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00:00Go and see Uncle Noel.
00:02Not all superheroes wear capes.
00:05He's so cute. Oh my God.
00:07I've got a new friend. He's beautiful.
00:09Professor Noel Fitzpatrick and his team
00:12Can you have some nice eggs for me?
00:14Offer cutting-edge solutions.
00:17What are you doing to me to dream these things up?
00:20I dream a very little else.
00:22To help save the nation's pets.
00:24This has to be done within the next 48 hours.
00:26Coming through.
00:27Please be okay. Please be fixable.
00:30You only get one chance at this.
00:31I just have to hope my best is good enough.
00:34Come on.
00:35You're a trooper. You'll be out there.
00:36Transforming the world for families.
00:39What have we got here?
00:41One animal at a time.
00:44That's crazy.
00:45He is just back to living his best life.
00:48You've got a super dog.
00:49He told me modestly that it was technology
00:51but it was so much more than that.
00:53You're cute.
00:54He'd worked a miracle.
00:55Now, it's me.
00:56Yeah?
00:57It's going to be alright.
01:06Eight years ago we started filming Noel's remarkable work.
01:10All right, mister. Look at what you're making me do.
01:13Thousands of beloved animals have walked,
01:16or been carried through the doors of this exceptional practice.
01:21All in search of hope.
01:23What's this?
01:25Good girl.
01:27Now, in this special puppy episode,
01:30we'll follow the incredible journeys, both old and new,
01:34of the young patients who have stolen hearts at the practice.
01:38Oh, my goodness.
01:39You're a big puppy, aren't you?
01:41And find out more from the families.
01:44She's had, like, three and a half great years so far.
01:48At the centre of these extraordinary stories.
01:51Without Noel, you know, I think it would be a very different ball game.
01:54Oh, my gosh.
01:55Hi, stinky baby.
01:56Who doesn't like puppies?
01:57Anything small and fluffy.
01:58The whole of the practice comes in just to give it kisses.
02:11Your ovaries dropping.
02:14You can't resist a puppy cuddle.
02:21One of our neurologists has got a little border collie puppy,
02:25which has melted all of reception's hearts.
02:28Absolutely to die for.
02:32They seem to kind of just bounce back.
02:34Oh!
02:36And they have such, like, a positive energy about them.
02:39Yes!
02:40Yes!
02:41She's very invasive with her love.
02:43She just licked in my eye, and I was like, thanks for that.
02:52People get puppies for many reasons.
02:54Some play a very special role in a family's life.
02:58This was the case in 2018, when we met six-month-old Roth collie Merida.
03:05Unfortunately, we were told that we were going to struggle to conceive children naturally.
03:10And that we might not be able to at all.
03:13Oh.
03:14When Merida came into our lives, it was just...
03:17It just picked us both up, didn't it?
03:19Give us some responsibility.
03:20Yeah.
03:21She was like our child.
03:22You think about the dog more than anything else?
03:24Yeah.
03:25The first Valentine's Day we had, I actually brought the dog a Valentine's gift before I bought Gemma once.
03:29Sadly, it soon became clear that Merida wasn't behaving the way a young dog should.
03:36She's quite subdued for a puppy.
03:38She likes to play lying down.
03:39She doesn't really get up on her feet that much.
03:42She'd started stumbling a lot more.
03:44And I was like, something's not right.
03:46The family were told that the bones in Merida's front legs were deformed and her elbows didn't fit together properly.
03:54It was absolutely devastating to be told that she's got joint problems already at 12 weeks old.
04:02It was a real shock.
04:08Desperate for help, Gemma and Lewis made the four-hour journey from Liverpool to seek Noel's advice.
04:16Hi guys.
04:17Come on in.
04:18Hello again.
04:19How are you doing? Nice to see you.
04:20Noel has taken CT scans, which have revealed the complexity of Merida's problems.
04:25So this is a physical model of that.
04:29And what this allows us to do is to assess exactly what's happening here and here.
04:34And this is what's called short illness syndrome.
04:36Which is where this bone does not grow as quick as this bone.
04:41Means that this bone acts as a ball string and that acts as a ball and it pops out of the joint.
04:46Not only does it pop out of the joint, it also bends and twists and pushes the paw out.
04:51Now this makes the repair very, very complex indeed.
04:54You've got to get the wrist and the humerus somehow back into general alignment.
05:00You have to remove the ball string effect of the ulna.
05:03And at the same time, you have to pull that radial head back in.
05:07And at the same time, you have to rotate it because it's facing out like a flipper at the moment.
05:13So this is a massive job.
05:15Is it the same on both legs, is it? Yes.
05:17Pretty much the exact same as that. Yes.
05:19That's really nice, aren't they?
05:21Now we've clipped both of her front legs so you can see just how deformed they are.
