- 1 week ago
Category
📺
TVTranscript
00:00Hello mate, do you understand Irish?
00:07Animals from all over the world
00:11Come to see one extraordinary man
00:14who's known as the Bionic Vet
00:17Yes!
00:18Professor Noel Fitzpatrick
00:21We 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
01:13Fitzpatrick Referrals sees animals of all ages
01:18From the very young
01:20It's like dropping off your kid to the nursery or something
01:23You know, it's the exact same feeling
01:25Though they're always quite worried
01:26To those with a few more grey hairs
01:30When you do have older animals
01:34You do see a personality come across, let's say
01:38They tend to not want to walk where you want them to walk
01:41And they make a lot of smells
01:44They don't smell the freshest when they get older, unfortunately bless them
01:47But then we treat them differently because they are the older patients
01:53I think old dogs mean a lot to their families
01:55Because obviously they've grown up together
01:57They've shared a large portion of their life together
01:59So the older the patient, the more passionate and caring their families are towards that animal
02:03Whatever their age, all Fitzpatrick patients come here in search of the cutting edge treatments on offer
02:13Waiting in reception is one dog whose problems started as a puppy
02:17I know, good lad, good boy
02:20I know, I know, I know, not much longer
02:23Four-year-old Springer Spaniel Luca is Barbara's devoted companion
02:29When he was a year old, we started noticing he had a limp
02:34He came along here and he had his front elbow scoped
02:37Luca had keyhole surgery to treat developmental elbow disease of his front left leg
02:43He's been fine now for basically three years
02:47But that limp's returned
02:49I'm hoping that there can be some sort of surgical intervention
02:53Because he's only four and he is so active
02:56He likes to be out
03:01Barbara and her family live on a small holding in the Kent countryside
03:04With just a few other animals
03:06We've got three dogs, two horses
03:11Seven sheep, about twelve chickens
03:15A couple of ducks and some quails
03:17I think we've always liked the outdoors life
03:20We've always had dogs
03:21This is an absolutely amazing spot to have dogs
03:23And to be able to enjoy the countryside
03:25Luca is my constant companion when I'm outside
03:29When I'm out working in the garden
03:31Or doing things with the animals
03:32He is always there
03:33I think if you ask the rest of the family
03:36They would say he's a mummy's boy
03:38He's very loyal
03:40He loves long walks
03:41And he absolutely adores swimming
03:43When I'm out and about now
03:46He does have to be restricted
03:48Because the limp is progressively getting worse
03:51Controlling him is a challenge
03:53Because he doesn't see that there's a problem
03:56But clearly there is
03:57Stay
03:58So suddenly a lot of his things that he likes to do
04:01And he assumes he's going to be able to do
04:04Have stopped
04:08All right big fella, off you go
04:10Good boy
04:11Back at the practice
04:12Noel needs to identify what's causing Luca's limp this time
04:16He's a bit lame but not too bad today
04:19Okay
04:20But Luca isn't giving much away
04:22Okay big guy, up we get
04:24He's difficult to examine
04:26He goes quite rigid doesn't he?
04:28He hides the lameness pretty well
04:31Noel is on the lookout for problems common to Luca's breed
04:35That may be caused by the poor fit of bones making up the elbow joint
04:40Okay
04:41So the two scenarios that are most likely are
04:44There's a crack going down there
04:45Yeah
04:46Because probably there's a poor fit
04:49Okay
04:50And that's progressive
04:51Okay
04:52Or there's progressive erosion in here
04:54Okay
04:55Because it doesn't fit
04:56Right
04:57Yes
04:58Oh
04:59And it's very common
05:00Come on can we again CT?
05:02Can we go now?
05:04Do you want to go to CT?
05:05Go to CT then
05:06Go on
05:07Off you go
05:08Are you an unloyal dog?
05:09Maybe I didn't sell it well enough
05:11CT is an amazing big donut
05:13That you go inside
05:14I'm normally with him when they do pre-meds and stuff
05:16But I'm sure she
05:17He'll be fine walking through this door
05:18He'd rather go that way
05:19Just walk ahead and keep going
05:21Like follow?
05:22No you're good
05:23She's got it
05:24Yeah
05:25She's got it
05:26Mummy I would imagine
05:28Panics a little more than is necessary
05:30But that's okay
05:31CT scans will help Noel identify which conditions Luca may be suffering from
05:38Now Lucas mommy please
05:47Lucas mom
05:48Right
05:49Okay
05:50You have both problems
05:52Oh
05:53Right
05:54Both elbows
05:55Both elbows
05:56Yep
05:57How's he managing that?
