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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
00:16We only get one shot at this, here we go
00:18Noel and his team offer
00:20some of the most advanced treatments available anywhere
00:22The perfect marriage
00:24of mechanics and biology
00:26This is what we have now, a brand new knee
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 of
00:44healing. 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. Against
00:54all the odds. Boom
00:56One small step for a dog
00:58One giant leap for mankind. Well done
01:08Fitzpatrick referral sees animals
01:10of all ages
01:12From the very young
01:14It's like dropping off your
01:16kid to the nursery or something
01:18you know, it's the exact same feeling
01:20They're always quite worried
01:22To those with a few more
01:24grey hairs
01:26When you do have older animals
01:28You do see a
01:30personality come across
01:32Let's say
01:34They tend to not want to walk where you want them to walk
01:36And they make a lot of smells
01:38They don't smell the freshest
01:40when they get older unfortunately, bless them
01:42But then we treat them differently
01:44Because they are the older patients
01:46I think old dogs mean a lot to their families
01:50Because they've obviously grown up together
01:52They've shared a large portion of their life together
01:54So the older the patient
01:55The more passionate and caring
01:56Their families are towards that animal
01:58Whatever their age
02:00All Fitzpatrick patients
02:02Come here in search of the cutting edge
02:04Treatments on offer
02:06Waiting in reception is one dog
02:10Whose problem started as a puppy
02:12I know
02:14Good lad
02:15Good boy
02:16I know
02:17I know
02:18Not much longer
02:19Four year old Springer Spaniel Luca
02:21Is Barbara's devoted companion
02:23When he was a year old
02:26We started noticing he had a limp
02:28He came along here
02:30And he had his front elbow scoped
02:32Luca had keyhole surgery
02:34To treat developmental elbow disease
02:36Of his front left leg
02:38He's been fine now
02:40For basically three years
02:42But that limp's returned
02:44I'm hoping that there can be
02:46Some sort of surgical intervention
02:48Because he's only four
02:50And he is so active
02:52He likes to be ours
02:54Barbara and her family live on a small holding
02:58In the Kent countryside
03:00With just a few other animals
03:02We've got three dogs
03:04Two horses
03:06Seven sheep
03:08About twelve chickens
03:10A couple of ducks
03:11And some quails
03:12I think we've always liked the outdoors life
03:15We've always had dogs
03:16This is an absolutely amazing spot
03:18To have dogs
03:19And to be able to enjoy the countryside
03:20Luca is my constant companion
03:23When I'm outside
03:24When I'm out working in the garden
03:26Or doing things with the animals
03:27He is always there
03:28I think if you ask the rest of the family
03:32They would say he's a mummy's boy
03:34He's very loyal
03:35He loves long walks
03:37And he absolutely adores swimming
03:39When I'm out and about now
03:42He does have to be restricted
03:44Because the limp is progressively getting worse
03:46Controlling him is a challenge
03:49Because he doesn't see that there's a problem
03:51But clearly there is
03:53Stay
03:54So suddenly
03:55A lot of his things
03:56That he likes to do
03:57And he assumes
03:58He's going to be able to do
03:59Have stopped
04:04Alright big fella
04:05Off you go
04:06Good boy
04:07Back at the practice
04:08Noel needs to identify
04:09What's causing Luca's limp
04:11This time
04:12He's a bit limp
04:13But not too bad today
04:14Okay
04:15But Luca isn't giving much away
04:17Okay big guy
04:19Up we get
04:20He's difficult to examine
04:21He goes quite rigid doesn't he
04:23He hides the lameness pretty well
04:26Noel is on the lookout for problems
04:28Common to Luca's breed
04:30That may be caused by the poor fit
04:32Of bones making up the elbow joint
04:35Okay
04:36So the two scenarios that are most likely
04:38Are there's a crack going down there
04:40Yeah
04:41Because
04:42Probably
04:43There's a poor fit
04:44Okay
04:45And that's progressive
04:46Okay
04:47Or
04:48There's progressive erosion in here
04:49Okay
04:50Because it doesn't fit
04:51Right
04:52Yes
04:53Oh
04:54And it's very common
04:55Come on can we again to CT
04:57Can we go now
04:58Do you want to go to CT
05:00Go to CT then
05:01Go on
05:02Off you go
05:03Are you an unloyal dog
05:04Maybe I didn't sell it well enough
05:06CT is an amazing big donut
05:08That you go inside
05:09I'm normally with him when they do pre-meds and stuff
05:11But I'm sure
05:12He'll be fine walking through this door
05:13He'd rather go that way
05:14Yeah
05:15Just walk ahead and keep going
05:16Like follow
05:17No you're good
05:18She's got it
05:19Yeah
05:20She's got it
05:21Mummy I would imagine
05:23Panics a little more than is necessary
05:25But that's okay
05:28CT scans will help Noel identify which conditions Luca may be suffering from
05:33Now Lucas mommy please
05:42Lucas mom
05:43Right
05:44Okay
05:45You have both problems
05:46Oh
05:47Right
05:48Both elbows
05:49Both elbows
05:50Yep
05:51How's he managing that?
