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00:00Hello, mate. You understand Irish?
00:02Animals from all over the world
00:04Ah, bonjour!
00:06Come to see one extraordinary man
00:08who's known as the Bionic Vet.
00:10High five!
00:12Yes!
00:14Professor Noel Fitzpatrick
00:16I'm gonna get one shot at this. Here we go.
00:18Noel and his team offer
00:20some of the most advanced treatments available
00:22anywhere. The perfect marriage
00:24in mechanics and biology.
00:26This is what we have now. A brand new me.
00:28Oh, wow!
00:30For some, it's a
00:32last chance. It is a life or
00:34death situation because we cannot leave him
00:36like he is. I just want you to do
00:38anything you can for him, really.
00:40Sorry. As Noel
00:42continues to devise new ways
00:44of healing. You're going to be Bionic.
00:46Thank you so much. All good. All good.
00:48He transforms the lives of his patients.
00:50Oh, that is just unbelievable.
00:52He's raring to go.
00:54Against all the odds. Boom!
00:56One small step for a dog, one giant leap for mankind.
00:58Well done.
01:04Hello, Ms. Patrick.
01:06Averro's orthopaedic and neurology.
01:08This week, I'm not going to help.
01:10There's a buzz of excitement in the air
01:14at Fitzpatrick Referrals this morning
01:16as a very unusual patient arrives.
01:18Oh, my God.
01:20Oh, my God.
01:24Oh, my God.
01:26Hello.
01:28Five-year-old Hermes is a
01:30one-legged Herman tortoise.
01:32I want to take him home.
01:34He's got a very good personality.
01:36When I first introduced him to the other tortoises,
01:38he chased them. He chases the cat.
01:40You talk to him when you come in.
01:42If he's asleep, he'll wake up and put his head up.
01:44Full of guts, I think you could say.
01:46Very gutsy tortoise.
01:47Hermes got his two front legs amputated to the elbow
01:51and, at the moment, one back leg amputated to the toes.
01:55So he's just come here to see if they can work out a way
01:58we can get him walking because, at the moment, he can't walk.
02:01Self-confessed tortoise lover, Helen,
02:04adopted Hermes from another family two years ago.
02:07I've got two tortoises.
02:09This is Thomasina.
02:11This is what a tortoise should look like with their four legs.
02:15She's 11 now.
02:17So this is Hermes.
02:19There's a good boy.
02:21How's that good?
02:23Hermes, he's only little.
02:25He's a baby, so he needs looking after.
02:28Following a vicious attack,
02:30Hermes has been left with multiple injuries
02:32and sometimes needs the help of a tube to feed.
02:37I mean, he's a cute little fella.
02:39I've never been able to explain why I like tortoises.
02:41I just do.
02:43They've got funny little faces.
02:45I've had them since I was about nine, I think, on and off.
02:49This is where it happened.
02:51There was a fence along here.
02:53He was just about here
02:55and he was kind of on his side, propped up against the fence.
02:59As soon as I got up to here, I could see immediately that he was hurt.
03:04And I guessed straight away that he'd been attacked by rats.
03:10OK, Hermes, please.
03:12Hermes.
03:13Helen has come to see Noel to see if there might be a way to make Hermes mobile again.
03:18Now, what have we got here?
03:20Hello.
03:21Hello, I'm Noel.
03:22I'm Helen.
03:23Helen, grab a seat there for me.
03:25You've got a little friend in here.
03:26We have, yes.
03:27Unusual for a Monday morning for me.
03:29Yes.
03:30Hello, mate.
03:31Do you understand Irish?
03:33Oh, look at you.
03:36You're so cute.
03:37Oh, look at that.
03:39Gosh, what happened?
03:42He was attacked by rats and he ended up having his front legs amputated,
03:48but his back leg looks better.
03:51OK.
03:52And did all of the injuries happen at the same time?
03:54Yes.
03:55They're very slow healing.
03:57Oh.
03:58So, yeah.
03:59They've got very slow metabolism.
04:00Yeah, yeah, yeah.
04:01No, I get it.
04:02Oh, dearie me.
04:04Look at that.
04:06Oh, that's horrible.
04:08Oh, dear.
04:11That's still infected, isn't it?
04:14No, that tip's going to go.
04:16Yeah.