05:59Because that's the way spaniels are
06:01They want to eat they want to run
06:03Yeah
06:04First Noel focuses on the most critical problem
06:07He's discovered splits forming within the bottom part of the humerus in both elbows
06:12So you can barely see it on the x-ray
06:15But on the CT scan it's hoochingly obvious
06:19See that?
06:20So there's a giant crevasse
06:22Crack
06:23Oh crikey
06:24And very importantly there's increased whiteness on either side
06:29And the reason for that is it's not healing
06:32No
06:33It does not
06:34Would it ever heal though?
06:35No it never heals
06:37To prevent this crack becoming an outright fracture
06:41Luca has the option of a standard screw to place across the bottom part of the humerus
06:46But to avoid the risk of the screw breaking Noel has designed a larger screw with a system for injecting a special bone growth gel around the metal
06:56To tackle the other issue of erosion on the inside of the elbow Noel may well need to cut the ulna and reset the angle to relieve pressure inside the joint
07:06Noel will aim to carry out these procedures in both of Luca's front legs
07:12And I wouldn't choose to do this but if you did nothing
07:16It is an option to do nothing but the chance of fracture are high given that the one that's splitting hard is really now opening up and the other one's getting worse
07:27Hello
07:28Alright mate
07:29Thank you Hannah
07:30You're welcome
07:31I would discourage you from letting him run after stuff because he could fracture
07:44Okay
07:45He's on a knife edge and if the knife cuts through you got a big fracture
07:49Barbara must make a decision and soon
07:53I'm just a little bit sort of flabbergasted with it all at the moment
07:57I think a very large glass of wine is in order and he can have some food
08:02He's going to be wanting to run around and that's going to be difficult living with that in the next few days weeks or whatever it is
08:10Knowing that something could happen to him
08:12I'm so broody for a new pup but it really hurts my ovaries
08:29At Fitzpatrick Referrals Oncology and Soft Tissue Hospital in Guildford, Charlotte and Danny have come with their seven month old puppy Beau
08:41To make a tricky decision
08:47Beau has a problem that has affected all their lives
08:51Oh she's dripping really bad today
08:54When we first got Beau she was eight weeks old nearly nine and we thought she was a puppy dribbler as puppies do dribble urine
09:04Then when she got to about five months old I thought this should have stopped by now
09:09When we first got her we were hoping she'd have been going to work with Danny
09:15But unfortunately because she leaks urine everywhere she can't
09:19So that means all my breaks from work I'm shooting home, spending all the time we can with her
09:25Lots of cleaning
09:26There's just so much cleaning to be done
09:28At home in South East London Charlotte's work is unending
09:40Cleaning routine is pretty relentless
09:43It starts as soon as I get downstairs
09:46I have to clean all of the previous night's bedding
09:50Clean her bed down, clean the kitchen floor, clean the dog
09:54By the time I've actually managed to get all the washing in the washing machine
10:00And the floor clean she's actually dripped somewhere else
10:05So I always seem to be two steps behind her with the cleaning materials
10:09And it's just a constant cycle of one lot of washing goes in as one lot of washing is coming out
10:17You think you're safe, the carpet's clear, it's fine to walk across it
10:21And as you're getting there, you're standing something and you're like, ah, it's a wet sock
10:27As much as she makes us laugh, this has all been quite difficult for us as a family
10:34The thought of her staying as she is is quite frightening
10:39Because she's going to get bigger, the puddles are going to get bigger
10:43This could be the rest of our lives with her
10:46So it's brought a lot of tears and a lot of difficult decisions
10:55The family are pinning their hopes
10:58On senior clinician Gerard McLaughlin
11:01Hey, is that Bo? It is, yes
11:03Who specialises in minimally invasive surgery
11:06Perfect, so we're just going to have a look at her as well
11:08I'm just going to put on some gloves because she's a little bit pea-stained
11:12Yeah, she's left you a puddle in the waiting room as well
11:13A little present
11:15And she gets excited, does she pee more?
11:17Yeah, and she pees more when she eats
11:19Because it's like, oh, it's a poo
11:22Infection is the biggest risk to Bo's health
11:26Yeah, it's all stained and it's quite red and angry looking everything back here
11:30It's just, it's absolutely soaking wet
11:32And you can see why she's going to get infections here
11:34Because it's just such a nasty environment for that to sit there, isn't it?
