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00:00Go and see Uncle Noel.
00:02Superheroes don't always wear capes.
00:05So cute, oh my god.
00:07I've got a new friend, he's beautiful.
00:09Professor Noel Fitzpatrick and his team
00:12Did you have some nice eggs for me?
00:14Offer cutting-edge solutions.
00:17What are you going to be doing to dream these things up?
00:20I dream a very little else.
00:22To help save the nation's pets.
00:24This has to be done within the next 48 hours.
00:26Coming through.
00:27Please be okay, please be fixable.
00:30You only get one chance at this.
00:31I just have to hope my best is good enough.
00:34Come on, you're a trooper, you'll be okay.
00:36Transforming the world for families.
00:39What have we got here?
00:41One animal at a time.
00:43That's crazy.
00:45He's just back to living his best life.
00:48You've got Superdog.
00:49He told me modestly that it was technology
00:51but it was so much more than that.
00:53You're cute.
00:54He'd worked a miracle.
00:55Now, it's me, yeah?
00:57It's going to be alright.
01:05There's a constant stream of families
01:07seeking the best treatment for their furry friends.
01:10Alright, Lou.
01:12I know what you mean.
01:13He's blocked the entire boot, hasn't he?
01:15If only he had his iPad, he'd go and sit in the front of the car again.
01:19Thank you, Noel.
01:20You look happy, sir.
01:21God bless.
01:23It's been an honour.
01:24Come on then, Lou.
01:25Put you in the car.
01:26It's a very good sit you've got there.
01:28I think it's the best hair I've seen in a long time.
01:30You have the best hair.
01:31Oh, our little movie star.
01:32I know.
01:33Look at you.
01:34Megan and Shana have brought their Boston Terrier to see Noel.
01:47Rogan.
01:48Mr Josh.
01:49He's not named after a carry.
01:51Rogan has suffered from hip dysplasia affecting both back legs since he was a puppy.
01:56So he's only a baby, you think.
01:57Yeah.
01:58Such a short life.
01:59Yeah.
02:00So he hasn't been able to actually experience a lot of things, has he?
02:05Two-year-old Rogan lives in Kent with his mums Shana and Megan and his animal siblings.
02:11Rave, don't break it.
02:13Our animals, we've got a bit of an R theme going on.
02:16Rogan and Raven are the best of friends.
02:19Riley bosses all of them around.
02:22More liveliness is on the way as Shana is pregnant.
02:27There is no chance that we'll be naming our child with an R. That's the one thing that
02:34we've said is not allowed.
02:36We love our animals like they're our own children, don't we?
02:41Yeah.
02:42So whenever they're in pain, it completely breaks our hearts, doesn't it?
02:46Yeah.
02:47Rogan was diagnosed with his debilitating hip condition at six months old.
02:51I could feel his hips clicking.
02:54He went lame quite a lot and couldn't use his back legs at all.
02:58You could tell that he was in a lot of pain.
03:01He was never able to be a puppy and he's not been able to be a dog.
03:04He's always been restricted.
03:06That's why he's such a big ball of energy.
03:08Calm down.
03:10So after this, we're hoping for him to do what he wants to do for the first time in his life, really.
03:18Right, girls, I'm ready.
03:19Yeah.
03:21Right.
03:22Oh, hello, sweetie pie. May I?
03:24Yeah, of course.
03:25OK.
03:26Oh, yeah.
03:27OK.
03:28Oh, oh, oh.
03:29Careful of your ears. He loves an ear.
03:30Kisses. He loves an ear.
03:31Oh, yeah.
03:32Well done, mate. Good.
03:34So my colleague took these radiographs and they show severe hip dysplasia,
03:42meaning that the femoral head is not in the socket at all. It's out here.
03:46Yeah.
03:47And because the head rubs on the top of the rim and then the socket fills in and becomes like a saucer
03:52and these spurs of new bone are due to tugging on the joint capsule and rubbing up there.
03:57So that's quite painful.
03:59Yes, mate. I know. I know. I know. Look, you can smell but you can't eat.
04:03Noel will need to check which of Rogan's hips is the most severely damaged.
04:08Hold tight.
04:15Good boy.
04:17Right, that's fine. Let's do the other one.
04:20Good boy. It's OK.
04:22So the right one's currently more painful than the left.
04:25Yeah.
04:26Is that what you found? I'm sorry about that.
04:27No, it's fine.
04:28Sure.
04:29Rogen is taken for further checks and a CT scan.
04:33All right. What can we do?
04:35Femoral head and neck excision.
04:37We cut the femoral head and neck off and leave a false joint which goes up and down like a piston
04:42and it certainly can give you a much better result than what you have now.
04:45Yeah.
04:46However, it's scientifically proven that no dog bears full weight on the leg.
04:51We want the best possible outcome for him to have the fullest life.
04:56Will, Rogan being one year, eleven, oh.
04:59He's two tomorrow.
