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00:01One, two, three. Whoa!
00:04Hello, mate. You understand Irish?
00:07Animals from all over the world
00:09Ah, bonjour.
00:11Come to see one extraordinary man
00:14who's known as the Bionic Vet.
00:16High five. Yes!
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 a perfect marriage in 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.
00:52...he transforms the lives of his patients.
00:55Oh, that is just unbelievable.
00:57He's raring to go.
00:59...against all the odds.
01:00Boom!
01:01One small step for a dog, one giant leap for mankind. Well done.
01:04It's mid-morning at Fitzpatrick Referrals' sister clinic in Guildford.
01:18Hello, kitty.
01:20And a seven-year-old Persian cat has been brought in after being hit by a car.
01:25Hello.
01:26He's a nice cat.
01:27He's a super nice cat.
01:28Simba.
01:29Do you reckon he was named after the Lion King?
01:31Hello.
01:32One of Noel's team, Soft Tissue and Reconstructive Surgical Specialist Dr Jonathan Bray is assessing his injuries.
01:40So Simba was hit by a car two days ago.
01:43Quite bad injuries to both front legs.
01:46He's lost most of the skin and there's some fractures.
01:51We are worried about blood supply to the foot.
01:53So before we anaesthetise, trying to get access to her toes so I can check her sensation.
02:03Good kitty.
02:05Do you want to come and get hot chocolate?
02:07Come and get hot chocolate.
02:08Come and help me.
02:09Come on.
02:10Simba is a therapy cat for 11-year-old Kian, who is autistic.
02:16If Kian's having a really, really bad day with his autism and a meltdown quite badly, Simba will lay on his head.
02:25Or if Kian's hurting himself, Simba puts his paws on his hands and he just goes everywhere with him.
02:33And Kian won't allow us anywhere near him some days.
02:37But who will you now near you?
02:39Simba.
02:40Simba.
02:41What does Simba do for you?
02:43Makes you feel happy.
02:46After the accident, Simba was taken to his local vet for emergency treatment.
02:52It became apparent that actually with the injuries to both legs, that they didn't think that they'd be able to save him.
02:59And they brought Simba in to say goodbye.
03:03At which point Kian obviously got very, very, very upset.
03:07Simba has substantial fractures in his right foot and the skin has been ripped off his left leg.
03:15I'll just see what's going on.
03:18The family have brought Simba to Fitzpatrick's as their last hope.
03:22He has got a chance here. Even if he loses a leg and a foot, he has still got a chance and that's huge.
03:29That's huge.
03:31So grab a seat.
03:33So we've got some injuries, but time will tell.
03:37Okay.
03:39Left side is the worst from a skin damage point of view.
03:44This side, honestly don't know.
03:47At worst, we might loosen toes.
03:50Okay.
03:51Okay.
03:52Okay.
03:53I get a sense that the leg is intact and moving freely.
03:56Again, we'll assess that as he's up and about and moving around.
03:59But no, amputation's not on the list at the moment.
04:02Okay.
04:03That's incredible.
04:04So we'll see.
04:05All right.
04:06I'll leave you to go home.
04:08Okay.
04:10The news comes as a huge relief for the family.
04:14Simba will be closely monitored over the next few days to see if the wound can support a skin graft
04:20and whether it's possible to reconstruct his crushed foot.
04:26I'm being told he's going to have no legs to this.
04:29So he's definitely going to move?
04:32Yes, darling.
04:33I might even keep both legs.
04:35It's an unusually quiet reception this morning at Fitzpatrick referral's main headquarters.
04:50But even in a crowd, there's something about Noel's next patient that stands out.
04:56He definitely has a bit of a large tongue.
04:59He sticks out all the time, constantly.
05:02He's not being rude.
05:03His tongue is too big for his mouth, basically.
05:06It doesn't do any harm whatsoever, but he looks cute.
05:10100% of the time.
05:11Where's your tongue gone?
05:13It doesn't do anything.
05:18My name's Melissa and I have an addiction.
05:21You all right, Snora?
05:22Good boy, Tiny.
05:24Two-year-old Staffy Cross, Tiny, lives with Melissa and her family.
05:29Come on, then. Presents.
05:31Sit.
05:32I rescue dogs and rehome them, rehabilitate them with behavioural problems.
05:37Will you get down, please?
05:38We don't get anything if we jump up, do we?
05:41And send them packing, hopefully, to a really lovely forever home.
05:45Right, one more, no more.
05:47The most amount of dogs that I've had in one go was 21 dogs.
05:55And it was hellish.
05:57Melissa began fostering dogs four years ago after suffering a brutal attack
06:01while on holiday in Spain.
06:03When I came home, it was quite a horrible recovery.
06:07And I was giving up a little bit, to be honest with you.
06:11And then Tiny's litter turned up on the doorstep.