05:52Because that's the way Spaniels are
05:56They want to eat
05:57They want to run
05:58Yeah
05:59First Noel focuses on the most critical problem
06:02He's discovered splits forming within the bottom part of the humerus in both elbows
06:07So you can barely see it on the x-ray
06:10But on the CT scan it's hoochingly obvious
06:13See that?
06:14So there's a giant crevasse
06:17Oh crikey
06:19And very importantly there's increased whiteness on either side
06:24And the reason for that is it's not healing
06:26No
06:27It does not
06:28Would it ever heal though?
06:29No
06:30It never heals
06:32To prevent this crack becoming an outright fracture
06:36Luca has the option of a standard screw to place across the bottom part of the humerus
06:41But to avoid the risk of the screw breaking
06:44Noel has designed a larger screw with a system for injecting a special bone growth gel around the metal
06:51To tackle the other issue of erosion on the inside of the elbow
06:55Noel may well need to cut the ulna and reset the angle to relieve pressure inside the joint
07:01Noel will aim to carry out these procedures in both of Luca's front legs
07:07And I wouldn't choose to do this but if you did nothing
07:11It is an option to do nothing but the chance of fracture are high
07:15Given that the one that's splitting hard is really now opening up and the other one's getting worse
07:22Hello
07:32Alright mate
07:33Thank you Hannah
07:34You're welcome
07:35I would discourage you from letting him run after stuff
07:38Because he could fracture
07:39Okay
07:40He's on a knife edge
07:41And if the knife cuts through
07:43He got a big fracture
07:45Barbara must make a decision
07:47And soon
07:48I'm just a little bit sort of flabbergasted with it all at the moment
07:53I think a very large glass of wine is in order
07:56And he can have some food
07:57He's going to be wanting to run around
08:00And that's going to be difficult
08:01Living with that in the next few days, weeks or whatever it is
08:05Knowing that something could happen to him
08:07I'm so brody for a new pup
08:20It really hurts my ovaries
08:23At Fitzpatrick Referrals Oncology and Soft Tissue Hospital in Guildford
08:32Charlotte and Danny have come with their seven-month-old puppy Beau
08:37To make a tricky decision
08:42Beau has a problem that has affected all their lives
08:46Oh, she's dripping really bad today
08:49When we first got Beau, she was eight weeks old, nearly nine
08:53And we thought she was a puppy dribbler
08:56As puppies do dribble urine
08:58Then when she got to about five months old
09:01I thought this should have stopped by now
09:05When we first got her
09:07We were hoping she'd been going to work with Danny
09:10But unfortunately, because she leaks urine everywhere
09:13She can't
09:14So that means all my breaks from work
09:16I'm shooting home
09:17Spending all the time we can with her
09:19Lots of cleaning
09:21There's just so much cleaning to be done
09:23At home in South East London, Charlotte's work is unending
09:35Cleaning routine is pretty relentless
09:38It starts as soon as I get downstairs
09:42I have to clean all of the previous night's bedding
09:45Clean her bed down, clean the kitchen floor, clean the dog
09:50By the time I've actually managed to get all the washing
09:53In the washing machine
09:55And the floor cleaned
09:57She's actually dripped somewhere else
09:59So I always seem to be two steps behind her
10:02With the cleaning materials
10:04And it's just a constant cycle
10:06Of one lot of washing goes in
10:08As one lot of washing's coming out
10:11You think you're safe, the carpet's clear
10:14It's fine to walk across it
10:16And as you're getting there
10:18You're standing something
10:19And you're like, ah
10:20It's a wet sock
10:22As much as she makes us laugh
10:25This has all been quite difficult for us as a family
10:29The thought of her staying as she is
10:32Is quite frightening
10:34Because she's going to get bigger
10:36The puddles are going to get bigger
10:38This could be the rest of our lives with her
10:41So it's brought a lot of tears
10:43And a lot of difficult decisions
10:51The family are pinning their hopes
10:53On senior clinician Gerard McLaughlin
10:56Hey, is that Bo?
10:57It is, yes
10:58Hi, how are you doing?
