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00:00Hello mate, you understand Irish?
00:02Animals from all over the world
00:04Ah bonjour
00:06Come to see one extraordinary man
00:08Who's known as the Bionic Vet
00:11High five!
00:12Yes!
00:13Professor Noel Fitzpatrick
00:15We only get one shot at this, here we go
00:18Noel and his team offer some of the most advanced treatments available anywhere
00:23The perfect marriage of mechanics and biology
00:25This is what we have now, a brand new knee
00:28Oh wow!
00:30For some, it's a last chance
00:33It is a life or death situation because we cannot leave him like he is
00:37I just want you to do anything you can for him really
00:40Sorry
00:41As Noel continues to devise new ways of healing
00:44You're going to be Bionic, thank you so much
00:47He transforms the lives of his patients
00:50Oh that is just unbelievable
00:52He's raring to go
00:53Against all the odds
00:55Boom!
00:56One small step for a dog, one giant leap for mankind
00:59Well done
01:04Scooby, please
01:06No, Nibbles folks, please
01:08Spengie
01:09Each week, Fitzpatrick Referral sees more than 150 pets
01:15Scrabble
01:16Okay, princess please
01:18Noel will see around 20 of them personally
01:21His first patient today is a one-year-old Labrador called Simba
01:28He's been referred for surgery with severe arthritis in both hips
01:32Oh lordy
01:36Look at those hips
01:38They're not even in the sockets
01:40That's really bad
01:42Sophie and her partner Costas first noticed Simba had problems when he was six months old
01:50When we took him for walks he was hopping like a bunny
01:53And we thought it was just because he was a puppy and we thought it was cute
01:56But then when he was crying in bed we thought there's something not quite right
02:01We booked a vet's appointment and they did an x-ray and they said it's one of the worst cases they've seen
02:07And that they would refer him here to get us sorted
02:11It's not just a dog for us, it's kind of like part of the family
02:15Sophie grew up with Labradors
02:19Simba, Simba come on
02:21Simba is the family's third
02:23Wait
02:24I've loved Labradors all my life
02:26Yes
02:27But with Simba I feel like maybe as close as it gets her to having a child
02:32And I put his needs before mine, which is insane because he's a dog
02:37But he just brings me so much happiness
02:41When we found out that Simba had been diagnosed with hip dysplasia
02:46I just felt like my world had ended
02:48I'd got like the perfect puppy who was so stunning, who was so lovely and cuddly
02:53And then to look at him thinking that inside him is damaged and not right
02:58It just made me want to cry all the time
03:00I just can't describe how heart-wrenching it was
03:04As the disease worsened, Simba's puppyhood came to an abrupt end
03:09Before we'd come home from work, he'd be sprinting round the house
03:13We'd have to walk him for ages on a night
03:15Now he'll stand at the bottom of the stairs and cry
03:18Because he wants you to carry him up the stairs
03:20And then he'll cry at the side of the bed
03:22Because he wants you to put him on the bed
03:25And he just won't move all night
03:28So I've just been like trying to massage his hips on the bed
03:32His hip dysplasia is so bad, even euthanasia was suggested as an option
03:39Just having him since he was eight weeks old
03:42And watching him develop like a little child growing up
03:45And then when somebody just says
03:47Well, you might have to get him put down and lose him
03:49It's as if, why?
03:52Like, I love you so much and I've done so much for you
03:56And just...
04:01Surgery is really the only resort for me
04:04Because if that doesn't work then
04:08At least we've done all that we could do
04:13Right, Simba please, Simba
04:20Thank you
04:21Hi, how are you?
04:22I'm Noel
04:23Hello, Simba
04:24Hi, how are you?
04:25Hi, how are you doing?
04:26Nice to see you
04:27Hello, how are you?
04:28Grab a seat there
04:29So listen, I've been looking at your notes
04:31It isn't good, is it?
04:32It doesn't paint a great picture
04:33They did the x-ray and said that he would need a full hip replacement
04:38I see
04:39First things first, let me have a look
04:41Because everything we do has to be in the patient's best interest
04:45Alright mate, come on then bud
04:48Let's just see what we got here
04:50Hold tight
04:56Yes, okay, sorry about that
04:58Right, so he's in quite a lot of pain
05:00And I can feel rubbing when I do that
05:02Alright, let him go
05:04Thanks girls, it's fine
05:05Well, he's in a lot of pain
05:09In this case, hip dysplasia has produced two very loose hips
05:13I mean, I would say they're both as bad as each other
05:15I can feel grating, which is bone rubbing on bone
05:18We hear that a lot
05:19Yeah, you hear it, you can hear it, yeah
05:21Because you've got no sockets left
05:23They've become saucers
05:24And the other big problem you've got is you've got severe muscle laxity
05:28He'll lie down a lot after walks like this
05:30And stick his legs out backwards
05:32Because that's the most comfortable position to put them in
05:34Because he's grown accustomed to the fact that he's in pain every day of his life
05:39Pain management will control the signs to some extent
05:43But obviously won't cure it
05:44So therefore, our only three options are
05:46Do nothing, chop the femoral head off and throw it away
05:49Try and make a false joint, which is called a femoral head and neck excision
05:52Or do a total hip replacement
05:54I believe, as does the current scientific literature
05:58That total hip replacement is superior to femoral head and neck excision in a dog of this size
06:02And we know that this technology works and has in fact worked for decades
06:07But you need to understand there's risk associated with that
06:10The primary complications are dislocation or fracture
06:14Infections are rare
06:15Also, when I pull the hip back in, if I have to make it very tense
06:20Then this nerve here may have a palsy
06:23Temporarily
06:24This is very rare
06:25But if you get it, don't be scared
06:27Sometimes they drag the foot for a while
06:29Alright friends, is this your first child?