06:16He was the ugliest puppy I've ever seen in all my days.
06:20He had a forehead that we didn't think he'd ever grow into.
06:24Thankfully, he's grown into a swan.
06:27Tiny.
06:28He brought me back from despair.
06:34I'd given up.
06:35I was able to care for somebody else.
06:38That gave me strength.
06:40He reminded me who I was when I couldn't remember.
06:44And that's a really special gift to give.
06:49Sadly, Tiny has started suffering from problems of his own.
06:53We'd go out on walks and then he'd have a bit of a limp when he came home.
06:58The vet suggested that it was elbow dysplasia.
07:01I hope that I can do for him as he's done for me.
07:05Because I don't want my boy in pain anymore.
07:07No, Tiny, please, Tiny.
07:13What do you know about elbow disease already?
07:18Absolutely nothing.
07:20OK, well, that makes it easy. We can start at the beginning.
07:23That should be a nice fit.
07:24So if that's an arse and that's a saddle, basically the arse doesn't fit the saddle.
07:29Yeah.
07:30In layman's terms.
07:32So it's too much pressure going down through there.
07:34And that cracks and rubs away.
07:37So almost certainly, if we stuck the camera in there, we would see that there's no cartilage between there and there.
07:43What's the plan?
07:45So the plan is we take a CT scan to see how much bone is rubbed.
07:51And then we do an arthroscopy to see how much cartilage is gone.
07:56Depending on what the camera inserted in the elbow shows, Tiny could have painkillers or injections.
08:03But it's possible that surgery may give him a more lasting relief from pain.
08:08Option one is an osteotomy, which is to unload it and shift weight to the other side.
08:12Yeah.
08:13Option two is partial, complete joint replacement. In this case, probably partial.
08:17Righto.
08:19And would that be both of them?
08:21I suspect both of them, yeah.
08:22Right.
08:24Every surgery has risk.
08:25He could have an infection, the bone might not heal right.
08:28Yeah.
08:29But at the end of the day, you're trying to do the right thing and get your dog out of pain.
08:31Yeah.
08:33He means the world to me.
08:34So whatever you need to do to make him as happy as he can possibly be is what I'd like you to do.
08:40Understood.
08:41Do you know how much trouble you're worth?
08:44All he's concerned is whether mummy gives him a big cuddle or not.
08:46Yeah.
08:47Yeah.
08:48Thanks.
08:52Okay, my love.
08:54Oh.
08:55Oh, his elbows are screwed.
08:58Oh, to put it bluntly.
09:00Well, you're in good hands.
09:02Yeah.
09:06It'll be the first night I've been away from him.
09:08But, you know, he's a good boy.
09:10He'll be all right.
09:11He's a bruiser.
09:12He's brave.
09:13But I'm looking forward to getting him home whenever that is.
09:19The arthroscopy will help Noel decide the best course of action for Tiny's elbows.
09:27As we move the joint, you can see where the humerus is rubbing against the ulna all of the time.
09:32And that's what causes the erosion.
09:34You can see here there's some raw bone.
09:36Cartilage is completely gone.
09:38And if we stick a needle into it just to show how hard it is, because it's rock hard.
09:47The inside of the joint is trashed, but the outside of the joint actually still seems to have cartilage on it.
09:54So that's a little beacon of light, all that there.
09:58So, it's a difficult situation because he's badly affected on both sides.
10:04The thing is that Tiny is only two years of age.
10:08I'm a little worried how an artificial joint's going to hold up over time.
10:14It's difficult.
10:15This is a difficult challenge.
10:23So, at the moment, what's going on in my head is that if I did an unloading osteotomy,
10:27then the body weight will go down through the outside of the joint, which is still okay,
10:31giving the inside of the joint a chance to recover and to not get bad as quickly.
10:38Tiny will have surgery to give him a chance of a future that's pain-free.
10:44All right, mate.
10:46We'll come back another day and try and fix you.
10:48Hey, buddy. How you doing?
11:03Hi, mate. How are you today?
11:06Ten days ago, Simba the therapy cat was hit by a car, badly injuring both of his front legs.
11:12So, it looks rather angry, don't you think?
11:14Surgeon Jonathan has been checking his skin regularly and Noel has come to assess the damage to his front right paw.
11:23Jon is going to do some skin grafting on one front leg to try and get that healing.
11:29And he wants me to try and fix the fractured fingers on the other front leg.
11:36Hmm.
11:38It's going to be challenging.
11:40You all right, buddy?
11:42Oh, yeah. Now you want cuddles. Oh, yeah. Now you want cuddles.
11:48This is the first time 11-year-old Kian has spent any time apart from Simba, who helps him cope with his autism.
11:55You wait till he sees you. He'll be climbing out that basket.
12:01Hey, guys. How are you?
