- 2 days ago
Category
📺
TVTranscript
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
00:11High five!
00:12Yes!
00:13Professor Noel Fitzpatrick
00:15We only get one shot at this, here we go
00:18Noel and his team offer some of the most advanced treatments available anywhere
00:23The perfect marriage of mechanics and biology
00:25This is what we have now, a brand new knee
00:28Oh wow!
00:30For some, it's a last chance
00:33It is a life or death situation because we cannot leave him like he is
00:37I just want you to do anything you can for him really
00:40Sorry
00:41As Noel continues to devise new ways of healing
00:44You're going to be Bionic, thank you so much
00:47He transforms the lives of his patients
00:50That is just unbelievable
00:52He's raring to go
00:53Against all the odds
00:55Boom!
00:56One small step for a dog, one giant leap for mankind
00:59Well done!
01:05Pets of every shape, size and variety arrive at Fitzpatrick Referrals for the specialist treatments they offer
01:12This morning Wren, a six year old Terrier crossbreed, is in urgent need of help
01:21I've brought Wren in today because the dog ran up to her and attacked her and bit most of her front foot off
01:27She runs like a mad thing and I think he just saw it as some sort of prey item
01:32Wren's injury is severe and Julie's own vet suggested taking her leg off but she wants to investigate other options first
01:41We've come to see whether she can have an implant rather than a complete leg amputation
01:46At home near Dumpstable Julie runs a rescue centre
01:53Come on
01:55And kennels
01:56Come on Scary
01:57I came here 25 years ago and it was just a boarding kennel then
02:02Hello
02:03But in 1999 we started taking the stray dogs for one council, we now take for two
02:08And because many of those dogs don't get claimed we set up a rehoming charity
02:13We home just over 200 dogs a year
02:16I've always been a dog lover
02:18Come on young man, go to bed
02:20The rescue has taken over my life now so I can't actually ever retire probably but
02:26It totally gets under your skin
02:30Julie has a big heart
02:32She now has nine dogs of her own
02:35We had settled at six for quite a long while but the last three were completely unhomeable
02:40And if they hadn't come to us they'd have stayed at the kennels for the rest of their lives
02:45So we had them
02:47Wren is a rescue dog who had a tough start in life
02:51Wren was found as a stray sitting in amongst a whole load of rubbish in the field
02:56When she was round about five months old
02:58She was actually in fairly good condition but not very confident
03:02It's a little bit intimidating being lost when you're such a tiny baby
03:08Julie has come to Fitzpatrick's hoping Noel may be able to give Wren a bionic implant
03:13To replace her badly damaged foot
03:17Hi there
03:18Hello
03:19Hello, I'm Noel
03:20How are you doing? What's your first name?
03:21Julie
03:22Julie, please take a seat
03:23Thank you
03:24Hello mate, how are you?
03:25Hi fluffy head
03:26She could be happier
03:27Yeah, I can imagine
03:28Okay, so I hear from the report that another dog attacked her
03:32Yeah
03:33I'm sorry about that
03:34Okay, so the x-ray pictures that they have sent through show that the paw is gone from here down
03:42Yeah
03:43Okay, so the end bit has been ripped off
03:46So it's entirely possible to give this dog a new foot
03:50Yeah
03:51That doesn't make it morally right though
03:53For me, we could take the leg off
03:56Right
03:57Because she's small, she is probably going to be just fine on three legs
04:03No, I do get that
04:04But she's always one of the ones that's out front when we're on a walk
04:08Let me see her walk
04:09And I'll have a little look myself
04:11Good girl
04:12Have a little walk around there
04:14Well done
04:16Well done
04:20Well done, Baba
04:21Good girl
04:22Okay
04:23She's very cute, isn't she?
04:24She's a sweet little dog
04:25And she's got a super temperament
04:27Yeah
04:28Boop, boop, boop, boop, boop
04:31Yeah, she's super cute
04:33But that aesthetic shouldn't sway us
04:35No, no, no, no
04:36And they haven't at all
04:37Yeah
04:38Absolutely don't come into it
04:39But, erm
04:40She's, what, halfway through her life probably
04:43So she's got quite a lot of years ahead of her
04:45I would be very reluctant to recommend a limb amputation prosthesis
04:52Which is skeleton anchored for her
04:54Because we would put her through an awful lot
04:56And she would probably be fine on three legs
04:58Yeah
04:59Okay, that's fine
05:00I mean, you're on the
05:01Yeah
05:02I will always go with what you say
05:03And what about a suction cup prosthesis?
05:05Have you considered that?
05:06Do you know I haven't really looked at those?
05:08I think that might be something we would consider for her
05:11Uh huh
05:12Noel suggests creating a prosthetic foot for Wren that's removable
05:16Rather than one that's fixed permanently
05:18If you're prepared to try it
05:20I'll work with our human prosthetist friends
05:22And we would try and make a stump socket prosthesis
05:25That would be amazing, I'd love that
05:26Let's do that
05:27Let's try that
05:28And let's see how you get on with a little socket on there, sweetie pie
05:32Pleasure to meet you
05:33Yeah, you too, thank you
05:34Thank you
05:35I will take care of this little one
05:36My pleasure
05:37We'll do our very best
05:38That went really well
05:39I'm ever so pleased
05:40We've ended up with a different plan
05:42To the one that I was originally expecting
05:44But I'm very, very happy with it
05:46And I think for her it's even better
05:51It's Patrick O'Farrows orthopaedic
05:53Anorelogy Natalie speaking
05:55How can I help?
