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00:00Fitzpatrick referrals orthopedics and neurology how can I help it's late July
00:06and Noel is preparing to leave the practice as you can see I've ironed not so good at the ironing
00:14front he's traveling 6,000 miles across the world to South Africa so I've been contacted by a few
00:24vets in South Africa they have incredible animals that they look after every day and that have similar
00:32problems to the animals I see osteoarthritis and all kinds of other issues but they're endangered
00:38they're in danger of extinction Noel has spent the last 30 years developing groundbreaking techniques
00:48to fix thousands of pets now he's hoping to transfer his skills to the treatment of wild
00:55animals to help transform their lives too I'm really well I'm very excited to go but I'm also
01:04a little bit afraid because it's something I've never done before I'm not sure what I'm gonna see
01:10I'm not sure what challenges are gonna meet me I mean there are techniques that I use here that I
01:15simply can't use in South Africa because it's is either not practical or not ethical so I know
01:22that I'm gonna have some intrinsic limitations but all I can do is my best and hope that my best is good
01:29we're here I'm in South Africa slightly different horizon to the hedge road country lanes of Surrey
01:52I've come to Gondwana game reserve which is a reserve for all five big species in South Africa and their
02:05model is sustainable tourism Gondwana is home to several at-risk species Wow as well as the first wild
02:15elephants born in the southern Cape in 200 years it's just extraordinary to get outside the
02:22practice where I spend so much time looking after animals in people's living rooms and backyards to
02:30the great living room backyard of nature Wow that's just incredible first rhino I've ever seen in the
02:40wild absolutely incredible I'm going to meet a vet here called dr. Brendan he's one of the best known
02:50wildlife vets in South Africa and I'm really hoping to learn a lot from him and share anything I might
02:57know which is gonna be a lot less than he knows Brendan has invited no to help with one of Gondwana's key
03:03conservation initiatives Brendan how are you which protects one of Africa's most iconic animals thank
03:13thank you so much thank you so much for having me here I already saw Rhino outside the first time in
03:19my life incredible yeah they're prehistoric with their gentle giants the rhinoceros is one of the most
03:27endangered species on the planet numbers have dropped over 95 percent in the last century and poaching is
03:35often the cause rhino horn sells for more than the price of gold on the illegal market for its mythical
03:45healing properties to deter poachers many reserves remove the horns but not here we made the conscious
03:53decision that we weren't going to dehorn our rhino and we believe that rhino need their horns with
03:57regards to foraging feeding social behavior dominance and we took the the stance that we would protect these
04:04rhinos and develop an anti-poaching unit to be able to do so Gondwana tried to keep the rhinos safe with 24
04:12hours surveillance using tracking bracelets around their legs but one of their oldest males has been
04:19giving the Rangers the runaround fondly known as Bruno he has been a dominant bull on the reserve for
04:27a number of years he really has been part of Gondwana's journey because every youngster that's actually
04:31young Gondwana at the moment has been fathered by Bruno he is very sexually mature so he's often out
04:39and about looking for ladies and he's lost his bracelet a few times so we've decided that we're going to be
04:44doing an implant into the horn of the rhino from a visual point of view you can't see it and the animal
04:50doesn't even know that it's there this is a brand new procedure for the reserve the lines are around
04:59we've got the cheetahs here so we don't want people wandering off Noel will be working alongside Brendan
05:05and the team this will be the first one on Gondwana transmits a signal 24 hours a day and that signal it
05:12can be used to track the rhino can't believe I'm going on a chopper but we are and we're going to go
05:19out and find a rhino this is a unique opportunity for Noel so show me the swinge pretty long yeah
05:31two and a half inch little bit right and what are you aiming for a shoulder no no no brum bruno is
05:40somewhere on the 11,000 acre reserve a male rhino's territorial range is between four and five
05:47kilometers but without his tracker bracelet he's going to be hard to find are we looking for a single