05:25Because you need to know in your head what to expect here.
05:28Come on, sweetheart. There we go.
05:30Oh, God.
05:32Come on. Hello.
05:34Come here.
05:36OK, the other thing that was quite apparent is how much pain there was on extension of the elbow, unfortunately.
05:42The reason to clip up is to double-check that you still want to go through with it
05:47because this is as complex as growth deformities gets.
05:51Just seeing her legs like that now makes you realise how much she's putting up with.
05:55See, we thought she was getting by, you know?
05:57Yeah, yeah.
05:59It was just heartbreaking and shocked.
06:02I was just like, how is she walking?
06:04How is she even getting up in the morning?
06:06I thought, she can't live like that.
06:07If you want me to, I will try my best to try and get her out of pain
06:11and to give her a functional quality of life.
06:13Yeah.
06:14That's what we want, don't we?
06:15Yeah.
06:16Is there anything you want to ask me before I proceed?
06:18I just needed to make a...
06:19I needed to look in the whites of your eyes and say to you
06:22that we are now on a four-month journey together.
06:26Yeah.
06:27OK.
06:28Yeah.
06:29There are many people both within and outside of my profession
06:32that would say that Merida shouldn't go through such a prolonged procedure
06:37and that euthanasia would be a justifiable option.
06:40But the reality is that we live in a world where surgery and possibility
06:46is moving forward all of the time.
06:48So our responsibility is to develop an ethical framework for that.
06:52And I think that the families who love animals deserve that choice.
06:57Are we doing right Bing?
07:07Yeah.
07:08Sure?
07:09Yeah.
07:10Thanks you, Helen.
07:11Have a good night.
07:13It's 9.30 in the evening and Noel has been asked to take a look at a
07:26seven-month-old Weimarana puppy called Tito, who's been involved in a traffic accident.
07:33Hi, Tito.
07:34Hi, mate.
07:35How are you?
07:36Oh, you're in a poorly state, aren't you?
07:38You're in a poorly state.
07:39Oh, my goodness.
07:41You're a big puppy, aren't you?
07:44She is extremely swollen.
07:47Holy schmolly.
07:48We're going to have to have a look and see what the story is.
07:51It's all right, matey.
07:53It's fine.
07:54I got you.
07:55What happened?
07:56Hit by a van.
07:57The van was going very slowly but she got clipped quite hard and then bounced on the pavement.
08:09The accident was a shock to Nicky and Matt, who had waited a long time for Tito to come
08:15into their lives.
08:16For 20 years we seemed to have been together.
08:19I was like, I really want a dog.
08:21And then we got to a point where we moved to this house and it just lent itself to having a dog.
08:28I suppose I had to give in.
08:31It had been a long time.
08:32Long, long time.
08:33And one day I found her online on this website and she just looked gorgeous.
08:40And Nicky went, OK.
08:43We're getting a dog then, aren't we?
08:45And I'm like, mmm, looks like it.
08:46So that was that.
08:47It was an instant love affair on my part.
08:55Tito's a brilliant dog.
08:56She comes to work with me every day.
09:00This particular breed is considered a felcro breed.
09:03They just want to be with you all the time.
09:07She is very affectionate, hasn't got a dangerous bone in her body.
09:20Tito was walking alongside her family when she was suddenly spooked by a passing van.
09:25The van literally came level with me and she just ran out straight in front of the van.
09:31I screamed, obviously.
09:33The van stopped dead.
09:35She was hit and sort of rolled over, but didn't get run over.
09:40I ran towards her to go, don't move.
09:43But she swung her head round and just bit my hand.
09:48So by the time I got round the van, Nicky was standing there with blood running down her arm.
09:53The dog was laying on the floor and it was carnage, really.
09:57Five to five on bank holiday Monday Easter.
10:00Beautiful sunny walk with the dog.
10:02Five past five.
10:03Armageddon.
10:04Absolute Armageddon.
10:05Absolute Armageddon.
10:09One, two, three.
10:12Noel has requested x-ray pictures of Tito's back legs to fully assess the damage.
10:19Holy shit.
10:20That's unlucky.
10:21The left femur has exploded in the middle here with several pieces exploded outwards into the muscle.
10:27It's not the worst fracture I've ever seen, but it's pretty bad.
10:33Ah, fuck.
10:34She's got a slipped capital femoral pyphysis on the other side.
10:38The x-ray pictures show more injury than originally thought.
10:41So the head of the femur has completely come off the neck here.
10:46That's a very, very serious injury in a puppy because there's a growth plate right here.
10:51Now, if you can't keep the blood supply to the femoral head and the femoral neck, then the femoral neck rots away.
10:56It's the luck of the draw whether the blood supply will hold up.