11:37CT scans and ultrasound from Bo's local vet suggest she has an ectopic ureta
11:42So if we think about a normal urine retract of a dog in two kidneys
11:47And from the bladder is the urethra, and that's where the urine comes to the outside
11:51There's two tubes, a tube that comes from the kidney to the bladder called the ureter
11:55And in a normal dog it enters well within the bladder like this
11:58And so the urine is formed in the kidney, comes down here and into the bladder, and then she pees it out
12:04And actually one of her sides is like that
12:05Yes
12:06So she's got one side that's doing its normal job, which is great
12:09The other side, the tube comes down here, and it still enters in the normal location, but instead of opening there, it continues on and opens down here
12:16And so the urine is filling straight into the urethra, and there's no continence there
12:20So traditionally, people would have done a surgical procedure, so it's quite a big thing to put her through
12:23It would involve opening her entire abdomen, and there's no continence there
12:28So traditionally, people would have done a surgical procedure, so it's quite a big thing to put her through
12:31It would involve opening her entire abdomen, and tying off this abnormal ureter, reattaching it to the bladder, and there's risks associated with that
12:44So what we're able to offer here is a minimally invasive treatment where we use a laser to correct it
12:49And we're going to just take away this top part of tissue, and we're going to open that so it's back within the bladder
12:55But every operation carries risk, and there's no guarantee it will be a complete success
13:01With this procedure, we'd expect a 50-60% continence
13:06But with this condition, it's not unusual, they have concurrent problems of their urinary tract
13:11So for instance, they can have weak sphincters around the opening of the urethra
13:16The urethra can be much shorter than normal, so those are the dogs, they're the 40% that won't become continence
13:22But I think it's a risk you have to take, because she can't go on like this getting infections and dribbling urine, it's not fair in her
13:28You'll be good, Mummy loves you, love you babes, you're going to be fine
13:36Although, like any procedure, the results can't be guaranteed
13:41This is Beau, he's super cute
13:44It's a gamble Charlotte and Danny are prepared to take
13:46He's got the waggy tail!
13:50We've got about a 50% chance of success, which is what we were hoping for
13:55So, we're just hoping and praying that everything's going to go as planned, all going to be good, I've got faith
14:01You get a puppy because you want to play with it and socialise it and it sits in the couch and give you cuddles and stuff
14:11They've not been able to do that
14:13Would I have a dog in my house that was dripping urine all over the furniture?
14:17No, and I think it's a lot to ask someone to live with and they've done it for seven months
14:21I'm nervous, stomach's turning a little bit
14:24I'll be happy when we've got a phone call saying, right, she's out
14:40At Fitzpatrick Referrals Sister Hospital in Guildford
14:44Seven-month-old puppy Beau is about to have laser surgery to treat her incontinence
14:49The procedure will be performed by specialist Gerard McLaughlin
14:55So what we're going to do is use the camera to go in and visualise the area
15:00And from that we're going to pass a wire and a catheter up the abnormal opening
15:04And then we're going to use a laser to take that ureter and cut it back into the bladder
15:13So there's the ectopic ureter there, so see that hole on the bottom there?
15:16That's abnormal
15:19So that's what we need to laser back there
15:22Great, yep
15:24Gerard uses a catheter to protect one side of the ureter
15:29He follows it with a laser to burn away the unwanted side
15:38So we're just slowly cutting away this tissue here
15:41The on-screen image is highly magnified
15:43Gerard has to work carefully within a tiny area
15:49Particularly because she's got lots of infections just now
15:52If we burst the bladder with the laser
15:54Then suddenly she gets all these bacteria through her abdomen
15:56And that becomes a life-threatening emergency
15:58So we have to be really careful
15:59I think it looks like we're pretty much done and we're in back into the bladder
16:07So that's her, so she will go home tonight
16:10There's a 50 to 60% chance she'll be completely content now
16:14Super, are you waking up?
16:15What happened?
16:17It's a little bit funny
16:18Just two hours later, Beau is out of the recovery suite
16:23And Charlotte and Danny are back, right on schedule
16:26It's now
16:28Four o'clock on the dot
16:30As we were asked
16:32We weren't going to be late, so we've been here a little while waiting
16:35Go on
16:37Even so, they've got to wait a little longer
16:40While Gerard tests the water
16:42I'm apprehensive because I'm afraid
16:45With our look, it's just not going to be as plain sailing as we'd like
16:50This is her just recovered, we're only like a couple of hours after the procedure
16:55And she looks dry
16:57I can't see any dripping at all
16:59Fingers crossed
17:01We've had all the stress, all the upset
17:03And now we're going to have the good times and be able to enjoy her for the next 13 years
17:08I'm really keen to see what she looks like with her mum when you come to collect her
17:11Because when she gets excited and things, that'll be really interesting to see how she does
17:15But yeah, I'm really pleased with how she's doing so far
17:19Oh, come on
17:20Come on
17:23Hello, who's this?