05:56No
05:57No
05:58No
05:59Lula
06:00Nole's next patient
06:02Is at the other end of the scale
06:04Look, she spotted the laugh
06:06To Lula the Newfoundland is five
06:09And weighs over 70 kilograms
06:13But over the past six months
06:15She's been suffering from lameness
06:16That no one can resolve
06:18So Carla and Steve
06:20Have been referred to Noel
06:21To see if he can find out the cause
06:24We'd like to know what it is
06:25Or what's caused it
06:26Because she wants to play
06:28But she can't play
06:29Because she's in pain
06:30And she's just down
06:31It's not her
06:32She's not a dog that's down
06:33She's always a dog that's really bubbly and lively
06:35To Lula means the world to me
06:38Without her
06:39Erm
06:40I don't know what I'd do
06:42So
06:43I'm really dreading today actually
06:45Mmm
06:46Sorry
06:51It's been a 200-mile trip
06:53For Carla and Steve
06:54From their home in Wakefield
06:56Oh, I know
06:58I know
06:59To Lula is an emotional support dog
07:02For Carla
07:03Who suffers from dissociative identity disorder
07:06Which means she has multiple personalities
07:09It's mine
07:10It's mine
07:11Stress can trigger a change
07:15I've got eight different people inside me
07:18I have children
07:19I have men
07:20I have an old lady
07:22As I'm not in control of them
07:24At any one time they can be violent
07:27Or they can be a six-year-old child
07:31Who's very vulnerable
07:33And Lula will come along
07:34And she'll interact with each one differently
07:37Depending on who they are
07:38When Carla switches
07:40To Lula
07:41Will recognise when she's switching
07:42She'll go up and she will help her
07:45With the children
07:46She's very soppy
07:47She's playful
07:48But with the mean men
07:50She really barge into you
07:52And it's a full force jump
07:55To try and get them out
07:57And me back
07:58I know that Tulu will protect Carla
08:01No matter what
08:02And Tulu's given Carla that push
08:04You know, a little bit of extra freedom
08:05She's been part of the family
08:07Since she was a puppy
08:09We met her at two days old
08:12So we've just had that process
08:14Of knowing her
08:15And loving her
08:16And letting her bond with us
08:17She's such a lovely, loving dog
08:23She is everything to me
08:25I'm hoping when we see Noel
08:28That he actually finds out
08:29What is wrong with her
08:30Because she can't keep carrying on
08:32In this sort of pain
08:34Other vets and specialists they've seen
08:41Suspect To Lula may have a tumour
08:43In her leg bone
08:44But so far
08:45All the biopsies that have been done
08:47Have come back inconclusive
08:49Hiya
08:50Hello
08:51Hi
08:52Hello
08:53How are you doing?
08:54Hello
08:55How are you?
08:56Nice to see you
08:57Nice to see you
08:58What's your first names please?
08:59I'm Carla
09:00Carla
09:01And you are?
09:02Steve
09:03I've seen brown berries now
09:04Yeah
09:05Yeah
09:06Now then
09:07I've spoken to my colleagues
09:09Over at our sister hospital
09:10And I know that they've been
09:12Trying to work up what's going on
09:14First thing I'm going to do
09:16Is we're going to go outside
09:17I'm going to take a little walk
09:18So I can have a look
09:19At the gait pattern myself
09:20Come on babe
09:21First things first
09:24Go down to that red wall
09:26And walk up this way for me
09:27Go on
09:28Tallulah has already been diagnosed
09:30With hip dysplasia
09:31But the latest problem is with her front leg
09:34There we go
09:35Good girl
09:36Good girl
09:37Good girl
09:38All right, no
09:40No, no, no, no
09:41Stop
09:42Okay
09:44I'm sorry guys
09:45But I had to do that
09:46Okay
09:47Let's go back in
09:48All right
09:49Let's go back in
09:50All right
09:51Now
09:52There's no question unfortunately
09:54That that's painful
09:55But I have to say
09:56Based on what I'm seeing there
09:58And on the imaging so far
09:59That in my opinion
10:01It's likely to be a tumour
10:03The dilemma we have is we can't get a big enough biopsy sample to definitively tell what it is without cutting it out
10:13But if this is a primary osteosarcoma, and it could be, the median survival time is only 11 months
10:20Yeah
10:21So that means she could die of cancer elsewhere in her body within a year
10:26Best next year
10:27All right Baba, relax, relax
10:30I can see she's very attached to you and you to her and I understand that, that's normal
10:36The last CT scans of Tallulah's leg were taken a month ago
10:40So Noel wants to perform an MRI with a powerful scanner to have a look at what's really going on inside the bone
10:47And what may have changed since then
10:50Everything hinges on what this MRI says
10:53It's vital
10:54Leave it to me
10:55Okay, off you go sweetheart
10:57Off you go
10:58Good girl
10:59We need an MRI of the humerus
11:05We're a little bit scared for you
11:08All right, come on
11:09Okay
11:10Carla and Steve are going to wait for the results
11:15We thought, you know, the cancer thing was pushed to one side and it was something else
11:19But now the cancer's back on the table, which is kind of shocking
11:23I've just got to think of Tallulah in the long run and her quality of life, sorry
11:30Yeah