05:53bull the ground team are also on the lookout below there's a bull there there's a runner
06:11they're on your proper clock right now looks like him no color only one small one the ground team confirm
06:22it's Bruno by the marking on his ear okay now it's down to Brendan to dart the 25 miles per hour moving
06:35target
06:38very nice
06:40down here
06:42okay Noel just remember to move forward from the helicopter
06:46these southern white rhino balls weigh around two and a half tons
06:54yeah he's a big boy
06:58wow he's unbelievably beautiful no you want to pop a cap it in sure this is pretty thick
07:08any place you can catheterize is on the ear veins we complain about trying to get a van in
07:12yeah
07:13Bruno's hide is up to five centimeters thick so Noel pierces the thinner skin on his ear flap
07:19to insert an IV line to top up the anesthetic in first time good thank you
07:25thank you didn't look like a total pillock thank you so much might be better to put it in slightly
07:33higher yeah thank you so much Brendan drills into the side of Bruno's horn to insert the tracker
07:45there's no nerve endings in here so there's no feeling it's keratin like my fingernail
07:53you can tidy it up for me no that'd be great
08:00despite the horn being made of the same material as nail or hair
08:04it's so valuable on the illegal market that every shaving has to be weighed and accounted for
08:10so you can see the grain in this like hair fibers growing side by side
08:15it's absolutely and utterly absurd that human beings are chasing this and killing these beautiful animals
08:26unbelievable
08:27the tracker is sealed into the horn using dental acrylic
08:32and that's on all the time as soon as you turn it on you turn on that frequency you'll pick it up
08:39and Bruno is none the wiser
08:42alright sweetheart
08:45you've got your tractor in
08:47to try and keep you safe you gotta stay safe too
08:51bye
09:04It's unbelievable when you're up close with that majesty.
09:21I mean, what a glorious, glorious animal.
09:34Today, there are less than 30,000 rhino left in the wild.
09:41It's actually devastating on a daily basis to see how many rhinos we're losing in a couple
09:46a day.
09:47If you look at the overall numbers of rhinos left, we can't sustain that.
09:51So something has to change and a lot of big effort that's been put in to try and change
09:55it, but it's a tough battle that we're fighting.
09:59We shouldn't really be praising the keratin from the nose of a rhino as a treasure.
10:04We should be praising the rhino as a treasure.
10:07Absolutely.
10:08The thing is, if we give up the fight on one species, what does that mean about the rest?
10:12And so it goes way beyond just the rhino.
10:15It's a much bigger picture.
10:18Noel has witnessed the struggle to protect Africa's endangered wildlife.
10:22Tomorrow, he will have the chance to share his skills to help preserve these precious
10:27animals.
10:28I can't help but think of the battles that these people are facing every single day to
10:34conserve species.
10:36My job back home is to look after the welfare of a cat or a dog.
10:42Their job is to look after a species on the edge of extinction.
10:46I really hope that I can make some kind of difference.
10:48I'll see.
10:49It's Patrick O'Farrell, orthopaedic and neurology Kate speaking.
10:53How can I help?
10:55Oh, I know.
10:56Sorry.
10:57Noel's in Africa at the moment.
11:13Noel is a long way from leafy godalming.
11:18The fight for the rhino has brought him to South Africa's capital.
11:23What we're going to look at is a prosthetic for a rhino's foot.
11:29It's going to be very different than what I'm used to, for sure.
11:32Noel has spent the last 15 years pioneering bionic limbs for cats and dogs.
11:38Where I grew up in Ireland, my father made the very first splints that I've ever seen
11:46out of twigs from the hedgerows to support fractures in the legs of lambs or calves.
11:52So, improvisation is the culture from which I've come.
11:59Vernis Smit is an animal prosthetist.
12:03He's heard of Noel by reputation and asked if he can help with his unique, super-sized project.
12:10How are you, Noel?
12:11Nice to see you.
12:12Nice to meet you.
12:13Nice to see you.
12:14That isn't a human foot.
12:15That is not a human foot.
12:17This is actually Khaleesi's prosthetic that we are working with at the moment.
12:24Three-year-old Khaleesi lives at the world's first rhino orphanage.
12:32He was just a few months old when a pack of hyenas attacked him and his mother.
12:37Khaleesi is such a brilliant rhino.
12:40He's got such a good character.
12:42He's been here for three years.
12:44He was mauled by hyenas.
12:46They grabbed him by the hind foot and pulled him everywhere.