17:25My baby!
17:27Are you sleepy little chicken?
17:30You look so sleepy still
17:33When she first came in here, she was dripping all the time walking around here
17:36Yeah, we're really well inside
17:38I can't see anything
17:40Everything will be a bit inflamed and things like that
17:42So we just need to give it a few days to settle down
17:44Time's settled, isn't it?
17:46Thank you so much
17:47Not at all, lovely to see you guys
17:49Beau may still have complications
17:52Let's go home
17:54And it will be 10 days before the family know for certain
17:57If the procedure has worked
18:04It's Sunday afternoon
18:06And an urgent weekend case has arrived to see Noel
18:10It's Ivor
18:12He's an eight-year-old Newfoundland
18:14A couple of weeks ago he actually collapsed in the back garden
18:19And we've been backwards and forwards to the vet
18:22But yesterday we got up
18:24And he was having problems limping the front
18:27And he couldn't move his head from side to side
18:30Yesterday was a different level altogether
18:34Having our little girl seeing him in so much pain
18:38And she says, oh, I was sad
18:40We have a three-year-old who loves him to bits and wants to give him cuddles all the time
18:46He wouldn't harm the fly, would he?
18:49He wouldn't hurt anything
18:51He's a gentle giant
18:55He's eight years old but he's still a puppy
18:58Yeah, he's a troublemaker
18:59Yeah, he's a troublemaker
19:05Our vet seems to think that it could either be a slit disc in his neck
19:11Or a tumour, a bone tumour
19:18It gets me all upset but
19:20I hope it isn't cancer
19:24If it is
19:26I think the kindest thing to do would be to let him go
19:36But we'll just have to wait and see and cross that bridge when we get to it, I think
19:41Yeah
19:42Giant breeds like Newfoundlands have shorter lifespans
19:52And Ivor is now in his twilight years
19:56You're an old man, aren't you?
20:00Ivor's mum and dad
20:03I'm ready for you
20:05Come on then
20:06Hello, what's your first name?
20:07Nice to meet you, Nicola
20:08Nicola and Dan
20:09Okay, can I see him walk?
20:11Good boy
20:13So he's quite ataxic, wobbly
20:15Is he normally that wobbly?
20:16He normally has a bit of a wobble but not as bad as this
20:20Right, let me just check him, you support his tummy please
20:23Noel checks for nerve damage
20:26Right, so that's a knuckle test, it's okay
20:30He's never done that before
20:32Okay, that's not okay
20:34I mean, no, he's eight years old
20:36Yeah, yeah
20:37Yeah, what's his life expectancy in your eyes?
20:40Eight to ten
20:42At the very...
20:44Yeah, I know
20:46We have to be very careful, morally, what we do here
20:49You know, because we wouldn't want to be putting him through major stuff, you know what I'm saying?
20:53Yeah
20:54Just gonna check his neck, hold tight
20:56He's quite stoical, isn't he?
20:58The symptoms most likely fit something high up in his spine
21:02Because it's unlikely you're gonna have a front leg affected if it's not above that
21:06I'll find out what's wrong and then we'll decide what to do next
21:09Okay
21:10That's all we can do
21:11MRI and CT scans will reveal whether the cause of Iva's wobbliness is a disc issue or cancer
21:20Thank you very much
21:22It's sad when you have walked out and someone else has taken him
21:27Someone else has walked off with your dog
21:29But you're walking out with his lead and his collar
21:32It's a bit like
21:34That's it
21:36It does feel like we're never gonna see him again, is it?
21:39We've done the best thing, we've done the right thing
21:41I think that's...
21:45We keep ourselves busy
21:47Until we get that phone call, really
21:48Yeah
22:00Okay, so we just have the images through for Ivor now
22:06So big decisions for Dan and Nicola
22:10Good news and bad news
22:12Good news, it's not cancer
22:15Okay
22:16Bad news, it is a very bad disc
22:19Okay
22:20So even though this is an eight-year-old dog
22:22And in real life may not live to more than nine or ten
22:26We are unfortunately in a surgical situation
22:30Okay
22:32Meaning that it's not gonna go away on its own
22:34And it'll probably get worse
22:36It is the source of significant pain
22:38I could give him medicine for pain
22:40But we just don't think it's gonna cut the cheese
22:42Because he's in too much pain
22:43Yeah
22:45Drugging him up all the time
22:47It's not really what I want to do
22:49Okay
22:50So I guess the only decision I need from you is
22:53Do you want me to explore the possibility of surgery?
