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00:01Professor Noel Fitzpatrick
00:03All right, Mrs. Cuddlemonster incoming.
00:07Is the super vet.
00:09We have issues.
00:10I knew I should have got chihuahuas.
00:12At his unique vet practice, he merges mechanics and biology.
00:17Past the point of no return now.
00:19Don't be pulling apart my repair, Mrs.
00:22To heal the nation's pets.
00:24Sorry about coronavirus.
00:25Oh, because you're responsible?
00:26I'm responsible for almost everything else.
00:30Even in the darkest days.
00:32I'm so sorry this has happened to you.
00:33Noel imagines the impossible.
00:36Oh, my little baby.
00:38Oh, my God.
00:39Let's go.
00:41Sometimes you have to bend the rules of mechanics to fit the biology.
00:45And offers hope.
00:47We've definitely made the right decision.
00:49Good boy.
00:50We've got my boy back.
00:52For families and their friends.
00:55Look at you.
00:56Why are you dog-o?
00:57Yes, mate, I love you too.
01:02You get such a wide range of animals here.
01:09We get, you know, your family pets.
01:12Some are people just best friends and their only companions.
01:16Come on, sweetheart.
01:17Good girl.
01:18But of all the animals that check in at Fitzpatrick's, working dogs have a special place in everyone's
01:25heart.
01:26When we are dealing with service dogs, there is that little bit of extra responsibility
01:30just to take that extra good care of them.
01:33The thing is that when a working dog is in my care, I'm not just treating the patient.
01:39I'm supporting a vital partnership as well.
01:42So, for me, it's a privilege to be entrusted with their care and trying to get them back to work.
01:48Big day, it's D-Day for the little man.
01:55He's got no idea, has he?
01:57No idea what's about to happen to him.
01:59Poor little sod.
02:00Two-year-old police dog Trigger has come to the practice for surgery on his spine.
02:06The main thing is he ends up pain-free because he is more and more wincing with pain.
02:11It's clearly getting worse and needs sorted.
02:15Poor little man.
02:18Rob's a dog handler with the Metropolitan Police.
02:22And he's responsible for training Trigger.
02:25His main purpose is to find people and they can follow the centre along grounds, over fences
02:30and just follow the track of where someone's gone till they find them.
02:33Or, if that person was to try and get away, then he's trying to bite them.
02:36Good boy!
02:38The bond between the dog and the handler is amazing.
02:54The only time I'm not with him is when he's asleep.
02:57He absolutely worships the ground I walk on and the feeling's mutual as well, you know.
03:02He's my best pal. He's a great dog.
03:05Trigger went to live with Rob when he was eight weeks old.
03:09And he's very much part of the family.
03:12Trigger gets on really well with the wife and kids.
03:15Sometimes it's so easy to forget that he is actually a police dog because he is a real big softy at home.
03:19Yeah.
03:20But when he is at work, his whole demeanor changes.
03:23And when he's in aggressive mode, the teeth, the snarling, the spitting,
03:27and then when he finds somebody, you find him hanging off of their arm and they're screaming in pain,
03:31you think, my little Trigger's doing that.
03:34Yeah.
03:36But Trigger may not be able to continue to work.
03:41Eight months ago, he had an operation for a stomach torsion.
03:45Whilst he was recovering, I noticed that when he was cold and he lifted his front legs,
03:49he would cry out in pain.
03:51The problem persisted, so then we went to Fitzpatrick and did an MRI scan
03:54and then it was quite clear that he had quite a serious problem with his lumbar sacral.
03:58And that was pinching the nerves that were running down his legs and causing him excruciating pain.
04:03Good boy.
04:07Trigger has been having hydro and physiotherapy sessions to strengthen his core before surgery.
04:13Fung, they're gone. Good boy.
04:16But if the operation isn't a success, Trigger won't be able to go back to work.
04:21And Rob, who already has two other dogs, will have some tough decisions to make.
04:27It would break my heart and the kids and the wife if he wants to go,
04:31but it wouldn't really be fair to keep a three-year-old dog at home.
04:34He will always have that drive to come to work.
04:36See you later, sir.
04:38See you later.
04:39If we keep him and then I get another working dog,
04:41he will make a hell of a racket every time I leave.
04:44For Trigger to be able to come back to work is everything.
04:48And just fingers crossed that it happens.
04:55Police dog, please.
04:57Hi there, you all right?
04:59Yes.
05:00Good morning.
05:01Rob, grab a seat.
05:03Now.
05:04So tell me what his work does.
05:05He's tracking, finding people, biting people, finding property.
05:09So he's attack as well?
05:10Yeah.
05:11OK.
05:12All right, big guy.
05:13I'm hopeful that you're not going to go into attack mode when I do the physical exam,
05:16but I need to track three things.
05:19I'm going to press on his back here to check the nerves here at the top.
05:23I'm going to check the nerves as they run down the back of his legs.
05:26Yeah.
05:27And the third test, I'm going to stick my finger up his bottom, and I'm going to touch that nerve in there.
05:32And all three of those tests would need to be negative in 12 weeks' time for me to sign them off for work.
05:38I don't want to cause him pain.
05:39Yeah.