12:50Dr. Pierre treated Khaleesi's wounds, but part of his foot bones had been eaten away.
12:57Every male rhino is a precious hope for the future of the species.
13:01So the team reached out for help.
13:04And Werner answered their call, designing and building the world's first prosthetic foot for a rhino.
13:11We had a few issues, definitely.
13:14It is the first in the world, so you have to come up with solutions yourself.
13:23Werner has had to adapt the prosthetic as Khaleesi has grown.
13:28He is currently working on a new version, strong enough to support Khaleesi's growing weight.
13:35I really have challenges, so I would really like to hear Noel's input.
13:41And I believe that he can give us some good advice so that we can improve the prosthetic for Khaleesi.
13:51So tell me what you're doing here now.
13:54Yeah, so Hyenas caught him and they damaged Khaleesi's growth place.
13:59So one paw is now six centimetres shorter than the other side.
14:03And that's causing back pain and he's starting to develop scoliosis.
14:08So we want to add six centimetres at the bottom to take the strain off the other side.
14:16I'm absolutely intrigued by the shortness of that tibia.
14:19Look at the fibula, amazing.
14:22Yeah.
14:23Werner has been hunting for the right material to help increase the height of the boot,
14:27to even out the length of Khaleesi's hind limbs.
14:31If we make a four centimetre recess here,
14:35we effectively make a silicone pad
14:39so that there is some comfort for that bulging tissue.
14:43Definitely.
14:44But not hardening like foam would.
14:46Yeah.
14:47Yeah?
14:48And a bit of stroke absorption.
14:49Yeah, well exactly.
14:50Noel and Werner's joint effort should help spread Khaleesi's weight across his hind legs
14:55and realign his spine.
14:57So there is going to be a gap to work in here,
14:59but we're going to have to work from the inside
15:01because the outside must be as strong as possible.
15:05Yes.
15:06I mean it's not going to be easy, that's for sure.
15:08Werner has a few days to make changes to Khaleesi's boot
15:13before he and Noel test it out at the Rhino orphanage.
15:16The work a doctor knows is really a big privilege.
15:22The way he's thinking is completely different to the normal.
15:27It makes you think, and I like that.
15:38200 miles away, the team at Lions Rock Big Cat Sanctuary are also preparing for a visit from Noel.
15:44So everything's in, yeah.
15:47Over a hundred big cats live at Lions Rock, rescued from all over the world.
15:52Noel has been asked to see if his experience in the UK can help these wild cats,
15:57many of whom are suffering with limb deformities and osteoarthritis
16:02due to mistreatment and captive breeding.
16:05All the big cats which were rescued from really bad circumstances,
16:11in circuses or in private keeping or entertainment.
16:15It's very hard to believe that people would use such beautiful creatures
16:20and treat them in that way.
16:22At Lions Rock, the big cats live in huge enclosures on the 1,200 hectare reserve.
16:29And he's a little crocodile, sometimes he takes my forceps.
16:34All these animals, they feel like my animals.
16:38Good boy!
16:40They mean the world to me.
16:42I want to improve their lives as best as we can.
16:47It's very rewarding to see them rehabilitate and to give them that second chance which they deserve.
16:58Hi guys, how are you?
16:59We're fine, thank you.
17:01So when I come and see you, tell me how I can best help you.
17:06Yeah, so we were thinking about two animals.
17:09One is Lazis, he's a tiger and he's been lame for quite some time.
17:15And my understanding is that you have a lion that has deformity of the limbs
17:20as a result of some nutritional issues, is that right?
17:23Yes, that would be Ricky.
17:26It was kept as a private pet.
17:28I have some equipment arriving that will allow me not only to see inside the joint,
17:32but also to check the level of cartilage where what we're really hoping to do
17:37is treat the pain in the joint with some anti-inflammatory of natural origin.
17:43Yeah, that sounds great. We are excited about it.
17:46Hopefully all the stars align and the different pieces of cape.
17:51Yeah, there's no point in Batman turning up without his cape.
17:58And this is South Africa, just saying.
18:01I know, we're going to do our best and we're going to cross our paws and everything will be fine.
18:06I'm excited to come and see you guys.