10:59Who specialises in minimally invasive surgery
11:01Perfect, so we're just going to have a look at her as well
11:03I'm just going to put on some gloves
11:04Because she's a little bit pea-stained
11:06Yeah, she's left you a puddle in the waiting room as well
11:09A little present
11:10As she gets excited, does she pee more?
11:12Yeah, and she pees more when she eats
11:13Because it's like, oh, it's food
11:15Infection is the biggest risk to Bo's health
11:20Yeah, it's all stained
11:22And it's quite red and angry looking
11:23Everything back here
11:24It's just, it's absolutely soaking wet
11:26And you can see why she's going to get infections here
11:29Because it's just such a nasty environment
11:31For that to sit there, isn't it?
11:33CT scans and ultrasound from Bo's local vet
11:38Suggest she has an ectopic ureta
11:40So if we think about a normal urine retract of a dog
11:44In two kidneys
11:45And from the bladder is the urethra
11:47And that's where the urine comes to the outside
11:49There's two tubes
11:50A tube that comes from the kidney
11:52To the bladder called the ureter
11:54And in a normal dog it enters well within the bladder like this
11:57As the urine is formed in the kidney
12:00It comes down here and into the bladder
12:02And then she pees it out
12:04And actually one of her sides is like that
12:06Yes
12:07So she's got one side that's doing its normal job
12:09Which is great
12:10The other side, the tube comes down here
12:12And it still enters in the normal location
12:14But instead of opening there it continues on
12:17And it opens down here
12:19And so the urine is filling straight into the urethra
12:21And there's no continence there
12:23So traditionally people would have done a surgical procedure
12:26So it's quite a big thing to put her through
12:28It would involve opening her entire abdomen
12:30And tying off this abnormal ureter
12:34Reattaching it to the bladder
12:36And there's risks associated with that
12:38Yeah
12:39So what we're able to offer here is a minimally invasive treatment
12:42Where we use a laser to correct it
12:44And we're going to just take away this top part of tissue
12:46And we're going to open that so it's back within the bladder
12:49But every operation carries risk
12:53And there's no guarantee it will be a complete success
12:56With this procedure we'd expect a 50-60% continence
13:01But with this condition it's not unusual
13:03They have concurrent problems of their urinary tract
13:06So for instance they can have weak sphinctures
13:08Around the opening of the urethra
13:10The urethra can be much shorter than normal
13:13So those are the dogs there, the 40% that won't become continent
13:17But I think it's a risk you have to take
13:19Because she can't go on like this
13:21Getting infections and dribbling urine
13:23It's not fair in her
13:25You'll be good
13:26Mummy loves you
13:28Love you babes
13:30You're going to be fine
13:32Although like any procedure the results can't be guaranteed
13:35This is Beau
13:37He's super cute
13:39It's a gamble Charlotte and Danny are prepared to take
13:42He's got the whitey tail
13:44He's got about a 50% chance of success
13:47Which is what we were hoping for
13:50So we're just hoping and praying that everything's going to go as planned
13:54All going to be good, I've got faith
14:00You get a puppy because you want to play with it and socialise it
14:03And it sits on the couch and gives you cuddles and stuff
14:05They've not been able to do that
14:07Would I have a dog in my house that was dripping urine all over the furniture?
14:12No, and I think it's a lot to ask someone to live with
14:14And they've done it for seven months
14:16I'm nervous, stomach's turning a little bit
14:19I'll be happy when we've got a phone call saying, right, she's out
14:23At Fitzpatrick Referrals Sister Hospital in Guildford
14:38Seven-month-old puppy Beau is about to have laser surgery to treat her incontinence
14:44The procedure will be performed by specialist Gerard McLaughlin
14:49So what we're going to do is use the camera to go in and visualise the area
14:54And from that we're going to pass a wire and a catheter up the abnormal opening
14:59And then we're going to use a laser to take that ureter and cut it back into the bladder
15:08So there's the ectopic ureter there, so see that hole in the bottom there?
15:11That's abnormal
15:13So that's what we need to laser back there
15:16Great, yep
15:18Gerard uses a catheter to protect one side of the ureter
15:24He follows it with a laser to burn away the unwanted side
15:32So we're just slowly cutting away this tissue here
15:35The on-screen image is highly magnified
15:38Gerard has to work carefully within a tiny area
15:42Particularly because she's got lots of infections just now
15:46If we burst the bladder with the laser
15:48Then suddenly she gets all these bacteria through her abdomen
15:50And that becomes a life-threatening emergency
15:52So we have to be really careful
15:58I think it looks like we're pretty much done
16:00We're back into the bladder
16:02So that's her, so she will go home tonight
16:04There's a 50-60% chance she'll be completely confident now
16:08It's okay, are you waking up?
16:10What happened?