11:00And speed is everything.
11:02So that is more urgent than this.
11:12Mr. Fitzpatrick.
11:14The femoral fracture on the left side is explosive, but it's no big deal.
11:21The other side is actually even more serious because there's a growth plate at the top of the femur from which the head of the femur grows.
11:30Now, at the moment, she is still growing, obviously.
11:34And therein lies the problem.
11:36That blood supply has been ripped apart.
11:38This has to be done within the next 48 hours.
11:40That's critically important because of blood supply.
11:43Time has already maybe run out.
11:55There you go, sweet petal.
11:57Seven-month-old Weimarana puppy, Tito, has been hit by a van and sustained multiple injuries.
12:04We're going to try and fix Tito now.
12:07Nine times out of ten, if there's a blood and nerve supply, everything is fixable.
12:12There are many, many dogs that get put to sleep and many dogs that get amputated limbs because people say nothing can be done.
12:20It's often, that's the easiest way out.
12:23But today, that is not the way out for Tito.
12:26Right, let's do it.
12:27Tito's left leg is fractured badly, but Noel's first job is to reattach the fractured head of the femur on the right side to try to restore the blood supply to the neck before it is irreversibly damaged.
12:45What we're going to do is put pins in, just like the stilts of the wigwam, but upside down.
12:52The head of the femur is down in the socket.
12:57We're just going to pop the neck in like so, on top of the head, which is like a shell.
13:03Noel reattaches the head to the neck by driving the pins into the head of the femur, avoiding penetration of the joints.
13:12If the pin goes through the shell into the joint through the cartilage, Tito will be in pain forever.
13:19So what I'm doing is I'm feeling for when the resistance happens to the tip of the pin, which is quite difficult,
13:26because you're feeling for the interface between cartilage and bone, both of which are soft in a puppy.
13:30All right, let's go. Flip, please.
13:47With the head reattached to the neck of the right femur, Tito is turned over so that Noel can now work on her exploded left femur.
13:55Let's go. Every second counts.
13:56To help pull all the pieces of bone back into place, Noel is using a distractor to stretch the contracted muscle.
14:04So we just turn the turnbuckle until it stretches a bit, then we let the muscle relax into that stretch, just like if you're stretching your own muscles.
14:13Once the muscle has sufficiently relaxed, Noel inserts a pin through the centre of the femur to align the two ends, before repositioning the splintered pieces.
14:22There's two fragments identified on the x-ray picture in the CT scan and several smaller fragments.
14:29So ideally, I want that to fit in without ripping blood supply off.
14:32Noel reattaches the fragments with wire, ready for a plate to hold it all together.
14:38Once you get the bones in around about the right place, they usually do very well, because puppies are healing machines.
14:45Can I have a hacksaw, please?
14:49Noel cuts halfway through the pin before driving it inside the bone.
14:54Hair pressed until it breaks off, and then it's countersunk onto the top. It can't do any damage.
14:59Lastly, Noel adds the final screws and wire to the plate.
15:09OK, so everything is reconstructed now.
15:12OK, mate, let's go to CT scan now, please.
15:18The repairs to Tito's legs have taken four hours.
15:21So far, so good. And Tito will hopefully be running around like a normal dog in six, seven weeks' time.
15:38Oh, look at you!
15:46Many puppies come to the practice with genetic limb deformities.
15:51I think you've got a combined problem, actually.
15:54I think you've got the plastic, mate. Plastic.
15:58Their options can be limited, and futures uncertain.
16:02Here you go, pups. What's happening?
16:04Come on, then. Come on, then. Come on, then.
16:07But Noel uses innovative techniques to give them a chance.
16:11Well done, mate. Well done.
16:15Good girl. Yeah.
16:19Right, let her down a little. Stay there.
16:22In 2018, six-month-old rough collie Merida, the puppy with deformed front legs,
16:28was about to undergo a complex procedure to try to get her out of pain.
16:36OK, here we go.
16:41Merida's ulna had grown too slowly, causing the radius to twist and pop out of the joint.
16:48Noel will remove a section of the ulna to release the radius.
16:52Next, he will fix traction olive-wise to the top section of the radius before making an oblique cut through the bone.
17:01Rigid arches are then used to twist the wrist back into alignment with the elbow,
17:08and are locked solid with clamps.
17:10Finally, a traction unit is attached, so that Noel can slowly pull the radial head into place over the course of two weeks.
17:22So, to a very large extent, this is a three-dimensional biological jigsaw puzzle.
17:27Noel begins by cutting the ulna bone.
17:30You can immediately see the ulna spring apart there because it's under a lot of tension.
17:38I'm going to take this segment out.
17:43OK, relax.
17:45So, it's possible if that ulna does not heal in that I may need to put a plate on it at a later date.