11:32The MRI results are back for Tallulah the Newfoundland
11:48Hi guys, please come in, sorry about the delay
11:53I wanted to be as confident as I could before I give you news
11:56Look, I'm just going to level with you, I'm pretty convinced this is a tumour
12:00Okay
12:01Jesus
12:02All right
12:03That's my opinion
12:04I am going to get other people's opinions
12:06I'm going to talk to my colleagues
12:07I know that this has dramatically changed since we had our tumour conference last week
12:14The minute I saw the dog I'm like, this is too painful to be anything other than a tumour
12:18The problem you've got is it's been growing inside the bone, you see
12:21Okay
12:22And nobody could tell
12:23Because every biopsy they took was inconclusive
12:26And I'm sorry, but I'm 99% sure that that is a cancer
12:30Because on the MRI scan, what you can see is this
12:34You can see this lesion growing inside the marrow cavity
12:39And you can see quite clearly how far up it's extending and how far out it's extending
12:44And it's the ubiquitous nightmare of intraosseous tumours
12:48Terribly difficult to pick up until they explode
12:51And this volcano has only erupted in the last week
12:54And that's been your problem
12:56And you've searched high and low for six months to try and find this
12:59And you couldn't have done any more
13:00You can't beat yourself up
13:01Nobody could have done any more because it's inconclusive
13:04Yeah
13:05So you've done your best
13:06The only bit of good news is that as yet
13:08The tumour hasn't dramatically infiltrated the soft tissues
13:12I'm really sorry, I know that it's heartbreaking for you
13:15But we now are going to have to talk about options
13:18Okay
13:19All right?
13:20Mm-hmm
13:21You okay for me to continue?
13:22Okay, mm-hmm
13:23So now we've got the moral and ethical implications of the three options
13:27Euthanasia
13:28Full limb amputation
13:30Or limb salvage
13:31Limb salvage would mean saving the leg by cutting out the tumour and the bone around it
13:37And replacing it with a metal implant
13:40Now that is all doable
13:42And given the fact that the chest CT is still negative
13:45We could do that
13:46But bear in mind that even if we save the leg
13:49It's possible she could die in six months
13:52Or who knows?
13:53Yeah
13:54I guess the fourth option is we just keep her going on painkillers until that fractures
13:58Or until it's a disaster zone
14:00Yeah
14:01The thing is you do not need to decide now
14:04But you do need to decide soon
14:07Decided?
14:08Sorry
14:09No, no, that's fine
14:12I mean I don't want to in any way influence your choice
14:16It's your decision
14:17If you can do it for us please
14:21Well I can do my best
14:23But I still could fail
14:24That's okay
14:25You're a lovely girl
14:26Thank you
14:27You're a nice guy
14:28And I'm really, really, really sorry
14:30Okay
14:31I'm really sorry
14:32I know it's tough
14:33Thanks a lot
14:34Cheers
14:35It will take two weeks for Tallulah's 3D printed implant to be manufactured
14:39In the meantime she's been given painkillers
14:42And what can we do?
14:45We can take this leg off, we can put her to sleep
14:48Or we can try and save her leg
14:50If we take the leg off she'll have great difficulty getting up
14:55Because of her hip arthritis on both sides
14:57Rocking a hard place
15:00I'm just devastated
15:03Every day with her is going to be a bonus
15:06Come on Tallulah, good girl
15:08Euthanasia was not an option
15:10Palliative care, you know, yeah we could do that
15:13But it's unfair
15:14I wouldn't want it
15:15The only other option was leg salvage
15:17You know, we wanted to be happy and out of pain
15:19At the end of the day
15:21Out in the prep area
15:31Little Ren is due to have the surgery to amputate her foot
15:35Noel is worried about infection
15:37I've seen what the x-ray picture looks like
15:40And unfortunately the other dog bit the foot off
15:43So it's probably going to look pretty ragged down here
15:46Yeah
15:48Okay, so it's fairly straight forward
15:52I'm going to chop it off here at the wrist
15:54Get above this area of infection
15:56Make a little stump
15:58And then we get a little stump socket prosthesis
16:00That we may be able to use
16:01Alright, that's fine
16:02Clip up, go to theater, thank you
16:04Alrighty
16:14We're going to keep skin enough to cover the stump
16:18To reduce the risk of infection
16:20Noel cuts well above the damaged area
16:23I want to leave as much skin as I can
16:25I've left the top row of carpal bones on there
16:29It could be argued that that will provide more cushioning
16:33Because we're leaving the stopper pad on here
16:36But we're going to leave as much limb length as we can
16:38And I'm going to see what we can get
16:40With the foot removed
16:41And skin and tendons stitched over the stump
16:44Noel needs to take a cast of the lower leg
16:47So I'm going to make a little boot
16:49Out of this casting material
16:52And this is going to set solid
16:54And that will give us an exact fit
16:56For a stump prosthesis
16:59So that's our cast that we can make a little mould out of
17:05Alright mate, are you under there?