04:17It's definitely going to fall off.
04:20Or be taken off because it's necrotic.
04:23I have to say, it looks a bit worse than it did the last...
04:25It looks horrendous.
04:26..time they did the dressing.
04:28And I would, well, at the moment,
04:31I would almost certainly get an infection in that if I did anything.
04:35He's very forthcoming, isn't he?
04:37With his head.
04:38Yeah.
04:39I mean, he's very outgoing.
04:40Yeah.
04:41Of everything else, he's doing so well.
04:44Well, you're certainly setting me an unusual challenge.
04:48I've done wheels.
04:49Yeah.
04:50On tortoises.
04:51His problem is propulsion, though.
04:52That's right.
04:53That's right.
04:54If he had two back legs that worked.
04:55Yes.
04:56That's right.
04:57Then I could put a wheel here.
04:58Yes.
04:59And he'd be fine.
05:00But the fact that he's missing one back leg is deeply disappointing.
05:02Yes.
05:03You are aware that nobody's ever done a limb amputation prosthesis on a tortoise?
05:07Yes.
05:08Yes.
05:09I don't know what to tell you at the moment.
05:11No.
05:12Because I don't know if it's possible.
05:15It's a very difficult moral dilemma, isn't it?
05:18Because it's easy to put to sleep.
05:21Hmm.
05:22It's just about whether it's morally right.
05:25Hmm.
05:26What do you think, mate?
05:28He's very cute, isn't he?
05:30Very cute.
05:33Okay.
05:34Right.
05:35I'll tell you what I'm going to do.
05:36We only have two options here.
05:37Either I investigate what's possible or we put him to sleep.
05:39Mm-hmm.
05:40Because we can't leave him as he is.
05:41Because he's going to have no quality of life at all.
05:43No.
05:44In order for us to do anything at all, I'm going to have to do a CT scan.
05:47Mm-hmm.
05:48Some of that right hind leg will have to be amputated anyway
05:50if we're going to keep him alive.
05:52Yeah.
05:53Do you want to say bye-bye for now?
05:55Yeah.
05:56Aww.
05:57He'd be a good boy, eh?
05:59Try and get better.
06:01I know you love him.
06:02And I know it would be heartbreaking for you to say goodbye,
06:04but we've got to do the right thing, don't we?
06:06Yeah, yeah.
06:07Okay, thank you.
06:08That's all I can say.
06:09It's an absolute pleasure to see you.
06:10Thank you very much.
06:11All right, God bless.
06:12Leave him with me.
06:13Yeah.
06:17He's not as hopeful as I thought.
06:19I think I'll be saying goodbye to him.
06:24Sorry.
06:25Yeah, I think he'll have to be either.
06:30I don't think they'll be able to do anything for him.
06:32But keep my fingers crossed.
06:34Keep my fingers crossed.
06:39For Hermes to have any chance of survival,
06:41Noel must act quickly to curtail the infection.
06:47He removes the necrotic tibia from his right hind leg.
06:57All right, let's go to CT and see what you've got. Thanks.
06:59Hermes is having a CT scan to establish how much bone stock he has left.
07:09To enable Hermes to walk,
07:10Noel is considering attaching prosthetic limbs to his three damaged legs.
07:16This is an X-ray picture of Hermes.
07:19We can see that the left back leg is fine.
07:23There's only the femur left of the right back leg.
07:26And there's only the humerus left on the two front legs.
07:30And the CT scan allows us to actually take the pelvis out of the body.
07:36And you can see where one leg only has a femur bone and we've amputated at the knee.
07:42But you can also see that that femur is not normally in the socket.
07:46Tortoises can live with a dislocated hip.
07:47The big problem is that every amputation prosthesis that I've ever done has been below elbow or below knee.
07:57So he's unlike any other amputation prosthesis that's ever been done in the world, ever.
08:01I mean, I often say everything is possible, but...
08:06This may in fact be pushing things too far.
08:12Hey Helen, it's Noel, how are you?
08:16Oh, hello. It's fine, thank you, yes.
08:18Now then, so most of the weekend myself and the engineering department have been thinking about Hermes
08:27and what we might or might not be able to do.
08:31The engineers and I have calculated implants that in theory could work.
08:37Yeah.
08:38But it would require a gigantic leap of faith.