16:12It's okay to be funny
16:14Just two hours later, Beau is out of the recovery suite
16:18And Charlotte and Danny are back, right on schedule
16:22It's now 4 o'clock on the dot, as we were asked
16:26We won't be late, so we've been here a little while waiting
16:30Come on
16:32Even so, they've got to wait a little longer
16:35While Gerard tests the water
16:37Come on
16:38I'm apprehensive because I'm afraid
16:40With our look, it's just not going to be as plain sailing as we'd like
16:46This is her just recovered
16:48We're only like a couple of hours after the procedure
16:50And she looks dry
16:52I can't see any dripping at all
16:54Fingers crossed
16:56We've had all the stress, all the upset
16:58And now we're going to have the good times
17:00And be able to enjoy her for the next 13 years
17:03I'm really keen to see what she looks like with her mum
17:05When you come to collect her
17:06Because when she gets excited and things
17:08That'll be really interesting to see how she does
17:10But yeah, I'm really pleased with how she's doing so far
17:14Oh, come on
17:18Hello, who's this?
17:20Hi, baby
17:21Are you sleepy, little chicken?
17:24Hi
17:25You look so sleepy still
17:27When she first came in here, she was dripping all the time walking around here
17:30Yeah, it was really well
17:31Yeah
17:32I can't see anything
17:34Everything will be a bit inflamed and things like that
17:36So we just need to give it a few days to settle down
17:38Like you said, it's time to settle, don't you?
17:40Yep
17:41Perfect
17:42Thank you so much
17:43Not at all, lovely to see you guys
17:44Beau may still have complications
17:46Let's go home
17:48And it will be 10 days before the family know for certain
17:52If the procedure has worked
17:59It's Sunday afternoon
18:01And an urgent weekend case has arrived to see Noel
18:05It's Ivor
18:06Ivor
18:07He's an eight-year-old Newfoundland
18:12A couple of weeks ago, he actually collapsed in the back garden
18:15And we've been backwards and forwards to the vet
18:17But yesterday we got up and he was having problems limping the front
18:22And he couldn't move his head from side to side
18:24Yesterday was a different level altogether
18:28Having our little girl seeing him in so much pain
18:32And she says, oh, I was sad
18:35We have a three-year-old who loves him to bits
18:38And wants to just give him cuddles all the time
18:40He wouldn't harm the fly, would he?
18:43He wouldn't hurt anything
18:45He's a gentle giant
18:50He's eight years old, but he's still a puppy
18:52Yeah, he's a troublemaker
18:55Our vet seems to think that it could either be a slick disc in his neck
19:06Or a tumour, a bone tumour
19:10It gets me all upset, but
19:15I hope it isn't cancer
19:19If it is
19:22I think the kindest thing to do would be to let him go
19:27But we'll just have to wait and see
19:32And cross that bridge when we get to it, I think
19:35Yeah
19:36Giant breeds like Newfoundlands have shorter lifespans
19:46And Iva is now in his twilight years
19:50You're an old man, aren't you?
19:52Iva's mum and dad
19:56I'm ready for you
19:59Come on then
20:00Hello, what's your first name?
20:01Nice to meet you, Nicola
20:02Nicola and Dan
20:03Okay, can I see him walk?
20:05Good boy
20:06So he's quite ataxic, wobbly
20:09Is he normally that wobbly?
20:11He normally has a bit of a wobble
20:12But not as bad as this
20:14Iva
20:15Come on
20:16Let me just check him
20:17Support his tummy, please
20:18Noel checks for nerve damage
20:20Right, so that's a knuckle test
20:22It's okay
20:23He's never done that before
20:26Okay, that's not okay
20:28I mean, he's eight years old
20:31Yeah, yeah
20:32Yeah, what's his life expectancy in your eyes?
20:35Eight to ten
20:37At the very
20:38Yeah, I know
20:40We have to be very careful morally what we do here
20:43You know, because we wouldn't want to be putting him through major stuff
20:46You know what I'm saying?
20:47Yeah
20:48Yeah
20:49I'm just going to check his neck
20:50Hold tight
20:51He's quite stoical, isn't he?
20:53The symptoms most likely fit something high up in his spine
20:56Because it's unlikely you're going to have a front leg affected if it's not above that
21:00I'll find out what's wrong and then we'll decide what to do next
21:03Okay
21:04That's all we can do
21:05Yeah
21:06MRI and CT scans will reveal whether the cause of Ivor's wobbliness is a disc issue or cancer
21:14Thank you very much
21:15Thank you
21:16Okay
21:17It's sad when you have walked out and someone else has taken him
21:22Someone else has walked off with your dog
21:24But you're walking out with his lead and his collar
21:27It's a bit like
21:29That's it
21:31It does feel like we're never going to see him again, is it?