17:07There you are
17:08She's such a sweetie pie
17:09She's really cuddly
17:11I'm pretty confident that I've got all of the infected tissue removed now
17:15And hopefully this will just settle down
17:18Okay sweetie pie, wake up, good
17:21Ren will spend the next few days in the wards
17:24While she recovers from the operation
17:28Do you want a little pillow?
17:30There we go
17:32Hey
17:33In reception, Claire and her mother Liz have brought in Dave, their young French bulldog
17:54Dave has a painful spinal deformity that's making his life a misery
18:01Sometimes he just sits there and just doesn't want to move
18:04It's horrible to see and especially when he cries out in pain
18:07It's not very nice to see at all
18:10Today he's booked in for surgery with Noel
18:13Hopefully it all works and we can have him back and running around in the future again
18:20But yeah, I'm nervous
18:24At home in Hampshire, Dave's quality of life has steadily been getting worse
18:29He started having problems quite early on
18:33He had come out with me on walks
18:35And in the evenings he had to get up and then he'd yell and cry out in pain
18:41And I could throw a bit of cheese, ham, you know, any morsel
18:45He just wouldn't move for it because it was just too painful for him
18:50Claire took him to see her local vet who diagnosed the lower spinal problem
18:55Dave used to do agility, obviously because of the problem that's arose with his back
19:01We've stopped doing that, but he absolutely adored it
19:04He was, he was pretty fast at it
19:07I mean I had trouble keeping up with him
19:09Claire's two dogs are her constant company
19:12My husband works abroad for three and a half months at a time
19:16Comes home for 18 days and then goes for three and a half months
19:19Thank you, thank you
19:21Maisie and Dave, just my absolute world
19:25Everything revolves around them
19:27Definitely my closest companions
19:29Good boy
19:31Dave's very young, he's just over a year old
19:35So, for a dog of that age, not able to do what he wants to do
19:41What he can do
19:42It's quite hard to think, gosh, this could be the rest of his life
19:46Dave's already been assessed at Fitzpatrick's and given medication
19:53But because he's still in pain, he's been booked in for surgery with Noel
19:58You're gorgeous, aren't you mate?
20:00It's alright
20:01Okay
20:02Hey mate, how are you?
20:03Oh, ah, oh, ah, oh, ah, oh, ah
20:07You alright?
20:08Beautiful dogs, but unfortunately genetically
20:11Yes
20:12In the spinal department, not so good
20:14No
20:15And unfortunately we see an increased instance of this now in this breed
20:18Yeah
20:19And this breed is growing in popularity all the time
20:21Absolutely
20:22Tell me what the clinical signs are
20:24Basically when he had a good home with his mates
20:27Come back, slept and got back up
20:29That's when he used to yelp out in pain
20:33Stop, pull up
20:35We'd done agility
20:37Agility?
20:38Yeah
20:39Yeah
20:40So he was intended to be a champion
20:42He was, he was on that route, bless him
20:45He really was
20:46Alright, well let's have a little look at him
20:48Arse towards me please
20:51We know from the scans that we've already taken that he has a deformity right here
20:55Yeah
20:56And I'm just going to check his nerves coming out of there
20:59Yeah, he's quite sore
21:03Dave is being affected by two things
21:07A genetic malformation of his sacrum and lumbar vertebrae
21:11Plus excess bone where the nerves travel to his legs
21:15It will require delicate surgery
21:18So in order to plan what we're going to do
21:22Because this is a very complex deformity
21:24We've made his spine
21:26The plastic model was created by 3D printing from a CT scan
21:31It will help Noel navigate through this difficult operation
21:35The deformity is pronounced
21:39And there's significant encroachment of the nerve canal
21:43You can see how narrow that hole is there
21:45Nothing there, is there really?
21:47So there's no room for the nerves at all, as you can see
21:51And that was only going to get worse
21:52That is going to get worse
21:54So we have a very clear option
21:57We either leave him with the painkillers
21:59Or basically we've got to make that hole bigger
22:02And stabilise it by putting pins and cement in
22:06That's a big job
22:08And there's three possible outcomes
22:11Outcome one, it works great and he's out of pain
22:13Outcome two, something bad happens to the nerves in the surgery
22:16And he ends up paralysed
22:19And outcome three is somewhere in between
22:22He doesn't end up paralysed but he's still in pain
22:24Yeah
22:25The problem with this surgery is that it is high risk
22:28Yeah
22:29And there's no getting away from that, unfortunately
22:33Hi big fella
22:35Hey mate
22:36Hi
22:37We knew he was bad
22:40But didn't probably realise he was that bad, I guess
22:47He was a major risk and, you know, could end up with him paralysed
22:53We really hope not because we just want the best for him
22:55We want to make him better
22:57And that's why we've, you know, that's why we've done it
23:00Fingers and paws crossed
23:02Alright guys, did I know something about this David?
