home to wait for news.
09:36So she just had an RTA.
09:40Noel and the team must get straight to work.
09:43I've seen a radiograph of the chest and the abdomen.
09:45It doesn't appear like there's any internal organ rupture.
09:48We'll repeat that.
09:49Get me a craniocaudal and a lateral and take that off.
09:52Just make sure her ECB trace is normal.
09:55Poppy is in a serious condition.
09:58Her blood pressure's through the floor.
10:00She's tachycardic.
10:01She just hasn't got the circulatory support because she's still shocking.
10:05Drugs are keeping Poppy out of pain, but the nursing team must stabilize her and take X-ray pictures.
10:14It's not good news.
10:16The original X-ray picture did not show fluid on the chest, and now there is fluid on the chest,
10:21which means the impact will have caused rupture of some of the blood vessels inside the lungs and in the lining of the lungs.
10:26We can see here there's fluid collecting all along here.
10:29That gray stuff is fluid, and it's leaking up around the lungs on the outside as well as within the lungs.
10:35And that means that we are in potentially big trouble, and we cannot anesthetize Poppy,
10:41because if she was to hemorrhage more into her lungs, well, she wouldn't be able to breathe.
10:47So that's life-threatening.
10:50This fracture isn't life-threatening, but it's a very bad break, and this bit of bone has come through the skin,
10:57which means there's infection in here.
10:59We can't operate on that tibia tonight because if we anesthetize her, she could die because of her lungs.
11:04It's too risky, and her kidney values and the blood test are not normal, so that means she's having trouble.
11:10Probably a big trouble.
11:21Today, Simba, the young Labrador, is having his first surgery.
11:26He needs total hip replacements on both legs.
11:29Turn on the suction.
11:31Noel is operating on the right one today.
11:34There's the arthritis joint right there.
11:37It's all grown in, and it's become a gnarly saucer and not a cup at all.
11:41I'm going to drill all that out and put a new cup in.
11:44This is a tricky one.
11:52This is a cup.
11:53It's got a honeycomb surface on it into which the bone will grow, hopefully,
11:56and a plastic liner for the head.
11:58Once new bone has grown into it, the metal cup should become part of Simba's pelvis permanently.
12:11Now, Noel must prepare the femur to fit the new implant.
12:15This is quite narrow, and the reason it's quite narrow is that the marrow canal has been hardened by remodeling,
12:22because the femur has never been in the joint properly, and as a result, it's twisted out like a banana.
12:29So this is a very specialized stem.
12:33You can see that it's got the honeycomb mesh here into which the bone can grow,
12:36and there's a hole right up through the neck here, which we're going to put a locking bolt in to stop it sliding down,
12:43even if the femur were to try and split.
12:46So we just gently guide it in, like so.
12:53We put a wire around the femur to stop it fissuring.
12:58Noel screws the bolt through the side of the femur into the stem to prevent it slipping down.
13:05Okay, so this is the head, we pop that on here, and then we're good to go.
13:11Now the leg can be reattached to the new hip socket.
13:15Okay, we're done.
13:17So we can see here where the bolt is holding the stem in place,
13:21and we can see if we look deeper that the ball is in position down there,
13:25and it's inside the plastic socket with a metal liner.
13:29And as we move it now, we can see an entirely new hip joint in position.
13:33It's tight. It's not going to come out, I would have thought.
13:37Alrighty, good boy. Let's go to x-ray.
13:49For the past 48 hours, Poppy, the three-year-old Cavachon, has been monitored around the clock.
13:56She was hit by a car and is in a serious condition with a broken leg and fluid around her lungs.
14:02Which could cause problems with her breathing if it were to deteriorate.
14:08The team have been x-raying her chest every 12 hours.
14:12We can see that there's fluid around the outside of the lung here, all the way up here.
14:17That's probably bleeding and hemorrhage, and probably right now that's becoming a clot,
14:23because we're two days in now.
14:24And at the moment, the area of fluid is not getting bigger, so we're not going to place a drain.
14:29We're going to let nature take its course, and hopefully in the next two days or so, that fluid will resolve.
14:35All right, sweetie, good girl.
14:41Noel can't operate on the leg until Poppy's lungs are clearing.
14:45Under anaesthetic, she could have complications.
14:48But the longer he waits, the greater the risk of infection taking hold in the open fracture.