06:32Yes
06:33Okay, well
06:35I will do my very best to look after your first born
06:38Expensive child
06:40Yes
06:41Okay mum and dad
06:42Give them a big cuddle there
06:44I'll ring you later guys
06:45Thank you
06:46Thank you
06:47Noel will go ahead with hip replacement surgery on both of Simba's hips
06:52When he was going through the risks of what could happen
06:55Then I suppose your heart sinks and you ask yourself is it worth it or why me?
07:00Why did I end up choosing one that had this?
07:02Or why has he got that wrong with him?
07:04But just got to man up and hope for the best
07:08Okay, Baba
07:23Alright
07:25Emergency cases are referred to the practice for specialist treatment at any time of day or night
07:31It's early evening
07:35And the Richards family and their friends have brought in Poppy, their three-year-old Cavachon
07:41Earlier today, she escaped from the garden and was run over on a busy main road
07:46Come and slap her in the corner
07:48And I'll pop her back down for you
07:50Poppy has been given painkillers by their local vet
07:53Do you need a hand there?
07:54This is Poppy
07:55Hi
07:56Yeah, this is Poppy
07:57Okay
07:58Hello sweetheart
07:59Okay
08:00Come on then
08:01She seems responding
08:02Can you carry her?
08:03Yeah, absolutely
08:04Good girl
08:05Good girl
08:08Come on in girls, come on in
08:09When did the accident happen, please?
08:11About 10 o'clock
08:1210am this morning
08:13Mum Tina was out at the time
08:16But daughter Megan was at home
08:18Did anybody see what happened?
08:20Uh, yeah
08:21I heard a scream
08:22There was a lady crying there
08:23And she was like, your dog just got run over
08:24And I was like, it can't be my dog
08:26And Poppy came in, I was crying and I saw her leg and it was like completely broken, it did not look right at me
08:33Has the bone come through the skin? Do you know?
08:34I don't think so
08:35You just said it was floppy
08:36It was really floppy
08:37You saw blood
08:38Yeah, I saw blood but I didn't know where it was coming from and she was completely out of breath
08:42And after that there was a lovely lady who took me to the vet with Poppy
08:46Right, so they've not taken x-ray pictures of the leg yet
08:49Oh they haven't?
08:50They've taken x-ray pictures of the chest
08:52Yeah, they've just checked for life threatening internal organ issues
08:55Okay
08:56Which they did not find
08:58Okay
08:59But we will need to recheck that
09:00Okay
09:01And she doesn't seem to be in pain
09:02Uh, well, they've given her a lot of methadone, yes
09:05So she's a lot of happy drugs going on there
09:07Yeah, okay, Bubba
09:09Alright guys, that's it
09:11I'll need to establish what's going on and what the prognosis is
09:14So if you want to give her a big kiss, guys
09:16I'll take her now
09:19Okay guys
09:20There we go
09:21I'm gonna take her through
09:22I'll call you later
09:23No worries
09:24Thanks
09:25For now, there's nothing more the family can do
09:29So they're going home to wait for news
09:33So she just had an RTA
09:35Noel and the team must get straight to work
09:38I've seen a radiograph of the chest and the abdomen
09:40It doesn't appear like there's any internal organ rupture
09:43We'll repeat that
09:44Get me a craniocaudal and a lateral and take that off
09:47Just make sure her ECB trace is normal
09:50Poppy is in a serious condition
09:53Her blood pressure is through the floor
09:55She's tachycardic, she just hasn't got the circulatory support because she's still shocking
09:59Drugs are keeping Poppy out of pain
10:03The nursing team must stabilize her and take X-ray pictures
10:09It's not good news
10:10It's not good news
10:11The original X-ray picture did not show fluid on the chest
10:15And now there is fluid on the chest
10:16Which means the impact will have caused rupture of some of the blood vessels inside the lungs
10:20And in the lining of the lungs
10:22We can see here there's fluid collecting all along here
10:24That grey stuff is fluid
10:26And it's leaking up around the lungs on the outside
10:29As well as within the lungs
10:31And that means that we are in potentially big trouble
10:34And we cannot anesthetize Poppy
10:36Because if she was to hemorrhage more into her lungs
10:39Well, she wouldn't be able to breathe
10:42So that's life threatening
10:46This fracture isn't life threatening
10:49But it's a very bad break
10:50And this bit of bone has come through the skin
10:53Which means there's infection in here
10:55We can't operate on that tibia tonight
10:57Because if we anesthetize her
10:58She could die because of her lungs
10:59It's too risky
11:00And her kidney values on the blood test are not normal
11:03So that means she's having trouble
11:05Probably a big trouble
11:12They've messed up
11:13He likes them
11:14That's fine
11:15They've strapped
11:17Today, Simba the young Labrador
11:19Is having his first surgery
11:21He needs total hip replacements on both legs
11:24Turn On the suction
11:27Noel is operating on the right one today
11:31That's the arthritis joint right there
11:33All gone in
11:34It has become a gnarly saucer
11:36And not a cup at all
11:37You can drill all that out and put a new cup in
11:40This is a tricky one
11:41tricky one.