08:43Mm-hm.
08:44And there is considerably more risk than normal of failing.
08:50So, do you think it would be better off than just to, um, to let him go now?
09:02Um, I think we, we need to think about it.
09:07We are willing to try, because...
09:10Well, it's a great fit to have tried and failed and never tried at all.
09:14It's a very difficult one.
09:17I think you need to sleep on this.
09:20I guess, uh, the bottom line, Helen, is we, we would be closer than we have ever been
09:26to committing to a procedure with as much chance of failure as success.
09:34It's a lively morning at Fitzpatrick Referrals, and six-year-old Rottweiler Dave has come to see
09:54Knoll after experiencing problems with his right hip.
09:58Dave.
10:00Lovely.
10:01We've come with our Rottweiler Dave today.
10:04He's had two hip replacements.
10:08The one on his right side is failing, and all the bones deteriorating,
10:11so what we're having to do is look at alternative solutions to how to fix it, really.
10:16Every now and again, he has a strain if he runs into the garden.
10:20But he would never let the kids, though, would he?
10:21No, he's all right, he still plays, but when he's, you know, when he's in pain, he's in a lot of pain.
10:26At home in Kent, despite the hustle and bustle of family life, Dave is always in demand.
10:38Dave, give me a kiss.
10:42We've got six children.
10:44Taylor, Sean, Sasha, Charlotte, May and Riley.
10:48Ranging from 22 to six.
10:51And two dogs, two Rottweilers, Dave and Tony.
10:55Dave is six, and we've had him since he was 12 weeks old.
10:59But since the failure of one of his previous hip implants, Dave's quality of life has deteriorated significantly.
11:07Every time he moves, he cries.
11:09It's really scary when he falls, and he is screaming in agony.
11:15The kids are scared.
11:16And the kids are crying, and it's awful.
11:18We're not prepared to just replace Dave's implant with exactly the same implant, and hope that this one works.
11:27Our biggest fear was it would then result in possible amputation.
11:33And because he's such a big dog, I just didn't think that was very fair on him.
11:37But he's a young dog, he should be enjoying his life, and he's not.
11:39He's in constant agony, and it's not fair.
11:41A veteran of two surgeries, Dave can be a little wary of vets.
11:54How are you, Matt?
11:55Matt, nice to see you.
11:56Hello, mate. How you doing?
11:57Hey, mate. How are you?
11:58Good boy. Good boy.
11:59This is Dave.
12:00Yeah. Hi, Dave. How are you?
12:01How old is he?
12:02Six.
12:03Okay, good boy.
12:04You kept him in pretty good shape.
12:06Yeah.
12:07Try to.
12:08Okay, so I've read your history.
12:09Yeah.
12:10You had the first hip replacement in 2011, was it?
12:12Yeah.
12:13And then the second one in 2013?
12:15Yeah.
12:16Okay.
12:17And which is it that has failed?
12:19That's the first one.
12:20So initially, was it okay?
12:23Absolutely no problems at all.
12:25And then we just noticed that he started limping.
12:28But it's not all the time.
12:29The only other thing I wanted to add, ever since he had the second op,
12:34as he's going to the toilet, he's panicking and he takes off like a, like a scalded cat, four years.
12:41We spoke to the vet and they said they thought to be psychological, but it never happened until we had the operation.
12:45And literally, as he goes to the toilet, it'll be three or four droplets as he's running off.
12:50You know, the toilet is never in one heat.
12:52Well, I don't have enough information yet.
12:54I'll need to watch him walk and we will need a CT scan.
12:58Let's go outside.
12:59Okay.
13:03That's great.
13:04Slowly, please.
13:05Keep him away from me.
13:12Okay, stop there.
13:15Come over here, please.
13:20Hold tight, hold tight, hold tight.
13:22This muscle mass is very poor.
13:24Hold tight, hold tight.
13:26Hold tight, darling.
13:27Okay.
13:28All right, that's enough.
13:29I'm not going to push it.
13:30Okay, come on, mate.
13:31Let me go straight in there.
13:34I note on your clinical history that three options have been given to you.
13:39One is revision of the total hip replacement.
13:41Yeah.
13:42One is ephemeral head and neck excision, where you excise the hip replacement and leave him with no head.