14:54So we're just going to change the bandage and the splint just to keep it clean.
14:58We know that there's already contamination in the leg, but all we can do at the moment is give antibiotics.
15:03It's too dangerous to anaesthetiser.
15:05That's it, good girl.
15:08So the hole that the bone came through is here.
15:11At the moment, there's no more swelling, so I think it's perfectly justifiable to continue as we are.
15:16She's got lots of painkillers on board.
15:18We've got to wait.
15:19Probably another 48 hours, I would say.
15:25Right, that's it.
15:26Good girl, pups.
15:27Well done.
15:28Well done.
15:29Good girl.
15:38Good girl.
15:39Out in the car park, there's a new patient for Noel to see.
15:44Nina and mum, Alison, have brought in their anxious basset hound, Tuli.
15:48We decided to keep her in the car today because she is on the nervous side with a waiting room full of dogs.
15:54I just didn't want her being a bit unpredictable in there.
15:56Nina has had Tuli since she was a puppy.
15:59She's now nearly nine and her health is beginning to fail.
16:03A couple of months ago, we noticed firstly that she was holding her tail quite strangely.
16:07She wouldn't hold it fully up in the air, things like that.
16:10And then when she went to run, she would just scream and then just hit the floor.
16:14And, you know, she wouldn't move.
16:16Took her to my local vet and did an x-ray.
16:19Established that she had spondylosis at the spine.
16:21So, I mean, that was quite a bombshell.
16:26At home in Hertfordshire, Tuli is one of Nina's four dogs.
16:34But she's her favourite.
16:36Tuli, she's my world.
16:38She's a very loving dog.
16:40Come here.
16:41She's fun and silly and smelly.
16:42But she's been my companion for the past nine years and I love it a bit.
16:47We've had dogs in the family since I was three.
16:51Most have been boxers.
16:53Like Bailey.
16:55He's Tuli's special friend.
16:58She just is besotted with him and it's lovely to see because I see how nervous she is with other animals.
17:03She just forged this great bond with him.
17:05It's just wonderful to see them together.
17:09In her spare time, Nina's a keen artist and paints portraits.
17:14When I'm painting, she sits with me and she'll watch me doing my work and I'll have my music on in the background and she'll kind of be happy with that.
17:22But over the past few months, Nina has noticed a change in Tuli despite her medications.
17:28She's deteriorating quite quickly.
17:30She seems very unhappy and she seems to be in pain.
17:33She's not getting better, she's getting worse.
17:36She's so inactive, she literally has very little quality of life.
17:41Nina's local vet has referred her to Fitzpatrick's where she's already seen Claire, one of the neurology team.
17:48Hello.
17:49Hi.
17:50Hi, I'm Noah.
17:51Nice to see you.
17:52How are you doing?
17:53Hello, Tuli.
17:54Hi, mate.
17:55Are you nervous?
17:56Are you nervous?
17:57It's okay, cheeky chops.
17:58All right, mate.
17:59It's okay.
18:00Yeah, quite nervous.
18:01Especially of big strange leprechauns.
18:04Yeah.
18:05All right, so Claire, you've already seen and she's filled me in somewhat.
18:09Yeah.
18:10Tuli's eight years and nine months of age, so I'm not a spring chicken anymore.
18:14No.
18:15The MRI scan that I've seen, this disc here is so degenerate that it is squishing both the nerves that go to the bladder, the anal sphincter and the tail, as well as the nerves that go to the back legs.
18:28Yeah.
18:29Additionally, unfortunately for you, the disc in front of that L67 is also bulging.
18:36Yeah.
18:37So every disc in this dog's back is diseased.
18:39Yeah.
18:40When the disc dries out, in the initial stages it just bulges, but then it becomes unstable.
18:45So as those two vertebrae become unstable relative to each other, they produce new bone.
18:50And that's called spondylosis.
18:52And that new bone can in fact squish the nerves even more.
18:56Okay.
18:57So that is your problem.
19:00And if you look at the CT scan that Claire's taken before, we can see just how aggressive that new bone is.
19:06There's loads of it.
19:07Tuli's nerves are being squashed both by the new bone growth and the bulging discs.
19:13So, poor thing, she's affected by significant sciatica.
19:17Yeah.
19:18I'm going to have a little look at you, sweetie pie.