11:48This is a cup, it's got a honeycomb surface on it, into which the bone will grow hopefully,
11:52and a plastic liner for the head.
11:59Once new bone has grown into it, the metal cup should become part of Simba's pelvis
12:04permanently.
12:06Now, Noel must prepare the femur to fit the new implant.
12:10So this is quite narrow, and the reason it's quite narrow is that the marrow canal has been
12:15hardened by remodeling, because the femur has never been in the joint properly, and as a
12:21result, it's twisted out like a banana.
12:26So this is a very specialized stem.
12:28You can see that it's got the honeycomb mesh here, into which the bone can grow, and there's
12:32a hole right up through the neck here, which we're going to put a locking bolt in to stop
12:38it sliding down, even if the femur were to try and split.
12:43So we just gently guide it in, like so.
12:49We put a wire around the femur to stop it fissuring.
12:54Noel screws the bolt through the side of the femur into the stem, to prevent it slipping down.
12:59Okay, so this is the head, we pop that on here, and then we're good to go.
13:07Now the leg can be reattached to the new hip socket.
13:11Okay, we're done.
13:12So we can see here where the bolt is holding the stem in place, and we can see if we look
13:17deeper, that the ball is in position down there, and it's inside the plastic socket with a metal
13:23liner.
13:24And as we move it now, we can see an entirely new hip joint in position.
13:29It's tight.
13:30It's not going to come out, I would have thought.
13:33Alrighty, good boy.
13:34Let's go to x-ray.
13:35For the past 48 hours, Poppy, the three-year-old Cavachon, has been monitored around the clock.
13:51She was hit by a car, and is in a serious condition with a broken leg and fluid around
13:57her lungs, which could cause problems with her breathing if it were to deteriorate.
14:02The team have been x-raying her chest every 12 hours.
14:08We can see that there's fluid around the outside of the lung here, all the way up here.
14:13That's probably bleeding and hemorrhage, and probably right now that's becoming a clot,
14:18because we're two days in now.
14:20At the moment, the area of fluid is not getting bigger, so we're not going to place a drain.
14:25We're going to let nature take its course, and hopefully in the next two days or so,
14:29that fluid will resolve.
14:30All right, sweetie, good girl.
14:35Noel can't operate on the leg until Poppy's lungs are clearing.
14:40Under anaesthetic, she could have complications.
14:43But the longer he waits, the greater the risk of infection taking hold in the open fracture.
14:48So we're just going to change the bandage and the splint just to keep it clean.
14:53We know that there's already contamination in the leg, but all we can do at the moment is give antibiotics.
14:58It's too dangerous to anaesthetise her.
15:00That's it, good girl.
15:04So the hole that the bone came through is here.
15:06At the moment, there's no more swelling, so I think it's perfectly justifiable to continue as we are.
15:12She's got lots of painkillers on board.
15:14We've got to wait. Probably another 48 hours, I would say.
15:16Right, that's it. Good girl, pups.
15:20Well done. Well done. Good girl.
15:22Out in the car park, there's a new patient for Noel to see.
15:39Nina and mum, Alison, have brought in their anxious basset hound, Thule.
15:44We decided to keep her in the car today because she is on the nervous side with the waiting for him for the dogs.
15:49I just didn't want her being a bit unpredictable in there.
15:51Nina has had Thule since she was a puppy.
15:54She's now nearly nine, and her health is beginning to fail.
15:59A couple of months ago, we noticed firstly that she was holding her tail quite strangely.
16:03She wouldn't hold it fully up in the air, things like that.
16:06And then, when she went to run, she would just scream and then just hit the floor.
16:09And, you know, she wouldn't move.
16:11Took her to my local vet and did an x-ray,
16:14established that she had spondylosis at the spine.
16:16So, I mean, that was quite a bombshell.
16:21At home in Hertfordshire, Thule is one of Nina's four dogs.
16:28There we go.
16:29But she's her favourite.
16:31Thule, she's my world.
16:33She's a very loving dog.
16:35Come here.
16:36She's fun and silly and smelly, but she's been my companion for the past nine years,
16:40and I love it a bit.
16:43We've had dogs in the family since I was three.
16:46Most have been boxers, like Bailey.
16:51He's Thule's special friend.
16:53She just is besotted with him, and it's lovely to see,
16:56because I see how nervous she is with other animals.
16:58She's just forged this great bond with him.
17:00It's just wonderful to see them together.
17:04In her spare time, Nina's a keen artist, and paints portraits.
17:10When I'm painting, she sits with me, and she'll watch me do my work,
17:13and I'll have my music on in the background, and she'll kind of be happy with that.
17:17But over the past few months, Nina has noticed a change in Thule,
17:21despite her medications.
17:23She's deteriorating quite quickly.
17:25She seems very unhappy, and she seems to be in pain.
17:28She's not getting better.
17:29She's getting worse.
17:31She's so inactive, she literally has very little quality of life.
17:37Nina's local vet has referred her to Fitzpatrick's,
17:40where she's already seen Claire, one of the neurology team.
17:44Hello.
17:45Hi.
17:46Hi, I'm Noel.
17:47Nice to see you. How are you doing?
17:48Hello, Thule.