18:09I'm here, thank you so much.
18:10See you soon.
18:11Bye, you too.
18:12Are all those rhino?
18:22Yeah.
18:23Quite a large population.
18:37Before Noel heads to Lions Rock, he has arranged to meet prosthetist Werner at Khaleesi's home,
18:44the rhino orphanage, to test out the new prosthetic boot.
18:48It's an amazing spot, surrounded by forests and mountains, but I'm not allowed to tell you where it is,
18:55because if the wrong people were to find out, that would be very bad news for the rhino.
19:04The rhino orphanage is a vital sanctuary for rhino calves who've been orphaned through poaching.
19:10We just try and save as many babies as we possibly can, so that they can contribute to saving iconic species.
19:22The orphanage looks after the young rhinos until they are old enough to be released back into the wild.
19:28Hi, gentlemen, how are you?
19:31Hi.
19:32You must be Ari.
19:33Lovely to see you.
19:34Nice meeting you.
19:35Thank you so much.
19:36Welcome.
19:37Today, Noel will help fit three-year-old rhino Khaleesi with his new prosthetic foot.
19:43I'm very excited about learning about rhino orthopaedics.
19:47It's an extraordinary privilege and honour to be able to deal with a different species.
19:53Werner and Noel agreed to redesign the boot with a four-centimetre padding.
19:59My god, the Paris fashion lines have nothing by comparison to this.
20:05It is one of the strongest boots I've ever made, so it should be very comfortable for Khaleesi to walk in it.
20:12OK, OK, OK, OK, OK.
20:15OK.
20:16But sedating Khaleesi for his fitting...
20:21Come.
20:22...is a delicate dance of man versus rhino.
20:26He's having a pop.
20:31Right, let's walk him to the shadow.
20:41Come on.
20:42Come on, mate.
20:45I enjoy to see them struggling a bit.
20:48Wrestling and rhino.
20:49Look at that.
20:50We're going towards you.
20:52Towards you.
20:53Yeah.
20:54Sitting on his...
21:03Alright, big guy.
21:05You rest for a minute.
21:06Good boy.
21:07Good boy.
21:08Let's look at the foot.
21:09Some of the tendons in Khaleesi's right hind leg were severed in the hyena attack and part of his foot bones were eaten away.
21:17Noel has studied x-ray pictures of the damage.
21:20As the foot hits the ground.
21:21As the foot hits the ground, it's supposed to roll over and the three digits spread out like so.
21:27But because the tendons have been ripped, flexor tendons here are not pulling this toe down into the appropriate posture for walking.
21:35So the purpose of the prosthesis is number one, to take the pressure from here and load it more favourably.
21:41And number two, to add some limb length.
21:46Let's get it on.
21:47Khaleesi's new boot is made from carbon fibre, with leather straps buckled tight around his leg.
21:53Push.
21:56That's the one.
22:01Last one.
22:02I love my job.
22:08I love your job too.
22:11Well done matey.
22:13The new design needs to support nearly one tonne of rhino.
22:18Just about to wake up now.
22:21Here we go.
22:23Well done mate.
22:25Good boy.
22:26Well done Khaleesi.
22:32So far it looks good.
22:43His spine looks straighter doesn't it?
22:46Yeah.
22:47It'll take more or less a day or two to get used to it and walk properly again.
22:53Walk normally.
22:54Look he's meeting his friend.
22:55Yeah.
22:56The feeling it brings for when fitting and prosthetic on a wild animal is really indescribable.
23:04It makes you feel like you are doing something to better the world.
23:11Running, look.
23:12Look, look, look, look, look.
23:13Running.
23:14Oh my goodness.
23:15Oh my goodness.
23:17Wowzers.
23:19Amazing.
23:24Oh hang on.
23:26Oh man.
23:28Might have come off.
23:30Yeah.
23:31That's everything the straps have broke.
23:33The straps broke?
23:34Yeah.
23:36Yeah.
23:37Despite Werner and Noel's best efforts, Khaleesi's new boot has come apart.
23:45It actually worked too well.
23:48Because he started running.
23:50He was comfortable running with that thing.
23:52And imagine the forces going into while he's running.