21:34You've done the best thing, you've done the right thing
21:38I think that's
21:40We keep ourselves busy
21:42Until we get that phone call really
21:44Yeah
21:55Okay, so we just had the images through for Ivor now
22:01So big decisions for Dan and Nicola
22:05Good news and bad news
22:07Good news it's not cancer
22:09Okay
22:10Bad news it is a very bad disc
22:13Okay
22:14So even though this is an eight-year-old dog
22:16And in real life may not live to more than nine or ten
22:20We are unfortunately in a surgical situation
22:24Okay
22:25Meaning that it's not going to go away on its own
22:28And it will probably get worse
22:30It is the source of significant pain
22:32I could give him medicine for pain
22:34But we just don't think it's going to cut the cheese
22:36Because he's in too much pain
22:38Yeah
22:39Drugging him up all the time
22:40It's not really
22:41No
22:42Not really what I want to do
22:43No
22:44Okay
22:45So I guess the only decision I need from you is
22:47Do you want me to explore the possibility of surgery?
22:50Yeah, definitely
22:51Okay
22:52Noel's solution is to remove the damaged disc
22:57And using spacers spread the vertebrae apart
23:01And allow the spinal cord to recover
23:03A custom implant will be made for Ivor over the next few days
23:08It's mid-morning at the practice
23:18Barbara and her loyal springer spaniel Luca are back
23:23Noel's worst fears have been realised
23:27He was booked in to have surgery on both of his elbow joints
23:31As sort of discussed with Noel
23:34He advised that he had these cracks in both of his joints
23:37And they could go at any time
23:39And he said as I went out through the door
23:41He's on a knife edge
23:42And I went away thinking that's been dramatic
23:45He's been fine
23:46Before the scheduled surgery could take place
23:49Fate intervened
23:51He went out through the door
23:52And we don't know quite what happened
23:54But there was this almighty scream
23:56And I came running down
23:58And he was literally lying on the ground screaming
24:01But with his leg up in the air
24:03His front left elbow joint fractured
24:06It was awful
24:08I've never heard a sound like it
24:10And I hope I don't hear one again
24:13Noel's colleagues were forced to do an emergency operation
24:17On Luca's fractured elbow
24:19Hi Barbara
24:20Hello there, hi
24:21Hello Luca
24:22How are you?
24:23You were in the wars mate
24:24You've been in the wars
24:25What happened to him was something that
24:29You know I could see happening
24:30Yeah
24:31Unfortunately it happened quicker than we both had hoped
24:34Now what they did was
24:35The very best that can be done right now
24:37Nowadays
24:38In terms of a fracture
24:39Which is to put a 4.5mm titanium screw through that
24:42But unfortunately osteoarthritis is inevitable
24:44Yeah
24:45Because you fractured into the joint
24:47Six weeks on from the emergency repair
24:50It's now more crucial than ever
24:52That Luca has surgery on the other elbow
24:55Now what we want to do on the other side
24:57Is three things
24:58Oh sorry
24:59We want to prevent fracture
25:00Yeah
25:01We want to minimise the potential for osteoarthritis
25:03Yes
25:04And we want to give you something that's going to last
25:05Till the death of the dog
25:06Yes
25:07Sorry
25:08Sorry Luke
25:09Go
25:11Good boy
25:12That's it
25:13He's off
25:14Luca is taken straight through for surgery
25:18Noel is using an arthroscope to investigate his elbows
25:24First he checks the joint that had the emergency repair
25:28To see if anything can be done to improve the outlook for the left elbow
25:32So there's where the fracture was
25:35It's this I'm concerned about
25:37This surface of the ulna rubbing against this surface of the humerus
25:41So if we cut the ulna and drop it down we might help the joint a bit
25:45Noel then looks inside the other elbow
25:48Okay so on this side there's a crevice right there
25:52And you can see in fact that as I wobble this that crack opens and closes
25:58And eventually that will fracture right through
26:01Okay so the first thing I'm going to do is I'm going to pop a blade into the joint here
26:09Because I want to cut a tendon down here that pulls the ulna against the humerus
26:14There you go cut