13:46Yeah.
13:47And the third one is full limb amputation.
13:49Yeah.
13:50Full limb amputation generally isn't something that we would consider off the get-go.
13:54Brilliant.
13:55Ephemeral head and neck excision is an option, but it would not be as good as a revision total hip replacement.
14:00Yeah.
14:01But bear in mind, I would have to take all of those implants out.
14:05These are big potential problems.
14:07Yeah.
14:08Take off your beautiful collar.
14:09There we go.
14:10Yeah.
14:11He's a lovely dog.
14:12See ya.
14:13All right, bye.
14:15Bye.
14:16All right.
14:17Bye.
14:18Here we go.
14:19He's going to be pretty out of here.
14:24Normally it takes you a couple of days to come down from there.
14:27Yes, he's going to be even soppier than normal.
14:34Noel needs to establish just how severely the existing hip replacement has deteriorated and how much bone stock remains.
14:42Right, so this is a three-dimensional CT scan of the limb.
14:46And you can see that this stem is loose.
14:48Now if you look at this...
14:50How do you...
14:51No.
14:52How do you see that this one's loose?
14:53So this is a cross-sectional view.
14:55So you can see here...
14:56Oh, yeah.
14:57Right, yeah.
14:58Okay.
14:59Black shadow.
15:00That's the void.
15:01Is the void, yeah.
15:02Yeah.
15:03So that shaft is windshield wipering.
15:05Yeah.
15:06Like so.
15:07Yeah.
15:08So when you rock the leg, that goes like that.
15:10Right.
15:11So you know that stem has to come out.
15:12Yeah.
15:13Right.
15:14This piece of the bone here would almost certainly fracture off once you take the stem off.
15:20Mm-hmm.
15:21Therefore, my plan would be to make a plate that goes up over here, goes all the way down here, and then that's secure.
15:27Blimey.
15:28Yeah.
15:29It's all doable.
15:31Good.
15:32The risks are we could get a fracture on the table.
15:35Usually I can mend that.
15:36Yeah.
15:37Infection, because you're going in a second time, that's a risk.
15:40Okay.
15:41Sciatic nerve trauma, meaning that they sometimes drag their leg.
15:45Okay.
15:46And it can take them a few weeks to recover.
15:48Oh, that's fine.
15:49It will be unlikely it doesn't come back, but it's possible.
15:52All right.
15:53Let me go get him for you.
15:54Okay.
15:55All right, guys.
15:56Cheers.
15:57Okay.
15:58Different size.
15:59Uh.
16:00It's going to be really hard to wake up.
16:04Shall we go?
16:05You ready?
16:06Shall we go?
16:07Shall we go?
16:08Come on, then.
16:09Come on.
16:10Come on, mate.
16:11You can do it.
16:12Come on.
16:13Come on.
16:14Oh, you're not going to get up from me, mate.
16:16You're not going to get up.
16:18Oh, come on, let me say.
16:20All right.
16:21I'm bringing mom and dad in.
16:23If you just stand back, please, we're all good.
16:27Now.
16:28Okay, big guy.
16:29Mom and dad are here.
16:30There we go.
16:31Okay.
16:32There we go.
16:33You ready?
16:34Come this way.
16:35Come on, darling.
16:36Come on, mate.
16:37Come on.
16:38Come on, buddy.
16:39You're getting grumpy of everybody.
16:41There we go.
16:42That's fine.
16:43I think he just, he's nervous on his hip.
16:45Oh, thank you.
16:46Okay.
16:47Great to see you.
16:48I can't wait.
16:49Yeah, and thank you for that.
16:50Really appreciate everything.
16:51Okay.
16:52All right, mate.
16:53Let's go.
16:54Bye.
16:55Bye.
16:56Bye.
17:01It's been nine days since Hermes' tibia amputation and Helen is ready to pick him up.
17:08A bit nervous, a bit worried.