17:52OK, so the next thing I do is the most critical step of the entire operation,
17:57and it's putting the wire into the head of the radius here,
18:01and it has to go in at exactly the right angle, up with the elbow, twisted sideways.
18:06That's it, stay.
18:14OK, so we've got two of these olive wires going through the radius.
18:18I'm going to attach some motors to these two wires here.
18:22It's going to pull that radial head down that way.
18:25And hopefully back into the joint.
18:28And in order to achieve that, I have to cut the radius at a very specific angle, which I'm going to do now.
18:37Next, Noel attaches a series of rigid arches to the ulna and the radius that will allow him to realign the elbow and wrist.
18:45Very challenging.
18:46So now, by rotating around this oblique cut inside in the radius, we've got the wrist parallel as best we can with the elbow.
18:57It'll never be perfect, but that's the best we can get it on foot.
19:01Hold the foot.
19:03Finally, the traction unit is attached.
19:05Relax, everybody.
19:06OK, so the right front leg was very, very challenging.
19:22In fact, it's the most challenging one of this kind that I've ever had.
19:25The apparatus is much more simple on this side, as if you could describe any part of this arm as simple.
19:33Over the next two weeks, Noel will use the traction motors to slowly reposition the puppy's radial heads until they fit beneath the humerus bones again.
19:42Good girl. Well done. There you go. I've done my best. There we go. Good girl. Let's go to CT. Well done.
20:03Oh, look at that. Look at that. No, she says your fingers are much more interesting.
20:10Who's this? Who's this? Who is this?
20:15Leave me alone.
20:17Oh, there's Mr Monkey. Oh, that's exciting. Oh, you're going to chew his ears. Oh, that's nice. Oh, that's nice.
20:25It's been eight days since Vimerana puppy Tito was hit by a van.
20:31She's been recovering from surgery to repair her fractured left femoral shaft and right femoral neck.
20:37So life has been unusually quiet for Matt and Nicky.
20:42She's only been with us since Boxing Day, day after Boxing Day.
20:45And she came into our life like a wrecking ball, literally like a wrecking ball.
20:49Matthew, Nicky. Oh, how are you? Hello.
20:51She's everywhere. If you're having a shower, she's licking the shower screen. If you go in her bedroom, she follows you in the bedroom. You trip over her all day long.
21:00Nice to see all your fingers. God bless you.
21:03She's a puppy and she's a lovely puppy and we just want her home and safe.
21:08Thanks for being great humans on the telephone. Thank you for being a great human in general.
21:14We're all in love with your dog. Oh, bless her.
21:17This is what you had and this is what you ended up with.
21:23Wow. Blimey. Thank you so much. It's amazing.
21:26It's my pleasure. My mother, God bless her, died in February and she said pride takes a fall, Noel. Don't ever get proud.
21:36So I never say I'm proud of a fracture repair, but I have to say this is as close as I've got.
21:42She'd be proud of it. I hope you're okay, Mammy.
21:45With regard to the other side, you will see what we call a slip capital femoral epiphysis where the neck had come away from the head.
21:53Oh, right, okay. She did it well, didn't she? She certainly did.
21:58The other thing I am concerned about is whether it's slightly loose on both hips.
22:03If there is hip dysplasia, well, we can deal with that at a later date, but there may not be.
22:07Okay. It may just be that it was severe trauma.
22:10Okay.
22:12Tito will have hydrotherapy to maintain her muscle mass, but it's possible she may need more surgery in the future.
22:19Oh, look at that. That's amazing.
22:24Now.
22:25Hello, sweetheart.
22:26Hello.
22:27Hi, Mama.
22:28Hello, sweetheart.
22:29Hi, Mum. Hi, Dad.
22:31Look at her wagging her tail.
22:32Hello, Mum.
22:34Hello, beauty.
22:35Waggy tail, taily wag.
22:38So you can see she's able to walk fine. I'm going to show you how to do the walking now.
22:41You can see she's raring to go. I'm taking a bit of weight here with this.
22:45Oh, you're not taking much at all now?
22:46No, I'm not taking much at all. Do you want to have a go?
22:48Yeah.
22:50Oh, right. I see what you mean.
22:51Yeah.
22:52Okay.
22:53So the main thing is no running, no jumping, no slipping, no sliding.
22:55No.
22:56Okay.
22:58Anxious about what we've got to do over the next couple of weeks.
23:00One of us is going to be sleeping downstairs with the dog, which won't be the first time that that's happened.
23:07But absolutely delighted that I've got my family back together, basically, which is all that matters.
23:12I feel like there's a buzz created when you know that there's a puppy coming in.
23:24Look what I have.
23:25Oh, my gosh.
23:27And whenever a puppy does arrive, I feel like people are just waiting their turn for a cuddle.