17:49Hi, mate. Are you nervous?
17:50Are you nervous? It's okay, cheeky chops.
17:52All right, mate. It's okay.
17:53Yeah, quite nervous, especially of big strange leprechauns.
17:58Yeah.
17:59All right, so Claire, you've already seen, and she's filled me in somewhat.
18:03Yeah.
18:04Um, Thule's eight years and nine months of age, so I'm not a spring chicken anymore.
18:08No.
18:09On the MRI scan that I've seen, this disc here is so degenerate
18:14that it is squishing both the nerves that go to the bladder,
18:18the anal sphincter, and the tail, as well as the nerves that go to the back legs.
18:23Yeah.
18:24So, additionally, unfortunately for you, the disc in front of that L67 is also bulging.
18:31Yeah.
18:32So, every disc in this dog's back is diseased.
18:34Yeah.
18:35When the disc dries out, in the initial stages it just bulges, but then it becomes unstable.
18:40So, as those two vertebrae become unstable relative to each other, they produce new bone,
18:45and that's called spondylosis.
18:47And that new bone can, in fact, squish the nerves even more.
18:51OK.
18:52So, that is your problem.
18:55And if you look at the CT scan that Claire's taken before,
18:58we can see just how aggressive that new bone is.
19:01There's loads of it.
19:02Thule's nerves are being squashed both by the new bone growth and the bulging discs.
19:08So, poor thing, she's affected by significant sciatica.
19:12Yeah.
19:13I'm going to have a little look at you, sweetie pie.
19:15All right, sweetheart.
19:16You're leaning against me here, huh?
19:18Good girl.
19:19Hold tight.
19:26OK.
19:27Stay right there.
19:28Unfortunately, I'm going to put a finger up her bum.
19:30I need to check the nerve.
19:31I'm sorry, sweetheart.
19:32If you were nervous before, you'll be nervous now.
19:34It's all right.
19:36You can feel it like a little string.
19:39Yep.
19:40That's sore.
19:41OK.
19:42Sorry, sweetheart.
19:43So, she's very stoical.
19:44Yes.
19:45She's in a lot more pain than she's letting on.
19:47Now, I know you're in expecting surgery.
19:50The reason you're here is if you do nothing, she remains in pain.
19:53Not being able to get up ultimately, having trouble pooing, having trouble peeing,
19:58all of that may well happen in the next several months anyway if we do nothing.
20:03To relieve Tuli from pain, Noel plans to scrape out the contents of two bulging discs in her lower back.
20:12To 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.
20:21And then attach screws, clamps and rods to stabilise three vertebrae, while the bones fuse together in their new position.
20:33All right.
20:34You ready for me to crack on?
20:36Now, sweetie pie.
20:37Well done.
20:38That's it.
20:39Now, bye-bye, family.
20:40All right, good to see you.
20:42Take care.
20:43All right, I'll do my best.
20:45All right, guys.
20:46God bless.
20:47Bye-bye.
20:48When we went through the imaging, it kind of took me aback.
20:50I kind of suddenly seemed to realise that it was actually worse than I initially thought it would be.
20:55It's upsetting.
20:56There's no other way of putting it.
20:57She'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.
21:04Do you need to add it to your doofa?
21:14Yeah.
21:15It took me ages to learn how to do it, but you get there in the end.
21:18Oh, you're babysitting.
21:19Oh, yeah.
21:20It's really cool.
21:21Good work.
21:22Is this your first week?
21:23Welcome.
21:25Oh, you've got a very good teacher there.
21:27I'm not...
21:30Natalie, do not be teaching the new receptionist bad habits.
21:33Never, ever, ever.
21:37I'm watching.
21:50It's been two days since Simba, the young Labrador, had his first surgery.
21:56He's made a quick recovery.
21:59Sophie and Costas have driven nearly 200 miles to the practice from Leeds.
22:04I really can't wait to see Simba again.
22:07It'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.
22:15But, yeah, it will be nice to have him home.
22:17Beautiful.
22:19So, Simba's doing well.
22:22This is the replacement.
22:23You can see here.
22:25Nice new cup.
22:26New stem.
22:27Ring around here.
22:28That bolt will prevent that subsiding.
22:31Yeah.
22:32And Simba thinks, this is great.
22:33We're fixed now.
22:34Off we go.
22:35So, you've got to be super careful for the first four weeks.
22:38Once the bone grows in around that mesh, it should be rock solid in eight weeks.
22:41Then you won't need to worry about it.
22:42I mean, run around like a normal dog on this side.
22:45Clearly, the other side is horrendous.
22:47It's the same, basically.
22:49So, but I think the strategy's in place for us to deal with that.
22:52There you go.
22:53Now, probably a lot better than you would think.
22:54Yeah, he is.
22:55Well, he thinks he's fixed, you see.
22:56All right, guys, let's go outside.
22:57Come on, Bob.
22:58So, as you can see, he'd run across a field.
23:00You must put the sling under him at all times.
23:03He can stand and walk without that, but that's an insurance policy.
23:05I don't want him twisting suddenly and fracturing something.
23:08This is as good as a kid.
23:09He's going to be a kid.
23:10He's going to be a kid.
23:11He's going to be a kid.
23:12He's going to be a kid.
23:13He's going to be a kid.
23:14He's going to be a kid.
23:15He's going to be a kid.
23:16He's going to be a kid.
23:17He's going to be a kid.