23:19Nice to meet you, are you the artist?
23:21Oh I certainly am
23:22He wanted to do a representation of your logo
23:24Oh I see
23:25I knew nothing about it
23:26Yeah
23:27That's, that's amazing
23:28Wow
23:29Wow
23:30He's got a bionic leg on there
23:31That's very nice
23:32Two weeks after their first consultation with Noel, Carla and Steve are back with Tallulah
23:42She's having surgery to cut out her tumour
23:45Hello Carla, how are you?
23:47And replace the bone with a metal implant
23:49Nice to see you
23:50How has she been?
23:51Yeah, she's been fine
23:52Hello babe
23:53That's great, let me have a little look
23:55It's growing, isn't it?
23:56You can feel that bump
23:58So it's massive now
23:59As far as I can spread my hand
24:01There
24:02That's all tumour
24:03Okay
24:04Wow
24:05This is a massive surgical undertaking
24:08Noel plans to remove the entire tumour in the humerus
24:13He'll cut out most of the bone from the shoulder joint to just above the elbow
24:18Then fuse the shoulder joint solid and replace the humerus with a custom designed 3D printed implant
24:26My major worry is first of all getting it done
24:30Because it's a big long operation
24:32Yeah
24:33And secondly tumour recurrence
24:35I'm really worried about that
24:37We're worried about
24:38Yeah, and I guess the last thing to say is
24:41She will die anyway from tumour spread
24:44Okay
24:45No matter what we do
24:46So I'm definitely worried going into this
24:48And we could lose
24:49But we'll give it everything we've got
24:51Okay, it's a big day
24:53Alright then guys
24:55Big cuddles
24:56Thank you
24:57You're welcome
24:58I'll do my very best
24:59Thank you
25:00Thank you so much
25:01Off you go sweetheart
25:02There we go
25:03Right guys
25:04God bless
25:05Bye bye
25:06Come on
25:07Come on
25:08Come on
25:09Come on
25:10Come on
25:11Come on
25:12Come on
25:13Come on baby
25:14Come on baby
25:15Come on baby
25:16In the prep area, Tallulah is being readied for major surgery
25:31This is a very challenging procedure
25:36It's going to be difficult to get all the tumour out
25:39It's going to be difficult to get the implant in
25:41And at the end of the day we may not succeed
25:49Okay let's do it
25:50Incision
25:52Obviously this is a very invasive procedure
25:56We're chopping from the top to the bottom of the humerus
25:59The tumour is in the humerus bone
26:04To remove it, Noel must first take the bone out of the shoulder joint
26:10We've got to be very careful at this point because we're coming in towards the major blood vessels of the arm
26:14If we hit those, we cut off the blood supply to the bottom of the arm
26:18Which would mean a full limb amputation
26:24Okay, so my finger is hooked around the tumour now
26:27I'm going to cut it out
26:31Okay, so that's our tumour
26:41The family have already decided that they do not want a full limb amputation
26:44So for them it's either a limb salvage or euthanasia
26:47And therefore I'm going to try and do my best to save this leg
26:52But they've got to know that there may already be tumour further down and I can't be sure there isn't
26:57We're going to take a sample
26:59I'm going to submit it to the lab
27:01And we're going to treble check
27:03Right, I need a formalin pot
27:05It will take two weeks before the lab has a definitive diagnosis on the samples and holds taken
27:11So we push back the dirty tray with which we took the tumour out
27:15And we move to a clean tray with no possibility of tumour cells on it
27:19Okay, so this is the implant that's going to go inside the leg
27:23He cuts off the bottom of the shoulder blade
27:27And then attaches the top section of the implant with two plates
27:38So we've got loads of screws along here now
27:40Seven screws in the front plate and seven screws in the back plate
27:43Give me a glove change
27:45Noel fixes the lower section of the implant to the stump of the humerus
27:49Using locking screws through the peg
27:52This peg's going to go inside the bone and these three plates are going to go outside the bone
27:56Because the bone segment, as you can see, is very, very small
27:59So we need all the holding power we can get
28:02This is specific and custom designed for this particular humerus
28:06So it should fit like it'd love
28:12Okay, so I'm just going to join the two bits back together now
28:15Just pick up the two pieces of metal
28:17Swing the leg down, slide it back up, slot it into place
28:22Got a new humerus
28:24Hold the foot
28:25So these two big nuts hold the top bit and the bottom bit together
28:29And that allows us to put the two pieces on separately
28:31Which was vital to get all the screws in
28:34Okay, we're finished now