23:31Who's going to be carrying them, and who's picking them, and who's going to feed them, and who's taking them out for wee-wees.
23:42Oh, I love you, too.
23:44Always brightens everyone's day up. You can feel it in the air that everyone's in a really good mood.
23:49Look at you!
23:50And the way they smell, they always smell amazing. You just want to just smoosh them all day.
24:01Hi, baby!
24:03Hi, baby!
24:05In 2016, the team were all of a flutter when a four-month-old cockapoo puppy with a fractured knee was brought in to see Noel.
24:14Hi there, who have we got here?
24:15We have Monty.
24:17Monty!
24:18How old is Monty?
24:20He is about 18 weeks.
24:23We know you're going to have all the nurses flocking after him.
24:27How about the dog?
24:30John had only had Monty a few months, but he'd already wriggled his way into his heart.
24:36You can't beat the greet you get from your dog.
24:38Come back from work and he's more keen to see you than the wife.
24:42Just the most loving, caring dog.
24:44And that's exactly what we wanted. A good trial run before children, I think.
24:50Fitness instructor John and social worker Jess got Monty soon after getting married.
24:55We fell in love with Monty straight away and I don't think you can ever prepare yourself before you get your own dog.
25:03You don't ever think you'll love him that much, but we love him so much and we just can't imagine life without him now.
25:10Makes you feel a bit more whole as a family.
25:15Monty fractured his knee when he wriggled out of Jess's arms.
25:20There and then I knew it was bad because he yelped and he was holding his leg up and it was floppy.
25:26I was devastated.
25:27Jess was so upset she couldn't face bringing Monty into the vets.
25:33It's far from her fault and yeah, a little bit emotional.
25:37So I had to man up and be the one to bring him in.
25:42John met Noel training in the gym 15 years ago.
25:46Now Monty, please.
25:49Come on.
25:50Hey mate, how are you?
25:52Long time no see.
25:54How are you?
25:56I'm not so happy for you here.
25:58There's a special test we have to do so you hold him tight.
26:02You're in good shape mate.
26:04You're in better shape than me.
26:05Let's lift the arm a little bit.
26:06There you go.
26:07That's it.
26:08One, two, three.
26:12Alright, that's enough.
26:13Pop him down for me.
26:14Good boy.
26:15Yeah.
26:16Good boy.
26:17Alright big guy.
26:18Okay.
26:19I see this fracture all the time.
26:20It happens in small breed dogs usually as a result of jump from someone's arms.
26:25I'm not jumping out of my arms.
26:27What's happened is the dog has fallen.
26:30This quad has put all of the load through the straight patellar tendon and popped that off.
26:34But not only that.
26:36I've had a look at the x-ray picture sent through from your own vet.
26:40There's another growth plate at the top there.
26:42Yeah.
26:43And we can see that there's a fracture through here and this has slipped backwards.
26:46Now, I don't anticipate I'll have any trouble putting that back in place.
26:50Okay, that's great news.
26:51But...
26:52There's always a butt.
26:53There's always a butt.
26:54This growth plate will stop growing.
26:56Which means that this leg could end up slightly shorter than the other leg.
27:01We'd only had Monty maybe six to eight months.
27:06And for that to happen, it was a very, very worrying moment.
27:10I'm going to set up my theatre.
27:11That's the sort of person I am.
27:12In 2016, Monty the adorable but fidgety cockapoo puppy was being sedated for surgery.
27:29Oh!
27:30Lucky, Moses.
27:31You are mischievous.
27:32Give him!
27:33Puppy, puppy.
27:34We go to sleepy.
27:35Lie down.
27:36Clever puppy.
27:37Hi.
27:38Shhh.
27:39Look at you.
27:40You're so cute.
27:41He gets so, like, nice and relaxed with his pre-med and then someone else comes along and strokes
28:00him and then he's like...
28:01He's sleepier than he was.
28:04Hey.
28:05You're not helping.
28:06No.
28:07Sorry.
28:08Oh my God, you're really cute.
28:21With Monty finally out for the count, Noel can start to fix his knee.
28:25Can you pull me?
28:27Goodbye.
28:30Noel's first job is to pull the fractured bone segments back into alignment.
28:35What we're going to do is we're going to drive a pin down through the back of the joint
28:40here into the bone.
28:42And the thing is you have to do all of this by feel.
28:45You can't actually see the fracture.
28:47The fracture's hiding in here.
28:49I've isolated the back of that piece of bone with this needle.
28:53I'm now going to isolate the front with this pin.
28:57I'm going to use the forceps to pull the front part of the tibia and the kneecap tendon
29:03back down.
29:04A little bit of orthopedic twister here.
29:08With the bone segments and attached kneecap tendon back in position, Noel anchors them.