22:56Yeah, definitely
22:58Okay
22:59Noll's solution is to remove the damaged disc
23:03And using spacers spread the vertebrae apart
23:06And allow the spinal cord to recover
23:09A custom implant will be made for Ivor over the next few days
23:13It's mid-morning at the practice
23:14Barbara and her loyal Springer Spaniel Luca are back
23:28Noll's worst fears have been realized
23:32He was booked in to have surgery on both of his elbow joints
23:35As sort of discussed with Noll
23:38He advised that he had these cracks in both of his joints
23:42And they could go at any time
23:44And he said as I went out through the door
23:46He's on a knife edge
23:48And I went away thinking that's a bit dramatic
23:50He's been fine
23:52Before the scheduled surgery could take place
23:54Fate intervened
23:56He went out through the door
23:58And we don't know quite what happened
24:00But there was this almighty scream
24:01And I came running down and he was literally lying on the ground screaming
24:06But with his leg up in the air
24:09His front left elbow joint fractured
24:12It was awful
24:14I've never heard a sound like it
24:16And I hope I don't hear one again
24:18Noll's colleagues were forced to do an emergency operation on Luca's fractured elbow
24:24Hi Barbara
24:26Hello there, hi
24:27Hello Luca, how are you?
24:28You were in the wars mate, you've been in the wars
24:30What happened to him was something that I could see happening
24:35Yeah
24:37Unfortunately it happened quicker than we both had hoped
24:39Now what they did was the very best that can be done right now nowadays
24:43In terms of a fracture
24:45Which is to put a 4.5mm titanium screw through that
24:48But unfortunately osteoarthritis is inevitable
24:50Yeah
24:51Because you fractured into the joint
24:53Six weeks on from the emergency repair
24:55It's now more crucial than ever that Luca has surgery on the other elbow
25:00Now what we want to do on the other side is three things
25:03Oh sorry
25:04We want to prevent fracture
25:05Yeah
25:06We want to minimise the potential for osteoarthritis
25:08Yes
25:09And we want to give you something that's going to last till the death of the dog
25:11Yes
25:12Sorry, sorry Luke
25:14Go, good boy
25:17That's it, he's off
25:21Luca is taken straight through for surgery
25:26Noel is using an arthroscope to investigate his elbows
25:30First he checks the joint that had the emergency repair
25:33To see if anything can be done to improve the outlook for the left elbow
25:39So there's where the fracture was
25:41It's this I'm concerned about
25:43This surface of the ulna rubbing against this surface of the humerus
25:47So if we cut the ulna and drop it down we might help the joint a bit
25:51Noel then looks inside the other elbow
25:54Okay, so on this side there's a crevice right there
25:57And you can see in fact that as I wobble this that crack opens and closes
26:03And eventually that will fracture right through
26:09Okay, so the first thing I'm going to do
26:12Is I'm going to pop a blade into the joint here
26:14Because I want to cut a tendon down here that pulls the ulna against the humerus
26:24There you go, cut
26:25So this is one mechanism I'm going to use to reduce the pressure between the ulna and the humerus
26:32I'm going to cut the ulna
26:34And let this surface here drop down a bit away from that
26:38Okay, so that's the intra-articular bit of the surgery done inside the joint
26:45Now I'm going to cut into the joint and try and put this special screw in here
26:49Noel hopes the screw will hold the deep crack in the humerus together
26:52It has to go in exactly the right place
26:56We're now down on the inside bottom of the humerus
26:59He uses a guide printed from the CT scan of Luca's elbow
27:05Which he secures with pins
27:09Now he can drill the hole
27:10We sure as hell better have this central at this point or we'll be drilling in the joint
27:16That's one big hole, you can see right down that
27:20He uses a thread cutter to prepare the aperture for the centrepiece of the operation
27:27So this is a highly specialised screw
27:30I'm going to inject fluid down the centre of the screw
27:33It's going to extrude through this hole
27:35Into the space in the bone between the two threads
27:38Giving me a half a millimetre of bone stimulating gel around this core
27:45So this gel contains one of the most valuable substances on the face of planet Earth
27:52Which is called bone morphogenetic protein
27:55In fact, per gram, it's 500 times more expensive than gold
28:00But the amount in here is about four thousandths of a gram
28:05Beautiful
28:07With the screws safely in place, Noel cuts the ulna to further release pressure within the joint
28:18To avoid Luca needing further surgery, Noel also cuts the ulna in the left leg
28:27There you go Luca
28:29You won't thank me now, but you'll thank me later hopefully
28:32All right Bubba
28:34See you in CT
28:37So this is always a nerve-wracking moment
28:40Because there's no way back if the hole's in the wrong place
28:43So it needs to be dead centre
28:47On that view it looks good
28:49There's the aperture through which we put the gel
28:54There's the cut in the ulna there
28:56So that's really good
28:58It's 11 millimetres from there to there
29:00And that's 5.5 millimetres of metal
29:02And one half a millimetre of bone inducing gel
29:06Okay, that's great, thanks so much
29:09Thank you
29:10It's now crucial that Luca has time to heal
29:13Another fracture could spell disaster
29:15At Noel's Guildford practice, Beau the Labrador puppy is back to see Gerard
29:29It's 10 days since she had laser treatment in an attempt to correct her incontinence
29:35But Charlotte and her daughter Olivia are worried that the operation hasn't cured the problem
29:41Hi, how are you, anything? Hello, I see you too
29:44Can you come?