17:10originally we were hoping we could save his one rear leg that's injured so that he would just
17:16have wheels for the front but Noel phoned me and said a viable option could be three prosthetic
17:23legs as Hermes has a dislocated hip and has lost one of his knee joints right Hermes mum please
17:30Hermes placing just one back leg prosthetic is unlikely to be enough to get him walking again
17:37hello mate oh hello darling okay now oh dear oh dear okay so I've removed the infected tibia
17:49it's extremely important given all the anesthetics that he has in hydration because otherwise his
17:56toxic excretion will be a problem obviously eating is is an issue and make sure he's well fed up
18:05but in his case other than the fact that he's got three stumpies he's fine the problem that we've
18:13got is that we only have a femur and we only have a humerus that's all you've got left on the front
18:19legs which is two very curved bones really difficult architecture it's three millimeters across and it's
18:26approximately 14 millimeters in length so we've done a lot of sums on this and this is what we've come
18:32up with so that's the front leg yeah that's the back leg mm-hmm that small implant has two plates
18:39on it and a tiny peg yeah the titanium implants will need to be attached to the remaining bone in the
18:49legs the humerus in the front two legs and the femur in the hind leg no hopes that within six months
18:58when the implants have bonded to the bone specially designed flipper like feet can be attached nobody
19:05knows if this is even theoretically possible in terms of the computer modeling it is possible but
19:14the risks are the bone fractures during the op the bone fractures after the op infection skin
19:21breakdown anything could go wrong and unfortunately with him I would say it's 50 50 at best I very rarely
19:31go into surgery with 50 50 odds very almost never and if we fail then we have to well yeah I've been
19:44thinking about whether we need to whether I should put him through it and I think that because he's so
19:52well we should give it a go well I'm willing to try okay I think it's probably gonna weigh heavily on
20:02our consciences if we don't try and that animal can live longer than me and you mm-hmm if this works
20:09but no matter what we cannot operate at the moment until the back leg heals over I do love him all right
20:19mate he loves a little headstroke he does yeah loving it loving it listen we'll talk thank you my pleasure
20:31there's a big challenge ahead for Helen if she's to help Hermes wounds heal I'm a bit worried that I'm
20:41asking too much of of Noel and Hermes to do it but he's done so well so far and fingers crossed that he
20:49he just carries on of course this is a very difficult ethical dilemma Hermes is a fighter he has a lot of
21:00life left in him he could live up to 80 years of age and just because he's a tortoise why should
21:05he be precluded from the same technology that's being deployed in dogs and soon even in humans at
21:13the end of the day to a vet all life matters and Hermes has very few options
21:18it's a tense day for big softy Dave the rottweiler who needs a revision to a hip replacement that has
21:33failed and with the pain worsening it couldn't have come a day sooner he's really deteriorated recently so
21:41I'm glad this perfect timing perfect timing so we're all a bit anxious kids are anxious everybody
21:46with all the kids are up this morning giving him extra cuddles lying all over him hugging him
21:51kissing him oh no he's not a tough dog no he's a baby now then Dave please Dave hi guys how are you
22:02come on hey mate how are you what's this then oh a double marathon did you run that yeah yesterday yeah
22:10not him no oh well done was it good hilly we've got to get him to run a marathon now yeah so I've got a
22:18custom-made plate which is this yeah which is specifically built for his bone so this will follow
22:26the curve of the top of the femur like a hook to put small screws in the top yeah and I've made two
22:33new heads okay to go on my stem which will look something like that okay so if I can get the angle
22:42on this right to fit the existing cup that's my preference yeah if I have to fracture that cup
22:49which is plan B my plan then is to put this fella on there bolted to the side of the ileum your first
22:58preference is to get it in the existing cup yeah that's right if there's an 80 chance it's gonna
23:03work I'm gonna leave it yeah if there's a 50 chance swap it that's right okay yeah all right friends
23:10that's it sorry mate oh baby all right big guy congratulations again i totally need to get back
23:18running myself thank you well it's difficult to get in the time when you're running at midnight
23:23yeah i mean i'm yeah i have three businesses six children the wife and i still manage so
23:29holy no there is no excuses oh my god i'm just gonna go away and feel inadequate
23:35see you later get some time running yeah
23:41joking aside noel has a tough job ahead both he and the family hope that he will not have to
23:47replace the cup of the original implant during surgery he's in the best uh he's in the best best