23:18I don't want him twisting suddenly and fracturing something.
23:21This is as good as it can be.
23:22I'm very pleased with him.
23:24Gently.
23:25Good boy.
23:26All right, big guy.
23:27We're going to close the door, mate, because you're going to jump out.
23:30Stay.
23:31Good boy.
23:32Good to see you.
23:33All right.
23:34Take care.
23:35Take care, mate.
23:36Behave yourself.
23:37All right, buddy.
23:38Take care.
23:39Feels really, really nice to have him back.
23:40He's doing really well.
23:41I thought he would be far worse than this, so I feel really surprised.
23:46We'll probably all be sleeping in the living room with him tonight while he's in his cage,
23:51to make sure he's OK.
23:53If all goes well, Simba is due back for his second hip replacement in four weeks' time.
24:00In the wards, Poppy, the Cavachon who was run over, is being monitored constantly to check if the fluid on her lungs is clearing.
24:13Until it does, Noel can't operate on her broken leg, so for now she's in intensive care, and it's a waiting game.
24:22Tuli, the Basset Hound, is being prepared for surgery. She faces a major spinal operation.
24:43Tuli'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.
24:53I'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.
25:02All right, here we go.
25:04So the first bit of this op is fairly brutal, where we separate the muscle and drill off most of the roof.
25:15The next bit is very, very delicate, where we gently file through the inner layer of the roof, which is eggshell thin.
25:22We must not touch the nerves.
25:25So this is the roof coming off now, and underneath that is the nerves that go to the tail.
25:32This bit of roof here has been squishing down on the nerves.
25:35So now I'm going to cut beside the nerves, taking the roof off the disc.
25:40There's a ton of disc material in here, loads of it, bulging up for probably years.
25:47With one disc cleaned out, Noel scrapes out the diseased disc from the adjoining vertebra.
25:53It's delicate work.
25:55The thing is that you're only ever a millimetre or two away from disaster when you're doing surgery like this,
26:02because if you catch one of these nerves, you can really inflict permanent damage.
26:08So we've got to be super careful.
26:10Now he can fit the spacer to push the vertebrae apart and take pressure off the nerves.
26:16So this is the scariest bit of the operation, where we're pulling the nerves over.
26:22You get this wrong, it could be game over.
26:25We get it right, and then potentially we get a lifetime pain free.
26:29I knew this would be tricky, but this is very tricky.
26:39It just does not want to go in the right spot.
26:44I'm 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.
26:54Hopefully I've done most of the blood losing now.
26:57So finally, I've got the spacer in there, and I've got a tiny screw through it here to stop it backing out.
27:06The spacer will keep the vertebrae apart, but once the bones fuse in their new position,
27:12they must be supported with screws, clamps and rods.
27:15Okay, so we've got four of six screws in now.
27:30We've got to get the fifth and sixth one in, and then we might be in some kind of shape.
27:34So I'm going to have to cut certain lengths of rod to fit these clamps,
27:42because it's an unusual length since I'm bridging between three vertebral segments.
27:48All the implants are in place now.
27:55We've got three clamps on each side and a rod bent between the three clamps on both sides.
28:01You can see here, if I grab the bar here, I can lift the bottom up off the table.
28:05I'm just going to put some collagen foam down over that now to cover up the nerves and then stitch the muscles over.
28:10The operation has taken nearly three and a half hours.
28:16All right, let's go to CT now, please.
28:28Simba, that's great. Take a seat and I'll let them know you're here, okay?
28:33Simba is back at the practice with Sophie and her friend Sarah.
28:37For the past four weeks, he's been a challenging patient at home.
28:44I struggled so much to cope with him.
28:48He just wants to explode every second.
28:50He chewed his entire cage door off in the first three days.
28:55So I had to order a new cage, but he won't go in it.
28:58So between me and my family so far, we've slept in the living room next to him every single night for four weeks.
29:05Everyone's exhausted.
29:07It's just, I suppose, like having a child.
29:10It's always put me off.
29:14Right, Simba, please, Simba.
29:16Today, he's due to have his second total hip replacement.
29:20Hi, guys. Hi.
29:21Hi, Simba. How are you doing?
29:23How are things going?
29:24He looks fine.
29:25Yeah, grab a seat.
29:26Hello.
29:27How are you? Nice to meet you.
29:28How are you doing?
29:29There you go. Grab a seat.
29:30So, he looks fine or are you worried about anything?
29:33He's just, we can't suppress him at all.
29:36Like, we've drugged him up to that.
29:37He's gone mad.
29:38Yeah, he's chewed his entire cage door off the first week.
29:41Oh.
29:42And he's just so strong.
29:44I see.
29:45He's feeling a lot better on that hip now.
29:46All right, let me have a look.
29:47Simba, come here.
29:48Good boy.
29:49Let me have a look.
29:51I think you're just going to have to use the sedatives.
29:54That feels fine.
29:55Hold tight.
29:56This one's probably still quite sore.
29:58Yeah, I know, mate.
29:59That's sore.
30:00I know.
30:01I know.
30:02That's naughty.
30:03We'll get you out of that pain.
30:04Good boy.
30:05It's fine.
30:06You're okay, mate.
30:07He looks pretty good, I have to say.
30:08I think it's just because he's a nutter.
30:10Yeah.
30:11That's just...
30:13What can you do?
30:14What can you do?