05:40But I've got to document the pain, and unfortunately, it's very subjective.
05:44True.
05:45OK, now you're going to hold his head, Rob.
05:47Yep.
05:48I'm going to move your chair over here, please.
05:49I'm going to move relatively close to that wall.
05:51True.
05:52Sure.
05:53All right, big guy.
05:54I'm going to check you out now.
06:00Well, I think it's safe to say that test is positive.
06:02Hold tight.
06:03Second test coming up.
06:04Good boy.
06:08Good boy.
06:09Sorry, mate.
06:10We'll do the other nerve on the other side.
06:12Good boy.
06:17I want something.
06:18Sorry, mate.
06:19This is the worst bit.
06:20All right, I'm on it now.
06:23Turn off.
06:24What?
06:25I'm just going to check his hips.
06:26Please.
06:27It's fine, mate.
06:28I'm finished with it.
06:29I'm finished.
06:30I'm finished now.
06:35Oh, dear.
06:36Yeah, he's in a lot of pain.
06:38It's reflected in all of his back end.
06:41We're done.
06:42So, definitely, from my perspective, all those tests would be definitive evidence of pain.
06:49It's called degenerative lumbosacral stenosis.
06:53So, the cause is believed to be primarily genetic.
06:58And it's believed that this disc loses its tendency to be able to hold onto water.
07:03Yeah.
07:04And has dried out.
07:05Yeah.
07:06And is significantly bulging in its centre.
07:09Yeah.
07:10The bulge gets gradually worse over time, so that it squishes the nerve root, and that is what causes the pain.
07:18Yeah.
07:19Another source of pain is new bone formation on either side of the disc, which is pressing in to trigger sciatic nerve roots.
07:28The objective is to remove movement, so there's no stimulation for that bone to form.
07:33And remove the degenerate disc material that is squishing the nerve, so there's no stimulus for it to come back.
07:38Yeah.
07:39Now, what can go wrong?
07:40Well, clearly, as I'm pulling the nerves around, that could go wrong.
07:43Yeah.
07:44But most dogs are out of pain within two weeks.
07:48Next thing is, can I get this dog doing what police dogs do?
07:51The answer is, most of the time.
07:53He's a super fit young dog.
07:55Yeah.
07:56And he's in this much pain already.
07:57Yeah.
07:58There's no real option, you know.
07:59If, worst case scenario, he doesn't come back to work, at least hopefully he can live out his days pain-free.
08:04The rules always should be if we can get him back.
08:06My goal is work at 16 weeks.
08:08Really?
08:09That's my goal.
08:10Okay.
08:11Yeah.
08:12Wow.
08:13That's what I'm hoping.
08:14All right.
08:15That's it. Anything else?
08:16I don't think so, no.
08:17All right. Bye-bye, Rob.
08:18Say goodbye to Sir Triggs.
08:19It's well done.
08:20All right. Thank you, Isabel.
08:21Hi, Trigger.
08:23Trigger surgery is scheduled for later today, and Rob hopes it will ease the severe pain in his lower back.
08:30Pretty horrific examination of him, which was awful to be on the receiving end of for him and for me to have to watch.
08:36And, you know, that poor little dog's a stoic dog, but he's living through this pain every day.
08:40Just hope we get that phone call to say everything's gone well.
08:48Oh, there's our baby! Hello, gorgeous!
08:51If you want to bond with a dog, you have to be able to communicate with them.
08:58Baby, baby, come here.
09:00It's an important part of the job for the team at Fitzpatrick's.
09:04I think you'd see me boy.
09:06Oh, the big baby!
09:10Look at you. You just go into knots.
09:12One-year-old Sheperdoodle Raven is much more than just a pet to Alan and Jane.
09:19He is our fur baby.
09:21All the children have left home.
09:23Yes, it's just us.
09:24So he is our baby.
09:29Ten months ago, Raven was an early Christmas present for Alan.
09:33He was just a big, fluffy ball of fun.
09:38He was interested in everything.
09:40He wouldn't sit on your lap all the time.
09:42Of course, he was small enough in to do that.
09:44Just sort of brought some more joy into the house.
09:48Sit!
09:49Now they can't imagine life without him.
09:52Good boy.
09:53He's a gentle giant.
09:55Yeah.
09:56He loves everyone.
09:57He loves the kids, he loves the grandchildren.
09:59He's absolutely full of fun.
10:01Good boy.
10:03And his personality is almost as big as he is.
10:09He's very cheeky.
10:10If he can get away with something, he will.
10:18Eight months ago, Jane noticed that Raven was limping and took him to their local vet.
10:24So they discovered that he had double hip dysplasia at literally four months old.
10:28I knew that it would be a very painful life for him if we didn't do something.
10:34And that's when we decided no matter what, we would get him fixed.
10:38Their vet referred them to Fitzpatrick's.
10:41And today the couple are meeting Noel to discuss the first of a proposed double hip replacement.
10:48Hello guys.
10:49Please grab a seat.
10:50You're beautiful, aren't you sweetheart?
10:51Oh, look at that beautiful coat.
10:53Oh, it's a little bit wet and soggy today I'm afraid.
10:56No, I can see that and I can also see this walking on eggshells on the back legs.