12:04Today, the family are meeting Noel to discuss surgery for Simba.
12:08Annette. Annette.
12:10Hi, Becky. Hello, mate. How are you? Nice shirt.
12:13I've got a shirt like that, too. What's your name?
12:15Kian. And this is your friend, I believe, to help you through the difficult patches. Is that right?
12:19Actually, we've never... I've never come across a cat that does what he does.
12:24Well, what does he do then?
12:25So, when Kian was little, his lungs didn't work and he would just stop breathing out.
12:29He could be eating, sleeping, and just his lungs would just stop and we'd just flatline.
12:34But Simba learnt that when it was going to happen.
12:37So, he would tell mum when your lungs were going to stop. That's amazing. How old is Simba now?
12:41Seven. Seven.
12:42But he does different things for you now, doesn't he? What does he do now when you're poorly?
12:47Um, he just comes up and starts rubbing his head on me.
12:50Oh, wow.
12:51Well, I'm sorry to hear you have such tough patches, but it's wonderful that you've found a little companion to help you.
12:57And I just hope that we can get Simba through this.
12:59I'm going to sit with you, actually, because I want you to be strong for him.
13:03Now, he needs you as much as you've needed him.
13:06Now, have you ever seen the movie character, Wolverine?
13:10Yeah.
13:11There you go. Did you see that boom of light? Boom. Boom.
13:16That's right. That's it. Yes.
13:19So, what does he have coming out of there?
13:21Um...
13:23Adamantium.
13:24Exactly, my friend. He's all over this.
13:27You and me are going to be best friends.
13:29He has Adamantium pegs coming out of here.
13:32So, I saw that movie years ago, the very first one, long before you were born.
13:37And I was captivated by that.
13:38Couldn't find Adamantium anywhere on planet Earth.
13:41So, I had to go to a different...
13:42It's only a fictional metal. It's actually real.
13:45Sorry.
13:46I love that. You're absolutely right. It's only a fictional metal. It's not actually real.
13:53So, we're going to have to make do with what we've got for now, which is stainless steel pegs.
13:55If, if we were able to put Wolverine's pegs up along the bones, then even if this bit was tiny and short, we could potentially skewer it in position like so, couldn't we?
14:11How long have you been doing this for?
14:13Me? Oh, good. Now we're getting the drilling on qualifications.
14:18A long time. I'm actually not particularly bright.
14:21I found exams very difficult.
14:23I'm not particularly good at anything, except trying to think of a way around problems.
14:28And when I see a frustrating problem, like the problem that Simba has now, I always think, well, why can't we do better than that?
14:36What do you say to Noel for acceptance?
14:38Oh, no, no. You're very... Listen, mate, it's my entire pleasure. Can we have a hug? Well done, mate.
14:43Oh, you're such a good boy. You're such a good boy. Thank you so much. I'll get him for you.
14:47Thank you. All right. And keep the faith. You're a good kid. You really are. Have I got a key fob? Have you got a key fob? Has anyone got a key fob?
14:56Are we locked in forever? We just have to consider what the implications of inventing stuff here forever is.
15:04We might go out this way. Okay.
15:08Hello, gorgeous boy.
15:11Sam's been looking after Simba. Now, mate, look who's here. All right, buddy.
15:15If you stand up, Cian, and just hold it. Lift this. There you go. Now, there you are. Look who's here, Simba's. There you go.
15:24Look who's here, Cian. There you go. Good.
15:27Aw, not a family bad boy. Oh, that's lovely.
15:31The family have decided Simba will undergo surgery in about a week, but for now, they can spend some precious time with him.
15:39Hello.
15:40He saves the attention. You're a little star, aren't you? That's what it is.
15:45It's so lovely.
15:47Yes.
15:56Whilst Noel's Cancer and Soft Tissue Centre is on a separate site from his orthopedics and neurosurgery practice, the clinicians work together closely every day.
16:06Gone are the days where an individual vet can do everything. So treat the belly as well as the brain, as well as a fracture. That's no longer the case.
16:17That is why I've built a team of people that can do what I can't do. In other words, individuals who are extraordinarily good at the specific area they work in.
16:26Every week, the entire team assembles to discuss cases.
16:34It allows us to bring our specialists in soft tissue surgery, together with our specialists in orthopedics, to try and make the best decisions possible for our patients.
16:44OK, next up.
16:45Today, they are considering treatment for a four-year-old lurcher called Kato, who has a cancerous tumour in his jaw.
16:54The dog is bright and happy, unbothered by the mass, but he's got a small cocktail-sausage-sized mass, just the base of the mandible.
17:04Kato's local vet attempted to remove the tumour, but it returned. His remaining option now is to have half his lower jaw cut away, unless the team can come up with another solution.
17:16So, I talked about options and said we need to know just how extensive this tumour is.