30:15He's so used to being in pain, that when you get him out of pain, he's like, I want to go crazy.
30:20He's trying to go on his back end all the time, like, jumping.
30:23He's never jumped up ever.
30:24Yeah.
30:25Well, that's because it doesn't hurt on that side.
30:28When I give him two bionic hips, he's going to be jumping for the stars.
30:32Be like a gazelle.
30:33And you're prepared for another month of challenges, right?
30:35Yeah.
30:36I'm afraid that's life, Sophie.
30:39It's just the way it is.
30:41Are you going to have a shit in my corner now?
30:43Oh, my lord.
30:45It doesn't...
30:46What?
30:47What are you like?
30:48There's a big poo in my corner.
30:49Look at that.
30:50He's never done that ever.
30:51Look, look.
30:52That's what you think of my efforts.
30:54What are you like, Simba?
30:56You're a naughty boy.
30:57All right, guys.
30:58God bless.
30:59Safe journey back home.
31:00Oh, and leave the poo to me.
31:02It's all fine.
31:03You're welcome.
31:05See you later.
31:06Can I have a hand, please?
31:09Yeah, I really didn't expect him to do that.
31:11He's never gone to the toilet inside.
31:13I think he's clearly remembered what Noel did to him last time and he's left him a present.
31:19Presents are part of practice life.
31:23Time's up.
31:24Cleaning up is a chore for all staff.
31:29Oh, I've got it on my shoes.
31:32After four days in the intensive care ward, the fluid in Poppy's lungs is finally receding.
31:42Noel feels it's safe now to anaesthetise her to fix her broken leg.
31:47Poppy 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.
31:54Keep that anaesthetic as short as possible.
31:57Get on me, please.
31:58These fracture ends have come through the skin here and potentially got bugs inside here.
32:07Normally I would put a rod in the center and a plate on the side, but I don't want to do that.
32:13If there is infection there, then that may track the infection up and down the bone.
32:19There's definitely a high risk of contamination here.
32:22Looks like there has been some impaction on the road.
32:26Yeah, we can see a few splinter segments here.
32:29Definitely a potential for infection.
32:31Give me a swab.
32:35So we're taking a sample, see if we can culture any bugs from there.
32:39Noel is going to put two plates on Poppy's leg.
32:44One to hold the broken bones in the correct alignment,
32:47and a second at right angles to stabilize the repair.
32:53So this is a very old style of plate that I first used 27 years ago.
33:00It comes in very handy for this kind of operation.
33:02Nowadays, plates are much more complex than this very simple one, but for positioning like this, it's perfect.
33:14Okay, so we've got two plates in, one on the inside here, one on the back side here,
33:19and they're both at right angles to each other, meaning that it's extremely difficult to bend that.
33:24There's lots of different ways we could have fixed this.
33:27We could have put a frame on the outside, but I would have had great difficulty lining up the frame.
33:31a transverse fracture just on an external frame.
33:36We're done, 45 minutes.
33:38Let's get a bandage on here, we're done.
33:41Alrighty, let's go to x-ray, thank you.
33:50Hello?
33:51Hey.
33:52I bet you're sitting on hot coals, I would imagine.
33:55Oh yeah, yes, definitely.
33:56Right, so I've done the repair, it went fine, everything went as planned.
34:03Right, so do you think it was infected?
34:05I think it was contaminated, but hopefully not yet infected.
34:10Okay.
34:11And so far everything's resolving in the chest, so we'll just keep an eye on that.
34:15We're going to take another x-ray picture tomorrow.
34:18Okay.
34:19So, so far so good.
34:21Okay.
34:22She's certainly not out of the woods yet, but we can definitely see the light in the clearing.
34:27Thank you, Noel.
34:28Cheers, bye-bye.
34:29Bye.
34:30All right, Tuli. How are you doing, sweetheart?
34:39Tuli, the Basset Hound, has spent the last five days recovering from her complex spinal operation.
34:45Hey.
34:47How are you doing with your big floppy ears?
34:50She's an older dog, nearly nine, but she's recovering well.
34:54Okay.
34:55The girl's telling me she's able to urinate, and hopefully she's able to walk a little bit better, but we're about to find out.
35:02Come on, Bubba.
35:03Come on, sweetie.
35:04Oh, what a brave effort.
35:07What's happening in here?
35:08It must be pee time.
35:10Oh, yeah, that's what we like, a nice big pee time.
35:14Well done, you.
35:16Well done.
35:17Come on over here, let me have a look at your legs.
35:20Okay.
35:21So she's making a valiant attempt to use her legs.
35:24Lots of movement in the leg there.
35:27So really strong, really strong withdrawal.
35:30Really strong motion there.
35:31That's good.
35:32Oh, poo on the hand alert.
35:33Poo on the hand.
35:34Ah.
35:35Thank you, Tuli.
35:36Well, she's able to poo.
35:38She's able to pee.
35:39She's able to walk.
35:40It's time to go home.
35:41All right, Darby.
35:42I'll let you do the peeing and the pooing then, because I think she's already started, it would appear.
35:46Nina has come to collect her.
35:51I just can't wait to see her.
35:54It's been agony not having her in the house for a week.
35:57So I've been a bundle of nerves all this morning.
36:00Hi, Nina.
36:01How are you?
36:02I'm good.
36:03Very excited.
36:04All right, so a big deal, a big surgery.