26:23So this is one mechanism I'm going to use to reduce the pressure between the ulna and the humerus
26:28I'm going to cut the ulna
26:30And let this surface here drop down a bit away from that
26:34Okay so that's the intra-articular bit of the surgery done inside the joint
26:40Now I'm going to cut into the joint and try and put this special screw in here
26:44Noel hopes the screw will hold the deep crack in the humerus together
26:48It has to go in exactly the right place
26:51We're now down on the inside bottom of the humerus
26:55He uses a guide printed from the CT scan of Luca's elbow which he secures with pins
27:03Now he can drill the hole
27:06We sure as hell better have this central at this point or we'll be drilling in the joint
27:11That's one big hole
27:13You see right down that
27:15He uses a thread cutter to prepare the aperture for the centrepiece of the operation
27:22So this is a highly specialised screw
27:25I'm going to inject fluid down the centre of the screw
27:28It's going to extrude through this hole
27:30Into the space in the bone between the two threads
27:33Giving me a half a millimetre of bone stimulating gel around this core
27:42So this gel contains one of the most valuable substances on the face of planet earth
27:47Which is called bone morphogenetic protein
27:49In fact per gram it's 500 times more expensive than gold
27:55But the amount in here is about four thousandths of a gram
28:00Beautiful
28:02With the screws safely in place
28:06Noel cuts the ulna to further release pressure within the joint
28:10To avoid Luca needing further surgery
28:15Noel also cuts the ulna in the left leg
28:18There you go Luca
28:23You won't thank me now but you'll thank me later hopefully
28:26Alright Bubba
28:28See you in CT
28:30So this is always a nerve wracking moment
28:34Because there's no way back if the hole's in the wrong place
28:37So it needs to be dead centre
28:41On that view it looks good
28:43There's the aperture through which we put the gel
28:46There's the cut in the ulna there
28:51So that's really good
28:52It's 11 millimetres from there to there
28:54And that's 5.5 millimetres of metal
28:57And one half a millimetre of bone inducing gel
29:01Okay, that's great, thanks so much
29:03Thank you
29:04It's now crucial that Luca has time to heal
29:07Another fracture could spell disaster
29:11At Noel's Guildford practice
29:21Beau the Labrador puppy is back to see Gerard
29:24It's 10 days since she had laser treatment
29:27In an attempt to correct her incontinence
29:30But Charlotte and her daughter Olivia are worried
29:33That the operation hasn't cured the problem
29:36Hi, how are you, anything?
29:37Hello, hello, good to see you too
29:38Can you come?
29:39Steady
29:40Good to see you
29:41No
29:42I guess the big question is
29:43How's her pee?
29:44After I'd been really excited
29:46And everything was good
29:47She decided now
29:48I'm going to prove you wrong now
29:49Okay
29:50We've had two dry nights
29:52Yeah
29:53A few slightly damp
29:54But then this morning we got up
29:56And she was absolutely drenched
29:59Point
30:00Okay
30:01Gerard will need to reassess what further treatment Beau needs
30:06If she is ever to be fully continent
30:08I'm hoping that he's going to tell us
30:11That she's going to get a bit better
30:13Because obviously we want it to stop completely
30:15I don't think it will stop completely
30:16But I think a bit better would be perfect
30:19And then it's just liveable
30:20It can be cleaned up
30:21First Gerard wants to check if Beau has any residual infection
30:27We're going to get a urine sample directly from the bladder
30:30Because she has had recurrent infections
30:32And that's part of her condition
30:33If she's still got an infection there
30:35Then that could be predisposing her to having further incontinence
30:39And weighting of her bed and things like that
30:40Come, come, come, you're fine
30:42In her excitement
30:44Beau leaves a strong impression on Porrig
30:47By releasing her anal glands
30:49All over Porrig's grass
30:51Leaving a lasting scent
30:53Her bladder is pretty
30:55Okay
30:56So that's all we need just for bacterial culture
31:01And then as well as emptying her anal glands for Porrig
31:04She's just peed all over him as well
31:06Oh, it isn't like a little bit, is it?