11:01Both.
11:02He doesn't know which leg to stand on.
11:04No.
11:05Now you've seen my colleague James.
11:07We have.
11:08So James will have spent a lot of time talking to you about that hip dysplasia is a developmental problem.
11:14He was born with the genes that make it.
11:16Yeah.
11:17What happens is the structures that normally hold the head of the femur in the socket don't.
11:22Okay.
11:23The next thing that happens is the socket gets shallow because the head isn't in there.
11:27Then the head rubs on the top of the socket and the joint capsule pulls and new bone forms.
11:33The next step is that the socket infill and the new bone formation on the top of the socket begin to rub on the femoral head.
11:41Oh, doodle.
11:43Okay.
11:44Right.
11:45Just stand him here, Daddy.
11:46Can you hold his head?
11:47There we go.
11:48Okay.
11:49Oh, I know.
11:50Oh, I know.
11:51He's got a very painful hip.
11:53Oh.
11:54Right.
11:55Okay.
11:56So your dog has arthritis now, which is the inflammation of the joint as a result of that rubbing.
12:01The objective is to remove the joint completely so there is no osteoarthritis.
12:06Uh-huh.
12:07The risks in the first week postoperatively include dislocation.
12:10Another risk is mechanical failure.
12:12If the bone were to fracture, the implant were to subside or the bone were to fail to grow into it.
12:18Those are all risks.
12:20And then lastly, infection can happen.
12:22So he must not lick it.
12:24I love your replacements because it gets dogs out of pain.
12:26Oh.
12:27If I do a good job and if you do a good job, you've got a very happy dog within two weeks,
12:32and you've got a dog that's able to run around on that hip by week 12.
12:37Got any questions?
12:38No.
12:39Um, good.
12:40Oh, bye-bye.
12:41Bye-bye, Mum.
12:42Bye-bye, Dad.
12:43Come see Mummy.
12:44Bye.
12:45All right, lovely to meet you guys.
12:46You go ahead and he'll come with me.
12:47Come on, buddy.
12:48Good boy.
12:49Come on.
12:50This way.
12:51Sit.
12:52Raven.
12:53That's it.
12:54That's it.
12:55That's it.
12:56Good boy.
12:57It's tough for such a young dog to be facing surgery on both hips.
13:02The biggest worry is that it doesn't heal properly or it doesn't work.
13:06And having put him through it all, that it doesn't work.
13:09But the couple hope it will allow Raven to live life to the full.
13:14He just wants him to be a puppy.
13:16He's not been able to run and leap and jump.
13:18He's sort of like an old man.
13:20He's stiff.
13:21He just needs that back.
13:32Two-year-old police dog Trigger is having a CT scan before undergoing major surgery on
13:38his spine.
13:40This will show Noel to what extent the nerves are being compressed by the new bone formation
13:46and help him plan the positioning of the implants.
13:49Then Noel spots something he hadn't expected.
13:55This is a fragment of bone which has come out of the vertebra right here and become displaced.
14:02So that white thing is a piece of bone which has come out of here which isn't super clear on the MRI scan
14:07but it is super clear on the CT scan.
14:09This is caused by a genetic disease known as osteochondritis dissecans.
14:14And that spiky bit of bone that is inside the bulging disc is squishing the nerve root.
14:21No wonder he's in so much pain.
14:23Poor fella.
14:24Wow.
14:25This is not going to be easy surgery.
14:27I'll do my best.
14:29Okay.
14:30Here you go.
14:31Incision.
14:32After separating the muscles, Noel will drill the roof off the vertebrae.
14:46He will move the nerves to one side and remove the bone fragment and disc bulge.
14:52Then he will insert a titanium spacer screw between the two vertebrae to push them apart.
14:58Finally, he'll place large specialised screws in the vertebrae on either side
15:03and link them with clamps and rods to stabilise the lumbosacral junction
15:07and push the new bone away from the nerve roots.
15:12Goggles, please.
15:15Thanks.
15:18First, Noel has to get to the disc by removing the roof off the spinal canal.
15:25Once we've cut enough of the roof off, we then just grab it and lift it up.
15:31Then he has to carefully remove the displaced fragments of bone.
15:37There's a piece of spiky bone right here,
15:40which is sticking up through the edge of the disc and squishing the spinal nerves.
15:51Here's the piece of bone coming out now.
15:53It's quite a large piece of bone.
15:55Taking it off in two fragments there.
15:58Trigger has amazing tenacity if he jumped over ten fences to catch a criminal with that sticking in his nerves.
16:07The next step is to cut away the fibrous disc material that's also compressing the nerves.
16:16One slip could be catastrophic.
16:20Cutting with a very sharp blade next to nerves that we must not cut
16:25because if we cut them then Trigger would potentially either not be able to walk
16:30or not be able to urinate or not be able to defecate.
16:33So we have to be very careful here.
16:35You can see here that there's a space where the disc used to be.
16:42Into that gap he'll insert a spacer screw to push the two vertebrae apart.
16:47So this is a Christmas tree spacer because it looks like a Christmas tree.
16:51Okay, so the spacer device is in now.