29:45Steady
29:47I guess the big question is, how's her pee?
29:50After I'd been really excited and everything was good
29:52She decided now I'm going to prove you wrong now
29:54Okay
29:55We've had two dry nights
29:57Yeah
29:58A few slightly damp
29:59But then this morning we got up and she was absolutely drenched
30:05Okay
30:07Gerard will need to reassess what further treatment Beau needs if she is ever to be fully continent
30:14I'm hoping that he's going to tell us that she's going to get a bit better
30:18Because obviously we want it to stop completely
30:20I don't think it will stop completely but I think a bit better would be perfect and then it's just liveable
30:26It can be cleaned up
30:28First Gerard wants to check if Beau has any residual infection
30:33We're going to get a urine sample directly from the bladder because she has had recurrent infections and that's part of her condition
30:38If she's still got an infection there then that could be predisposing her to having further incontinence and weighting over bed and things like that
30:46Come, come, come, you're fine
30:48In her excitement, Beau leaves a strong impression on Porrig by releasing her anal glands
30:55All over Porrig's gloves
30:57Leaving a lasting scent
31:00Her bladders
31:01It's not bad
31:03Okay
31:05So that's all we need just for bacterial culture and then as well as emptying her anal glands for Porrig
31:10She's just peed all over him as well
31:12Oh, it isn't like a little bit is it?
31:14No, no, she went for it
31:15Good girl, peeing all over Porrig
31:18Well that's a win-win for everyone involved
31:22Hi Beau
31:24I first just caused chaos
31:26I'm really sorry
31:28Only mild chaos
31:30Yeah, I can smell you've caused chaos
31:31Luckily I was at the front end so it's all fine
31:35Yay, you're all right, you're good
31:37I'm not sure
31:39I'm not sure
31:41If there is infection, Beau will be prescribed medication
31:45There we go
31:47And further treatment for the weakness in her bladder sphincter
31:50Come on then
31:51She will finally be dry
31:58Ivor, the eight-year-old Newfoundland's custom-made implant, is ready
32:03Surgery can now go ahead
32:06My objective is to get in
32:08Take the disc material that's squishing the spinal cord and nerve roots out
32:12Put the spacers in
32:14And get out
32:16Spinal discs lie between the vertebrae below the spinal cord
32:19Noel will get access to the spine through Ivor's neck
32:23Okay, here we go
32:25So this disc is in a tricky spot, it's quite near to the entrance to the chest
32:33We could get quite a lot of bleeding in here
32:37Oh shit
32:39Okay, so that's our first bleeder
32:42That means we're in far enough, that's for sure
32:44We know when we're in the right spot, taking the material out, it's going to bleed like crazy
32:49So we just push collagen in there like that and then that stops the bleeding
32:54Having removed the damaged disc material, Noel can now insert the spacers
33:03So as I drive the spacer, it pushes the vertebrae apart along the groove that I've created for it
33:08Newfoundlands are one of the biggest breeds in the world, so Noel is using two spacers side by side
33:17To secure the spacers in place and prevent collapse of the vertebrae around them
33:23Noel will attach a custom-made link plate based on CT scans of Ivor's neck
33:28The two spacer devices are going to attach into here, they will then be linked into eight screws
33:34One in each of these holes, the screws lock in so they can't back out
33:38One vertebrae here, one here
33:51With all the screws in place, Noel packs bone marrow he's taken from Ivor's shoulders around the vertebrae
33:56To help them fuse together
34:00Everything's now rock solid, we're going to stitch up
34:03For 90 minutes of surgery, we can give one to two years of life
34:07Hopefully pain free and happy
34:09What's not to like?
34:11Hi Nicola, so I've done the operation
34:15Oh fantastic
34:17The post-operative imaging looks good
34:19Yeah
34:20So everything went in the right position
34:22Okay
34:23It improves well over the next 48 hours, I'll consider sending him home on Sunday
34:27Fantastic, thank you so much Noel, really appreciate it
34:30No problem, my entire pleasure
34:32Are you playing? Are you playing?