31:08No, no, she went for it
31:09Good girl, peeing all over Porrig
31:11Thanks
31:12Well, that's a win-win for everyone involved
31:16Hi, Beau
31:18I thought she's caused chaos
31:20I'm really sorry
31:21Only mild chaos
31:23Yeah, I can smell you've caused chaos
31:26Luckily I was at the front end so it's all fine
31:29Yay, you're all right, you're good
31:31I'm not sure
31:33You're going to get in the car like that
31:34In fact
31:36If there is infection, Beau will be prescribed medication
31:40There we go
31:41And further treatment for the weakness in her bladder sphincter
31:44Come on then
31:45Hopefully then, she will finally be dry
31:54Ivor, the eight-year-old Newfoundland's custom-made implant is ready
31:58Surgery can now go ahead
32:01My objective is to get in
32:03Take the disc material that's squishing the spinal cord and nerve roots out
32:06Put the spacers in
32:08And get out
32:11Spinal discs lie between the vertebrae below the spinal cord
32:15Noel will get access to the spine through Ivor's neck
32:19Okay, here we go
32:24So this disc is in a tricky spot
32:26It's quite near to the entrance to the chest
32:29We could get quite a lot of bleeding in here
32:34Oh shit
32:36Okay, so that's our first bleeder
32:38That means we're in far enough, that's for sure
32:40We know when we're in the right spot
32:42Taking the material out
32:43It's going to bleed like crazy
32:45So we just push collagen in there like that
32:47And then that stops the bleeding
32:52Having removed the damaged disc material
32:55Noel can now insert the spacers
32:58So as I drive the spacer
32:59It pushes the vertebrae apart
33:01Along the groove that I've created for it
33:05Newfoundlands are one of the biggest breeds in the world
33:08So Noel is using two spacers side by side
33:11To secure the spacers in place
33:15To secure the spacers in place
33:16And prevent collapse of the vertebrae around them
33:18Noel will attach a custom made link plate
33:21Based on CT scans of Ivor's neck
33:23The two spacer devices are going to attach into here
33:26They will then be linked into eight screws
33:28One in each of these holes
33:30The screws lock in so they can't back out
33:32One vertebrae here, one here
33:34One here
33:46With all the screws in place
33:48Noel packs bone marrow
33:49He's taken from Ivor's shoulders
33:51Around the vertebrae
33:52To help them fuse together
33:54Everything's now rock solid
33:56We're going to stitch up
33:57For 90 minutes of surgery
33:59We can give one to two years of life
34:01Hopefully pain free and happy
34:03What's not to like?
34:05Hi Nicola
34:08So I've done the operation
34:10Oh fantastic
34:11The post-operative imaging looks good
34:13Yeah
34:14So everything went in the right position
34:16Okay
34:17If he improves well over the next 48 hours
34:19I'll consider sending him home on Sunday
34:21Fantastic, thank you so much Noel
34:24Really appreciate it
34:25Me too
34:26No problem, my entire pleasure
34:27Are you playing?
34:28Are you playing?
34:29Are you playing?
34:30Are you playing?
34:31Good boy
34:32Good boy
34:33Good boy
34:34Four days ago Luca the Springer Spaniel
34:42Had multiple procedures on both front legs
34:45Barbara is back today to take him home
34:50I'm a little bit apprehensive as to
34:53And what sort of dog I'm going to find
34:56Because I think he's going to be lame on both legs
34:58So a little bit apprehensive
35:00Hi Barbara, how are you doing?
35:03So this is what we have now
35:04This is the big screw
35:05Oh okay
35:06So that should be pretty rigid
35:07That's a pretty big bar
35:08Okay
35:09Okay
35:10The next element of both surgeries was cutting the ulna
35:14There
35:15There
35:16Because it's supported by the radius it heals pretty quick
35:19Okay
35:20I'm very pleased
35:21He's doing great at the moment
35:23Are you coming in?
35:24Come on Bob
35:25Hello
35:26Hello
35:27Hello
35:28Oh
35:29So even though he's had both bones broken
35:31He's actually doing remarkably well
35:33But he doesn't seem to be too bothered to be honest
35:37You've got two poorly legs, haven't you?
35:40You have been through it, haven't you?
35:42Come on
35:43I mean
35:44I mean
35:45As it nears sunset, Noel is checking up on Ivor
35:58Come on buddy
35:59The old Newfoundland
36:01He's on day three after surgery now
36:02Actually he's doing remarkably well
36:04He's still a little bit wobbly on his back legs but not much
36:08much for an eight-year-old dog to be doing this well after a major surgery like that it's very
36:13hard to argue that you're not going to give him another year or two years of life for the sake
36:18of 90 minutes in surgery and he's such a lovely boy so I definitely think we made the right decision
36:23come on buddy now Ivers folks please hi guys for Nicola and Dan the wait is over it's nice to see
36:33you smile yes he's just rallied he bounced right back I mean I hate to be too optimistic too soon
36:39but he really has our job was to go in underneath here so you can see here where there's two spacers
36:45and you can see that the saddle acts like a grappling hook and holds those vertebrae together
36:52okay it's quite an advanced piece of machinery and you can see that what the two spacers do is they
36:58push apart those vertebrae so that there's no pressure on the cord in here he should live a
37:05normal life span having had this done so I think it's definitely well worth doing good all right
37:10come on Ivor yes he's still wobbly spinal cord obviously damaged by the disc and then slowly
37:22gets better thank you so much you're very welcome I think he's going to be back to normal very
37:28quickly you could see as he walked in he was eyeing up the bones on Noel's desk and I'm sure he was