19:20All right, sweetheart.
19:22You're leaning against me here, huh?
19:24Good girl.
19:25Hold tight.
19:32Okay, stay right there.
19:33Unfortunately, I'm going to put a finger up her bum.
19:35I need to check the nerves.
19:36I'm sorry, sweetheart.
19:37If you were nervous before, you'll be nervous now.
19:40It's all right.
19:41You can feel it like a little string.
19:44Yep.
19:45That's sore.
19:46Okay.
19:47Sorry, sweetheart.
19:48So, she's very stoical.
19:50Yes.
19:51She's in a lot more pain than she's letting on.
19:53Now, I know you're in expecting surgery.
19:56The reason you're here is if you do nothing, she remains in pain.
19:59Not being able to get up ultimately, having trouble pooing, having trouble peeing, all of that may well happen in the next several months anyway if we do nothing.
20:09To relieve Thule from pain, Noel plans to scrape out the contents of two bulging discs in her lower back.
20:17To keep the vertebrae apart, and to stop the new bones squashing the nerves, he'll place a spacer between the last lumbar and sacral vertebrae.
20:27And then attach screws, clamps and rods to stabilise three vertebrae, while the bones fuse together in their new position.
20:35All right, you ready for me to crack on?
20:41Now, sweetie pie.
20:42Well done.
20:43That's it.
20:44Now, bye-bye, family.
20:45All right, good to see you.
20:47Take care.
20:48All right, I'll do my best.
20:50All right, guys, God bless.
20:51Bye-bye.
20:52When we went through the imaging, it kind of took me aback.
20:55I kind of suddenly seemed to realise that it was actually worse than I initially thought it would be.
21:00It's upsetting.
21:01There's no other way of putting it.
21:02She's so stoical that she's really not sure how much pain she's in, and you then realise just how bad it's probably been for a long time.
21:09Do you need to add it to your doofa?
21:19Yeah.
21:20It took me ages to learn how to do it, but you can get there in the end.
21:23Oh, you're a babysitter.
21:24Oh, yeah.
21:25It's really cool.
21:26Good work.
21:27Is this your first week?
21:28Welcome.
21:30Oh, you've got a very good teacher there.
21:32I'm not...
21:35Natalie, do not be teaching the new receptionist bad habits.
21:38Never, ever, ever.
21:41I'm watching.
21:55It's been two days since Simba, the young Labrador, had his first surgery.
22:01He's made a quick recovery.
22:04Sophie and Costas have driven nearly 200 miles to the practice from Leeds.
22:09I really can't wait to see Simba again.
22:12It's been really hard being without him, knowing that he might be in pain and on his own, and hoping that the nurses are looking after him.
22:20But, yeah, it would be nice to have him home.
22:23Yeah.
22:24So, Simba's doing well.
22:27This is the replacement.
22:28You can see here, nice new cup, new stem, ring around here.
22:33That bolt will prevent that subsiding.
22:36Yeah.
22:37And Simba thinks, this is great, we're fixed now, off we go.
22:39So, you've got to be super careful for the first four weeks.
22:42Once the bone grows in around that mesh, it should be rock solid in eight weeks.
22:46And then you won't need to worry about it.
22:47I mean, run around like a normal dog on this side.
22:50Clearly, the other side is horrendous.
22:52It's the same, basically.
22:54So, but I think the strategy is in place for us to deal with that.
23:01There you go.
23:02Now.
23:03Probably a lot better than you would think.
23:05Yeah, yes.
23:06Well, he thinks he's fixed, you see.
23:09All right, guys, let's go outside.
23:11Come on, Bob.
23:14So, as you can see, he'd run across the field.
23:17You must put the sling under him at all times.
23:20He can stand and walk without that, but that's an insurance policy.
23:23I don't want him twisting suddenly and fracturing something.
23:26This is as good as it can be.
23:27I'm very pleased with him.
23:29Gently.
23:30Good boy.
23:31All right, big guy.
23:32We're going to close the door, mate, because you're going to jump out.
23:35Stay.
23:36Good boy.
23:37Good to see you.
23:38All right.
23:39Take care.
23:40Take care, mate.
23:41Behave yourself.
23:42All right, buddy.
23:43Take care.
23:44Feels really, really nice to have him back.
