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00:00Yes, mate. Oh, that deserves a picture.
00:05He's known as the super vet.
00:07You all right, mister?
00:08That's good. Just going to make you stand again.
00:10Very gently hold that.
00:12His extraordinary vet practice and cutting-edge procedures...
00:15Hi, mate.
00:1625 years ago, I would have said it was impossible.
00:19...have saved the lives of thousands of the nation's pets.
00:23Oh, that's so good.
00:25Well done. Good girl. Good girl.
00:27Professor Noel Fitzpatrick and his team
00:29are constantly developing new treatments
00:32where other options have run out.
00:34All right, all hands on deck. Let's get into theatre now.
00:38Nothing about this fracture is textbook.
00:40This is totally unpredictable.
00:42And when hope fades...
00:45I'm not telling you that he has to be put to sleep,
00:48but I am telling you that we do have some big decisions.
00:51I'm sorry, I'm sorry.
00:53Noel continues...
00:54All right, let's go.
00:55...to search for medical solutions.
00:58I'm not God.
00:59I am just a blog trying to do his best.
01:01Come on in, baby.
01:02Offering a chance.
01:03I've got my dog back with bells and whistles on.
01:06Against all the odds.
01:07It's okay, Baba. It's okay.
01:09Right.
01:09I just think it's amazing. Amazing.
01:11That special time of year is approaching.
01:27Okay, right.
01:29We've got a problem.
01:31It won't stay up.
01:33You want any scissors?
01:33And for all the staff at Fitzpatrick Referrals,
01:37there's excitement in the air.
01:38Yay!
01:40I love Christmas.
01:42Always.
01:44Ah, you're so cute.
01:46Everyone's got a little bit of sparkle in their uniforms,
01:50a little bit of tits in their hair.
01:51Oh, Merry Christmas to you two.
01:53It's really happy and jolly,
01:55and everyone is just singing Christmas carols to the animals.
01:58We put sometimes little hats on, the ones that like it.
02:02Christmas hat.
02:04Do you want to play with a little ball?
02:05We give them presents.
02:06The cats look a bit suspicious,
02:08but the dogs, I think, appreciate it.
02:10Hi, baby.
02:19Good afternoon.
02:20Fitzpatrick Referrals, Orthopedics,
02:22and Rolody, Natalie speaking. Can I help?
02:23The Fitzpatrick team always try to get patients
02:26back with their families in time for the holidays.
02:30But for some complex cases,
02:32the journey to Christmas has been long and emotional.
02:38Little Gabana was first referred to Fitzpatrick's
02:41earlier in the year.
02:43Basically, my dog Gabana started showing signs of weakness
02:46in her back end,
02:47but then that progressed forward to her front legs as well,
02:50so it was the worry that she was going to go off the legs.
02:53It's really upsetting to see how quickly she's gone downhill, really.
02:56Rachel lives in the Midlands.
03:02She's an animal lover with a house full of pets.
03:08So, these are the budgies.
03:12That's Louis Vuitton, Mont-en-Blanc.
03:14That's McQueen and Versace.
03:17This is Fabergé.
03:20And then you've got Miyake, her little friend.
03:23Come on!
03:25All her birds and dogs are rescues,
03:28as are her friend Paula's.
03:30They're both mad about their animals.
03:32OK, so, this is Dolce, and this is the Gabana.
03:38These two, I believe, came out of the same litters,
03:41so they are sisters.
03:42Then we had Dior.
03:44Again, I'm her second home.
03:46Somebody had her as a puppy.
03:48And then we've got little Cavalli here,
03:50who looks like Butterworth Mountain's mouth.
03:53All my dogs are a rescue.
03:55Dottie, the big fat one.
03:57This is Dinky.
03:58Mine are all the Ds.
03:59This is Digby.
04:00And this is Dainty.
04:02The amount of people who say,
04:03are you a dog walker?
04:04No, they're all ours.
04:06We're just mad.
04:08They're my babies.
04:10Gabana is 11.
04:11She's the eldest child.
04:13Gabby's very affectionate.
04:15Loves spending time with me.
04:17Loves playing with the other dogs.
04:19But a few weeks ago,
04:21Rachel noticed Gabana was in trouble.
04:24It started off that I noticed
04:26she was a little bit wobbly on her back legs.
04:28Gabby, very carefully.
04:30And then I noticed one day
04:31when we'd been out on a walk
04:32and I put her in the bath
04:33and she started leaning
04:34at one of the other dogs.
04:36And I knew at that point
04:38something was wrong.
04:40Gabana has already been seen
04:41by one of the specialists at the practice
04:43who has asked Noel to take a look.
04:46Good girl.
04:47Good girl, Gabana.
04:49So we can see that she's
04:50having great difficulty getting around.
04:53She's very, very wobbly.
04:55And she's knuckling on all four legs.
04:57So normally she would pull it back.
05:00But because she can't sense where it is,
05:01she's not pulling it back.
05:03Sadly, that front foot as well
05:05is a bad situation.
05:09Gabana needs MRI and CT scans.
05:12Hello, I'm Noel.
05:18Hi, Noel.
05:18Hi, I'm Rachel.
05:19Nice to meet you.
05:20Hello.
05:20I'm assuming your sartorial elegance
05:22is reflective of the cabana.
05:24Do you have a dolce?
05:26That's very embarrassing, isn't it?
05:26Yeah, I do.
05:27Well, you actually do.
05:28Yeah, yeah.
05:29Fantastic.
05:30So how long has this problem been going on?
05:33I noticed it probably about six weeks ago
05:36and she'd had the odd bout of shivering.