29:14We've got five pins in now, two on the inside, one on the outside, two in the front.
29:19A loop of wire will prevent the kneecap from pulling upwards.
29:25Now we've got a figure of eight band pulling against the kneecap tendon.
29:31So when the knee flexes and extends like so, there's a pulley pulling against the natural pulley.
29:38So that bit of bone can't flip up again.
29:41So that's it done.
29:42Ready to close.
29:43Monty's knee joint is back as it should be.
29:46Let's go puppy.
29:49A second growth plate further down his tibia bone will continue to grow.
29:54And if Monty's lucky, he won't develop further problems.
30:01All right, Merida.
30:05Hello.
30:08In 2018, collie puppy Merida was recovering from her challenging double leg surgery.
30:19Noel had been gradually adjusting her traction frame to get the head of her radius back into position in her elbow joint.
30:26There's little numbers on the dice here.
30:30And every time I turn from one to four, we push this part of the frame away from that part of the frame by one millimetre this way.
30:39Hopefully it's going to pull the radial head inwards and downwards.
30:44Merida's family drove regularly from Liverpool to see her.
30:49Gemma knew exactly what her puppy was going through.
30:52Growing up, her bones also hadn't formed properly.
30:56I was 14, going on 15 at the time when I had my foot surgery.
31:02It was bone lengthening and reconstructive surgery and it was painful.
31:09Turning that fixator, you know, every day was uncomfortable.
31:14And you're just thinking, this is a lot for a puppy to take on.
31:23She's gone fair here, hasn't she?
31:29After two weeks of daily adjustments and a frame reduction, Noel advised that Merida would benefit from further surgery.
31:36The leg's in pretty good alignment, but we can see here where Merida's ulna is still moving.
31:45So we're going to have to stabilise the ulna on both sides.
31:49Merida's ulna bones were cut to straighten her legs.
31:52But they were moved so much that Noel had to stabilise them in their improved position and add metal plates.
32:02You've just got to be very, very conscious that we could fracture the radius here.
32:06Because then we'd lose all the alignment we've already got.
32:09I need IM pins, please. Give me a 1.8.
32:15Use a bendy wire to line it up.
32:18And now we're just going to put a plate across it.
32:21Because there's an S-shaped bend in the middle of the ulna, I'm going to have to bend the plate in multiple directions.
32:27Noel inserts two plates to make sure the ulna is secure.
32:32We're going to put bone graft in here into the middle now to try and get all that fuse together.
32:39Surgery is repeated on Merida's other leg, and it will be another week before she can finally return home to her family.
33:10Three days after the operation to fix his fractured knee, wriggly cockapoo Monty was ready to go home.
33:18John and wife Jess were there to collect him.
33:22Monty from and down.
33:24Hello.
33:25How are you?
33:26Lovely to meet you.
33:27How delightful to meet you.
33:29Your little baby is doing fine.
33:30Good.
33:31The point is, don't beat yourself up, because this happens all the time.
33:34It literally happens all the time.
33:35I just feel like he's so young to have this done.
33:36It's more that he's so tiny.
33:38I told him I see 10 or 12 of these a year.
33:41I don't think that's that many.
33:42Well, that's one a month.
33:43You said like five a month.
33:44It's one a month.
33:45Everybody cuddles their puppy and puppies jump.
33:47Yeah.
33:48So this happens.
33:49Okay.
33:50When he jumped, he twisted his leg.
33:51The top of the tibia came off, because that's a weak growth area.
33:54Mm-hm.
33:55So that's pulling it back in place with two pins and a pulley wire, so that that pulley pulls against that pulley.
34:01Okay.
34:02Let me get him for you.
34:03Come on, mate.
34:04In you go.
34:05Hello, rascal.
34:06My boy.
34:07Hello.
34:08Look at your leg.
34:09Pick him up so he doesn't struggle.
34:10Mama's boy.
34:12Hello, Teddy.
34:13To be fair, when John left the other day, he was quite emotional.
34:17I'd never seen him like that.
34:19I just kept sobbing.
34:20It's awful.
34:21Yeah.
34:22Ooh, hello.
34:30John and Jess will need to keep Monty calm for two months of cage rest to allow his bone to heal.
34:37Super happy to have him back.
34:39We'll fill him with some treats, and that's it.
34:42He'll be back to normal.
34:43As you can hear, he's already going nuts.
34:44So, keen to get out, and I think so are we now.
34:48So, I think it's all good.
34:49It's been six weeks since big pup Tito was hit by a van, breaking both back legs.
35:07The x-ray pictures revealed she could also be affected by hip dysplasia.
35:12So, to improve her muscle mass, she's enjoying twice weekly hydro sessions.