28:36We're going to stitch all those muscles back in place
28:38The elbow moves fine
28:40And the shoulder blade will move up and down the side of the chest
28:42Alright, sweetie, you're still under there
28:49The new bionic leg
28:51There are seven operating theatres at the practice
28:58With almost 100 surgeries each week
29:01Noel often performs four operations a day
29:04Alright, here we go
29:05Dave, the French bulldog, is ready for his spinal surgery
29:10Okay, so this is a routine but risky procedure
29:16Risky in this case because the vertebrae are dramatically deformed
29:22Meaning that the nerves may not be entirely where we predict they should be
29:28So we've got this bone model here and you can see a tiny hole here
29:32Very large hole there
29:34Same on the other side there
29:36That hole should be the same size as that hole but clearly it's not
29:39So I'm going to take the entire roof off here to enlarge these holes
29:43To release the pressure on the nerves that are in here
29:53There's a big defect there
29:55Which is evident on the model here, there's a hole
29:57So that's just filled with fibrous tissue
29:59So if I was to drill through that like I normally would
30:02I'd hit nerves and potentially paralyse the urinary bladder or alternatively the legs
30:07So I'm going to prise up that fibrous tissue away from the nerves and try not to damage them
30:14With the excess bone and tissue cut away, the nerves are now free
30:22I think that's as much as I dare
30:24Noll will place pins and cement to stabilize the vertebrae
30:28So I've covered the nerves with collagen and I'm going to pour the cement around the pins to hold everything together
30:42Once the cement is set solid, that's it, these vertebrae are held in this position forever hopefully
31:00All right, let's go to CT
31:06Hello baby
31:08Hello baby
31:09Hello baby
31:10All animals who've had surgery spend some time recovering in the wards
31:14Little Wren has been here for five days now
31:18After the operation to amputate her foot
31:23Wren is fine
31:24No issues
31:25Yeah, I wasn't too worried about her
31:27No, she's quite tough
31:29She's right outside here
31:31All right then
31:32Come on gorgeous
31:33There we go
31:34She has her swimming collar on there to stop her licking it
31:37Hello
31:38Thank you Laura, that's fine I got it
31:39Thank you
31:40Thank you
31:42She's happy to see you isn't she?
31:43Yeah, I'm not worried
31:44I mean to some extent it's nice not to chop the whole leg off just because the rest of it's normal
31:49I've taken a cast and we're working with our colleagues who make the stump soccer prosthesis for humans
31:54Yeah
31:55And we're trying to develop a little foot
31:57It'll be a few weeks before Wren's prosthetic foot is ready
32:01That's amazing
32:02Wonderful
32:03Really appreciate it
32:04Look after yourself
32:05Take care
32:06It's being made at a local company
32:08Their clients include Paralympians and wounded soldiers
32:11So Wren's prosthetic is a little different
32:14This has been a bit of a discovery in thinking that actually that technology that we do is human
32:21Can be applied to animals in the same way
32:23The team have taken the cast Noel has made and filled it with plaster to create an exact model of Wren's lower leg
32:31This material is carbon fibre
32:34Same material with Formula 1 cars will be manufactured out of
32:37It's flexible in this stage
32:39There's no resin so you can put it to any shape you want
32:43It'd be about five layers in total and then once we've done that add the resin
32:49Once the resin has set the leg is machined to the ideal shape
32:55Whether Wren will know that she has the prosthesis I would say yes but it's going to be very subtle
33:02I hope that she will be happy and happy to wear it
33:13Try to be serious
33:23Back at the practice Claire and Mum Liz have come to collect Dave the French Bulldog
33:28Good boy
33:29Just two days since his major spinal surgery and he's already walking well
33:34Good boy
33:35Really excited, nervous, anxious but yeah so looking forward to seeing him
33:41Good morning
33:43So this is a three dimensional CT scan of the actual construct
33:48And at the moment Dave's doing great
33:52So I'm happy with his progress
33:54Other than the fact that he's got scrunched up lower back he's beautiful
33:59I'll get it by
34:00Okay
34:01It's good isn't it?
34:04Yeah
34:05Is this anything you can't?
34:09Hello Mum, go down to his level so he doesn't jump
34:12There you go
34:13Hello guys, how are you doing?
34:15I'm alright thank you very much
34:17I'm fine
34:18I'd like some more dinner please
34:20Yeah I do
34:21He looks much better than I thought he would
34:24Doesn't he?