05:00Birthday tomorrow. Yes, of course.
05:02One year, eleven months and twenty-nine days.
05:04Happy birthday, Rogan, tomorrow.
05:06Yeah.
05:07So the gold standard remains hip replacement.
05:10Yeah.
05:11But there are some challenges intrinsic to this breed.
05:14Yeah.
05:15They've got strong muscles.
05:16They're short-legged.
05:17Uh-huh.
05:18They bounce around and twist and turn.
05:20So there's a lot of force on the implants if you're going to put in a hip replacement.
05:25Uh-huh.
05:26He has a higher risk than normal of dislocation.
05:31At the moment, the only options for hip replacement for Rogan that we have are cemented.
05:39Cemented down in the femur like so.
05:42And this would be cemented into the socket, into the existing socket like so, and then the head would pop in.
05:47Right?
05:48That's all we got commercially.
05:49Yeah.
05:50Which is fine.
05:51Except this is a very young dog.
05:53It's possible that, given the architecture of this particular dog, that the cement bone interface could break down over time.
06:04This is an uncemented hip replacement that you hammer into the bone and the bone grows into the metal.
06:09Mm.
06:10It's a shell that gets bolted into the pelvis and then you can alter the angle of this plastic liner to give you more active capture of the head.
06:19Yeah.
06:20Hence making it less likely to come out.
06:22In this size of dog currently, we do not have uncemented hip replacements.
06:29It's a shame this kind of thing's not available for the small ones.
06:32Not yet.
06:33Now, so it is theoretically possible for us to make an uncemented implant for this dog, but it will be significantly more expensive because it's custom made for him.
06:46Mm-hm.
06:47So I'm sorry for introducing variables into the equation here, but it is what it is.
06:52Mm.
06:53Are you okay?
06:54You're a bit overwhelmed.
06:56Take a break.
06:58We'll talk in a minute.
07:01Megan and Shana now have to balance what they feel is best for Rogan with what it may cost.
07:07Sorry.
07:08Shana, I apologise.
07:10Um...
07:11It's just, er...
07:15It's a bit overwhelming.
07:16Yeah.
07:17What is going to give him the best life possible?
07:19What do you think?
07:20Because the thought of it breaking down and having to do this again in five years, I don't know if I can take it.
07:26No, I can't.
07:27Yes, that's what got me a bit upset when he said it could just break down.
07:32If we have to get second-hand stuff for the baby, we get second-hand stuff for the baby at this point.
07:36They're not going to know any difference, are they?
07:39It's really hard to have a life in your hands and you make the decision of how his life's going to be.
07:46I'm going to get upset.
07:47I'm going to get upset.
07:48I might have a pop of chocolate in my mind..
08:05Treat it down.
08:09He'll be fine.
08:12Megan and Shana are facing a difficult decision for their Boston Terrier, Rogan.
08:17Terrier, Rogan.
08:21Wake up.
08:22An off-the-shelf cemented hip replacement that may loosen over time
08:26or a custom-made uncemented system which will screw into the bone.
08:31Just so you're clear, you do not have to operate today.
08:35Fact.
08:36The dog isn't going to get dramatically worse in ten minutes or ten days.
08:40It's not going to happen.
08:41I think our decision is we chose to come here for a reason.
08:43We wanted the best possible outcome for him
08:46and we trust that you'll do that.
08:49So I think we've decided to go for the bespoke option.
08:54Yeah.
08:55The uncemented system will be designed using Rogan's 3D CT scan.
09:02Are you happy?
09:04You've made the bad decision.
09:06Here he goes. Come on, mister.
09:08Here you come.
09:09So happy birthday to you.
09:12Happy birthday to you.
09:14For Rogan's a jolly good fellow.
09:16For Rogan's a jolly good fellow.
09:18For Rogan's a jolly good fellow.
09:20And now he's not having the surgery today,
09:22we're going to go out and get him a birthday cake.
09:24Yeah.
09:24And birthday steak as well as a tradition in our house.
09:27It is indeed.
09:29Good boy.
09:30So gentle.
09:31Normally he tries to bite your hand off.
09:32Yeah.
09:34Maybe sedation is his friend.
09:35Jolly, sit down.
09:48Sit down next to mama.
09:50You good boy.
09:55It's late morning and Sarah has brought in Brody,
09:58desperate to see if Noel can get her Vizsla out of pain.
10:01Sit down.
10:04Sit.
10:05Sit down.
10:06Good boy.
10:07He's had surgery performed by another vet,
10:10but it's gone badly wrong.
10:12In 2022, more than one third of my surgical cases
10:17have been revisions of surgeries that have gone wrong.
10:21Every surgeon can have complications.
10:23I certainly have.
10:24Sometimes it's just bad luck.
10:28But other times,
10:29better implants or better technique
10:32could have been used from the outset.
10:35I'm really hoping that we're going to be able to start
10:39a new journey in putting right
10:42what's obviously not been done correctly.