05:40And do you think now that that might be pain?
05:41I think it was pain.
05:42Right.
05:42So has Corinna filled you in so far?
05:44Do you know what's wrong?
05:45I basically know about its three discs.
05:48Yeah.
05:48So all of the discs are dried out.
05:51There isn't a single normal disc in the spine.
05:54It's genetics.
05:56A normal disc is a jam donut
05:58with a white pulpy center
05:59and a ring of dough
06:01which is called the annulus fibrosis.
06:02Yeah.
06:03When it dries out,
06:05the jam leaks out
06:05which is what's happened here.
06:07And you can see that the disc has leaks
06:09and it's coming up
06:10and squishing the spinal cord.
06:12That will be causing pain
06:13and that is what is producing the wobbliness
06:16because the spinal cord signals
06:18are not getting from the brain
06:19down to the back legs properly
06:20or indeed the front legs.
06:22Clearly we need to do something with those discs.
06:25We would be very concerned
06:27that that cord could be pushed over the edge.
06:29I.e. paralysed.
06:30Paralysed, yeah.
06:31That's what we thought.
06:32That's what we wanted to get away quickly.
06:33Now what can we do?
06:35One thing we can do
06:36is go in underneath here
06:37you put a pin in here
06:38and a pin in here
06:39you pull them apart
06:40and you go down there
06:41and you pull everything out.
06:42Yeah.
06:42And then put something in between the vertebrae
06:45Spaces.
06:45Space, some kind of spacer
06:47and then bridge the vertebrae underneath
06:50using small pins and cement.
06:52Yeah.
06:53Gabbana has three consecutive collapsed discs.
06:57Bridging the vertebrae
06:58should take pressure off the spinal cord
07:00and keep her spine stable.
07:02It's a big procedure though.
07:03Mm-hmm.
07:04It's not without risk.
07:05I realise that.
07:07The only thing I would say...
07:08Yeah, I know what's coming.
07:09Yeah.
07:10If she shouldn't make it.
07:12Yeah.
07:12Well, I'm not saying that will happen
07:14at all.
07:15But if that were to happen
07:16you need to ask yourself
07:17whether you want to see her now.
07:19I would like to see her
07:20but I don't want to upset her.
07:21Entirely up to you.
07:22She'll think she's coming home
07:23and I don't want to
07:24put through leaving her again.
07:27Right, girls.
07:27OK, I'll do everything I possibly can.
07:29God bless.
07:30Bye.
07:31Bye.
07:33So, she will go through for surgery
07:36and I will have a sleep this night
07:39and wait for the phone call.
07:41No, I'm not going to be calm.
07:42At all.
07:44I'm just holding in my own.
07:46So, fingers crossed, will go well.
07:48For one of Noel's patients
07:55earlier this year
07:56Christmas at home with the family
07:58was a distant dream.
08:01Sorry, he's just trying to get him.
08:03Eight-month-old rescued German shepherd
08:05Bran was a very special case.
08:09When he arrived
08:10he could only walk
08:11with the aid of a sling.
08:12We're here today
08:16because Bran's having problems
08:17with his hick.
08:19He's only got three legs
08:20so the issue is
08:21on his remaining hind leg
08:23so it's causing a lot of trouble
08:25with walking.
08:26Casey and Joey
08:28live in Hertfordshire.
08:30Good boy.
08:31They got Bran as a companion
08:33for their other German shepherd.
08:37We adopted Bran
08:38from a rescue centre.
08:41We saw that he only had
08:42three legs
08:43like obviously
08:44from the photos
08:45but that didn't put us off.
08:47Bran's leg
08:47had been amputated
08:49after a fracture
08:50and didn't heal properly.
08:52We just had to help him
08:53didn't we?
08:54We fell in love
08:55with him instantly.
08:59Bran's very
09:00loud.
09:02He's a very barky
09:03young puppy.
09:05Likes to let everyone
09:06know that he's there.
09:08He tries to do everything
09:09like a normal puppy.
09:10He wants to play
09:10he wants to run around.
09:11Go on.
09:13But a few months
09:14after they got him
09:15a problem developed.
09:17You hurting?
09:18It was almost overnight
09:19he went from limping
09:21to having no movement
09:24whatsoever.
09:24Just dragging himself
09:25on his two front legs.
09:27And the painkillers
09:28weren't doing anything
09:29for him.
09:31It's got to the stage
09:31where Bran can't
09:33even walk anymore.
09:35We love him to bits
09:36and we won't give up
09:38on him.
09:41For Bran and his family
09:42Fitzpatrick referrals
09:44could be his last chance.
09:47Hi there.
09:47How are you doing?
09:48Hi.
09:49I'm sorry.
09:50Now you've taken on a friend.
09:52Yeah.
09:53So just start
09:53start at the beginning.
09:55He was doing
09:56absolutely fine
09:57and about two and a half
09:59months ago
10:00I just woke up
10:01one day
10:02and he just wasn't
10:03able to walk.
10:04He was running around
10:05fine before that?
10:07Oh absolutely fine.
10:08You would not have known
10:09he had to pull up three legs.
10:10He was running around
10:10with the other dogs.
10:12Do you have any
10:13recent x-ray pictures?
10:15No.
10:16I've had three vets
10:17tell me to put him down
10:18in the last few months.
10:20Sorry.
10:21It's been really
10:22really stressful.
10:23I've spent so much money.
10:25I just
10:26I don't want to lose him.
10:27Yeah no I understand that.
10:28Is that all
10:28coming out of your own pocket?
10:31I've had to borrow money
10:32off my mum
10:33and take it out
10:34of her life savings.