17:25Well, the other two options are to chop the entire mandible out, or replace it.
17:30We talked about an implant and explained that that's reasonably new technology, but they were interested in trying.
17:39The dog is young, so I think it would be a perfect candidate for an implant.
17:43A 3D-printed jaw implant could offer Kato a chance of a normal life.
17:52One week later, and Kato is back, with Beverley and John, to discuss the surgery.
17:58The family rescued Kato three years ago.
18:02When we first got him, he was very, very nervous. I think he'd been mistreated.
18:06He was a stray, so he was quite thin, and he looked like he'd been fending for himself.
18:10We would call him a dustbin dog. He'd eat anything and everything.
18:14He's a little more discerning palate now, but...
18:17The really funny thing is, he absolutely loves bin men.
18:22He gets really excited, and our bin men come and fuss him on Friday.
18:26And I just wonder whether, when he was a stray, perhaps the bin men fed him or something.
18:30I don't know, but he's just got a real affinity to bin men.
18:35So...
18:37Are you going to be brave?
18:39We understand that if they have the jaw removed, you may have to hand feed them,
18:44because obviously they don't have the same function.
18:47And Kato loves playing with a stick and a ball, and playing with his toys.
18:50So the option of having an implant would mean he'll still be able to do those things.
18:56But before the implant surgery can go ahead, Noel needs to address a concern.
19:02So there's a possibility that the tumour comes from a nerve.
19:04The jawbone, the mandible, has a hole in it here through which a big nerve and some blood vessels go.
19:11It may be possible to actually get rid of the tumour forever.
19:15But, if the tumour tracks along the nerve, and is going further up from here towards the back of the mouth,
19:23that's not possible.
19:27Kato will need an MRI scan to determine the extent of the tumour's spread.
19:32Right, what have we got?
19:41Wow.
19:42I'm worried now because that tumour is growing towards the other side.
19:47That's not good.
19:49OK, thanks.
19:51There's good and bad news.
19:53The good news is it's still very localised, and we cannot see it tracking up the nerve.
19:59The bad news is it's touching the other mandible.
20:01OK.
20:02Which you can see there.
20:04There's a small line of grey between it and the other jaw.
20:09So I'm going to need to consult with John and the radiologist to determine whether he thinks that's enough margin.
20:15Couldn't that just be touching?
20:19Yes.
20:20And then you take it away and it just peels away.
20:22But I want John to say, because it's just touching, will it leave cells on that that could come back?
20:29Yeah.
20:30Yeah.
20:31Yeah.
20:32Yeah.
20:33We have to be as confident as humanly possible that we get all this humour out.
20:35Otherwise it's all for nothing.
20:37OK.
20:39I'll go to the bar.
20:41I said I'm going to go the bar.
20:45OK.
20:47For now, Cato must return home.
20:51I've got something nice for you.
20:52I want some fish skin.
20:53to wait and see if he can have the operation tiny and his overlong tongue
21:08are back at Fitzpatrick's Melissa has asked Noel to go ahead and perform the
21:15surgery which will hopefully treat his painful elbows today we're in for him
21:20to have his elbow done his left elbow and they're going to break his poor little
21:25leg and and then they're going to put a plate in which will reposition the
21:30weight and put the pressure on his good side rather than his bad side and stage
21:35two will be the other leg and in four weeks time
21:40tiny is aptly named because he has tiny bones relative to his body size so we've
21:52got a specifically made plate which should accurately fit the contours of the bone
21:58when we go in here a lot depends on what this fella here does he supports the leg
22:03so it doesn't rotate downwards and upwards so basically if this goes wrong it's
22:08entirely a fault no I'm joking primary surgeon always takes the blame man we
22:18got the implant for me please this is the plate shaped like a hockey stick as you
22:23can see with a step in the middle there the underside is flat so we have to be
22:26very careful how we position it you get that wrong you get everything wrong just
22:34hold on no needs to screw the top section of the plate into position on the
22:39humerus before he can cut through the bone
22:44I'm not happy with that it's gonna have to rotate a bit more well proving very
22:53difficult to get this centered on this short stubby bone okay hold that again
23:00normally the humerus is like an oval in cross-section this one's triangular and
23:05the apex of the triangles right under the plate don't don't go down don't go down
23:11pull let me travel check that relax still not happy that's very annoying
23:22okay so that's in the right position we've locked the top part of the plate down onto the bone we're
23:33now going to saw the bone in half
23:35so as we tighten these screws the bottom segment let go let go the bottom segment should just slide up
23:48towards the plate creating a step so the body weight is going to go down through the outside
23:55noel packs in donor bone graft to form a scaffolding into which he hopes new bone will grow and this