34:25Yeah he's happy enough
34:26As long as he doesn't jar it'll be fine
34:27Yeah
34:28Thank you so much
34:29And you'll need that Mum
34:30Lovely
34:31Alright look after yourself
34:32Thank you so much
34:33Pleasure it's nice to see him doing so well
34:34Thank you nice to see you
34:35Take care
34:36Make sure nothing bad happens now
34:37No it won't
34:38God bless
34:39Cheers
34:40Bye bye
34:41I'm so surprised at how well he looks you know
34:44And going yeah I'm hi
34:46And just getting on with it like he does
34:48Hope he's going to be a good patient
34:50Smothering in cotton wool
35:06Right girl
35:08Alright sweetheart, good girl
35:10Come on Bubba
35:11It's 36 hours since Tallulah had major surgery to cut out the tumour in her front leg
35:17And replace it with a custom made metal implant
35:20Good girl
35:22She's using the leg with every step now which is really good
35:25She's also seems much brighter today
35:28We don't know how long she's going to live
35:30But as long as she does live she'll have four legs to walk on
35:33Which will significantly help her given that she already has trouble on her back legs
35:37And I think she'd find it difficult on three legs
35:39So, so far I'm very pleased
35:41We're only on day two and she seems much happier now
35:44Five days later, she's going home
35:47There we go
35:48Now, hello mum, hello dad
35:50Hello, hello baby
35:54Hello, hello everybody
35:56Now we'll just take this off for a moment
35:58Hello, I love you too
36:00I love you too
36:03She's already using it really well
36:05As you can see
36:06And what we do is
36:07We walk from this side
36:08And we just take it slow
36:09There you go
36:10Okay, so you can see she's pulling me along
36:13Yeah
36:14And you can see she's placing it pretty good
36:15Yeah
36:16If you just give her a little support on here
36:18She'll get the hang of it
36:20So, she's happy
36:21Yeah
36:22And she still has her leg
36:23She's actually in really good shape
36:25Alright Bubba, take care
36:26Look after yourself
36:27It's an amazing thing that he's done for us
36:31I keep thinking she's just going to live forever
36:33So, that's my optimism on it
36:37Yeah, I'm not living up to reality
36:39I'm going to bring the mattress in
36:41And sleep with her every night
36:43So that she's not alone
36:45I'm just so happy, yeah
36:47Oh, sorry
36:48I'm going to start crying again
36:52Tallulah has pulled through her first challenge
36:55But even with regular checks and chemotherapy
36:59Her future remains uncertain
37:10Two months ago, little Wren lost her foot
37:13After being attacked by another dog
37:15The family have decided on a removable stump socket prosthesis
37:19To try to help her walk on the limb again
37:22Now the prototype is ready
37:24And Julie has brought Wren in for her first fitting
37:28How are you sweetheart?
37:29Yeah, very good yourself?
37:30Nice to see you
37:31Come on, pop it
37:32This is my colleague Cameron
37:33Hi there
37:34So Cameron helps me with all of these design prosthetics
37:36Hi sweetheart, how are you doing?
37:38Hi
37:39Hi Munchie
37:40So, the plan is to use this
37:43And this has two basic components
37:46One is a silicone liner
37:47Yeah
37:48So we just take that
37:49That silicone liner, put your finger in it
37:51You can see it's super soft
37:52Yeah
37:53So that's intended to buffer the skin
37:56So that hopefully sores don't occur
37:59Yeah
38:00The second component is a carbon fibre sleeve
38:03Which you can see we've made with a rubber foot
38:08Yeah
38:09To try and encourage weight bearing
38:10But of course we haven't yet been able to judge what length that should be
38:14How tight that should be
38:15Yeah
38:16It's pretty rigid
38:17It's really light though isn't it?
38:20Super, you can feel it, feel it
38:21Super light
38:22Brilliant
38:23You hold her for one second
38:24Yeah, that should be great
38:26And then hopefully
38:28Good
38:30Now, let's see what that works like
38:32Yeah, so too short I'd say
38:39To get the lead on
38:40We're going to take her outside
38:41Okay
38:42Come on, sunshine
38:46Run
38:47Keep going
38:48Good
38:49And back down again please
38:51That's not too bad as a starter for ten
38:53It's amazing, yeah
38:54Yeah
38:55Because actually at that speed
38:56She would normally hold her leg right up
38:58I think if we got another centimetre on that
39:00That might be interesting
39:01Hold tight this machine might help
39:03Good
39:04Right, let's put another centimetre on here and then see how we got
39:07Okay
39:08Cameron makes the adjustments on site
39:11This won't be the final version
39:13Once they've got exactly the right length a new one will be made
39:17Because she's such a lightweight little doggy
39:19There's a bit of give and take on the distance
39:21So we reckon we need about a centimetre, a centimetre and a half extra
39:25So we're going to sandwich these together, super glue them
39:27Then pop them on the end there
39:29We'll just give that a bit of time to bond
39:31And then we'll pop it back on Wren
39:33It looks really good, I'm really happy with it
39:34Come on
39:35Keep going
39:38Keep going
39:39That is much better
39:42Wow
39:43That's actually she's standing on it for the first time now isn't she
39:46I'm delighted about that
39:47She hasn't even looked at it, amazing
39:49All right good, goodbye
39:50Thank you
39:51Thank you so much
39:52The new measurements will be sent to the prosthetic company to build the final model
39:58I am absolutely over the moon with what's happened today
40:02Really, really chuffed
40:03She's so laissez-faire about it, I'm really surprised
40:06She hasn't even sniffed at it or licked at it or looked