10:36What a terrible
10:36scenario for you to be in.
10:38I'm sorry about that.
10:39Alright let me have a look.
10:41Hiya big guy.
10:46Alright.
10:47Alright it's a painful
10:48hip for sure.
10:49Well done mate.
10:50Well done.
10:50Good boy.
10:51I'm very reluctant
10:52to spend your money
10:53that's the thing.
10:55If I'm not going
10:55to be able to help you
10:56but at the bare minimum
10:57I need some x-ray pictures.
10:59Yeah.
11:00That's fine.
11:01I just want to know
11:02what I'm working with.
11:04Take him through
11:05on these clothes guys
11:06and let's get some
11:08x-ray pictures
11:08of that pelvis.
11:10Then I'm going to
11:10give you my opinion.
11:11Okay.
11:12Right stay brave.
11:13I'll see you very shortly.
11:17Yeah.
11:19Bran is sedated
11:20for the x-ray pictures.
11:22It doesn't take long
11:24for the images
11:24to come through.
11:27Now Bran's family please.
11:30No then.
11:30Grab a seat.
11:31So anybody can see
11:34from that x-ray picture
11:35that the hip
11:36is dislocated.
11:37Right.
11:38So hip dysplasia
11:41is a genetically
11:42mediated condition
11:43whereby the muscles
11:44and the ligaments
11:45and the tendons
11:45don't hold
11:46the femoral head
11:47in properly.
11:49We can see
11:50that this head
11:50is rubbing on the rim
11:51so that will be
11:52causing pain.
11:53The socket
11:54will be full
11:55of fibrous tissue
11:56that is not
11:57empty.
11:59So therefore
11:59it's impossible
12:00to try and put
12:01that head back
12:02in there
12:02because this
12:04would be
12:04constantly painful
12:06bad cartilage
12:08rubbing on bad cartilage
12:09and eventually
12:10bone on bone.
12:11So the obvious
12:12question is
12:13what to do next.
12:14Most people
12:15with this dilemma
12:16they would say
12:16put the dog to sleep.
12:18Now
12:18total hip replacement
12:20is possible
12:21in this dog.
12:22Is it morally
12:22and ethically
12:23the right thing
12:24to do?
12:24That's not
12:25my decision
12:26that's not
12:26your decision
12:27that's a committee
12:29decision
12:30an ethics committee
12:32of veterinary
12:32professionals.
12:33So what the
12:35regulations are
12:35designed to do
12:36is protect the
12:37animal against
12:38over-treatment
12:39or treatment
12:40that's not in
12:40the animal's
12:41best interest.
12:43Because Bran
12:44only has one
12:45back leg
12:45a lot of weight
12:46will be put
12:47on a hip replacement.
12:49It could fail.
12:50So if they say
12:51no then
12:52there's nothing
12:53that can be done.
12:56I just feel
12:57like he deserves
12:58a chance
12:59because of
12:59everything that's
13:00happened to him
13:01and he's actually
13:01he's such a happy
13:03dog and he wants
13:04to play
13:04and he tries
13:05to play
13:06it's just
13:06Well unfortunately
13:08it's out of our
13:09hands.
13:10So right now
13:11there's nothing
13:11to be done
13:12I'll draw up
13:14an ethics
13:14approval form
13:15and we'll see
13:16what they say.
13:18Casey and Joey
13:19came looking
13:20for answers.
13:20Hi baby!
13:24But for now
13:25Bran's future
13:26is uncertain.
13:27Right good
13:28alright guys
13:29God bless
13:29take care.
13:30I'm trying to
13:31keep very positive
13:32and hopefully
13:33Noel will be able
13:34to help him
13:35and give him
13:36a better life
13:37and give him
13:38a new hip
13:39as well.
13:40I don't know
13:41what's going
13:41to happen.
13:42So you're
13:52looking forward
13:53to Christmas
13:53Sam?
13:54I am.
13:55You've never
13:55done a Christmas
13:56I've not
13:57had a Fitz
13:58Christmas
13:58no.
13:58Okay well
13:59the most
14:00important thing
14:00of course
14:01is that all
14:01the families
14:02get a phone
14:02call on
14:02Christmas Eve
14:03because they'll
14:04be worried
14:04because dogs
14:06and cats
14:06are integral
14:06family members
14:07it's really
14:08important
14:08that we
14:09don't forget
14:09that.
14:10Right
14:10where's the
14:11decorations
14:12Professor
14:12Sam of
14:13Christmas?