24:03bone graft was donated from a deceased dog the same as you or me can donate parts of our body when we die
24:09I think it's a good thing I think that every dog should carry a donor card when I'm dead certainly the
24:16living are very welcome to parts of my body that's for sure all right let's go to x-ray
24:21hello hey melissa it's noel how are you doing hiya noel how are you doing good thank you
24:29everything went fine with tiny oh superb a bit tricky in the middle but the plate on the post-op x-ray
24:35picture looks good done me proud well we don't know yet we've got still another you'd like to go
24:42but uh hopefully this one will heal well okay darling thank you so much my pleasure
24:47have a good night's sleep and thank you so much for looking after my boy you're a nice girl
24:53uh not many people thank me as effusively so thank you very much
24:56all right take care talk to you tomorrow all right bye bye bye bye what a lovely girl
25:03good boy three weeks ago a car accident ripped off most of the skin from Simba's left front leg
25:16leaving him in too much pain to walk finally got Simba's wound to a point where I'm happy with how the
25:24surface is to support a skin graft so we're going to put a what we call a free skin graft on the area today
25:32so that involves lifting off some skin on the chest wall dissecting free all of the fat
25:40and all of the non skin tissue so we're really just left with a thin wafer of skin
25:50Jonathan then makes holes in the skin like a pie crust to allow moisture out and to give it the
25:57flexibility to wrap to the contours of the leg we'll put quite a series of stitches all the way
26:03around the outside yeah movement is movement is what kills us the graft is secured in place making
26:10sure the hair follicles will grow in the right direction and then it's up to nature to take its
26:16course fluid and plasma literally moves from the body into the skin and that's how the skin cells get
26:24their nutrients over the next two or three days and as long as that's allowed to happen and it
26:30doesn't move it doesn't get disturbed then the skin cells will survive they'll make a happy home for
26:35themselves it just becomes integrated that looks lovely okay rest is down to you little Simba
26:46easing up now
26:50oh
26:52oh
26:53oh
26:54oh
27:07see
27:08sit right don't have my fingers thank you
27:10Kato, the ever-hungry lurcher, has arrived for the surgery on his jaw.
27:21Because he's gone out under the anaesthetic, he couldn't have any breakfast.
27:25So we tracked him to a late supper last night.
27:28He had some roast beef, which didn't last very long, did it, Kato?
27:33After examining Kato's MRI scan, Jonathan and Noel feel they have a good chance
27:38of completely removing the cancerous tumour.
27:41You're going to get rid of that nasty lump. Yeah.
27:44A unique, custom-designed implant created from Kato's CT scans
27:49will replace one side of his jaw.
27:53We've tried to tell him, but I don't know whether he's understood.
27:57But we've told you that it's a necessary thing, isn't it, that we have been done.
28:03Now, this is your present.
28:05This is as close to state-of-the-art as we can get.
28:08Yeah.
28:09This 69 millimetres of metal is specifically designed to recapitulate bone.
28:15It's the first time this specific kind of reinforced honeycomb titanium implant has been used.
28:22So this goes onto the back of the jaw bone there.
28:26And because this is three-dimensionally printed to fit this jaw exactly,
28:31when that slots in there, it isn't going to wobble.
28:34Please, God, everything will go fine.
28:35You know what the risks are.
28:36Primarily infection, the secondary risk is mechanical,
28:39but I think we've done all we can to avoid a mechanical problem.
28:43Okay, big guy. Good.
28:46You're going to be bionic.
28:47Yeah.
28:48You're going to be bionic.
28:50Kato.
28:53Roisin, this is Kato.
28:55Lovely, lovely Kato.
28:57Kato.
28:58You're going to be beardless.
29:00Noel and soft tissue specialist Jonathan will be performing the complicated surgery together.
29:06The main thing for me is that you can get the tumour out to your satisfaction.
29:10Yep.
29:11I'm confident we can get the implant done.
29:13Okay.
29:14Jonathan begins carefully prizing the tumour away from the healthy side of the jaw.
29:20The big question is, are we going to be able to get all the tumour out without actually damaging the opposite side,
29:28because it's got a lot bigger since the last time we saw it.
29:31So we're just going to put some local anaesthetic around the main nerve that feeds that lower jaw,
29:37so it's very similar to having a nerve block at your dentist.
29:41If this is what your dentist normally does to you, I'd go to a different dentist.
29:48So what John has done here is he's separated the tumour from the other jaw bone,
29:52and I'm going to cut right between these teeth here, which are called the incisors.
29:56Noel will remove the entire left-hand section of jaw bone that contains the tumour.
30:03The anatomically contoured 3D implant can then be fixed into place using special locking screws,
30:10packed on either end with bone graft and sprayed with stem cells
30:15to encourage bone to grow into the titanium mesh of this new half-jaw bone.
30:21So that's the jaw bone with the tumour growing in it.
30:25So hopefully we've got all the tumour out.