35:17We're hoping from those sessions that she will build up the muscle, and if it doesn't mend the injury, the trauma that she's had, then at least it builds her up to have the other surgery to replace the hip.
35:27I think she's making good progress.
35:28Her age is actually on her side because they feel a lot quicker when they're younger.
35:29She needs a little bit more encouragement to use her back legs.
35:30She wants to tuck them up a little bit at the moment.
35:31This is your engine.
35:32You've got to use this more.
35:34In general, she's much more confident on her back end now than she's been.
35:39Hopefully, oh God willing, if she goes through the hydrotherapy and comes out the other side of it with a mended kind of socket, ball and socket, that would be brilliant.
36:00After two major operations and regular traction on her front leg bones, Collie puppy Merida was finally ready to return to her family.
36:16It's been a long journey and an emotional journey, but we can see the light, finally.
36:24We're excited today because we get to bring her home.
36:27We achieved a really good result considering where we started with.
36:32That's amazing.
36:33And she's actually very happy with her elbows.
36:37Now, she's got very floppy wrists on both sides, but I'm hoping with some judicious hydrotherapy at your local hydrotherapy centre that we can start building up.
36:45Yeah, yeah.
36:46All right, Merida, you ready, sweetheart?
36:50Come on, Baba.
36:51Who's here?
36:52Who's here?
36:53Oh, there we go.
36:54Hello.
36:55Hi, sweetie.
36:56Good girl.
36:59Well done.
37:00Well done, Baba.
37:01Well done.
37:02Well done.
37:03Well done.
37:04Yeah.
37:05Oh, look at your little legs.
37:07She was better than what I thought she was going to be.
37:10Much better.
37:11Better.
37:12Come on.
37:13Good girl.
37:14Oh, you're off now.
37:15I'm going to slow you down.
37:16You're pulling me.
37:17Serious stuff is over, like the surgeries and the phone calls.
37:20So, yeah, it's just a case of us doing the hard work now and keeping up with everything.
37:25Yeah.
37:26I'm sure she'll recover as well when she's in our care.
37:28I know.
37:29Are we going to go home?
37:30Yeah?
37:31Nine months after taking their precious puppy home, Merida's family returned to Fitzpatrick's with a serious concern.
37:50So, she was doing really well and then just before Christmas we noticed she had a little wound on her right leg and we thought she'd just been bitten by something and it would clear up.
38:04She's now been on rounds of antibiotics and the wounds aren't healing.
38:08Hey.
38:09Hi.
38:10How are you?
38:11Nice to see you.
38:12Nice to see you, mate.
38:13How are you?
38:14Nice to see you again.
38:15You can have, as a human or an animal, a metal implant in your body, i.e. a hip replacement or a knee replacement or whatever, and it can get infected months to years after you've had the surgery.
38:26The hope would be if we can get rid of the metal, the immune system will still deal with the bug.
38:33Yeah.
38:34As her ulna bones have successfully healed, Noel will remove her supporting plates and give antibiotics in the hope that he can clear her infection.
38:44We were just being like a normal family, weren't we?
38:46Yeah.
38:47And this has happened, so it's just another setback for her.
38:52Right.
38:56I was like, this is it.
38:57I said to Lewis, she's going to lose a leg, but if she loses a leg, her right one's not strong enough.
39:01And he was like, don't think anything like that, because that was the worst case scenario.
39:04We couldn't let our head go there, you know what I mean?
39:13I'm not jumping out of my arms.
39:15When Monty the Cockapoo fractured his leg at just four months old, the growth plates at the top of his tibia were damaged, leaving questions about how the bone would compensate in the future.
39:27When it all happened, we were very concerned that certainly when Noel said that he might have one leg longer than the other, and for me, I kind of thought, I've got a dog now that's looking more like a book.
39:37I suppose at the time I just thought, that's it, you know, game over, he's never going to be the same again.
39:43Monty had two months of cage rest and rehabilitation to get him back walking normally again.
39:50And five years on, he's back to his bonkers self.
39:57Monty has a huge character. He's a law run to himself, and he gets away with anything and everything, and he does what he wants, when he wants.
40:06This was not my choice, but he decides to sleep on the bed, so I will often wake up when he is behind my head, licking my pillow, which is slightly frustrating when you're up at half four in the morning.
40:20A few years ago, the family decided it was time to move to the Surrey countryside.
40:26We moved from quite a small house to something a little bit bigger, so he's loving the garden, loving the kind of country life.
40:36Monty, this way. Come on.
40:40To see Monty running around now is, I think, a bit of a dream, because we did think at one point that, you know, that might not have happened.
40:48He does have a very, very slight limp, but you'd only know if you really kind of knew and knew the story behind it.
40:55But now he's back to full fight and fit.
40:57Monty is still very much top dog.