17:02Finally, Noel stabilises the lumbosacral junction with screws, clamps and rods
17:08to ensure the two vertebrae are kept apart and the pathways for the nerve roots stay open.
17:14There was a good job.
17:18Okay, let's go to CT.
17:22The entire operation has taken almost three hours
17:26and Rob's desperate to find out how it's gone.
17:30Hello, Rob speaking.
17:31Hello Rob, how are you?
17:33Yeah, nervous.
17:34Yeah, I can imagine.
17:36I've done the surgery, it went fine.
17:39Brilliant, I'm tough for that, right.
17:41Right.
17:42Yeah, it was challenging because there was a chunk of bone
17:45that had in fact separated from the end plate of the sacrum
17:51and was sticking into the nerves.
17:53Oh, poor little child.
17:54I'm pleased with the post-operative CT.
17:56Yeah, well that's all we can ask for.
17:58Exactly, and please God we'll get the result we want.
18:00Brilliant, okay, well thank you so much.
18:02No problem, bye-bye.
18:03Although the CT scan shows that everything is in the right place,
18:10there will be an anxious wait to see if Trigger recovers sufficiently
18:14to get back to police work.
18:17As a new day dawns, it's a full house at Fitzpatrick Referrals.
18:36I know.
18:38And Noel's about to do something he rarely does these days.
18:43I'm going to see a little kitten with trauma now.
18:47And I don't do simple trauma cases very often.
18:50But today, everybody's busy.
18:52I have a slot in my diary and I'm about to see a kitten called Fury.
18:58You have to stay.
19:00You have to.
19:01No, no, no, no, no.
19:02You have to.
19:03Ah, ah, ah, ah.
19:04Here.
19:05Oh.
19:06Three-month-old kitten Fury hurt himself when he was playing with his sister Stormy.
19:11We just heard a yelp and saw that he was limping his back left leg.
19:16He was holding it up.
19:17Called our local vet and the x-ray showed that he's got a broken tibia.
19:23Fury and Stormy were a surprise birthday present for Barry's 50th.
19:27From his wife and three sons.
19:30My reaction was actually one of shock.
19:33Because I hadn't been thinking about getting kittens at that point.
19:36And it took me a couple of days to come round to fully appreciating the idea.
19:40But by the time that we picked the kittens up, I was just so excited.
19:44As was all the family.
19:50It was Aidan and his two brothers who came up with the cats' names.
19:56A couple of years ago, we were joking about how if we ever got a pet, we'd name it something silly.
20:01And we came up with Furious Destroyer as it's very aggressive, such a cute and cuddly animal.
20:07And he's lived up to the name, I guess.
20:09Fury's much more dominant than Stormy and Stormy's much more inquisitive and much braver.
20:18So she'll go out and do things first.
20:20He'll watch from a distance.
20:22And then when he thinks it's safe, he'll go and do it and push her out of the way as if he's always been the one in charge.
20:28But sometimes Fury's a bit too dominant for his own good.
20:34So I was working in my office and I heard something just outside the door in the hall.
20:40I came out and saw Fury acting quite strange.
20:44He was meowing like something was wrong.
20:47And the local vet, the vet insisted that he needed to have a referral to go to Fitzpatrick.
20:53Yeah.
20:54Bye, Fury.
20:55Fortunately, Barry is able to get an appointment for the day after it happened.
21:00Now, good morning, sir. What's your first name?
21:03Barry.
21:04Barry, nice to see you.
21:05Here's the seat for you.
21:06This is my colleague, Lisa.
21:07How are you, gorgeous kitten?
21:09Hello.
21:10Oh, I have two cats as well.
21:13Oh, hello, mate.
21:14Hello.
21:15Right.
21:16So what happened?
21:17We got one of those kitten towers and him and his sister were playing on it.
21:22He fell off.
21:23I think he fell off.
21:24Right.
21:25Well, he has a very common injury.
21:26Well, the fractured growth plate.
21:28I've seen it on the x-ray pictures.
21:30And because the bone is actually quite strong, the weakest spot is where the bone is growing
21:36from, which is called the growth plate.
21:38Yep.
21:39So if he fell and twisted at the same time, he sheared off here, which is the weak spot from
21:45which the tibia, which is the shin bone, actually grows.
21:49Right.
21:50Because, and I'll draw it for you now.
21:52Well done, mate.
21:53I'm going to put you safely back in here for a moment.
21:56So, that's what it looks like, the ankle of a cat.
22:02That's the tibia.
22:03That's the fibula.
22:04And then you've got this iron here, which is the growth plate, and that's fractured.
22:09Problem number one, there's going to be no more growth from this growth plate.
22:13So inevitably, this leg is going to be slightly shorter than the other one in terms of the
22:18shin bone, the tibia.
22:19In any of these situations, does that bone formation ever recover?
22:23I've not personally seen one that didn't destroy that growth plate when it happened.
22:29Nowadays, the gold standard of care would be to fix this with metal.
22:32Right.
22:33You use what's called a cross-pinning technique.
22:35You line it up, you put a pin in here and drive it through that way.
22:39You put another pin in here, and you drive it through that way.
22:44This is a very friable, very narrow, very tiny piece of bone.
22:49You have to get the hit right first time.