23:56I think we should think of a better way to keep it on.
24:00Because the fitting is definitely good.
24:04You can see the spine is not curving anymore.
24:07But the strapping was obviously not strong enough.
24:10It snapped.
24:11It's just the power going into it.
24:14Yeah.
24:15Oh man, I feel so sorry for you.
24:16All the artisan craftsmanship that went into that and then it just blows.
24:20I think we're going to need to get wider straps.
24:21And you know those tent straps that hold up tents?
24:22Yeah.
24:23If we had a ratchet on it.
24:24Tight and tight and tight.
24:25Yeah.
24:26And then buckle down at the side.
24:27Three or four of those.
24:28It definitely is part of working with wildlife.
24:29Everything is more or less a first.
24:30There's no reference you can go back to.
24:31Dr. Pierce says it's also the first time he ran.
24:32So that is a real good point and we're not giving up now.
24:37You know what, it's actually more familiar to the territory that I normally walk in than I thought it would be.
25:06Because success and failure are part and parcel of trying to do difficult things.
25:14And every success stands on the shoulders of failure.
25:19And I've spent the last 25 years disproving lots of things that were cast in stone as truth.
25:27Everything is impossible until it happens.
25:31The worst thing would be not to try.
25:36So we're here, Lion's Rock.
26:01It's with equal measure of intrigue and trepidation that I come in because, of course, I've never dealt with surgery on big cats before.
26:10The biggest cat I've ever operated on is a Maine Cone.
26:13So it'll be an extraordinary privilege, I think, to be in the presence of these magnificent animals.
26:20Noel will be examining two big cats with the team at Lion's Rock.
26:25Hello, how are you?
26:26Working alongside orthopaedic wildlife specialist, Peter.
26:30Peter, nice to see you.
26:32The kit has arrived from the UK.
26:35So we're going to see Laziz and Ricky today?
26:38Yes.
26:39Good.
26:40His first patient is 15-year-old Bengal tiger Laziz.
26:45He's limping quite badly, isn't he?
26:47There are just 2,000 Bengal tigers left in the wild.
26:51Many hunted for the illegal trade in body parts.
26:54If you don't mind, I'm going to video while I can to see his gait.
26:58Laziz has lived at Lion's Rock since he was rescued six years ago.
27:03Laziz came from the Gaza Strip in a private zoo.
27:11It became publicly known in the media as the worst zoo in the world.
27:17Animals were starving and died.
27:20And Laziz was the only big cat left.
27:24Laziz and the other tigers were confined to tiny, concrete-floored cages in the war-torn city for nearly a decade.
27:32But in 2016, Laziz was brought to Lion's Rock.
27:42But the conditions in Gaza had left him with more than just mental scars.
27:53He's been lame for about almost two years.
27:56Coming and going, much worse in the wintertime.
28:00Laziz is suffering with severe elbow osteoarthritis associated with growth deformities.
28:07The team are hoping Noel can help.
28:10The hope is that he will have less pain, a better mobility, and we're really hopeful that he has another good five years with us.
28:20Hello Laziz. Good boy. Good boy.
28:23You're a good boy.
28:24Yes. I know. I know it's tough, isn't it?
28:27I'm just here to help, buddy.
28:29So what I'm doing right now is just looking at his gait as much as I would with a dog or a cat.
28:33Trying to establish what's going on.
28:36He's got a significant limb deformity on both sides, but especially on the right side.
28:41Do you think that his osteoarthritis is in any way related to a developmental elbow disease akin to what we get in dogs?
28:51What I mean by that is the fit between the ulna and the humerus in terms of how that articulation works.
28:59Absolutely. 100% spot on. That's what I've seen a lot in these bigger animals.
29:05Really?
29:06Really.
29:10Ricky is the one which is in the feeding enclosure.
29:13Hello, boy. Hi, boy. I brought you visitors.
29:18Noel has also seen radiographs of Ricky.
29:22Hi, bud.
29:23A 13-year-old lion from Romania who was kept as a pet.
29:27You can see him walking and you can see his paws.
29:31When he arrived at the sanctuary, he had stunted growth and deformed front legs.
29:37He was mechanically unstable, but now he's showing a slight lump in the left leg.