34:35Are you playing?
34:37Good boy
34:39Good boy
34:40Four days ago, Luca the Springer Spaniel had multiple procedures on both front legs
34:52Barbara is back today to take him home
34:56I'm a little bit apprehensive as to what sort of dog I'm going to find
35:01Because I think he's going to be lame on both legs, so a little bit apprehensive
35:06Hi Barbara, how are you doing?
35:08So this is what we have now, this is the big screw
35:11Oh, okay
35:12So that should be pretty rigid, that's a pretty big bar
35:15The next element of both surgeries was cutting the ulna there
35:20There
35:22Because it's supported by the radius, it heals pretty quick
35:24Okay
35:26So, I'm very pleased, he's doing great at the moment
35:28Are you coming in? Come on, Bob
35:31Hello, hello
35:33So even though he's had both bones broken, he's actually doing remarkably well
35:38But he doesn't seem to be too bothered to be honest
35:41You've got two poorly legs, haven't you?
35:45You have been through it, haven't you?
35:46I have been through it, I mean
36:00As it nears sunset, Noel is checking up on Ivor
36:03Come on, buddy
36:04He's on day three after surgery now, he's doing remarkably well, he's still a little bit wobbly on his back legs but not much
36:14For an eight year old dog to be doing this well after a major surgery like that, it's very hard to argue that you're not going to give him another year or two years of life for the sake of 90 minutes in surgery
36:25And he's such a lovely boy, so I definitely think we made the right decision
36:29Come on, buddy
36:30Now Ivor's folks, please
36:34Hi guys
36:35For Nicola and Dan, the wait is over
36:38It's nice to see you smile
36:39Yes
36:40He's just rallied, he bounced right back
36:42I mean, I hate to be too optimistic too soon, but he really has
36:45Our job was to go in underneath here, so you can see here where there's two spacers
36:51And you can see that this saddle acts like a grappling hook
36:55And holds those vertebrae together
36:57Oh, wow
36:58Wow
36:59Okay
37:00It's quite an advanced piece of machinery
37:02And you can see that what the two spacers do is they push apart those vertebrae
37:07So that there's no pressure on the cord in here
37:10He should live a normal lifespan having had this done, so I think it's definitely well worth doing
37:15Good
37:16Come on, Ivor
37:17Hello
37:18Hi, look who's there
37:19Look who's there
37:21Yes, there you go
37:23Hi, he's still wobbly
37:25Spinal cord obviously damaged by the disc
37:27And then slowly gets better
37:29Thank you so much
37:30You're very welcome
37:32I think he's going to be back to normal very quickly
37:34You could see as he walked in, he was eyeing up the bones on Noel's desk
37:38And I'm sure he was thinking I could have one of those
37:41Yeah
37:43He's been in this pain for so long and we haven't known
37:47Noel said he's recovered extremely quickly, which is amazing news
37:54He still stinks though
37:55He does
37:56He does stink
38:08Bo, the incontinent Labrador puppy, has now received medication as well as laser treatment
38:15Finally, she's home and dry
38:18Since the operation, Bo's been doing amazing
38:21And 95% improvement, which is unbelievable
38:26The washing's cut down, the cleaning's cut down
38:31We weren't living, we were existing to keep the house and the dog clean
38:37Bo is now welcome out in public, without Charlotte, Danny and Olivia worrying about any accidents
38:46Her quality of life for her and for us has improved dramatically
38:51Come on then
38:52We know as long as she's had a medication that she's going to be fine
38:57It's the little things in life that people take for granted, being able to go out to a pub with their dog
39:04We can now do that, we can just live
39:07She just loves life, she's such a gentle soul
39:10I'm just glad that she's been fixed because I know she was feeling sore by it
39:15What?
39:16The fact that she's fixed and she feels better, that's what makes me feel better
39:20I still melt when I see her
39:21It's six weeks since springer spaniel Luca had surgery on both his front legs
39:38Barbara is back at Fitzpatrick's, but she's worried that once again there's been a setback
39:45Hi Luca, hello, how are you? Nice to see you
39:50How was he doing?
39:51He was doing absolutely fine, but we did have an issue over the weekend where we had a bit of a yelp
39:57My son came back from uni and he rushed to the door because he wasn't in the cage
40:01And then I think he went to pick something up and I think that's when he might have
40:04So has he had periods outside of the cage?
40:08Well that's, I mean, he's in the cage, but when we're in the kitchen for example, I'll have him out
40:14I guess ideally he would just have total strict cage rest
40:18Really? Okay
40:20He was doing...