23:54hands possible if he can't fix it no one can fix it no seems to know what he's talking about
23:59i'm confident i think he'd see he does just yeah
24:07dave will be operated on tonight
24:13dave the rottweiler has been anesthetized for his surgery to revise a previous hip replacement that has
24:29failed noel first needs to see whether he will be able to salvage the original cup okay so it looks like
24:41the cup that is in there might work the poly which is the plastic liner is still intact
24:49i'd like to keep it in if we can because if we have to take it out then i'll have to fracture here
24:54and here to get it out the remainder of the implant needs to be removed without causing further trauma
25:01there's a lot of debris coming out now it's just bone debris from the metal rocking around in the bone
25:11so i've made a custom plate that's going to go down along the femur here
25:16because i'm worried that the top part of the femur might fracture off because of that big hole
25:21and slide it down there and it should hook over the top nice and neatly because it's made
25:27specifically for this bone
25:36should be rock solid no closes off the old hole with titanium mesh
25:44then he's ready to begin inserting the new implant
25:50all right here we go it is time
25:52noel fills the canal of the femur with quick drying surgical cement ready for the stem
26:00i need another cement on standby in case i don't have enough
26:08next it's the challenging task of trying to place the new head on the stem
26:12at the best possible angle for the existing cup
26:15so i'm setting the angle of version of the neck right now i'm going to get that right so that it
26:24hits the cup exactly right we get that wrong that's game over really
26:34okay so now we're going to try and put the custom engineered head back into this cup
26:38and say a little prayer that it fits well and that we do not need to take the cup out
26:47one thing is for sure if i have to take this cup out of the bone i am going to have to break the pelvis to
26:52get it out
26:58hold on as you can see it's not hitting the cup exactly straight
27:04i mean it's pretty solid i'm lifting it now and it's not pulling the hip out of the socket
27:10i think it's much better than 50 50 that it'll stay in but i could be wrong
27:17with the existing cup still in place dave is sewn up
27:21all right let's go get some radiograph please thank you
27:25and rushed straight off to radiography to ensure noel has made the right decision
27:30and that the revision hip surgery has the best chance of success
27:37hello hey it's noel oh hi noel zap went fine yeah i took the original stem out
27:46and then i put my new stem in there and my new head in the existing cup so we went with plan a oh
27:54brilliant i was happy that there was a much better than 50 50 chance that it was not going to dislocate
28:00thank you my my entire pleasure take care now thank you bye bye bye bye lovely people i cannot
28:08believe that guy has six kids what have i been doing
28:11dave will be under the care of fitzpatrick's night shift who've taken over from the three
28:25daytime shifts and are doing their rounds this is sg bruce he had ct and x-rays and a workup today
28:32he's been eating he's urinating and he's gonna go for surgery tomorrow the night team work really
28:40hard they have to give all the treatments all the painkillers they have to check bandages
28:48they have to feed they have to walk they have to do a lot you can go for a walk it takes a very
28:55special person to come in and be able to give the dogs off to tlc in between all the treatments
29:02he's a good boy sometimes you'll get a dog who can be aggressive or who won't settle and in the
29:11meantime they have to keep really quiet so the dogs can keep asleep they really have to work on their
29:17tiptoes like little fairies hi dave it's okay hey hey it's all right good boy next morning dave is still
29:33recovering from his anaesthetic but overnight he's been feeling confused and uneasy away from his family
29:39and noel has called them in we got a call um about an hour ago um from no saying that dave's not
29:51happy um although he's still although he's doing well he's better off at home he gets a bit scared
29:57doesn't he when he goes to the vets so he can come across a little bit grumpy so i think it's better
30:03for him to be at home all right buddy you're a good boy you're a good boy
30:08i would not normally send a patient with this degree of surgery home at this point post-operatively
30:14but i think that's in his best interest he's not an intrinsically aggressive dog he's just a little
30:20bit afraid okay one two three there we go all right big fella dave is sedated again so that the
30:27team can move him safely without causing him any distress good boy well done
30:34okay so okay big fella there you go good boy it's fine it's okay buddy it's all right mate
30:44right my friends we're ready oh baby it's all right
30:49sorry we weren't able to wipe out the inside of his dribble because he wouldn't let us how long
30:55will that cone need to stay on until the stitches are two weeks two weeks this is now what he has
31:01friends i took that implant out completely yeah the problem is that the head is not hitting the cup