14:14Oh look
14:15we've got
14:15what's that
14:15a star
14:16Christmas tree
14:18you know what
14:18Sam you have
14:20potential my
14:20friend
14:21you have
14:21potential
14:22well done
14:23Fred
14:24let's get
14:24you home
14:24for Christmas
14:25so body
14:29up on a
14:30trough
14:30the neck
14:31should be
14:31about that
14:32Noel is
14:34hoping that
14:35little
14:35Gabana
14:35will be
14:36fixed for
14:36the holidays
14:37too
14:37good girl
14:39but today
14:40she's having
14:41the complex
14:41spinal surgery
14:42to fix her
14:43collapsed
14:44and damaged
14:45discs
14:45it's always
14:46challenging
14:47when you're
14:47going into
14:48neck surgery
14:48because
14:49the spinal
14:51cord in the
14:51neck
14:52effectively
14:52controls
14:53the entire
14:53body
14:53from there
14:54down
14:54and bad
14:55things can
14:56happen
14:56but
14:57you just
14:57hope that
14:58they're not
14:58going to
14:59happen
14:59today
14:59alright
15:02let's do
15:02it
15:03so we're
15:05cutting down
15:05underneath the
15:06neck
15:06now
15:06there's
15:07various nerves
15:08and blood
15:08vessels
15:09we must
15:10not cut
15:11right
15:12we can see
15:12here the
15:13three discs
15:13we're chasing
15:14this one's
15:15collapsed
15:16this one is
15:17bulging a little
15:18and this one's
15:19bulging a lot
15:19Noel carefully
15:25drills into
15:25the damaged
15:26discs
15:26we can see
15:30here where
15:30I've dug
15:31holes in
15:31the three discs
15:32here
15:33here
15:34and here
15:34just underneath
15:36just underneath
15:36my instrument
15:37is the
15:38spinal cord
15:39we can get
15:40as much as
15:41we can out
15:41horrible gritty
15:44cottage cheese
15:44Noel drives
15:47spacers between
15:48the vertebrae
15:49to push them
15:50apart
15:50and take
15:51pressure off
15:52the spinal cord
15:53and nerves
15:53okay
15:55okay so that's
15:56the three spacers
15:57in
15:57now the more
15:58difficult bit
15:59it requires
16:00judgment
16:01on how far
16:03to put the pins
16:03in
16:03if you put them
16:04in too far
16:04you'll hit
16:05the spinal cord
16:05the pins
16:08will hold
16:08the vertebrae
16:09together
16:09whilst they fuse
16:10they must
16:12be placed
16:12in a corridor
16:13of bone
16:13only 1.8
16:15millimetres
16:15wide
16:16so Noel's
16:17printed a 3D
16:18model of
16:19Gabbana's spine
16:20to help
16:20guide his
16:21pins
16:22every single
16:26pin requires
16:27utmost concentration
16:28because every
16:30single pin
16:30could cause
16:31death
16:31Noel adds
16:37bone graft
16:38and uses
16:38biological
16:39cement
16:40to hold
16:40the pins
16:41in position
16:41until the
16:42vertebrae
16:43fuse
16:43then we just
16:45close the
16:45muscle
16:46over the
16:46cement
16:47we stitch
16:48up
16:49we're done
16:49of course
16:52you can never
16:52tell until
16:53the postoperative
16:54CT scan
16:55where exactly
16:56the metalwork
16:56is
16:57but hopefully
16:58the 3D
16:59model
16:59intraoperative
17:00measurement
17:00and some
17:01good judgment
17:02will stand us
17:03in good stead
17:03and we'll be
17:04okay
17:04good
17:05thank you
17:07the first stage
17:11of Gabbana's
17:11journey is over
17:12that's it
17:14good girl
17:16now it's back
17:18to the wards
17:19to begin her
17:19recovery
17:20your little hairy
17:22face
17:23the practice
17:32is open
17:32throughout the
17:33Christmas period
17:34as emergency
17:36referrals come in
17:37at any time
17:38it's late evening
17:45and Tony and his
17:46son have brought
17:47in their 3-month-old
17:48French bulldog puppy
17:50Lexi
17:51basically I finished
17:57work just fed
17:57the puppy
17:58she went out
17:59in the back garden
18:00and then all of a sudden
18:00I heard her yelp
18:01and noticed that
18:03next door's dog
18:04had jumped through
18:05the fence
18:05and had her
18:07in his mouth
18:08and so the first
18:09thing I do
18:10is grab her
18:10and run to my
18:11local vet's
18:12with her
18:12it turns out
18:13that she's got
18:13fractured legs
18:14Mr. Baker
18:16hello I'm Noel
18:17how are you doing
18:17oh look
18:18oh my goodness
18:20hello sweetie pie
18:21how old is she
18:22she's 14 weeks
18:23hi Booper
18:24oh she's gorgeous
18:26come on in
18:26grab a seat
18:27you guys tell me
18:28that another dog
18:29attacked her
18:30oh oh
18:31and just caught
18:33her by the leg
18:34well as I went out
18:35he had to
18:36by the shoulder
18:36but her leg
18:37was like
18:37flat in the mouth
18:38oh poor little thing
18:40so I think
18:42that what we've
18:43got here
18:43is fracture
18:45through there
18:46so because
18:47she's a baby
18:48she's growing
18:49and she grows
18:50from here up
18:51and from here down
18:53that's how her
18:54legs grow
18:54so the thing
18:56about it is
18:57we can't tell
18:57from this x-ray
18:58picture
18:58how badly
18:59it's affecting
19:00the growth plates
19:01meaning that
19:02it could disrupt
19:03her growth
19:04and the leg
19:05might grow wonky
19:06now that's
19:07the big worry
19:08and I truly
19:09don't know that yet
19:10I'm going to need
19:11a three-dimensional
19:11x-ray
19:12which is called
19:12a CT scan
19:13and the back
19:14legs are fine
19:15yeah
19:15she had some
19:19tenderness
19:20in her neck
19:20so she was
19:21a bit worried
19:22about
19:22standing in front
19:24of her there
19:25and just talk
19:25to her
19:26and that's
19:28what she's been
19:29doing with her neck
19:30oh my goodness
19:31that is not good
19:32she can't really
19:34stand up
19:35can she
19:35she's just
19:37falling over
19:38oh missus
19:40oh missus
19:43the fact of the matter
19:44is though
19:45that sometimes
19:46when a dog
19:47bites another dog
19:48and shakes him