22:51Yep.
22:52You stay sleeping for now, mate.
22:54Bye-bye, Dada.
22:55Bye-bye.
22:56Hey.
22:57Oh, you're tired then.
22:58No.
23:03Noel isn't the only one captivated by the cute little kitten.
23:07Have you broken your leg?
23:09What did you jump off of?
23:11He's in a lot of pain, I can see.
23:14And finding out that Fury's got an injury that could affect his growth is a real worry.
23:18Oh, my God, whose cat is this?
23:20And why am I not taking it out?
23:33Please don't fall, buddy, OK?
23:36Raven, the Sheperdoodle with hip dysplasia, is being prepped for surgery.
23:42He's only a year old, and it's been hard for him to have such a debilitating condition.
23:48It's like a sheep shearing.
23:51So I'm going to put implants in Raven's left hip now, and that's the difference between having a painful hip and not.
23:58Noel's plan is to replace Raven's worn-out hip with a new prosthetic stem, neck, ball, and socket.
24:09A lot of fluid in this joint because it's very loose, and the joint capsule is inflamed, a very arthritic joint.
24:16First, Noel removes the femoral head.
24:21We can see where it's flattened like a mushroom and has lost its cartilage right there.
24:28Noel then inserts a plastic cup into the socket.
24:33Its mesh coating will allow the bone to grow around the implant.
24:36See the plastic liner? Replaces the cartilage.
24:41He then inserts a titanium stem into the femur.
24:47And in its side, he puts a bolt to prevent the stem subsiding.
24:52Through that in till it's tight.
24:56Noel puts the head on the stem.
25:01We pop the head into the socket.
25:03Then he checks the head is firmly in place.
25:07As I tug on it, it doesn't dislocate, which is really good.
25:11We now stitch up, we're done.
25:13This hip will hopefully be pain-free in two weeks' time.
25:17One, two, three.
25:19The whole procedure has taken less than an hour.
25:25I'm very pleased with this one.
25:27It's chalk and cheese, the difference between the two.
25:30That's awesome.
25:33It'll be six weeks of cage rest for Raven.
25:36And then if all goes well, Noel will perform the whole thing again on his other hip joint.
25:49It'll be six weeks of age.
25:53Fury, the three-month-old kitten with a fractured growth plate, is about to go into surgery.
26:04Although a simple fracture, Noel has thought again about how he's going to repair it.
26:09I've had a look at the x-ray pictures and because the little bone on the other side, which is called the fibula, is still intact, we do not need to put a second pin in.
26:18But Noel is drilling the wire into a tiny piece of bone that crumbles easily.
26:24So we can see the fracture is there, and we can see the pin I've put in goes across the fracture here, doesn't move anymore, feels very stable.
26:38So let's hope the post-op x-ray picture looks okay, and I've got that pin in the right spot.
27:04All looks good.
27:05It just needs to be held in place for three weeks.
27:22Come on mate, let's go for a little walk. Good boy.
27:25It has now been two days since Raven's operation.
27:29Well done mate.
27:31And Noel wants to see how the puppy is walking on his new hip joint.
27:35Oh, on a windy day like today, your hair goes everywhere, doesn't it mate?
27:40He's doing brilliantly well on his hip replacement, it's like nothing happened.
27:44He's very comfortable, and he wants to run around, don't you mate?
27:48So he's ready to go home.
27:50At the end of the day, it's all about getting him out of pain and giving him a good quality of life, and that's hopefully what we'll be able to do now.
27:55But this is just the start.
27:59If all goes well, Raven's other hip joint will also be replaced, and it's going to be three months before he's fully recovered.
28:07Until then, Alan and Jane have to keep their boisterous puppy in check.
28:15OK.
28:17OK.
28:18He just wants to go, doesn't he?
28:19So this is how you walk him, right?
28:20Yeah.
28:21This is an insurance policy so he doesn't run.
28:23Correct.
28:24So you understand?
28:25Yeah.
28:26Anything else you need to ask me?
28:27No.
28:28Thank you. Bye-bye.
28:32For the next six weeks, Raven will spend most of his time in a cage.
28:37I think he's going to be a real problem at home.
28:39He's just going to want to be bounding around all the time.
28:41And we've got to try and stop him.
28:42Yeah.
28:43I think for the first few days there's going to be us three in the living room watching telly every night, overnight, on a blow-up.
28:52On a blow-up bed, just to make sure he's OK.
28:55We don't spoil him.
28:56Not much.
29:06After major surgery on his spine, two-year-old police dog Trigger is also ready to be collected.
29:14And Rob's looking forward to having his best pal back.
29:18We're all set up.
29:19We've got the cage set up.
29:20I hope the kids are really excited.
29:21Wife's really excited.
29:22But it's going to be really, really hard.
29:25One slip and we can undo all the good work that Noel's done.
29:28These next 12 weeks and how I manage his recovery is absolutely critical.
29:32In 12 weeks, Noel will repeat the tests he performed initially to see whether Trigger can start fitness training before returning to work.
29:40Morning. How are you doing today?
29:41Morning, Noel. How are you doing?
29:42You all right?
29:43Nice to see you.
29:44Please grab a seat.