30:27There's a little muscle and tissue on the side there,
30:30which hopefully will act as a buffer between the other bone,
30:33so the tumour has not spread.
30:36With one side of the jaw bone removed, the implant can now be put in place.
30:41It's a sculpture of rare beauty.
30:43Bone marrow extracted from near Cato's shoulder is then packed around the ends of the implant.
30:52Finally, Noel sprays on stem cells from Cato's bone marrow,
30:56mixed with platelets and clotting factors from blood,
30:59and a man-made catalyst glue that will help the mixture to set.
31:03So this is the future, a three-dimensionally printed implant that exactly fits the body,
31:08plus the body's own natural healing system propagated to get the perfect marriage of mechanics and biology.
31:16That's our goal.
31:17Thanks very much everybody, well done.
31:22The cutting edge surgery has taken two and a half hours.
31:26The 3D CT looks really good.
31:30You can see how the implant contours onto the mandible.
31:35It's very nice.
31:36Well, so far so good.
31:38Now we've got to hope that the cells really help the tissue to grow on,
31:41because I think mechanically that sound looks good.
31:44Super cat Simba is being transferred to Noel's Orthopaedic Centre,
31:57to undergo the Wolverine-inspired surgery on his fractured foot.
32:03But before the operation,
32:05Jonathan needs to uncover the skin graft he performed four days ago.
32:10The moment of truth, my friend, the moment of truth.
32:13And either the graft will come off on the bandage,
32:17or the bandage will come off and the graft will stay on the leg.
32:26Pretty good all round?
32:28I would be happy with that.
32:30Yeah, that's all good.
32:32That's a huge relief.
32:34Well done, mate.
32:35Good.
32:36It's all up there.
32:37It's down to you now.
32:40My bit's done.
32:41My bit is done.
32:42No pressure.
32:43No pressure then.
32:44All right.
32:45Let's get the kit rocking and rolling.
32:47Well done.
32:48OK.
32:49Thanks, Noel.
32:51Simba's metacarpal bones have fractured into tiny pieces,
32:55very close to the joints.
32:57Noel needs to realign these bone segments,
33:01so he can pin them into place.
33:03Try and find the bottom part here.
33:05Give me a 0.9 millimeter drill bit.
33:10So as you can see, this is tiny.
33:12Noel inserts metal pins through the minuscule pieces of bone.
33:20Dealing with these bones is like trying to put matchsticks back together, really.
33:24Oh, my lord.
33:25Is this a pussycat or a hamster?
33:31And so Wolverine begins to emerge.
33:41So this isn't in any textbook.
33:42I don't think there's any other technique out there that will be superior to what we're
33:47doing now.
33:48But yet, it's not widespread in terms of acceptance.
33:52And I think that that's a real shame.
33:56OK, so we're just going to put a little bit of this bionic glue on each of the fracture sites.
34:03Hold that.
34:04Hold that.
34:05Hold that.
34:06The team are pioneering another technique today,
34:09a newly developed gel with a bone protein suspended in it
34:13that should slowly help to heal the fracture.
34:16Oh, man.
34:17I love bionic juice.
34:19Finally, Noel builds a frame to take Simba's weight off the foot while it heals.
34:29So these are the pins that have gone up like the Wolverine pegs into the metacarpal bones.
34:36Meanwhile, we've held everything stable from the wrist down using this rod attached to this
34:42walking frame so that Simba can put this on the ground without affecting the foot.
34:47Having had two major operations in four days,
34:52it will be some time before Noel knows if Simba's legs will make a full recovery.
34:58I see you're missing your little friend as well, aren't you?
35:07Two days ago, two-year-old Staffy Tiny had the first operation to treat the painful erosion affecting his elbows.
35:14Come on, Noel.
35:17Stop being a superhero and bring us tiny.
35:20I hate you.
35:21Melissa and husband, Saj, have come to take him home.
35:24I've been desperate to get here.
35:26I've been pacing around for over an hour.
35:29And he was late home from work as well.
35:32So I was literally clock watching.
35:34And, yeah, I was running to the car almost really, wasn't I?
35:39Yeah.
35:40To get here.
35:41I couldn't wait to get here to pick up my boy.
35:45Get myself prepared.
35:47Now, buddy.
35:50Who's in here?
35:51Hello, darling.
35:52Who's in here?
35:53Go down to his level now.
35:55There we go.
35:56No excitement, mate.
35:57No excitement.
35:58You've got to be careful.
35:59Let me come in there with you.
36:00Happy to see you.
36:02Happy to see you.
36:03Let's go out into reception because he's quite boisterous.
36:06Now, as you can see, he's using it reasonably well.
36:09We'll go on the carpet there.
36:11Now, remember, although he feels full of beans...
36:14Yeah.
36:15..the reality is different.
36:16Yeah.
36:17The reality is he could break all those screws.
36:19Yeah.