31:10at the angle it should be but i can't make it that way unless i take the cup out
31:14so does that mean it's going to pop out easy not necessarily it might do but it's unlikely okay
31:18that's good and if it comes out we've got to replace that cup yeah okay yeah how confident you
31:24are you're not going to have to see me again with with um i would say i'm confident i'm not a hundred
31:32percent not there yeah there we go up we go one two three up we go up we go there we go now now
31:38now we're set yeah yeah you take that good boy oh we're going home it's your favorite this is the
31:45dog walking guys all right man you lift the front i lift the back you got him we want him to lie on the
31:50on the good side that's it and he's all set well done see you soon all right good it sounds as if
31:59it's all gone well but i think he just wants to be at home yeah everyone wants him at home so we're
32:05getting back now and
32:11back in worthing intensive care nurse helen has been looking after hermes the tortoise
32:32it's taken him 11 months to fully recover from his infected leg
32:36they have very slow metabolism so it's taken a long time for his back leg to heal there we are
32:46how's that this is hermes special feed with all the nutrients he needs to help him grow and stay
32:54strong and ensure he gets all the calcium and different vitamins and things that he needs
33:01hermes has got a feeding tube mainly it was to build him up to make him strong enough
33:11to get through the surgery to make sure his bones are strong enough to take the prosthesis
33:19there we go
33:21how's that yes hello yes hello i'm hoping that this operation will be a good success
33:31and it's hermes last chance i think
33:39finally hermes is well enough to come in for surgery
33:43and helen's husband robert has come along as moral support
33:46today noel will fit hermes with his three prosthetic limbs to try to give him a chance of walking
34:05again
34:12how is harmy's doing let me have a look let me have a look at the legs
34:16hi mate how you doing in there hiding how's this tube yes that's fine
34:22okay so the stumps are all healed more or less yeah
34:24right right well there's a very good reason why this is never done before and that's because
34:31number one it's very hard and number two there's a very high chance of failure
34:35so i've designed this implant that's the size of him oh gosh
34:42so this is going to be incredibly difficult incredibly difficult uh we've designed feet which
34:50we're considering due course but my main worry um to be perfectly frank with you is that then he may
34:56not may not make it it through yeah yeah i know that yeah but um you know if it works it'd be much
35:03better for him than the life he's got now yeah so um you've got to try something yes okay so i'll do my very best
35:13okay all right big fella okay lovely all right lovely thank you thanks all right sorry look after
35:22yourself i'll do my very best bye homies i'll talk to you tonight okay lovely thank you very much
35:26you're welcome thank you
35:27i was quite calm before i i got a slight finger of doubt has now raised itself and i'm well you know
35:45i'm i'm very worried hopeful but worried
35:52after almost a year of dedicated nursing from helen
35:56the stakes couldn't be higher for hermes
36:00so this is high risk high reward stuff um basically it's life or death either i'll be able
36:06to replace all three legs and allow him to walk again or i won't and if i can't he's going to have
36:14to be put to sleep can i meet hermes assisting noel with the surgery is exotic animal expert neil forbes
36:23with reptiles in particular when we give an anesthetic injections we want to put it in the
36:27front of the body you put it in the back and it goes out through the kidney before it gets around
36:32the body it's really important to have an expert in exotic species by your side when you're doing a
36:39long procedure on an animal like a tortoise because their metabolic rate and their demands
36:44under anesthesia are very different cats and dogs
36:54morning everybody hello hello okay right hind implant please
37:03mine
37:03so the bone is exposed here i'm gonna drill a tiny hole down into its center to take the peg of the
37:12implant now
37:18right be careful i don't fracture this it's very very very delicate bone
37:31holding power for these screws they're not all as tight as i would like them to be
37:41okay so we've got five little screws of course all of this depends on biology smiling on us a little bit
37:48it could fail but so far so good this implants in
37:52all right number one done two to go give me the right front implant please got it thanks
38:12the bone stock's much better in this bond than it was in the other one much better these screws have
38:24fantastic purchase
38:30the third implant is finally in and hermes happily has remained stable throughout
38:35it'll be brilliant if this works neil won't it it'll be absolutely fantastic
38:41okay so that's as good as i can achieve it's in the lap of nature now we've done our best
38:46off we go yeah go go go noel is keen to get hermes into radiography and recovery as quickly as possible