29:46We will quite clearly see that on the post-operative CT scan, the spine, the vertebrae are much straighter.
29:53And by placing that screw in, we push the compressive elements away from the nerve.
29:59So that has to fuse across through that device.
30:02And that is going to take 12 weeks.
30:04Yeah.
30:05So for the first six weeks, you're just going to do lead walking only and that's it.
30:08Nothing else.
30:09We just need to let everything settle down.
30:11And I'll see you at week six.
30:12Yeah.
30:13Okay.
30:14He's so sweet, which is extraordinary.
30:16It's amazing.
30:17You can turn...
30:18You're on off switch with him.
30:19It's just...
30:20Unbelievable.
30:21Just with a command word and all of a sudden he's a different dog.
30:24Yeah.
30:25I don't want to know the command word.
30:27I was like thinking to myself, man, I hope I don't say it accidentally, whatever it is.
30:32I'm sure you have to have that secret, that's top secret stuff that you have to have between you and him.
30:36Can't tell you.
30:37No, I don't want to know.
30:38Don't want to know.
30:39I'll get him for you.
30:42Now.
30:43There we go.
30:44He's a little man.
30:46There we go.
30:47So let's just go outside.
30:49Let's take it easy, mate.
30:50You've got to take it easy enough.
30:53And I'll see you soon.
30:54In a few weeks time, you'll be back to catch a nose camera.
30:56Good boy.
30:57Good boy.
30:58Well done.
30:59All right.
31:00Good.
31:01Take care.
31:02You know, a two year old dog with that sort of drive is going to be challenging.
31:05It's going to be really stressful for him and pretty stressful for the family.
31:08He's on.
31:09Yeah.
31:10We think we've got lockdown.
31:11That boy's got a big lockdown.
31:12Yeah.
31:13Yeah.
31:14Poor thing.
31:15Yeah.
31:16Yeah.
31:17Yeah.
31:18Yeah.
31:19Yeah.
31:20Yeah.
31:21Yeah.
31:22Yeah.
31:23Yeah.
31:24Yeah.
31:25Yeah.
31:26Yeah.
31:27Yeah.
31:28Yeah.
31:29Yeah.
31:30Yeah.
31:31Yeah.
31:32Yeah.
31:33Yeah.
31:34Yeah.
31:35Yeah.
31:36Yeah.
31:37Yeah.
31:38Yeah.
31:39Yeah.
31:40Yeah.
31:41Yeah.
31:42Yeah.
31:43Yeah.
31:44It's been two days since Noel operated on Fury's fractured growth plate.
31:51And his family are waiting in reception to pick him up.
31:56Whoa.
31:56The camera switched and it's now pointing at us.
31:58Yes, they're filming us. Oh, I see. Let's see if it follows me
32:11It's not done to you wait, will it do it if I walk over? No
32:22Come through I've got five chairs in here
32:25Grab a seat over there
32:27Fury is an adorable little kitten like really adorable. You're very lucky to get him back because we're going to adopt him here
32:35This is a very simple procedure
32:37However, it could go badly wrong if he was to get out and run around and twist it because there's only one pin holding it
32:45But if that pin holds it for three weeks, it's healed for life
32:47So your mission is to look after this cat for the next three weeks
32:51No running no jumping no slipping no sliding which is difficult with a cat that wants to run jump slip and slide
32:56All right, you got a cage set up at home
32:59So this is the cage is no bigger than that tape. Yeah, that's perfect. That's perfect. I'll just get him for you now
33:04Oh
33:12Very very sweet
33:14Hello mr. Can I? No
33:16Come on. He's a lovely boy
33:18Good
33:22So he has to stay in the cage for three weeks. Yeah the minute we get him out. He's just going to jump his knees and get him out and cuddle him
33:28But we have to hang on to him. Yes. Oh my goodness. You poor little thing. Okay. Yeah
33:36You go good boy
33:38It should all be fine if you follow the rules
33:42You take care of that little man
33:51Come on you
33:52After Raven's first hip replacement went well
33:55Noel was able to operate on his second
33:57Come on
33:59And once again, he's at home recuperating
34:02Good boy
34:03Although Alan and Jay no longer have to sleep downstairs with him
34:07This recovery for the second op is it's been a bit longer the first one within a week
34:13It was like he'd never had it done this one. He is still limping and it is a slower process
34:18The boisterous one-year-old doesn't like being cooped up
34:24Quiet
34:26When he's got medication, he's absolutely fine. He will just sleep
34:28When he's not, he's really hard. One of us has to be with him all the time
34:32Otherwise, he just tries to do naughty things
34:34It's been awful for my neighbors because he's probably barked all the time
34:38Wait, no, quiet
34:40He's weenie
34:42There are just too many people who have to sleep
34:44It's a slower process
34:46The boisterous one-year-old doesn't like being cooped up
34:48Any distractions for the pub
34:50They have a love-hate relationship
34:52Raven loves the cat
34:54The cat loves Raven on his terms
34:56He won't come downstairs when Raven's excited
34:58But every now and again when Raven's asleep
35:00He'll come down and lick his feet
35:02Where is he?
35:04Where is he?