19:48it can jar
19:50the neck
19:51but not cause
19:52a fracture
19:53what I suggest
19:54we do tonight
19:55is give her methadone
19:57to get the pain
19:58under control
19:59and see
20:00what her nerve
20:00status is
20:01in the morning
20:02okay
20:03we'll take care
20:04of her
20:05and I'll do
20:05my very best
20:06okay thank you
20:07very much
20:07look after yourself
20:08I'll do everything
20:09I can
20:09do you want to
20:10give her a little
20:10kiss
20:10baby see you soon
20:11oh baby see you soon
20:13okay thank you very much
20:15all right my sis
20:18oh yeah
20:19oh it's okay
20:19it's okay
20:20good girl
20:22it's made me think
20:23about long term
20:24with her
20:24if she has got
20:26a broken neck
20:27good girl
20:27good girl
20:28will she come back
20:30out of the hospital
20:30all right big girl
20:31here we go
20:32I'm going to pop this
20:33on to give you
20:33a little support
20:34yeah
20:35good girl
20:36this means a lot
20:37to me
20:37I lost my wife
20:39five years ago
20:40and then recently
20:42we lost a dog
20:43so
20:43death seems to occur
20:46in the family
20:47and it's just like
20:47I can't do it anymore
20:48it's early morning
20:59good girl
21:00come on bubba
21:01and Noel
21:02is encouraging
21:03Gabana
21:03to take a few
21:04first steps
21:05after her spinal
21:06operation
21:07come on sweetie
21:08oh
21:09still very
21:10sleepy aren't you
21:11Gabana's actually
21:13doing quite well
21:14she is able to stand
21:15which is fantastic
21:16she's still very sore
21:18so it's going to
21:19take a little while
21:20for that to resolve
21:21but encouraging
21:24thought it was
21:25coming back
21:25that's great
21:26that's even better
21:28than it was
21:28preoperatively
21:29so I didn't expect
21:30her to be this good
21:31this quickly
21:32all right baby
21:33you'll get that
21:35good girl
21:40a few days later
21:41Gabana is well
21:42enough to go home
21:44you've got what
21:46I haven't got any
21:46black under my eyes
21:47have I
21:48Rachel look fat
21:49darling
21:49Rachel her friend
21:51Paula and Dior
21:53have come to
21:53collect her
21:54now girls
21:57come on in
21:58another friend
21:59another friend
22:00this isn't Dolce is it
22:01no
22:02it's Dior
22:03hello Dior
22:04how are you
22:05right girls
22:06grab a seat
22:06okay
22:07okay so far
22:08so good
22:09her pain has now
22:10gone right down
22:12she's very comfortable
22:14now then
22:15this is what we have
22:16ended up with now
22:18oh my god
22:20so those are the pins
22:22that go into the vertebrae
22:23and you'll see
22:25from this image here
22:26the angle is pretty tight
22:28god that's close
22:29the bones need to fuse
22:33if the bones didn't fuse
22:35eventually this cement
22:36would break
22:36so the most important
22:38take home point
22:39is no sudden jarring
22:40in the first six to eight weeks
22:42yeah
22:42now
22:43who's here
22:44now
22:46hello
22:48hi
22:48oh
22:49oh
22:51baby girl
22:53oh
22:53bless her
22:54she's so full
22:55right girls
22:56okay
22:57thank you very much
22:58that's it for me today
22:58good
22:59really appreciate it
23:00no worries
23:00no worries
23:01look after yourself
23:01group hug
23:02take care
23:03okay take care guys
23:04oh bless her
23:06this would have been really tough for her
23:09the whole thing's an emotional rollercoaster isn't it
23:11it's just
23:12you know
23:13you come in
23:14you're panicking
23:15because you're worried
23:16you don't know what the outcome's going to be
23:17and then obviously
23:18you're relieved
23:19because they've got through the surgery
23:21but then you worry about
23:22what happens after that
23:24I wanted her to have the best chance
23:27you know
23:27I wanted her to get through the surgery
23:29she's done that
23:30someone get upset
23:31I know
23:32now it's your part to follow it through
23:33really
23:34that's it
23:34we're going to get you home
23:36give you some treats
23:37give you lots of love
23:38you might want to tinkle
23:39yeah she probably will
23:41yeah
23:41let's go to the pool
23:43let's go to the pool
23:44oh yeah
23:48oh yeah
23:48please go to the pool
23:48Lexi, the French bulldog puppy, who was attacked by another dog,
23:57has spent the night in the wards.
24:00One, two, three.
24:01This morning, she's had a scan on her fractured arm and her neck
24:05to see if it's damaged.
24:09Hello, Tony, it's Noel.
24:11Hiya.
24:12The good news is that the neck is not broken.
24:15OK, brilliant.
24:16However, as expected, she has broken her elbow.
24:21And it's quite a bad break.
24:23It's right through the joint.
24:25I am recommending surgical intervention to try and put it all back together again.
24:30And I'll ring you in a few hours, OK?
24:33Yes, please.
24:34Bye.
24:37I'm now going to try and fix the right elbow fracture.
24:42And it's going to be tricky because the bone is very soft
24:44and it's splintered somewhat.
24:47Plus, it's damaged the growth plates.
24:53Do our best.
24:57All right, let's do it.
24:59Decision.
25:02Noel starts by repositioning a large fragment of humerus bone that has fractured off.
25:07So we can see the fracture fragment there.
25:11So I've got to get the screw dead centre.
25:18Push it gently against my finger.
25:19Push it down.
25:21Don't move.
25:21The screw will hold the fragment back in position.
25:26Right.
25:28Noel will put two more screws in to stop the fragment from rotating.
25:32The problem is that the ulnar nerve is right here.
25:37If I damage that, the leg won't work.
25:39So I've got to be really careful.
25:40So that's about 1.5 millimetres in width, that nerve.
25:46Pull that up there like so.