38:53hello helen it's noel oh hello well that was a herculean task right we did manage to achieve it
39:05but of course we're by no means out of the woods yet no no now it depends of course on biology which
39:12means the bone needs to grow in and the skin needs to grow in and of course um that's a six
39:19million dollar question we we don't know but we've built a very nice uh home for for hermes here
39:26lovely thank you very much thank you so much take care helen you're welcome bye bye bye bye
39:32i really hope we get a result long road ahead though long road ahead
39:49noel's orthopedic referral center carries out an average of 20 surgeries a day
39:57with most requiring sedation or anesthesia the sight of sleepy patients is commonplace
40:09today it's pretty dreary outside all right off we go
40:13but six-year-old rottweiler dave's family are looking on the brighter side keep going straight
40:19line great excellent good that's what i need let's come back in dave's six-week radiographs show the
40:28implants are stable and pleased with his obvious improvements since his surgery three months ago
40:34matt and teresa are hopeful that noel will sign him off today all right great and i will have a
40:39little look all right big fella good boy that's it well it's still in yeah um and the tissue's
40:47healing very well muscle mass actually remarkably good he's doing so well i don't have any concerns
40:54at the moment that's fine honestly he's brand new again he takes off down the garden when he is
40:59something oh so he's already done that i was just going to talk to you about going off lead but i guess
41:03that's already happened yeah yeah so i'm sorry how many weeks did he actually follow the plan zero
41:10weeks the thing to do is remember we said he goes to toilet a month not done that at all good excellent
41:15you're not afraid of your poo anymore mate that's a triumph my job is simply just to sign you off
41:21and to give you the okay to crack on we got our dog back i'm delighted that's great look after yourself
41:27but thank you thanks for everything you've done so much okay thank you thank you very much yeah thank
41:33you come on in baby just so relieved i'm unreal to know now that he can live the rest of his life
41:44as a normal dog run around with children just we couldn't pass for anything better we've got a dog back
41:50we live with me so hermes the tortoise now has his three prosthetic leg implants but before noel can
42:09fit his feet he needs to go home and recover helen come to pick up hermes special tortoise he is
42:19i'm feeling really excited to come to pick up hermes today i'm a bit nervous about having to continue
42:24his care at home um don't want anything to go wrong so a big day today folks big day let me get that
42:31and let me give this to the girls out here girls here you go good good um so this my friends is what
42:41we've got it looks very strange now clearly we can't put the feet on yet because we need the bone
42:50to grow on and we need to make sure that it doesn't infect it so i'll bring him in now mate there we go
42:58hello there we go mommy hello baby hello oh gosh i have to call you peggy hello oh hiya handsome
43:08hello yes so as you can see the little stumps are quite neat yes yeah and the same on the backbone
43:15yeah so at the moment i'm very happy with him i will not be going near him with prosthetic feet until
43:23well into next year okay thank you for looking after you for looking doing everything
43:28it's my pleasure it's my pleasure in kent dave the rottweiler is back enjoying life
43:41so get off with tony and the family since he's recovered really well it's nice for him to have a
43:50a bit of companion they sleep together they do enjoy each other's company it seems to have brought
43:55the uh the puppy back back out in him in dave and the kids enjoy them both
44:04he's probably 100 improved from what he was or certainly from what he was gonna be
44:09the biggest improvement just is everything you know he's a different dog he can do everything
44:13he can do everything a normal dog you should be able to do yeah it's a lot happier in himself you
44:18can tell you look at him there you know he's running walks around no problem plays he's just
44:23thoroughly enjoying his life again yeah dave
44:32good boy go on dave
44:38the wounds on his leg his leg wounds were still fantastic and healing
44:53the last three or four days he just suddenly looked a bit sorry for himself so i took him to the local
45:00exotic vet and um they kept him in for two days and when i left him i just thought now i think this
45:08is it just something about him made me think i wasn't going to see him again
45:16i got a phone call half past eight in the morning and he died in the night
45:19it's difficult when we lose any patient but myself and the team are devastated that hermes didn't make
45:28it his legs were doing great but at the end of the day he had internal organ failure and he passed away
45:36so this is um where we've buried hermes a little memorial for him
45:53he was always quite a fighter and and
45:55and there we are he couldn't fight any more i don't think he fought for two years but 18 months
46:15so
46:28so
46:37so
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