29:44With lions, they've got an extremely high pain threshold.
29:47So the moment they start showing pain, you know that they've got an advanced situation happening.
29:53They're all calling each other now.
29:57They're having a conversation.
29:59Yeah, that's usually this time of the day.
30:01They're talking to each other?
30:02Yeah.
30:03I'm a lion. I'm a lion. I'm a lion. I'm also here.
30:08Yeah, that's very normal.
30:10Tomorrow, Noel will take his first ever x-ray pictures of a lion to see if he can help Ricky.
30:17And he'll perform an arthroscopy on Laziz, an extremely rare procedure for a tiger, only ever attempted a few times worldwide.
30:26It's humbling just to be in their presence, let alone operate on them.
30:32Every day is a school day for me.
30:34So the fact that we get to share knowledge is just an incredible thing for me.
30:38If I can contribute in some small way, then that can only be a good thing.
30:42It's a good thing.
31:12It's the morning of the big cat surgery.
31:18This is a safety zone.
31:23There's two gates for safety.
31:25Both gates will get closed.
31:27Then we're in the compound.
31:31First up is Tiger Laziz.
31:34Have you pre-prepped with syringes?
31:36I'm going to load a dart now.
31:38Right.
31:39Okay, fine.
31:41Noel will perform an arthroscopy on Laziz's elbows to investigate his lameness.
31:46He then plans to use a cutting edge anti-inflammatory treatment to ease his pain.
31:51This has never been used in big cats before, so Noel and the team don't know how successful it may be.
31:58It is a little bit worried always with, you know, new procedures because obviously we haven't done this.
32:05So this is Noel's baby, but not ours.
32:08So, yeah, we just hope everything works well and, you know, the animals are better afterwards.
32:14Six milligrams is 0.3 milligrams.
32:17Well, dealing with the big cats with anesthetic is always a little bit complicated because you have to estimate the weight of the animal because you can't just weigh him.
32:26You've got to estimate what kind of metabolism it has or she has.
32:31Right, here we go.
32:45Once you've immobilized them, you start your stopwatch, you're under time pressure.
32:49We'll see how he responds now when I go there.
32:52Yeah.
32:53You're welcome to come with me, just stick on my right side, okay?
32:55Understood.
32:57I'm your right hand man.
33:00Yeah.
33:01It means I'll be eaten first.
33:04Alright, let's sneak in slowly and quietly.
33:12Thanks.
33:13Thanks.
33:14They are dangerous animals.
33:16You've got to be vigilant of it all the time.
33:21Because sometimes they can just jump up and be dangerous to all the surrounding people.
33:30I just want to give him some chocolate.
33:32Cat, bring the stretcher.
33:40Quite extraordinary to see such a large animal incapacitated like this.
33:47Sedation is time limited in big cats, so the team must work fast.
33:54Need the head pulled back that way.
33:57I expected to feel completely out of my comfort zone.
34:02But because I was in the presence of a cat, albeit a bigger, bigger cat,
34:07I felt a strange sense of familiarity in spite of the wildness.
34:13Someone grab the drip for Ivy.
34:15One, two, three.
34:17This will be Noel's first ever arthroscopic procedure on a tiger.
34:21Not very different to scrubbing for any of the operations back home.
34:24We just have a larger patient.
34:27It's not a chihuahua.
34:28It should be relatively easy to get in the joint.
34:31But then famous last words.
34:35You ready?
34:37You happy?
34:41Laziz is suffering from inflammation and cartilage wear,
34:45caused by a poor fit of his elbow joint, which results in osteoarthritis.
34:50Noel will insert a large needle called a trocar,
34:54down which he will place an arthroscopy camera to examine the joint.
34:58Then he will inject anti-inflammatory platelet-rich plasma,
35:02followed by a viscoelastic cushioning agent,
35:06which will hopefully relieve the symptoms of the arthritis.
35:09Scope going in.
35:13So this is very, very similar to the anatomy of a dog.
35:19Actually, there's really not much difference at all.
35:22It's like home from home.
35:24I just feel like I'm in a different house with a different wallpaper.