36:06That's what the implants look like.
36:08That's a lot of metal.
36:09Yeah.
36:10Very challenging anatomy.
36:12Mm.
36:13Now, for the first 12 weeks, until that all sets solid, there is risk associated with too much motion.
36:20Okay.
36:21So just be careful.
36:22All right.
36:23I think the best thing to do now is let's meet outside the front door and I can show you exactly.
36:27Okey dokey.
36:31Now, there we go.
36:33Hello.
36:34Who's there?
36:35Who's there?
36:36Oh, who's there?
36:38Hi.
36:39Hello.
36:40Hi.
36:41There you are.
36:42There you are.
36:43So she walks with this as a support and her tail is beginning to move as you can see.
36:48Yeah.
36:49So you hold this and this and off you go and take about maybe 30% weight on here.
36:54Yeah.
36:55You don't need to lift her.
36:56Yeah, that's it.
36:57That's it.
36:58That's it.
36:59Exactly.
37:00That's exactly right.
37:01A little bit drunk on the back end.
37:02Well, she's inevitably going to be.
37:03Yeah.
37:04It's a big deal.
37:05All right, sweetie.
37:06Come on.
37:07Come on, mom.
37:08Good girl.
37:09Good girl.
37:10You lift this in.
37:11Yeah.
37:12Okay.
37:13Come on.
37:14Good girl.
37:15My head's a bit scrambled at the moment.
37:17I'm just overjoyed to see her.
37:19I think she's happy to see me and she'll be happy to be home and tucked up in her bed.
37:26So I'm just over the moon.
37:28I think I'll just snuggle with her for the rest of the afternoon.
37:30That's my plan anyway.
37:31Hi, Simba.
37:32Hi.
37:33Hi, Simba.
37:34Hi.
37:35Hi.
37:36In the kennels, Simba has been recovering from his second total hip replacement.
37:50Come on, mate.
37:51Good boy.
37:52Good boy, huh?
37:53Good boy, huh?
37:54Good boy.
37:55Good boy.
37:56Yeah.
37:57I've done those in some complications.
37:58Simba's four days postoperatively now.
37:59The left hip is recovering slower than the right hip did.
38:03That's just the nature of biology.
38:05There were two fundamental differences between the left hip and the right hip in terms of recovery.
38:12I'll just take this off.
38:13One was that there was a big spur of bone at the back of the socket here
38:17that was sticking to fibrous tissue, which was sticking to the nerve,
38:21and I had to prise that away, and so the nerve has to recover from that.
38:24The second issue was that when I put the new head on the femur,
38:28I had to pull that right back into the socket,
38:31which means the tissue is going to be stretched, and that in turn stretches the nerve.
38:35So we get what's called neuropraxia, which is a temporary palsy of the nerve,
38:40and that's why we've got this booty on, because without the booty, the foot just knuckles over.
38:45Generally, they do come back, so I'm not too worried.
38:48I think he's ready to go home.
38:50Good boy. All right, mate, let's go back in.
38:54I was supposed to be picking Simba up on, I think it was Wednesday this week,
39:00and then I got a call from Noel to say that he wasn't well enough to be collected,
39:05so it's just been a bit of a stressful week, really.
39:09When I've been ringing you on the telephone, you've been a little bit down about this.
39:13Don't feel down. It's all okay.
39:15The first thing I need to say to you, though, is if you didn't do this, Simba's going to be in pain forever.
39:20I mean, it's tough that he has to go through two total hip replacements at such a young age,
39:23but we get it right, we set him up for life, and I'm confident that the hip itself is fine.
39:29Everything should be fine, providing we get a little bit of luck, and you do what I ask you to do.
39:34All right.
39:35Okay? So I'm going to move your chairs back.
39:37I'm going to put this rubber mat on the floor.
39:38I'm going to bring him in, and I'm going to show you how to do it.
39:41He'll be well boisterous when he sees you, so go down to his level.
39:44Come on, mate. Mom and Dad are here.
39:46Come on, look who's here.
39:46Hey!
39:49Now, this is the sciatic slinger that keeps his toes up when he's walking along.
39:54When he's standing there, this toe will knuckle over.
39:56So you put this on when he goes out.
39:58That is what the problem is going to be.
40:00You look frightened.
40:02I just can't see how that's going to get better.
40:04Oh, well, then you've just got to trust me, don't you?
40:07Yeah.
40:07Yeah, so the reality is, you do any surgery, you can have challenges.
40:12You've just got to believe that I've been through this however many times,
40:17and you've just got to have faith, as simple as.
40:20Let's walk him out into reception.
40:22So, as you can see, when he's walking along, it's fine, isn't it?
40:25It's just he needs the elastic to hold it up.
40:28So just have faith that that's going to recover.
40:31Yeah.
40:31All right, buddy, come on.
40:33Where's your car?
40:34Quite shocked, really.
40:36A bit overwhelmed.
40:37Okay.
40:38When we get home, definitely spoil him and wrap him up in blankets
40:41and just kiss him.
40:43Come back in.
40:43Just let's get him in the car.
40:46Good.
40:51Hi, Poppy.
40:52How you doing, Bubba?
40:53You all right?
40:54Yeah.
40:55Oh, you're doing great.
40:57Standing up, walking around.
40:58It's four days since Poppy had the operation to mend her broken leg.
41:03Got a puppy on the side.