37:33he was thinking I could have one of those yeah he's been in this pain for so long and we haven't known
37:41Noel said he's recovered extremely quickly which is amazing news he still stinks though he does
37:58Bo the incontinent Labrador puppy has now received medication as well as laser treatment finally she's home and dry
38:13since the operation Bo's been doing amazing and 95% improvement which is unbelievable the washing's cut
38:22down the cleanings cut down we weren't living we were existing to keep the house and the dog clean
38:29Bo is now welcome out in public without Charlotte Danny and Olivia worrying about any accidents
38:39quality of life for her and for us has improved dramatically we know as long as she's had a
38:49medication that she's gonna be fine it's the little things in life that people take for granted being
38:56able to go out to a pub with their dog we can now do that we can just live she just loves life she's such a
39:04gentle soul I'm just glad that she'd be fixed because I know she was feeling so by it the fact
39:11that she's fixing she feels better that's what makes me feel better I still melt when I say it's
39:28six weeks since springer spaniel Luca had surgery on both his front legs Barbara is back at Fitzpatrick's
39:37but she's worried that once again there's been a setback hi Luca how are you nice to see you how is
39:45he doing he was doing absolutely fine but we did have an issue over the weekend where we had a bit
39:51of a yelp my son came back from uni and he rushed to the door because he wasn't in the cage and then I
39:56think he went to pick something up and I think that's when he might have so has he has he had
40:00periods outside of the cage well that's I mean he's in the cage and but when we're in our kitchen
40:06for example I'll have him out and I guess ideally he would just have total strict cage really yeah yeah
40:14he was doing she got to remember he's got a fracture in there yeah that's the problem
40:20anyway it is what it is right now let's check it out okay come on mate come on mate
40:30hello hi well he's taking them in Noel's not happy with me no
40:38scans will show if there has been any damage to Luca's front legs
40:46hiya hi everything's okay I mean I think he just jarred it by by possibly slipping or something
41:04like that but the implant is fine so it's healing but not healed okay so that will take somewhat
41:10longer Luca is also taking longer than usual to come round from the sedative but we want to tell
41:20you when you can let off lead because you we were aiming for 12 weeks remember yeah I'd like him to
41:33stay calm and I'd like him not to jar it if possible we need it to heal yeah we've a lot of biologics in
41:39there now to try and get this bond to settle down as well as mechanics yeah and that takes time yeah I
41:44know I'm having having this rather than a new bathroom so I'm sorry far better than a new bathroom
41:50I haven't had a new bathroom for 25 years it's far better let's just walk let's just walk all right
41:57I'll do you deal one more lap and you can go home yeah Luca oh much more weeks than you hello hello
42:07what are you doing to your tongue it doesn't look very silly it's not a good look is it for a bit yes
42:15I've had my knuckles wrapped completely I felt like I was really put on a naughty step and told no you
42:20know he should be in a cage and he's if he's out of the cage he has to be tied to my leg apparently
42:26but no rushing around the kitchen rushing to the door as he'd done before but it's healing and it's
42:31healing really slowly so we've we've got to go back to the drawing board and make sure we manage it
42:36better now
42:50over in Windsor six months after his spinal operation Ivor is back enjoying being fussed over
42:57at home after cage rest and lead only walking his vertebrae have now fused and he's been signed off
43:05Dan and Nicola's two daughters Esme and Nora have their playmate back straight after the surgery he
43:13seemed to recover and get back on his feet quite quickly within a week or so he was much better like
43:19a puppy again he was up to no good within a week of his operation yeah please pretty much back to
43:33his his old mischievous self what he actually had the whole thing all right where's the ball with the
43:47bionic implant alleviating the pain in his neck he's no longer wobbling
43:53he's a bit slower than what he was he's definitely now showing that he's an old man
44:02but I'm definitely pleased that we did the surgery it means that we've got a bit more time with him
44:09come on we've made his life better and he is a joy to be around you're it I don't think we've got a huge
44:19amount of time left with him but we'll try and make it as fun for him as possible and as fun for
44:26Esme as possible so she can remember him good boy good boy other poor and in Kent Barbara and her
44:42family have been following Noel's instructions to the letter and Luca is getting back up to full strength
44:49we are hopefully on the sort of final straight he's still lead walking but the six weeks time he
44:56should be sort of you know completely off the lead Luca is now able to enjoy his favorite pastime a
45:03bit of daily aqua therapy Noel said it was fine for him to go swimming and so we can do that with a
45:10clear conscience and think well we're still abiding by the rules he just loves it he's really really
45:18happy you know he pulls me all the way as soon as we turn the corner I'm being pulled off my feet
45:22and I think he's happy he's really really happy doing that again now we've given our dog hopefully
45:31another eight years of active life and that's you know that is immeasurable really
45:40you
46:10You
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