40:21She's got to remember, he's got a fracture in there
40:24That's the problem
40:29Anyway, it is what it is right now, let's check it out
40:31Okay
40:32Yeah
40:33Come on mate, good boy
40:34Come on mate
40:37Hello
40:38Hi
40:40Well he's taking him in
40:41Noel's not happy with me, no
40:47Scans will show if there has been any damage to Luca's front legs
40:52Let's have a get a bite, you've got a bite
40:54Because I actually lost in the play
40:57Hiya
40:58Hi
40:59Hi
41:02Everything's okay
41:06I mean, I think he just jarred it by possibly slipping or something like that
41:10But the implant is fine
41:12So it's healing, but not healed
41:14Okay
41:15So that will take somewhat longer
41:17Yeah
41:18Luca is also taking longer than usual to come round from the sedative
41:24But we want to tell you when you can let off lead
41:26Because we were aiming for 12 weeks, remember?
41:29Yeah, I know, I know
41:30Yeah
41:31I've got that date on very much of my radar
41:33Yeah
41:35Okay
41:37I'd like him to stay calm and I'd like him not to jar it if possible
41:40Yeah
41:41We need it to heal
41:42Yeah
41:43We've got a lot of biologics in there now
41:44Yeah
41:45To try and get this bone to settle down as well as mechanics
41:47Yeah
41:48And that takes time
41:49Yeah, I know, I'm having this rather than a new bathroom, so it's...
41:52Oh, I'm sorry
41:54Far better than a new bathroom
41:56I haven't had a new bathroom for 25 years
41:58It's far better
41:59Let's just walk
42:00Let's just walk
42:02Alright, I'll do you a deal
42:04One more lap and you can go home
42:08Now, Luca
42:10Hello
42:11Hello
42:12Hello
42:13What are you doing to your tongue?
42:15It does look very silly
42:17It's not a good look, is it, Poppet?
42:20Yes, I've had my knuckles wrapped completely
42:22I felt like I was really put on a naughty step and told no, you know, he should be in a cage
42:28And if he's out of the cage he has to be tied to my leg apparently
42:32But no rushing around the kitchen, rushing to the door as he'd done before
42:36But it's healing and it's healing really slowly
42:38So we've got to go back to the drawing board and make sure we manage it better now
42:52Over in Windsor, six months after his spinal operation, Ivor is back enjoying being fussed over at home
43:04After cage rest and lead only walking, his vertebrae have now fused and he's been signed off
43:10Dan and Nicola's two daughters, Esme and Nora, have their playmate back
43:16Straight after the surgery, he seemed to recover and get back on his feet quite quickly
43:21Within a week or so, he was much better like a puppy again
43:25He was up to no good within a week of his operation
43:37Yeah, he's pretty much back to his old mischievous self
43:40He actually had the whole thing
43:49Alright, where's the ball?
43:52With the bionic implant alleviating the pain in his neck
43:56He's no longer wobbling
44:01He's a bit slower than what he was
44:04He's definitely now showing that he's an old man
44:07Thank you
44:08But I'm definitely pleased that we did the surgery
44:12It means that we've got a bit more time with him
44:15Come on
44:16We've made his life better
44:19And he is a joy to be around
44:21You're it
44:23I don't think we've got a huge amount of time left with him
44:26But we'll try and make it as fun for him as possible
44:30And as fun for Esme as possible
44:33So she can remember him
44:34Good boy
44:36Good boy
44:37Other paw?
44:38Any other paw?
44:39Good man
44:45And in Kent
44:47Barbara and her family have been following Noel's instructions to the letter
44:51And Luca is getting back up to full strength
44:55We are hopefully on the sort of final straight
44:59He's still lead walking
45:01But in six weeks time he should be sort of, you know, completely off the lead
45:04Luca is now able to enjoy his favourite pastime
45:09A bit of daily aqua therapy
45:12Noel said it was fine for him to go swimming
45:14And so we can do that with a clear conscience
45:16And think we're still abiding by the rules
45:18He just loves it
45:22He's really, really happy
45:24You know, he pulls me all the way
45:25As soon as we turn the corner
45:26I'm being pulled off my feet
45:28And I think he's happy
45:30He's really, really happy doing that again
45:35Noel's given our dog hopefully another eight years of active life
45:39And that's, you know, that is, you know, immeasurable really
45:41It's miserable really
46:11All right
46:13Let's get started
46:15On sagen
46:18No
46:19Only
46:21i
46:24Poor
46:26In
46:37i
46:38I
Be the first to comment