41:01There's definitely a pecking order.
41:03And it probably starts with Monty, and then it goes to Jess, and then it goes to me.
41:08I adore him massively. I think it's the next level for her.
41:12And, yeah, she loves him to bits.
41:15We don't have children, and I think that he's kind of our little boy at the moment.
41:20Noel was amazing, and he was so kind, and he did try and reassure me, but it's still our puppy.
41:29I feel like he still had to go through a massive ordeal, and I do feel really bad about that.
41:34Without Noel, you know, I think it would be a very different ballgame.
41:38The job that he did was just phenomenal, and the aftercare and everything else that he's done for us.
41:44I can't thank him and his team, and I'm sure if he could tell it himself, he would.
41:49He's just living his best life.
41:50It's been almost four months since Tito fractured both femur bones when she was hit by a van.
42:07Today, all three of the family are back walking in their favourite spot, which is also the scene of Tito's accident.
42:14We had to do it, we had to bring Tito back, we had to walk her, because it's such a lovely place to walk.
42:22Weirdly, she has no issue with it. She doesn't care at all.
42:28She's very tentative now of vans, bizarrely.
42:31When she goes near a van, she's like, OK, I think they hurt quite a lot.
42:35Come on! Come on!
42:38Tito has continued her twice-weekly hydrotherapy sessions to strengthen her limb muscles.
42:44We think she's come on leaps and bounds, absolute leaps and bounds.
42:47And she has done brilliantly, considering the back end of her was completely incapacitated three and a half months ago.
42:54Good girl! Oh, good catch!
42:56It's been hard, but she's suddenly, I think she's turned a corner in the last probably months.
43:04Tito's hip looseness may still warrant further surgery in the future, but for now, she's living life to the full.
43:11Good girl!
43:14I think Tito, without Noel's intervention, I don't know where we'd be, but we wouldn't be looking at a dog that runs like she does now, and is as fit and healthy as she is.
43:23I think we've been very lucky.
43:26Eh?
43:35In 2019, Merida was readmitted to Fitzpatrick's with an infection, and had her plates removed.
43:42Thankfully, the rough collie pup fought off the infection, but there was still some doubt over how well she would walk.
43:52Noel did say to us that the outcome might not have been as good as we anticipated.
43:56He never said she'd be 100% better. He said you were looking at maybe like 60-40.
44:01She might be a dog that just plods around and lays down a lot.
44:05Merida had other ideas.
44:08Ready? Let's go. Let's go.
44:13Being able to see her running around, chasing a ball, running up and down the hills, it's great.
44:19She can do about 60 minutes to an hour and a half walk.
44:23When she was a puppy, she was doing 10-15 minutes.
44:26You can see when she walks, she still walks on her pad and a bit at the back of her leg, but it doesn't bother her.
44:32Merida is full of life. She loves company. She loves all our family coming round.
44:41Merida is spoiled, Ron.
44:43If you're a dog person and you know what we've been through, you'd understand why she is our world.
44:48She's had like three and a half great years so far.
44:52Merida's recovery came at a time when her family needed her love the most.
44:56Unfortunately, we lost our little girl, who was born prematurely and she lived for about an hour.
45:07And then she passed away in Lewis's arms.
45:10And then we had Charlie, who was also born prematurely and was stillborn.
45:16And she just got me through it.
45:20She got me out of bed in the morning.
45:21She pulled the covers, you know, come on.
45:25Almost like, it's time to get up. You need to let me out. Let's go for a walk.
45:29You know, she'd bring me a teddy.
45:31And then for this one time, Lewis put a little bow in her hair.
45:36And she came trotting through with this bow in her hair and she just looked at me and gave me a paw.
45:41And that's when anyone was like, we're going to be okay.
45:44You know, we've got Merida.
45:45We didn't want to put ourselves through any trauma.
45:48And then Leo magically happened.
46:00I look at them in disbelief.
46:02We've got our little girl Merida and our, you know, boy Leo and our other babies will always be in our hearts.
46:08They'll never, ever be forgotten.
46:10We're in a really, really good place at the minute and Merida's living her best life.
46:13Her and Leo are like best friends.
46:15So we just hope that continues.
46:18I'm massively grateful to Noel.
46:20He's helped keep our family, our little family together.
46:22She's as happy as a dog can be.
46:24A dog can be.
46:26Ah!
46:54The褋泻le step here and the field and his income is ready for the gente we met.
47:00To overcome him, if the job is going to bite them, when he was just a little girl, there's one woman who is a
47:05Peach.
47:07That's why I'm a young lady who is getting pregnant.
47:09Let's eat, too.
47:11Come on.
47:13The dog can be.
47:15That microscope is 芯写薪芯泄.
47:18Yes.
47:20The figure of poop.
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