25:47Very challenging fracture in a very soft bone.
25:56Very crumbly.
25:58We've avoided our friend there, which is the nerve.
26:00Time to stitch up.
26:06There you are, missus.
26:07Good girl.
26:08Hi, you can go straight to x-ray, please.
26:11Noel has fixed the fracture.
26:13But it will be several weeks before he knows if Lexi's leg growth will be affected in the long term.
26:26At Fitzpatrick referrals.
26:28Both staff and animals are getting in the mood.
26:36Oh, you're so cute.
26:38Oh, no, the ball is small.
26:40Merry Christmas.
26:54This will be Lexi the French Bulldog puppy's first Christmas.
26:59Hello, sweetie pie.
27:02And her family are hoping she will be fixed and running around by then.
27:07So as you can see, we're getting on quite well.
27:10Lexi's been here now for four nights.
27:15Her leg's doing great.
27:17We took the bandage off yesterday.
27:18She's very happy.
27:19She wants to run around.
27:20The concern I have is that metal implants will only hold so much and she could easily overdo it.
27:26And if she jumps, she could break the metal implants, which would be a disaster.
27:30Right.
27:31Come on, we're going home.
27:33Good girl.
27:33It will be a further six weeks before this bundle of energy can run free again.
27:38Now, Bran.
27:52It's been two months since Bran, the three-legged rescue dog, was last at the practice.
28:01Finally, the ethics committee have approved his hip replacement operation.
28:06I was so shocked when they phoned me up.
28:10I was just like, I had to make them repeat what they said because I couldn't, I was just like, what is actually happening?
28:16There we go.
28:17Bran will have his surgery today.
28:19So, if we look at what's going to happen when we put in a new hip, in a normal patient, the hip replacement will go in like so.
28:30Whereas in a three-legged dog, the dog only has that leg to stand on.
28:34So this leg migrates towards the median plane and therefore there's a greater tendency for dislocation.
28:41To try and prevent this happening, Noel has designed a custom-made titanium implant, the first of its kind in the world for a three-legged dog.
28:51It's so tiny.
28:52I don't know why I thought everything would be...
28:55You get one chance at this.
28:57Yes.
28:58Because the ethics approval board have said, and this is the key point, that if he dislocated, if things are going wrong at week six,
29:06then the ethics review board have pretty much insisted on euthanasia because of quality of life issues.
29:16So, yeah, I think it's best if you say bye-bye now.
29:19Yeah.
29:20OK?
29:21Oh, good boy.
29:23I love you so much.
29:25Come on, sweetheart.
29:26Come on, I hope you go, bud.
29:26Come on, then.
29:27Good boy.
29:27There we go.
29:28Thanks, Mike.
29:30Ultimately, you may lose him, but you have to do that in the knowledge that you've done your best.
29:35Yeah.
29:35If all goes according to plan, get him well for Christmas.
29:39It's a three-month recovery.
29:41He needs that chance.
29:45Oh, sweetie.
29:47It was really hard hearing that the first six weeks are so crucial, and that if his leg comes out of the socket again,
29:57then he hasn't got any other chance, really.
30:00I just really hope this goes well.
30:02I really don't want it to go wrong.
30:03There you go.
30:10Bran is taken through for surgery.
30:15So we get one chance at this, and that's it.
30:19All right, let's do it.
30:20Okay.
30:21You're just done.
30:21Right.
30:21No.
30:22Now we'll retract the muscles, cut the head off the femur, and drill out Bran's diseased hip socket.
30:35He's made a custom titanium shell with a plate, which will be screwed to the pelvis to provide a ledge under which he can cement a plastic cup.
30:44The femur canal will be drilled and broached for a titanium stem, which is secured with
30:52a special bolt.
30:54Finally, a head is put onto the stem, articulated into the new cup, and the muscles are stitched
31:01back in place.
31:04So we can see here where the head is all worn away.
31:11The cartilage has gone off the head, that's why it's so painful, because this is raw bone
31:18rubbing on raw bone.
31:22We're just chopping off the worn away femoral head now.
31:31The first challenge we meet here is a vastly ingrown socket, because the head's never been
31:38in there for a long time.
31:44Noel drills out the socket, and attaches the new implant.
31:52Right, so this is shaped like an ice cream scoop.
31:56The cup is specially shaped to reduce the risk of dislocation.
32:00So we can see now where we've bolted the plate to the side of the ileum, which is the pelvis,
32:08using five screws here.
32:10Okay, don't anybody move.
32:13So this is the plastic liner.
32:17It's extremely important how we position this cup, because ultimately everything hinges on
32:25the femoral head not dislocating from this cup.
32:27We've got a new rim here to hold the cup in.
32:34A lot of Bran's weight will be taken on his one back leg.
32:39So Noel reinforces the bone with loops of wire, and inserts a stem into the top of the femur.
32:47This trabecular titanium here will allow the bone to grow in over time.
33:00A ball-shaped head is put onto the stem, and now femur and pelvis can be put back together.
33:06Hold that mic, put it back slightly, stop, relax, lift the limbs slightly, slowly, slowly,
33:14So we always knew it would be difficult to reduce the hip because it's been dislocated for so long.
33:21Reduce means put it back in the socket.
33:24Mark and I are just trying to overcome the muscle here, which has become contracted.
33:29Be very careful.
33:31We don't want a fractured femur.
33:33Do not twist.
33:34Lift the leg slightly, Mark.
33:37Come on.
33:39Gently lift the leg, Mark.
33:43Relax.
33:46Okay, so we can see the head in the socket now.
33:50You can see as we move the head, it's staying inside the socket.