23:45He's doing really well.
23:46I thought he would be far worse than this, so I feel really surprised.
23:51We'll probably all be sleeping in the living room with him tonight while he's in his cage,
23:56to make sure he's okay.
23:58If all goes well, Simba is due back for his second hip replacement in four weeks' time.
24:05In the wards, Poppy, the Cavachon who was run over, is being monitored constantly to check if the fluid on her lungs is clearing.
24:18Until it does, Noel can't operate on her broken leg, so for now she's in intensive care, and it's a waiting game.
24:27Tuli, the Basset Hound, is being prepared for surgery. She faces a major spinal operation.
24:48Tuli's op's going to be challenging. It's a very small target area relative to the amount of metal work I'm going to have to get in there to make it stable.
24:58I'm not entirely convinced I'm going to be able to get the spacer device in because looking at the MRI scan, it's pretty tight in there.
25:07All right, here we go.
25:09So the first bit of this op is fairly brutal, where we separate the muscle and drill off most of the roof.
25:20The next bit is very, very delicate, where we gently file through the inner layer of the roof, which is eggshell thin.
25:27We must not touch the nerves.
25:30So this is the roof coming off now, and underneath that is the nerves that go to the tail.
25:37This bit of roof here has been squishing down on the nerves.
25:40So now I'm going to cut beside the nerves, taking the roof off the disc.
25:45There's a ton of disc material in here, loads of it, bulging up for probably years.
25:52With one disc cleaned out, Noel scrapes out the diseased disc from the adjoining vertebra.
25:58It's delicate work.
26:00The thing is that you're only ever a millimetre or two away from disaster when you're doing surgery like this,
26:07because if you catch one of these nerves, you can really inflict permanent damage.
26:11So we've got to be super careful.
26:14Now he can fit the spacer to push the vertebrae apart and take pressure off the nerves.
26:21So this is the scariest bit of the operation, where we're pulling the nerves over.
26:27You get this wrong, it could be game over.
26:30We get it right, and then potentially we get a lifetime pain free.
26:34I knew this would be tricky, but this is very tricky.
26:44It just does not want to go in the right spot.
26:47We're losing quite a lot of blood now, so soon we'll be having a real problem here if I don't get this screw in.
26:55Hopefully I've done most of the blood losing now.
27:01So, finally, I've got the spacer in there and I've got a tiny screw through it here to stop it backing out.
27:11The spacer will keep the vertebrae apart, but once the bones fuse in their new position,
27:16they must be supported with screws, clamps and rods.
27:21Okay, so we've got four of six screws in now.
27:34We've got to get the fifth and sixth one in, and then we might be in some kind of shape.
27:40So I'm going to have to cut certain lengths of rod to fit these clamps, because it's an unusual length,
27:49since I'm bridging between three vertebral segments.
27:53All the implants are in place now.
28:02We've got three clamps on each side and a rod bent between the three clamps on both sides.
28:06You can see here, if I grab the bar here, I can lift the bottom up off the table.
28:10I'm just going to put some collagen foam down over that now to cover up the nerves and then stitch the muscles over.
28:16The operation has taken nearly three and a half hours.
28:21All right, let's go to CT now, please.
28:34Simba, that's great. Take a seat and I'll let them know you're here, okay?
28:38Simba is back at the practice with Sophie and her friend Sarah.
28:43For the past four weeks, he's been a challenging patient at home.
28:48I've struggled so much to cope with him.
28:53He just wants to explode every second.
28:55He chewed his entire cage door off in the first three days.
29:00So I had to order a new cage, but he won't go in it.
29:03So between me and my family so far, we've slept in the living room next to him every single night for four weeks.
29:10Everyone's exhausted. It's just, I suppose, like having a child.
29:14It's always put me off.
29:19Right, Simba, please, Simba.
29:21Today, he's due to have his second total hip replacement.
29:25Hi, guys. Hi.
29:26Hi, Simba. How are you doing? How are things going?
29:29He looks fine, but...
29:30Yeah, grab a seat. Hello. How are you? Nice to meet you. How are you doing?
29:33There you go. Grab a seat.
29:34So he looks fine, or are you worried about anything?
29:37Erm, he's just, we can't suppress him at all.
29:40Like, we've drugged him up to the... He's gone mad.
29:42Yeah, he's chewed his entire cage door off the first week.