41:04Up, up, up, up, up, up.
41:05Good girl, good girl, good girl.
41:06There we go.
41:07We've had a bandage on since surgery that we've been changing every day.
41:10We want to see if there's any signs of infection.
41:13The culture result did not come back showing a major bug,
41:18which is good news.
41:20Good girl.
41:20Good girl, Pops.
41:22So there's just a little bit of fluid coming out there still.
41:24She's standing fantastically well on the leg.
41:27She doesn't know anything's wrong at all.
41:29So I would be inclined to leave this open now.
41:31Let's amirate it.
41:33All the swelling's gone down.
41:35Plates are working really well.
41:36All right, let her up.
41:37And let's just see her walk up and down the corridor.
41:40That's it.
41:41Good girl.
41:42Well done.
41:43Good girl.
41:44Good girl.
41:45Well done.
41:48Tina and Megan haven't seen Poppy for ten days.
41:52But Noel has been phoning with updates.
41:55We are so excited.
41:57I don't know how she'll be, though,
41:58because hopefully she'll remember us.
42:00Poppy's doing great, you'll be pleased to hear.
42:05She thinks she's fixed.
42:08So she wants to run around the field.
42:11She must not have any strenuous activity.
42:12She can go for as long a lead walk as you like to get her tired.
42:16Mm-hmm.
42:17And then she must rest.
42:18Right.
42:19Just push your chairs back and bring her in.
42:20Yeah.
42:20Yeah.
42:22Now, look at this.
42:24Oh, my baby.
42:25How you doing?
42:25Oh, hi, everybody.
42:27Come on.
42:28There we go.
42:29Hi, everybody.
42:31Now, waggy tail.
42:33Waggy tail.
42:33She's walking as if there was nothing wrong.
42:35Okay.
42:36So let's go to reception.
42:37I'll show you how to walk her.
42:38Come on, Bubba.
42:40Good girl.
42:41Pop the sling under.
42:42There you go.
42:43So this is more an insurance policy.
42:45Off we go.
42:46She's walking normally, as you can see.
42:48Yeah.
42:49So as you can see, she actually wants to run.
42:52She does.
42:53She loves running.
42:54She looks amazing.
42:56Her tail's wagging.
42:58She's really happy.
42:59Didn't expect her to look so well.
43:02Come on, then.
43:02That's perfect.
43:03Yeah, there you go.
43:04We'll just take her home and give her lots of loving now.
43:07This is beautiful.
43:08I love this.
43:09Snowdrops and daffodils are my favourite.
43:10Oh, yeah.
43:11Thank you so much.
43:12Bye, guys.
43:13Bye.
43:13Bye.
43:14Come on.
43:15Come on.
43:16Good girl.
43:17In Hertfordshire, it's been six months since Thule had her spinal operation.
43:25Come on, Thule.
43:27Come down there.
43:27Good girl.
43:29Basset hounds rarely do anything in a rush.
43:32Thule.
43:33But nine-year-old Thule is getting stronger every day.
43:37Come on, Thule.
43:38Come on.
43:41She just seems so much happier.
43:44Her whole personality is kind of lifted.
43:46What are you doing?
43:47Are you hooked up?
43:48She can run around again, and she can use her tail, and she's pain-free.
43:52Come on.
43:53I just feel I've got my dog back, but there's just a bit more to it.
43:57So it's been remarkable.
43:59I don't believe she would be here today if we hadn't had surgery.
44:03So it's smashed my expectations.
44:06You're in your port, too.
44:07Yeah.
44:08I just feel so much closer to her in a way that I'd never thought possible before.
44:12So she's just a big part of my heart, and I just feel like I've got my dog back again.
44:18Come on.
44:20In Surrey, Tina, Megan, and Snoopy have also got their friend back.
44:26Hoppy, come on.
44:27It's been four months since she was hit by a car.
44:30Hoppy's doing really, really well.
44:33At one point, we weren't even sure whether she was going to survive, whether she was going to lose a leg.
44:39Suppling. Good girl.
44:40Now she's just completely, like, fine.
44:42It's just as if nothing's ever happened to her.
44:45No, no, no, no.
44:46You can't. She's the baby rabbit.
44:48She's got all her confidence back again, and she's raring to go.
44:51Look at you. Clever girl.
44:54It seems like she's got more energy.
44:56She just runs and runs and runs, and I guess she's just enjoying the freedom.
45:00Whoopsie. Come on.
45:02Look at those legs.
45:04It's the best gift that we could have just to see her back to her old self.
45:08She's just been given another chance of life, and she's enjoying it.
45:12Oh, she's in.
45:20The locals call it God's own country.
45:24In Yorkshire, Sophie and Costas have got their puppy back.
45:29Three.
45:29Simba is racing now.
45:33Just doesn't stop running around, and we feel like Noel might have put a motor inside him.
45:39We're just exhausted all the time, but in a nice way.
45:41Now he's leaping like a salmon, which he never used to be able to do before, or jumping all the time in the air.
45:49It's just a miracle to see what he can do now.
45:51It highlights how bad he was before.
45:53When I see him running around now, you would just never believe that all his back end is bionic.
46:01It's just unreal how it's been so successful.
46:05He's one of us.
46:06He's part of the family, and now that he's fixed, it's 100% worth it.
46:11Just seeing him happy and being worry-free just means the world to me now.
46:16He's part of the family.
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