33:56So that's pretty solid.
33:58Time to stitch up.
34:00Noel has done everything he can for Bran.
34:03All right, that's your chance, mate.
34:05Make the most of it.
34:06Good.
34:07Good extra.
34:09In reception, there's a bit of a commotion.
34:16Lexi, the excitable French bulldog puppy, is back.
34:31Four weeks ago, she was attacked by another dog who broke her leg.
34:44As you can see, she's doing fine.
34:46She's walking well with it.
34:48She don't seem to be in any pain.
34:50She just wants a mix of other dogs at the moment, but I'm not letting her.
34:55So today's for her to have a scan to see if her growth plate's fine and that we can finally go out for walks.
35:05Lex.
35:08If the scans reveal problems in Lexi's growth plate...
35:11Your arm's in the way.
35:12..she may need further surgery.
35:19I wouldn't have it any other way.
35:20I would not like that I'd put her down.
35:22All my mates would say, no, man, you can't afford that.
35:24Yeah, but they don't understand.
35:25No, mate, she's my baby, man.
35:27She's my dog, man.
35:28She's my...
35:29She's my friend.
35:32Tony.
35:33Hello.
35:34Hello.
35:35Slightly sleepy, just waking up.
35:37Come on in.
35:38So if we look at this fracture, everything's healed.
35:43So the bottom line is that there should not now be any asynchronous growth between the two sides.
35:50In other words, they should grow the same.
35:53This growth plate will grow slightly faster to compensate for that one.
35:57OK, brilliant.
35:58In most cases.
35:59Well done.
36:00Thank you, sir.
36:01Thank you so much.
36:02Good to see you smile.
36:04No misses.
36:05No misses.
36:06Take care.
36:07Look after yourself, Bubba.
36:08Walks.
36:09When can I start back on?
36:10Walks.
36:11Two more weeks, build up on the lead and then off lead.
36:14Oh, yes.
36:15She's going to love that.
36:16Take care.
36:17Look after yourself.
36:18All right.
36:19Take care.
36:20Bye-bye.
36:26Ah, fantastic.
36:27Her growth plates are all growing correct and positioning's all fine.
36:33Do you know, the most thing I'm looking forward to is going for a long walk with her off the lead.
36:38There you go.
36:39There you go.
36:40How embarrassing that you have to hold your dog upside down so she can go to sleep.
36:45Come on.
36:46Good boy, Bran.
36:47That's it.
36:48Come on, big guy.
36:49Out in the yard, Bran, the German shepherd puppy, is making a valiant attempt to walk again with his new bionic hip.
37:07There we go.
37:08Good boy.
37:09That's it.
37:10We're three days post-op now and he's actually doing really well.
37:14And he doesn't seem to be in any significant discomfort, which is actually quite surprising because it's quite soon after surgery.
37:21And I expect him to have more muscle spasm here considering how difficult it was to pull the hip back down into position.
37:27And he's actually got a lot less vocal while he's been in here.
37:30Yes, you're a good boy, aren't you?
37:31Yes.
37:32Having a dog this good after three days makes it very difficult to argue that you shouldn't do these kinds of advanced surgeries or create an ethical framework where it's possible.
37:41All right, mate.
37:42Let's go home.
37:43Good boy.
37:44There we go.
37:45Come on, buddy.
37:46There we go.
37:48Casey and Joey have come to collect him.
37:54Now, Bran's family, please.
37:57There they are.
37:58Grab a seat.
37:59So, if we look at the situation before and after on the x-ray picture.
38:05So, this is before.
38:07Oh, my.
38:10That is such a big difference.
38:13And that's after.
38:14He must have been here so much away.
38:17There's no nerve problems.
38:18There's no bone problems.
38:19All of that is going great.
38:21But the big risk, of course, is dislocation.
38:24He's not allowed to slip or slide.
38:26When he's in the pen, he's in the pen all of the time.
38:30Except when he's with you, tight to your leg.
38:33All right.
38:34Move your chairs back.
38:35Do you want to bring him in?
38:36Come on.
38:37Hi, baby.
38:38Hi.
38:39Hello.
38:40Oh, baby dog.
38:41Come on, mate.
38:42Come.
38:43Good boy.
38:44Good boy.
38:45That's it.
38:46There you go.
38:47Good boy.
38:48That's it.
38:49So, you can see he's actually doing fine.
38:50He's just excited now.
38:51Right.
38:52Up we go.
38:53One, two, three.
38:54Up.
38:55There we go.
38:56Good boy.
38:57That's it.
38:58There you go.
38:59Good boy.
39:00That's it.
39:01So, you can see he's actually doing fine.
39:02He's just excited now.
39:03Right.
39:04Up we go.
39:05One, two, three.
39:06Up.
39:07There we go.
39:08Good boy.
39:09That's it.
39:10I'm just actually so...
39:11I'm just so shocked at how well he looks.
39:14I was expecting him to be not doing much, but...
39:17Well, he's better than he was before the surgery.
39:19Definitely.
39:20Yeah.
39:21So, how are you going to know if something goes wrong?
39:23If it dislocates, he won't want to put it down.
39:25Right.
39:26And you'll know.
39:27And we've agreed that, you know, at six weeks, if it doesn't work out,
39:31then morally, from his welfare perspective, that that might be the outcome.
39:37But at the moment, there's no evidence that he's having any problems whatsoever.
39:43Thank you, sir.
39:44You're welcome.
39:46All right, mate.
39:47Look after yourself.
39:48What a great hug.
39:49I'm a big man.
39:50I like that.
39:51I like that.
39:52Good.
39:53Let the emotion out.
39:54Good.