29:45Oh. Oh.
29:46And he's just so strong.
29:48I see.
29:49So he's probably feeling a lot better on that hip now.
29:51All right, let me have a look. Simba, come here. Good boy.
29:53Let me have a look.
29:55I think you're just going to have to use the sedatives.
29:57That feels fine. Hold tight. This one's probably still quite sore.
30:02Yeah, I know, mate. That's sore. I know. I know. That's naughty.
30:06We'll get you out of that pain. Good boy. It's fine.
30:09You're OK, mate. He looks pretty good, I have to say.
30:12I think it's just because he's a nutter.
30:14Yeah.
30:15That's just... What can you do? What can you do?
30:19He's so used to being in pain that when you get him out of pain,
30:23he's like, I want to go crazy.
30:24He's trying to go on his back end all the time, like jumping.
30:27He's never jumped up ever.
30:29Yeah, well, that's because it doesn't hurt on that side.
30:32When I give him two bionic hips, he's going to be jumping for the stars.
30:36You're like a gazelle and you're prepared for another month of challenges, right?
30:40Yeah.
30:41I'm afraid that's life, Sophie. It's just the way it is.
30:45You're going to have a shit in my corner now.
30:47Oh, my Lord. It doesn't... What? What are you like?
30:52There's a big poo in my corner. Look at that.
30:55He's never done that ever.
30:57That's what you think of my efforts.
30:59Oh, you like Simba. You're a naughty boy.
31:02All right, guys. God bless. Safe journey back home.
31:05Oh, and leave the poo to me. It's all fine.
31:07You're welcome.
31:08Thank you. See you later. Bye.
31:10Thank you. Bye.
31:11Bye.
31:12Can I have a hand, please?
31:14Yeah, I really didn't expect him to do that. He's never gone to the toilet inside.
31:19I think he's clearly remembered what Noel did to him last time and he's left him a present.
31:25Presents are part of practice life.
31:29Cleaning up is a chore for all staff.
31:33Oh, I got my shoes.
31:41After four days in the intensive care ward, the fluid in Poppy's lungs is finally receding.
31:47Noel feels it's safe now to anaesthetise her to fix her broken leg.
31:52Poppy is finally stable enough to operate, which is a good thing, but we've got to get in and out as quick as we can.
31:58Keep that anaesthetic as short as possible.
32:01Go on me, please.
32:07These fracture ends have come through the skin here and potentially got bugs inside here.
32:12Normally I would put a rod in the centre and a plate on the side, but I don't want to do that.
32:18If there is infection there, then that may track the infection up and down the bone.
32:23There's definitely a high risk of contamination here.
32:27It looks like there has been some impaction on the road.
32:31Yeah, we can see a few splinter segments here.
32:34Definitely a potential for infection.
32:36Give me a swab.
32:41So we're taking a sample, see if we can culture any bugs from there.
32:46Noel is going to put two plates on Poppy's leg.
32:49One to hold the broken bones in the correct alignment, and a second at right angles to stabilise the repair.
32:58So this is a very old style of plate that I first used 27 years ago.
33:04It comes in very handy for this kind of operation.
33:11Nowadays, plates are much more complex than this very simple one, but for positioning like this, it's perfect.
33:19Okay, so we've got two plates in, one on the inside here, one on the backside here.
33:24And they're both at right angles to each other, meaning that it's extremely difficult to bend that.
33:30There's lots of different ways we could have fixed this.
33:32We could have put a frame on the outside, but I would have had great difficulty lining up a transverse fracture just on an external frame.
33:41We're done, 45 minutes.
33:43Let's get a bandage on here, we're done.
33:44Alrighty, let's go to x-ray, thank you.
33:55Hello?
33:56Hey.
33:57I bet you're sitting on hot coals, I would imagine.
34:00Oh, yes, yes, definitely.
34:02Right, so I've done the repair.
34:05It went fine.
34:06Everything went as planned.
34:07Right.
34:08So do you think it was infected?
34:10I think it was contaminated.
34:12Okay.
34:13But hopefully not yet infected.
34:15Okay.
34:16And so far everything's resolving in the chest, so we'll just keep an eye on that.
34:20We're going to take another x-ray picture tomorrow.
34:23Okay.
34:24So, so far so good.
34:26Okay.