36:20And believe you me, you don't want that.
36:21Oh, God, no.
36:22Yeah, do you want to get the car and just bring it up to the door?
36:25I think I'll get some sedatives for him for you to go home with,
36:29just in case.
36:33Do you know what?
36:34I don't want him to be like it at all.
36:38Tony.
36:39Shh.
36:41Calm down now, chat.
36:42So these are sedative tablets not to be taken yourself
36:44no matter how stressed you get.
36:46OK?
36:47Damn it.
36:48I honestly think that once we get him home,
36:50he's just going to be totally zonked.
36:53Yeah, I'll tell you what, after what I've done to secure him at home,
36:56I'm either going to make a great dominatrix or a fab sailor.
36:59Oh, great.
37:00OK.
37:01I'm going with sailing.
37:02But I'm going to leave Saj with the other aspect of that.
37:07Good lad.
37:08Thank you, I'll take that.
37:09Yeah.
37:10Thank you so much.
37:11Mate, look out for yourself and keep that tongue in.
37:13Simba the therapy cat has been at Fitzpatrick's for four weeks now.
37:25Like many regular visitors, the staff can't help but become attached.
37:30It's the patients you see back week in, week out that you get to know really well.
37:34Hey, baby.
37:36They kind of become a little bit part of the family.
37:38Come on, sausage.
37:39You need to get waking up.
37:41Yeah.
37:42You've nursed this animal back to health.
37:44You kind of develop, like, this love for them.
37:50I honestly could fall asleep so easy right now.
37:54I have no favourites.
37:56No favourites?
37:57Some favourites.
37:58I have favourites.
37:59You can't help it.
38:01I do have favourites.
38:05But that's not a lie.
38:08Do you have favourites?
38:09Favourite animals?
38:10I like pandas.
38:11I mean, in the best.
38:12Hey.
38:13Do I get a hug?
38:14Oh, yeah, buddy.
38:15Yeah.
38:16Well done, mate.
38:17For Kian, being away from Simba is proving challenging, so he and mum, Becky, have come
38:30for a visit.
38:31Do you want to see where he stays?
38:33OK.
38:34Now, I don't normally do this.
38:35In fact, I'm not going to bring mummy through because normally I don't.
38:38So you have to stay by my side.
38:39Come on.
38:40Here we go.
38:41Come this way.
38:50Simba, look who's here.
38:52Hey, mate.
38:53Look who's here, buddy.
38:55There you go now.
38:57Shall we lift him out a little bit?
39:00There we go.
39:04There we go.
39:05Hello, Peter.
39:06Now.
39:07Steady, steady, steady, steady.
39:09As you can see, he's very lively.
39:11Yes.
39:12He wants to walk on it.
39:13Good boy.
39:14So why don't you chill out with him for a little while.
39:16Just hang, and I'll come back and see you.
39:18All right, buddy?
39:19What would you say to Noel?
39:20You OK?
39:21You're very welcome.
39:22How do you feel?
39:23How do you feel to be with him?
39:26Happy.
39:27Happy.
39:28Oh, that's what you wanted to lay down.
39:30There's a good boy.
39:31There.
39:32Although Simba is gradually improving, he's not yet ready to go home.
39:37All right.
39:38How's it going?
39:39Fine.
39:40I know.
39:41I know.
39:42I know.
39:43It's all.
39:44It's all.
39:45It's all.
39:46It's all.
39:47It's all.
39:48It's all.
39:49It's all.
39:50It's all.
40:06It's five days since Kato received his bionic jaw implant.
40:09It may not be roast beef on the menu, but he certainly doesn't seem to have lost his appetite.
40:16We brought him all soft food in.
40:19We've not got any hard food.
40:21All soft treats for him as well to try and make it as easy as possible.
40:24He does have a really clever way, though, of being able to inhale a piece of ham without actually chewing it.
40:30If you hold up a piece of ham, he just goes, and it's just gone.
40:33So I think he'll be OK.
40:36I can't imagine what it's looked like without his beard.
40:40Pretty.
40:45All righty.
40:46Kato's mommy and daddy.
40:47How are you?
40:48Nice to see you smile.
40:50Nice to see you smile.
40:51Come on in.
40:52Oh, you've got a white box.
40:53That's super kind.
40:54Wow.
40:55Look at that.
40:56Look at that.
40:57Oh, look at that.
40:58Oh, that's amazing.
41:00Did somebody make that from his picture?
41:02It was a photo.
41:04That's brilliant.
41:05And then I've iced it.
41:07You iced it?
41:08Yeah.
41:09Hidden talent.
41:10Did she make one of those for your birthday ever?
41:13That's pretty impressive.
41:14Thank you so much.
41:15That's super kind.
41:16And I'll go and get him for you.
41:17Thanks.
41:21You're not going to cry, are you?