39:55I'm really happy to have Bran back.
39:56He seems a lot more himself, more so than he has ever been, really.
40:01So, it is a lot of pressure knowing that if anything goes wrong, that there is nothing
40:08that he can do.
40:09There's no more chance for him.
40:11It's going to be a lot of work, but I think, in the end, it's going to be worth it.
40:16Bran still faces uncertainty.
40:18If his new hip fails, he may yet lose his life.
40:23In the Midlands, life for Gabbana and the rest of the Couture crew is getting back to normal.
40:41Good girl.
40:42Come on, then.
40:43Going for a walk.
40:44Gabbana has recovered well from her spinal surgery and is enjoying her pampered life once
40:51again.
40:52It's just fabulous, just the fact that, you know, I've still got her.
40:56She's coped so well.
40:57Good girl.
40:58Good girl.
40:59She's just been an absolute little trooper.
41:01Good girl.
41:02Yeah, I'm really, really pleased.
41:04It's just nice to see her with the others mooching around and enjoying life.
41:07Good girl, baby.
41:10With Christmas around the corner, there's celebrations and doggy outfits to enjoy.
41:16Good girl.
41:18Always chaos at Christmas with our dogs.
41:21Oh, look at him.
41:23Bright.
41:24What have we got?
41:26Oh, straighties.
41:28Yeah, I mean, I'm still emotional now and I think the burst into tears throughout this
41:32journey has been my thing.
41:34Oh, she's loving it, yeah.
41:36And you just want it to work and you want everything to go really well.
41:39And I just couldn't bear the thought of losing it, to be honest with you.
41:43Yeah, fabulous.
41:44It's just been fab that they're all together and enjoying themselves.
41:47None of the dogs will miss out this Christmas.
41:50But Gabana will get special attention.
41:53Yeah, I couldn't do a wish for anything better this Christmas.
42:03Come.
42:04Good girl.
42:05In Woking, after weeks cooped up inside, little Lexi is finally off the lead.
42:11Come.
42:12Lexi is doing very well at the moment.
42:14Yeah.
42:15No issues with her leg at all.
42:17She's made 110% recovery.
42:19For me watching her run, you're always apprehensive.
42:24But over time that leaves you because you realise what an expert job's been done with her
42:28and she can run as fast as she can.
42:30This way.
42:32I think her being in the cage for six weeks was one of my fears were that she would find it hard to socialise again.
42:41Lex, come.
42:43But she's not really scared of any other dog at the moment.
42:46She's just a really friendly dog.
42:48Lexi.
42:49Back home...
42:50...picks, come.
42:51...pickles the cat is less pleased.
42:52Lexi is running around again.
42:54Pickles the cat is less pleased.
42:56Lexi is running around again.
42:59Ah!
43:00Stop fighting.
43:01Nicely.
43:02Nicely.
43:03You don't have your own space for Lexi.
43:05Wherever you are, she's there with me.
43:07Nicely.
43:08Nicely.
43:09Nicely.
43:10She loves all the attention.
43:12I think Lexi is more than just a best friend to me.
43:15She's a companion.
43:17She's a purpose to get up in the morning.
43:19A kiss.
43:20A big kiss.
43:21A nice kiss.
43:22A nice kiss.
43:23Not only is she someone to share Christmas with, but to share all the journeys and trials
43:28and tribulations that lay ahead of me.
43:34Good boy.
43:36Six months ago, Bran, the three-legged German shepherd, came to Fitzpatrick's,
43:41hoping for a miracle.
43:44Come on, Bran!
43:45Come on!
43:46Look at you!
43:48When we first met Noel, we didn't think there was a chance.
43:51We definitely didn't expect to have him at Christmas, did we?
43:56Now, after his groundbreaking hip replacement operation, he's been given the chance of a new life.
44:03He's amazing, isn't he?
44:05Yay!
44:06Good boy!
44:07Look at him now.
44:08Just typical naughty puppy, running around, active.
44:13Give away!
44:18Come on, Bran!
44:19Come on!
44:20How can you give up on a dog like Bran?
44:24He doesn't want to give up.
44:26He's just constantly happy, aren't you?
44:28And he just, he's so inspirational.
44:31Come on.
44:32After his tough start in life, he's free to enjoy Christmas in his new, forever home.
44:38He's a lot happier now.
44:39He can actually keep up with his big brother a little bit more.
44:41They can play a little bit more together.
44:42Merry Christmas, Bran!
44:43What's that?
44:44The best Christmas present we could ask for is that, you know, Bran's at home for Christmas,
44:58and we've got that.
44:59So, we've got everything we wanted.
45:05Good boy.
45:07Good boy.
45:12For Noel and his team, it's the end of another challenging, but rewarding year.
45:17So, this is magnificent, ladies.
45:19Thank you very, very much.
45:21Which present is for me?
45:23Is this big one for you, Claire?
45:25Because I keep you late in theatre every night.
45:28I like that.
45:29I like that very much.
45:30Let's have a picture.
45:31Come on in, everybody.
45:32Philippa, can you stand?
45:33Put yourself on still.
45:34There you go.
45:36Perfect.
45:38Merry Christmas!
45:40Thank you very much, everybody.
45:45Close the door.
45:47I'm getting sweaty.
45:48I'm getting sweaty.
45:49I'm getting sweaty.
45:50I'm getting sweaty.
45:51I'm getting sweaty.
46:00Wow.
46:02See you next time.
46:06Bye.
46:08Bye.
46:09Bye.
46:10Bye.
46:12Bye.
46:14Bye.
46:15Bye.
46:17Bye.
46:21Bye.
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