34:27She's certainly not out of the woods yet.
34:29Okay.
34:30But we can definitely see the light in the clearing.
34:32Thank you, Noel.
34:33Cheers.
34:34Bye-bye.
34:35Bye.
34:36All right, Tuli.
34:37How are you doing, sweetheart?
34:38Tuli, the Basset Hound, has spent the last five days recovering from her complex spinal operation.
34:50Hey.
34:51Oh, how are you doing with your big floppy ears?
34:54She's an older dog, nearly nine, but she's recovering well.
34:58Okay.
34:59The girls tell me she's able to urinate and hopefully she's able to walk a little bit better, but we're about to find out.
35:06Come on, Bubba.
35:07Come on, sweetie.
35:08Oh, what a brave effort.
35:11What's happening in here?
35:13It must be pee time.
35:15Oh, yeah.
35:16That's what we like.
35:17A nice big pee time.
35:19Well done, you.
35:21Well done.
35:22Come on over here.
35:23Let me have a look at your legs.
35:25Okay.
35:26So, she's making a valiant attempt to use her legs.
35:29Lots of movement in the leg there.
35:31So, really strong, really strong withdrawal.
35:34Really strong motion there.
35:36That's good.
35:37Oh, poo on the hand alert.
35:38Poo on the hand.
35:39Ah, thank you, Tooley.
35:41Well, she's able to poo.
35:43She's able to pee.
35:44She's able to walk.
35:45It's time to go home.
35:46Right, Darby.
35:47I'll let you do the peeing and the pooing then, because I think she's already started, it would appear.
35:55Nina has come to collect her.
35:58I just can't wait to see her.
36:00It's been agony not having her in the house for a week.
36:02So, I've been a bundle of nerves all this morning.
36:05Hi, Nina.
36:06How are you?
36:07I'm good.
36:08Very excited.
36:09All right.
36:10So, a big deal.
36:11Big surgery.
36:12That's what the implants look like.
36:13That's a lot of metal.
36:14Yeah.
36:15Very challenging anatomy.
36:17Mm-hmm.
36:18Now, for the first 12 weeks, until that all sets solid, there is risk associated with too much motion.
36:25Okay.
36:26So, just be careful.
36:27All right.
36:28I think the best thing to do now is let's meet outside the front door and I can show you exactly.
36:32Okie dokie.
36:36Now, there we go.
36:38Hello.
36:39Who's there?
36:40Who's there?
36:41Oh, who's there?
36:42Who's there?
36:43Hi.
36:44Hi.
36:45I'm so big.
36:46There you are.
36:47There you are.
36:48So, she walks with this as a support and her tail is beginning to move as you can see.
36:53Yeah.
36:54So, you hold this and this and off you go and take about maybe 30% weight on here.
36:59Yeah.
37:00You don't need to lift her.
37:01Yeah, that's it.
37:02That's it.
37:03Exactly.
37:04That's exactly right.
37:05A little bit drunk on the back end.
37:06Well, she's inevitably going to be.
37:07Yeah.
37:08It's a big deal.
37:09All right, sweetie.
37:10Come on.
37:11Come on, Bob.
37:12Come on, Mom.
37:13There we go.
37:14Good girl.
37:15You lift this in.
37:16Yeah.
37:17Good girl.
37:18My head's a bit scrambled at the moment.
37:21I'm just overjoyed to see her.
37:24I think she's happy to see me and she'll be happy to be home and tucked up in her bed.
37:31So, I'm just over the moon.
37:32I think I'll just snuggle with her for the rest of the afternoon.
37:35That's my plan anyway.
37:47Hi, Simba.
37:48Hi.
37:49Hi.
37:50In the kennels, Simba has been recovering from his second total hip replacement.
37:55Come on, babe.
37:56Good boy.
37:57Good boy.
37:58This time, there have been some complications.
38:00Simba's four days postoperatively now.
38:03The left hip is recovering slower than the right hip did.
38:07And that's just the nature of biology.
38:10There were two fundamental differences between the left hip and the right hip in terms of recovery.
38:16Let me just take this off.
38:18One was that there was a big spur of bone at the back of the socket here that was sticking to fibrous tissue,
38:25which was sticking to the nerve.
38:26And I had to prise that away and so the nerve has to recover from that.