40:09It's just like, oh I've got my leg back
40:11She just put her foot down and went
40:13As if that's what she'd been waiting for
40:16It shows that it is still a proper vet's
40:20Where actually the result is the important thing
40:22You know, it's not all about the high-tech stuff
40:25It's about getting what they want
40:27As a result for the animal
40:28And I think that's brilliant
40:34In Hampshire, Dave, the French Bulldog
40:37Has recovered from his spinal operation
40:39And is once again enjoying life
40:41With Claire and his best mate Maisie
40:44Dave is doing brilliantly well
40:47Good boy
40:49He's happy, he's free, he's running around
40:53Just enjoying life
40:55He can do most of the things he did before his spinal operation
40:59Except one
41:01Noel advised us not to do agility with Dave
41:04Because it's just so high impact
41:06It's just not worth putting him at that risk
41:09He can run about and do all the other things a dog normally can do
41:12He just loves to run
41:14Just loves to hoon about
41:16And just loves being an idiot
41:18Davey
41:20He has two speeds
41:22He is stop or just zooming off at a million miles an hour
41:26He's just got this permanent grin on his face
41:28He's just a happy dog
41:30Good boy
41:32Good boy
41:40Back at the practice
41:42It's three months since Tallulah had her tumour removed
41:46The lab results have confirmed it was an osteosarcoma
41:49For which she's been having chemotherapy
41:51But in the past week she's been lacking energy
41:55Carla and Steve have brought her back for scans and blood tests
42:01Something's not quite right with her
42:05Hoping for the best with her today
42:07Hoping the cancer hasn't spread
42:09If not then
42:11Yeah
42:12Decision time
42:13Yeah
42:14Make the decisions then
42:16Hard ones
42:18Now the images are back
42:21The implant is fine
42:24But unfortunately I think I can see some mets
42:27Some cancer
42:29Spread
42:30Yeah
42:31We thought it was cancer
42:32Yeah
42:33Not in the leg
42:34Okay
42:35But there's some early stages in the chest
42:37I'm sorry about that
42:39The implant looks fine
42:41There's no problems there
42:42It all looks absolutely fine
42:44Now the chest
42:45I can see that it has changed
42:47In the sense that we have a small blotch there
42:50Almost certainly that is a tumour spread
42:52And there's another one right there
42:54Okay
42:55Look, you have a few months
42:57And I don't know how long those months will be
43:00Just let her have a normal life
43:02Yeah
43:03As normal as you can
43:04Yeah
43:05And enjoy every day you have with her
43:06That's all you can do
43:08It's heart breaking cancer
43:09You know there's some cancers you can't cure
43:11And unfortunately this is one of them
43:13I'm really sorry
43:17I'm really sorry
43:18Sorry
43:19It's a tough one
43:20It's a tough one
43:21I'm sorry
43:22I'm sorry
43:23I'm sorry
43:24Thank you for you
43:25You've done right
43:26Well
43:27You've done your best
43:28You have done your best
43:29You could not be nicer human beings
43:31It's heartbreaking
43:32Get a breath of fresh air
43:34I'll see if she's awake
43:35I'll get okay
43:36Okay
43:37I'm sorry
43:38Thank you very much for reading
43:39No problem
43:40Thank you
43:41All right
43:42Okay
43:43It's hurt
43:44It's uncertain how much longer Tallulah has left
43:49But Noel has given her medication to make her as comfortable as possible for the rest of her days
43:55What can you say? We just give her the best couple of months she's got
43:59Extra hugs, extra kisses, more treats
44:02My main concern is Carla and Lula both together
44:13Well done
44:14Back home in Wakefield the family are taking things a day at a time
44:19In her head she thinks she's well but the body's going no I'm not
44:24Love her
44:25Yeah
44:26Each day is different you know she pushes herself one day and the next couple of days she's pretty more lame
44:31Then she's back bouncing again so it's two steps forward one step back
44:35No you're not going in there
44:37She's very stoic
44:38Sometimes you question whether you've done the right thing
44:41So long as she's happy and not in pain then I'm happy
44:45As soon as it changes any then we shall have to make that decision sadly
44:52Oh the ducks look
44:56In the meantime Carla and Steve are making every moment special for her
45:01Oh no it's hello
45:03They got a bit close
45:05Come on in
45:07Good gal
45:08Plan to go to the beach with her while she can still do it
45:12Taking each day as it comes
45:14That's all we can do
45:16That's my gal
45:18In Bedfordshire little Wren has got her new prosthetic foot
45:30Come on
45:32Wren's really doing well she just has a completely normal life now
45:36It's absolutely fantastic
45:37Come on good dogs
45:38The other dogs don't appear to have noticed there's any difference to her
45:42It's really funny they were thrilled to have her back in their group
45:46They just treat her exactly as they always did
45:49She's one of the playmates and you know the same order for everything that we do
45:53Dogs are really resilient
45:55Good girl come on
45:57Her running is no different to how it was before she had an accident
46:00She absolutely flies along
46:02Good dogs
46:03She just thinks she has four legs when she's got her prosthetic on
46:06She is exactly who she was before and I never ever could have hoped for that
46:11It's just amazing
46:33This is just amazing
46:34Looks like I'm making a puzzle
46:35Thinking about the illness
46:36of the pain
46:37Of the pain
46:38Of the pain
46:40The pain
46:41Of the pain
46:42The pain
46:44The pain
46:47The pain
46:49The pain
46:50The pain
46:50The pain
46:53Is everything
46:56The pain
46:57The pain
Be the first to comment