35:26Using the camera, Noel can see how much damage has been done to the cartilage inside Laziz's elbow.
35:36Okay, this is really bad.
35:38Is this the erosive cartilage down here?
35:40Yes, so that's raw bone on raw bone.
35:42That's raw bone on raw bone, I see, yeah.
35:44No cartilage at all?
35:46Nothing, yeah?
35:47So this is typically what I will see in dogs that have medial compartment disease,
35:51where the humerus wears away against the ulna because of poor fit.
35:55And this is particularly severe.
35:57If this was a medium-aged dog, for example six,
36:01I would consider an unloading osteotomy,
36:03which is to cut the humerus in half and transfer the load to the outer part of the joint.
36:07And whilst we could do that in a tiger,
36:10he's exerting such extreme load on it that it is likely he would simply blow it apart.
36:16This is extreme.
36:17However, our objective is to gain a few years of function for Laziz,
36:22so that's what we're going to do.
36:24Noel makes small holes in the worn-away joint surface
36:28to release stem cells in an effort to reduce inflammation.
36:32We're running long anaesthetic.
36:35Okay, we're good, yeah, we're good.
36:37So give me the PRP, give me the lubricant.
36:39Claytlet-rich plasma, derived from Laziz's own blood,
36:43is injected into his elbow.
36:45That's it.
36:48He then adds the lubricating hydro-elastic gel that suspends the platelets in the joint for longer.
36:55Look at that gel going in, pushes it back.
36:58Do you see the volume effect there?
37:00We're creating an artificial cushion.
37:02That will hopefully treat the inflammation and pain inside the joint.
37:04I'm super excited about this.
37:07As far as I know, this procedure has never been done in wild, big cats before.
37:12So I'm excited and elated and can't wait to see what the results are.
37:17Go up out.
37:19So we just put two tiny stitches in and our job here is done.
37:23All right, ladies and gentlemen, that's it. It's good. We're out of here.
37:25Quickly, because he's going to wake up quickly, yeah?
37:31Okay, let's go.
37:33Laziz is taken back to recover in an enclosure.
37:38Whoa!
37:39It's incredible to see him waking up because you genuinely feel like you've made a difference.
37:49I can't tell you how special that feeling is.
37:52All of this technology is the same for a human, the same for a dog, the same for a tiger.
37:58We are all one.
38:00If people could only realise that for a moment, wouldn't the world be such a better place?
38:03Noel's first ever procedure on a tiger is complete.
38:14Now it's the turn of the king of the beasts.
38:18Right, we're going to dart.
38:22Ricky has deformed front legs due to inbreeding and a life in captivity.
38:30You got it, thank you.
38:36Noel is going to do a radiographic work-up to see if anything can be done to ease his pain.
38:42It's an extraordinary thing to touch such a magnificent animal up close.
38:46He is truly mind-blowingly gorgeous.
38:50I mean, before I came here, I'd never seen a male lion in the wild.
38:55And now I'm hunched beside one as he goes to sleep.
38:59An extraordinarily humbling experience.
39:02It makes me wonder how we take so much for granted until it's gone.
39:06And, my goodness, do we have a moral responsibility to look after this guy.
39:11Get an IV guy.
39:15Okay, we're going to do a flex natural because we're interested in the growth deformity as well as the elbow.
39:23What I found the most interesting is how to position for your x-rays correctly, how to get the most out of it.
39:32Pull. Pull.
39:33So, remember, it does not matter where the wrist ends up on an antebrachal growth deformity.
39:38You're referencing off the elbow in every single case.
39:41It's a lot for my brain to process, but yeah, he's a brilliant man.
39:45Ricky's radius and ulnar bones have grown at different rates, causing his forearms to twist and splay outwards.
39:56If I was straightening this, I would take a wedge out there and straighten it back and I would rotate the paw relative to the elbow to make it into a normal orientation.
40:06At the end of the day, the job of a veterinarian is to care desperately and to act within the confines of what's available.
40:13We're going to do a similar treatment to what we did with Laziz.
40:18We're going to spin down the platelets from the blood, mix it with the lubricant and inject into both elbow joints.
40:24Noel hopes that this new treatment may alleviate Ricky's pain and also reduce the need for oral drugs, which can cause stomach and kidney problems in big cats.