38:29The second issue was that when I put the new head on the femur, I had to pull that right back into the socket,
38:36which means the tissue is going to be stretched and that in turn stretches the nerve.
38:40So we get what's called neuropraxia, which is a temporary palsy of the nerve.
38:45And that's why we've got this booty on, because without the booty, the foot just knuckles over.
38:50Generally, they do come back, so I'm not too worried.
38:53I think he's ready to go home.
38:55Good boy.
38:56All right, mate.
38:57Let's go back in.
38:59I was supposed to be picking Simba up on, I think it was Wednesday this week.
39:05And then I got a call from Noel to say that he wasn't well enough to be collected.
39:10So it's just been a bit of a stressful week, really.
39:15When I've been ringing you on the telephone, you've been a little bit down about this.
39:18Don't feel down. It's all OK.
39:20The first thing I need to say to you, though, is if you didn't do this, Simba's going to be in pain forever.
39:25I mean, it's tough that he has to go through two total hip replacements at such a young age,
39:29but we get it right, we set him up for life.
39:31And I'm confident that the hip itself is fine.
39:34Everything should be fine, providing we get a little bit of luck and you do what I ask you to do.
39:39All right.
39:40OK?
39:41So I'm going to move your chairs back.
39:42I'm going to put this rubber mat on the floor.
39:43I'm going to bring him in and I'm going to show you how to do it.
39:46He'll be well boisterous when he sees you, so go down to his level.
39:49Come on, mate.
39:50Mom and Dad are here.
39:51Come on, look who's here.
39:53Hey!
39:55Now, this is the sciatic sling that keeps his toes up when he's walking along.
39:59When he's standing there, this toe will knuckle over.
40:01So you put this on when he goes out.
40:03That is what the problem's going to be.
40:05You look frightened.
40:06Mmm.
40:07I just can't see how that's going to get better.
40:09Oh, well, then you've just got to trust me, don't you?
40:11Yeah.
40:12Yeah.
40:13So the reality is you do any surgery, you can have challenges.
40:18You've just got to believe that I've been through this however many times and you've just got to have faith.
40:23Simple as.
40:25Let's walk him out into reception.
40:27So, as you can see, when he's walking along, it's fine, isn't it?
40:30It's just he needs the elastic to hold it up.
40:33So just have faith that that's going to recover.
40:35Yeah.
40:36All right, buddy.
40:37Come on.
40:38Where's your car?
40:39Quite shocked, really.
40:41A bit overwhelmed.
40:42Okay.
40:43When we get home, definitely spoil him and wrap him up in blankets and just kiss him.
40:48Come back in.
40:49Just let's get him in the car.
40:51Good.
40:57Hi, Poppy.
40:58How you doing, Bubba?
40:59You all right?
41:00Yeah.
41:01Oh, you're doing great.
41:02Standing up, walking around.
41:04Four days since Poppy had the operation to mend her broken leg.
41:08Got a Poppy on the side.
41:09Whoop, whoop, whoop, whoop, whoop.
41:10Good girl.
41:11Good girl.
41:12Good girl.
41:13There we go.
41:14We've had a bandage on since surgery that we've been changing every day.
41:16We want to see if there's any signs of infection.
41:19The culture result did not come back showing a major bug, which is good news.
41:25Good girl.
41:26Good girl, Pops.
41:27So just a little bit of fluid coming out there still.
41:30She's standing fantastically well on the leg.
41:32She doesn't know anything's wrong at all.
41:34So I would be inclined to leave this open now.
41:36Let some air at it.
41:38All the swelling's gone down.
41:40Plates are working really well.
41:41All right, let her up.
41:43And let's just see her walk up and down the corridor.
41:45That's it.
41:46Good girl.
41:47Well done.
41:48Good girl.
41:49Good girl.
41:50Well done.
41:53Tina and Megan haven't seen Poppy for 10 days.
41:57But Noel has been phoning with updates.
42:00We are so excited.
42:01I don't know how she'll be though, because hopefully she'll remember us.
42:07Poppy's doing great, you'll be pleased to hear.
42:10She thinks she's fixed.
42:12So she wants to run around the field.
42:15She must not have any strenuous activity.
42:17She can go for as long a lead walk as you like to get her tired.
42:21Mm-hmm.
42:22And then she must rest.
42:23Right.