41:22No.
41:23Now, who's in here?
41:26Oh, hello.
41:27Hello, family.
41:28Hello.
41:29Hello, family.
41:30Hello.
41:31How are you doing?
41:32Good.
41:33So, as you can see, he looks fit.
41:35I mean, you wouldn't know, really.
41:37Apart from he's lost his beard.
41:38Apart from he's lost his beard.
41:40I had to shave his beard off.
41:41But that'll grow back, won't it, Kato?
41:44It was great to see him.
41:45And I think it was great for him to see us as well.
41:48He seemed excited.
41:50Can I have a kiss kiss?
41:51Are you going to forgive us for what we've done to you?
41:54Eh?
41:55There's a few little worries that we have.
41:57Whether the skin heals back to the implant
42:01and whether he gets an infection.
42:03But we're keeping our fingers crossed
42:05and hopefully it will all go well.
42:07We're going home now.
42:08We are.
42:13Come on, then.
42:15Come on.
42:16Come on.
42:17Come on, then.
42:18Come on, then.
42:19Come on, then.
42:20He absolutely is ecstatic.
42:22He's made great recovery.
42:24And we can have him off the lead now.
42:26Come on, then.
42:27Come on.
42:28Come on, then.
42:29Come on, then.
42:30It's a little bit sad because I was almost hoping
42:32he'd run off into the sunset.
42:34And because he's such a mummy's boy,
42:37he's sort of stuck to my side anyway.
42:40Come on.
42:41Come on.
42:42Come on.
42:43Come on, then.
42:44Come on, then.
42:45He absolutely loves, loves his life now.
42:48You can see it in his face.
42:49Totally different dog.
42:51Are you good boys?
42:52It's your heart.
42:53Come on, then.
42:54Well, Noel, he's just brilliant, isn't he?
42:57Come on.
42:58He's got my dog who I adore out of pain.
43:01Come on.
43:02What?
43:03You can't get better than that.
43:04Come on.
43:16All right, Simba.
43:17It's time to go home.
43:19Hey.
43:20Hey.
43:21Therapy cat, Simba, has spent two months at Fitzpatrick's,
43:23after the car accident that devastated his front legs.
43:27Here he is.
43:30Hello.
43:31Hey, Simba.
43:32Look who it is.
43:33Here it is.
43:34It's finally time to go home, to continue his recovery with best friend Cian and the family.
43:40I don't think any of us ever, ever, ever dreamed he could survive this.
43:46And here he is, happy and smiling and purring and, ah.
43:51Coming home, darling.
43:57Simba will need to return for a check-up, to see if his paw, held together with Noel's
44:02Wolverine pins, has fully healed.
44:11It's five months since Cato had the tumour removed from his jaw.
44:15What's that?
44:16What have you got to do?
44:17Good boy.
44:18Do you like it?
44:19You don't like ham, do you?
44:20I'm going to have some ham.
44:21Sit down then.
44:22The insatiable lurcher's new bionic implant is making fast work of anything that comes
44:27his way.
44:28He is a bit more messy now.
44:30He tends to drop it all over the kitchen and bits fall out of the side where he hasn't
44:35got any teeth.
44:36Oh, you've got it all down the side of your mouth.
44:40And when he shakes his tongue comes out and sometimes showers us a little bit.
44:45But we don't mind that, do we, eh?
44:47We don't mind a little bit of dog spit.
44:50That's very cute.
44:51For a while I think we sort of thought, what have we done?
44:54And should we have, you know, should we have done it?
44:57I think him coping with it helped us cope with it, really.
45:00Hey, Tom.
45:01What about football?
45:02I don't even think now he's aware that anything's different.
45:05He's just a completely happy, bonkers dog.
45:11Yeah, we're at the forefront of veterinary medicine, but at the end of the day, we've
45:15got our dog and he's going to live for as long as he should live.
45:18So that's what really matters.
45:20Good boy.
45:21It's been seven months since Simba the super cat was hit by a car.
45:31Simba, come on.
45:32Simba's doing really well now.
45:34He's running around.
45:35He's taking Cian to bed as he used to.
45:37His hair's all grown back.
45:39There's no scars anywhere.
45:41Simba!
45:46And it's so nice to see Cian and Simba back together because the difference
45:50Simba makes in Cian's life is huge.
45:54It was very difficult without him.
45:57It just didn't feel safe.
46:01Yay, Simba.
46:03It's probably the best feeling ever, having him home.
46:07Other cats would have given up, but Simba just has patience and the wheel to live,
46:13and I never lost faith in him.
46:16He's my bestest friend.
46:20No one can replace him as a best friend.
46:22He's the best cat ever in the world.
46:25Here will you please,
46:33and he stays.
46:35Maybe it was just your,
46:37maybe you'll try to reach out.
46:38Transcription by CastingWords
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