40:35You ready with the PRP?
40:37I am, yeah.
40:38Thank you. Got it.
40:39Using the PRP in the joint is a totally different procedure that I was not aware of that existed.
40:49I'm excited about the prospect of not giving oral medication.
40:54Could be revolutionary for multiple of my clients.
40:58And we're out of here.
40:59Okay, well done everybody.
41:00As a team, us veterinarians work extremely well together.
41:11You're involved with wildlife veterinary science now.
41:14Congratulations.
41:16I have arrived.
41:18Obviously, because it's a new procedure, we don't know how it's going to affect them.
41:21We'll be monitoring it together, seeing how well they recover.
41:26The bottom line with any first time effort to transfer technology between species is that it may not work in the way we hope.
41:35But this isn't documented anywhere.
41:37There's no book you can open and rewrite in the book now.
41:41It's been an absolute honor.
41:47Truly.
41:48To be able to contribute to his quality of life is an extraordinary privilege.
41:52Yeah, absolutely. For me too.
41:54Yeah.
41:56It's rewarding.
41:57Oh, very.
41:59You're going to be okay.
42:01Love you, May.
42:02You're a good boy.
42:03It's November, and three months since Laziz and Ricky became the first ever wild big cats to have anti-inflammatory PRP,
42:32and viscoelastic lubricant treatment for osteoarthritis.
42:37Since Noel was here, as you can see, even the environment has changed a lot.
42:41It's very green now.
42:43It was a great experience.
42:44It was great to work with Noel.
42:47He has so much knowledge to share.
42:50With Ricky and Laziz, it hasn't been as successful as we were hoping for.
42:55It doesn't mean that we're going to give up.
42:58We know now exactly what the joint, for example,
43:02all of this looks like.
43:03We can maybe use the next type of more gel,
43:06or think about, you know, including stem cells.
43:10There's a lot more options.
43:12This is why this, you know, collaboration is so great.
43:17Biology is infinitely variable, and we are at the mercy of biology.
43:21But the important thing is we have to keep trying.
43:25I'm working with Christine, Peter, and the other vets to do the very best we can,
43:30because we must progress to provide quality of life.
43:34In Pretoria, Werner has been working to improve Khaleesi's prosthetic boot,
43:43and has added Noel's suggestion of ratchet straps.
43:47We adapted the straps, as Dr. Noel said.
43:50So each strap can take up to a tonne, so it should hold this time.
43:55Three months after the last boot failed,
43:59Khaleesi is fitted with his new super-strapped boot.
44:03Come, Khaleesi.
44:06Here we go.
44:11We fit the boot two weeks ago, and he's actually quite comfortable on it.
44:21Checked it two weeks after the fitting, and he runs easily, walks easily.
44:32Meeting Dr. Noel was really a great privilege.
44:35I learned a lot.
44:36He really thinks out of the box, using anything and everything that is available in the world.
44:44He's inquisitive.
44:46He's bloody hardworking.
44:48He's got passion doing the right thing.
44:57I can't think of anything more precious in the world than being in the presence of the giants of nature telling us,
45:02come on guys, up your game.
45:05Look after the world a bit better.
45:07And if I could, for one moment,
45:10transfer the love that somebody feels for their dog or their cat in the United Kingdom,
45:16to these animals and make us realize that this is our home too,
45:21then that would be enough.
45:22Truly, I have felt more at ease and welcomed by this environment than any place I've ever been in my life.
45:34It's quite...
45:38It's...
45:41It's overwhelmingly beautiful.
45:43It's gonna be hard to go back to the real world after this.
45:55Can I just stay here?
45:56Can you guys just go home?
45:58Can I just live here?
45:59Can I just stay here?
46:29Can I just stay here?
46:32Can I just leave here?
46:33I'm calling for what I just want to look for...
46:34Can I just stay here?
46:36So, great.
46:39And I was just again, I'm all right.
46:49I'm always coming here here with me.
46:51And I do...
46:52Like I'm coming here.
46:53I hit this time...
46:54I am coming here to my heart.
46:55Let's take aopf Joseph's quest наб from Satelu.
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