42:24Let's push your chairs back and bring her in.
42:25Yeah.
42:26Yeah.
42:27Now, look at this.
42:29Oh, my baby.
42:30How are you doing?
42:31Oh, hi, everybody.
42:32Come on.
42:33Oh.
42:34There we go.
42:35Hi, everybody.
42:36Hi.
42:37Now, waggy tail.
42:38Waggy tail.
42:39She's walking as if there was nothing wrong.
42:40Okay.
42:41So let's go to reception.
42:42I'll show you how to walk her.
42:43Come on, Bubba.
42:44Good girl.
42:45Pop the sling under.
42:46There you go.
42:47So this is more an insurance policy.
42:50Off we go.
42:51She's walking normally, as you can see.
42:54Yeah.
42:55So as you can see, she actually wants to run.
42:57She does.
42:58Yeah.
42:59She loves running.
43:00She looks amazing.
43:01The tail's wagging.
43:02She's really happy.
43:04Didn't expect her to look so well.
43:06Go on, then.
43:07That's perfect.
43:08Yeah.
43:09There you go.
43:10We'll just take her home and give her lots of loving now.
43:12This is beautiful.
43:13I love this.
43:14Snowdrops and daffodils are my favourite.
43:15Oh, yeah.
43:16Thank you so much.
43:18Bye.
43:20Bye.
43:21Come on.
43:22Come on.
43:23Good girl.
43:26In Hertfordshire, it's been six months since Tuli had her spinal operation.
43:31Come on, Tuli.
43:32Come down here.
43:33Good girl.
43:34Basset hounds rarely do anything in a rush.
43:37Tuli.
43:38But nine-year-old Tuli is getting stronger every day.
43:42Come on, Tuli.
43:44She just seems so much happier.
43:49Her whole personality is kind of lifted.
43:51What are you doing?
43:52Are you a dog?
43:53She can run around again and she can use her tail and she's pain free.
43:57Come on.
43:58I just feel I've got my dog back, but there's just a bit more to it.
44:02So it's been remarkable.
44:03I don't believe she would be here today if we hadn't had surgery.
44:08So it's smashed my expectations.
44:11You're 40.
44:12Yeah.
44:13I just feel so much closer to her in a way that I'd never thought possible before.
44:17So she's just a big part of my heart and I just feel like I've got my dog back again.
44:25Come on.
44:26In Surrey, Tina, Megan and Snoopy have also got their friend back.
44:31Poppy, come on.
44:32It's been four months since she was hit by a car.
44:35Poppy's doing really, really well.
44:38At one point, we weren't even sure whether she was going to survive, whether she was going to lose a leg.
44:43Stop pulling.
44:44Good girl.
44:45Now she's just completely, like, fine.
44:47She's just as if nothing's ever happened to her.
44:50No, no, no, no.
44:51You can't.
44:52She's the baby rabbit.
44:53She's got all her confidence back again and she's raring to go.
44:56Look at you.
44:57Clever girl.
44:59It seems like she's got more energy.
45:01She just runs and runs and runs and I guess she's just enjoying the freedom.
45:05Whoopsie.
45:06Come on.
45:07Look at those legs.
45:09It's the best gift that we could have just to see her back to her old self.
45:13She's just been given another chance of life and she's enjoying it.
45:17Oh!
45:18She's in!
45:25The locals call it God's own country.
45:29In Yorkshire, Sophie and Costas have got their puppy back.
45:34Three.
45:37Zimba is erzing now.
45:39Just doesn't stop running around.
45:41We feel like Noel might have put a motor inside him.
45:44We're just exhausted all the time, but in a nice way.
45:47Now he's leaping like a salmon, which he never used to be able to do before.
45:51Jumping all the time in the air.
45:54It's just a miracle to see what he can do now.
45:56It highlights how bad he was before.
46:00When I see him running around now, you would just never believe that all his back end is bionic.
46:06It's just unreal how it's been so successful.
46:11He's one of us. He's part of the family.
46:12And now that he's fixed, it's 100% worth it.
46:15Just seeing him happy and being worry-free just means the world to me now.
46:21You may not.
46:22You may not.
46:23You may not.
46:24You may not.
46:25You may not.
46:26You may not.
46:28You may not.
46:31Hate the solitude VI
46:33Transcription by CastingWords
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