35:06At the moment we have to be really careful
35:08Because obviously Raven can't run around
35:10But once the time comes
35:12I think the cat needs to watch out
35:16Wait
35:17Wait
35:19It's really difficult taking him for a walk at the moment
35:21Because he does pull because he just wants to get everywhere
35:23And he's used to a long lead
35:25He's going
35:27Ah-ah! No running
35:29Eyes on me
35:30But of course he can't run, he can't jump
35:31He can't do anything than walk sedately
35:33So it's really frustrating for him and for us
35:35Right, go
35:37Eyes on me
35:38So it's just become pitting our wits against him
35:40And getting through it
35:46People next to us have had tons of food
35:48We should have bought more stuff
35:50Well we didn't know what we were
35:52Didn't know what to expect
35:54We know next time to bring chips, burgers
35:56Maybe we should knock on and say
35:58Can we have some of your chips please?
36:02Fury, Fury
36:04Oh you can hear the birds can't you?
36:06Seven days after his operation
36:08Fury's back to have his bandage removed
36:11But it sounds like it's been difficult
36:13Following all Noel's rules
36:15We've let him out the cage a little
36:17Watching him very carefully so he doesn't do any jumping
36:19And he looks a wee bit sad for himself
36:21The whole thing's been a bit traumatic
36:23We'll take him out every afternoon
36:25Just so he can get a bit of freedom
36:27And live out with us
36:29Hi guys, how are things going?
36:31Good, thanks
36:32Thank you Lisa
36:33How have things been?
36:35Tough to begin with
36:36Yes
36:37But he settled down
36:39And we let him out to wander about
36:41Without jumping
36:42Sorry you just said
36:43You let him out to wander about?
36:45To basically
36:46He'll sit with us on the sofa
36:48Okay so he's definitely
36:49Definitely not allowed to wander about
36:51Okay
36:52Wander about
36:53As in not even walk
36:54On a flat surface?
36:55No
36:56Definitely not
36:57Right okay
36:58Well we've been doing that
37:00That's the whole point of the cage
37:02Right
37:03I thought it was to stop him from jumping
37:04But you've explained that
37:05And I understand
37:06So I'll need to x-ray him now today
37:08In case anything's moved
37:09But I would rather
37:10He didn't let him out at all
37:11Except to cuddle him
37:12And put him back in again
37:13But I'll check it
37:14Right
37:15Okay
37:16Grab a cup of tea or coffee
37:18Whatever
37:19We need to sedate him
37:23And we need to x-ray him
37:25X-ray him
37:35Alright sweetheart let's have a look
37:40Let's flip so I can see that
37:43He's a good little boy
37:46You're a good boy
37:47You have been taking the mickey
37:48Haven't you?
37:49Yes
37:50Yes you have
37:51You're not allowed to walk
37:52You're not allowed to run
37:53You're not allowed to jump
37:54Is that okay?
37:55Good boy
37:56Good boy
37:57It's been a stressful wait for Barry and Aidan
38:02Hi guys
38:03Oh you're a lucky man
38:05Everything's still okay
38:06Oh thank god
38:07There is no problem here
38:08Happy days
38:09And I will see you on Monday
38:11Okay?
38:12Well done
38:14The most beautiful cat
38:15She's in love
38:16They're in love
38:17I'm in love
38:18Everybody's in love
38:19It's the nicest cat
38:21I mean my cats
38:22When I go upstairs in my office
38:23They're jealous
38:24Because they can smell
38:25That I've just been cuddling him
38:27Ah
38:28Well done mate
38:30I was actually quite scared
38:32Because the doctor mentioned
38:34That we had actually done something wrong
38:36I was glad to hear that he's okay
38:37And he'll be recovering
38:39We won't let him back out of the cage again
38:41Hopefully in the next week or two
38:43He'll be recovered
38:44And we'll be out of the woods
38:59It's been 12 weeks since Trigger had surgery on his spine
39:05Noel and his team are carrying out a series of tests
39:08To check his progress
39:09If Trigger is still in pain
39:12He may not be able to continue as a police dog
39:14Last night went to bed
39:16Thinking about it
39:17Then I woke up about 3 o'clock this morning
39:18And that was it
39:19Just
39:20Yeah, just a worrying day isn't it?
39:22If Trigger can't go back to work
39:24Rob may have to re-home him
39:26So it's a massive day for me
39:28And especially for Trigger
39:30Go here
39:35Go here please
39:36The most important tests are the same as Noel performed during the first consultation
39:42Sorry mate
39:44Alright big guy
39:45If Trigger's still in pain when he repeats the tests
39:47Noel won't be able to sign him off today
39:49Okay, that's it
39:50That's it
39:55But Trigger remembers how much the tests hurt first time round
40:00And he's not happy
40:02Being silly
40:04Relax buddy
40:05Good boy
40:06Alright
40:07You ready?
40:08Go
40:11A human patient with nerve pain can say to the doctor
40:15This is where it hurts
40:16But a dog can
40:18And that's why the clinical tests for nerve pain are so important
40:24And the only way that one can tell if a patient responds to surgery is to perform exactly the same tests
40:31Before and after
40:34Alright great
40:35Sir can you take him through for imaging please?
40:36Yes
40:37Thank you very much
40:39Come on big guy
40:40Come on
40:44So it's good news really about Trigger
40:47And I would say that this is as good as it gets at 12 weeks
40:50So that's really good
40:51I was worried you did the checks outside
40:54The pain on one side seems similar
40:57There was no pain
40:58I literally hadn't touched him
41:00Okay
41:01He was just being silly
41:02When I did the test he didn't respond at all
41:04Oh right
41:05Oh brilliant
41:06So where do we go now pushing him on wise?
41:08The goal is to get him back to full activity within two months from now
41:13Brilliant
41:14Yes
41:15I think he's ready
41:18Hello Trigger
41:20Okay
41:22He's fine
41:23Well done mate
41:24Thanks again mate
41:25Pleasure pleasure
41:27I can't believe he did that to me
41:29Ultimately he was I think anticipating the pain he was going to be in
41:32And
41:33Fell over and acted like a div
41:35So
41:36Exactly the result that we wanted
41:37Yeah
41:38Hopefully we'll have him back out on the streets doing what he loved
41:40Hi Fury
41:50I love Fury
41:51He's such a good boy
41:52It's now been six weeks since Fury fractured his growth plate
41:57Noel has asked his team to take an x-ray image of the kitten's injury
42:06And he's surprised by the results
42:08I've never actually seen this before but the growth plate has continued to grow
42:14That's very rare
42:15Delights to hear this for the kittens
42:18Yes
42:19I mean that's
42:20It's the best possible outcome
42:21Fantastic
42:22Well done
42:24Well done
42:25It's such a joy to meet you
42:26Good luck with the research
42:28At home a month later
42:30Fury's keen to start exploring
42:33After he recovered we let him go outside for the first time
42:37He's been climbing trees and he's been playing with any other animals that he can find out there
42:42And back to being a normal cat which we're really pleased to see
42:48His sister is delighted to have her playmate back
42:54Now that we've got the two cats both running around both very happy
42:58It's a good thing
43:01We've got a kitten back to exactly the way it should be
43:03And I'm grateful to Noel and the team for that
43:07Let's go Raven
43:14One year old puppy Raven has spent the last three months recovering from a double hip replacement
43:20Are you ready? Let's go
43:22And Alan and Jane were worried that they'd never get the old Raven back
43:26Before we had to be careful what he did
43:28Can't jump on this
43:29Can't go up the stairs
43:31Now no more being careful all the time now
43:33We've got our puppy back
43:35Are you ready? Are you ready?
43:37Go on in for daddy
43:38Go on in for daddy
43:39Go on in for daddy
43:41It's a bright future for him now
43:43It's a happy future
43:45He's back to his cheeky self
43:46I'll take him out in the morning and then he wants to have a walk by lunchtime
43:51Yeah
43:52He's just getting better by the day
43:53It's been six weeks since Noel signed Trigger off
44:01And Rob's been putting him through his paces
44:04Training him once again to be an attack dog
44:08And so far Trigger's risen to every challenge
44:14Recovery has just come on loops and bounds and he's genuinely stronger than I think he's ever been
44:20Today marks another milestone
44:22Trigger's first practice bite since surgery
44:32Good boy
44:33Good lad
44:34I've gone from a dog that wouldn't lift his front paws up to as we've just seen the dog that will chase somebody and literally take them at full pelt with no wincing of pain
44:46I think he will be able to comfortably work for the rest of his life
44:49Couldn't have been better
44:50And look who's turned up to check how he's doing
44:54Wow
44:55Wow
44:56That's not a chance
45:00There's no way any human being would ever outrun him
45:05Noel's even been persuaded to play the part of the bad guy
45:09I've got my protective sleeve should things go wrong
45:13I've got a reward should things go right
45:16And we're hoping things will go more right than wrong
45:20Let's see
45:21We're going to show yourself now
45:23Tell him to go, she lost chance
45:29As long as Noel stands still
45:31Trigger's been trained not to bite him
45:34Here he comes, here he comes
45:41Alright mate
45:43Phew
45:44Yeah
45:51So what has he been up to so far?
45:52So he's only been off lead now for three weeks
45:55We've done one practice bite this morning
45:56Oh wow
45:57Which went really well
45:58And almost a practice bite on me
45:59Almost a practice bite on you
46:01Yeah
46:02And he genuinely is having a great day
46:04Absolutely
46:05Well I'm just thrilled to be part of his great day
46:07Thanks mate
46:08Thank you for letting me be part of your great day
46:10You're such a good boy
46:11You're such a good boy
46:12It gave me good boy
46:13That was a great Does Johnson
46:14Vensge- please
46:15Thank you such a good boy
46:16Oh my gosh
46:17Because I like you to see a great day
46:18With that
46:19That was perfect
46:20Yeah
46:21Of course
46:22Pretty good morning
46:23I've been doing it
46:24Thank you guys
46:25To advance you
46:25Yeah
46:26Just leave me
46:27Yeah
46:27I've made it
46:29Too large
46:29Right
46:30Did you have to do nothing
46:32There's a realities
46:33dismissive
46:34Into your remembrance
46:35And you just see
46:36Those questions
46:37For child
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