10:45Our poor dog has gone from an animal
10:49that he's never complained of any pain
10:51to somebody who really is struggling.
10:56I think the noise he's making at the moment
10:58is because he's hungry.
11:02Sarah and her family live in Surrey.
11:05They've had nine-year-old Hungarian Vizsla Brody
11:08since he was a puppy,
11:10and he has a younger Vizsla brother, Fido.
11:12They are dogs that are made to go fast.
11:19And on a normal day,
11:21we will take them for three walks,
11:23and at the end of that,
11:25they'd come back and they'd want to go out for a run.
11:30It was out on a walk in February 2021
11:33that the family's beloved Brody suddenly went lame.
11:37Our local vets diagnosed
11:39that he'd got slight elbow dysplasia.
11:42She put him on anti-inflammatories
11:44and all the swelling went down
11:45and he started going back to a normal gait.
11:47However, the vet referred Brody
11:49to an orthopedic surgeon
11:51who told Sarah that Brody's condition
11:53was so severe,
11:55he needed a partial elbow replacement.
11:57He felt that there was virtually no cartilage
12:00in his elbow
12:00and he needed to have an implant.
12:03We were really, really concerned
12:06because by this stage,
12:09Brody was back on four legs,
12:10he was running around normally
12:12and he seemed to be back to his normal self.
12:15And we were being told
12:16that his leg could go at any point
12:18and that a dog of this stature
12:20couldn't survive on three legs
12:22and that they'd have to euthanize.
12:24And it was such an emotional,
12:27fraught situation
12:28that we agreed to go ahead with it.
12:31Come on then, boys.
12:32Let's go.
12:33Brody has not been able
12:35to put weight on his front leg
12:36without pain since the surgery.
12:38It's very traumatic
12:40to see your beloved pet
12:41rattling almost
12:43with the amount of painkillers
12:45that he has to be on.
12:46I want my dog back as he was
12:51and you will do anything
12:52for the animal that you love.
12:54Come on, Brody.
12:57Now, Brody, please.
12:59Oh, poor old Brody.
13:00Come on.
13:00Come on, Brody.
13:01Come on.
13:03Please come in.
13:03All right, there you go.
13:05There's pages and pages of history,
13:07but can you tell me
13:07how many months now
13:08has he held that leg up?
13:10You can sit down.
13:11Oh, mate, I'm sorry.
13:12You are next to the wheel.
13:13Since the surgery.
13:14He's never put it down.
13:16Poor fellow.
13:17So he hasn't put it down
13:18then for nearly nine months?
13:20Yeah.
13:23OK.
13:25I've already had
13:25several surgeries
13:26from this surgeon
13:27that I've been asked
13:29to have a look at,
13:30which is profoundly sad.
13:32Mm.
13:33But we're going to have
13:33to face it.
13:34Yes.
13:36Noel has been given
13:37the radiographs
13:38that were taken
13:38of both elbows
13:40before Brody's operation.
13:42And there is evidence
13:43of whiteness here
13:44and there is evidence
13:44of some osteoarthritis here,
13:46OK?
13:46Mm-hmm.
13:47And there's also
13:48a concretion of bone
13:51here on the left
13:52and on the right
13:55associated with mineralisation
13:57around the joint.
13:59Having said that,
14:01would I have felt
14:02that this patient
14:04definitively warranted
14:05this procedure?
14:06No, I wouldn't
14:07at that point.
14:09That's my opinion.
14:10We were blackmailed
14:12emotionally into doing this.
14:14Lauren told me
14:14you felt you had
14:15a gun to your head.
14:16That was exactly
14:17how I felt.
14:18You go in front,
14:19Mama,
14:19and talk to the head end.
14:21Oh, my boy.
14:22So I would wonder
14:23if the X-ray picture
14:24for this leg
14:25doesn't look that
14:25different to the other leg,
14:26how come the other leg
14:27had a big surgery
14:28and that one's doing OK?
14:31OK.
14:32We're going to need
14:33a CT scan.
14:34Yep.
14:34and the girls
14:35will take him through.
14:36Yep.
14:39Thanks, ladies.
14:41We're not going
14:42to get your dog
14:43back to what
14:43he was before.
14:45It's not going to happen.
14:47I'm sorry.
14:47Mm-hmm.
14:48I wish it could happen,
14:49but it's not.
14:51It's OK.
14:52I know you've got
14:53a poorly arm,
14:54haven't you?
14:54It's OK.
14:57Oh, poor man.
14:58Come on, beautiful.
15:02Although not as a result
15:03of Brodie surgery,
15:04the original vet
15:05has since been struck off
15:06by the Royal College
15:07of Veterinary Surgeons
15:08in January 2022
15:10for performing
15:11inappropriate hip surgeries
15:13without adequate investigation
15:15or informed consent.
15:18It's really hard
15:19to hear that
15:20we're not the only one
15:22that he's having to look at.
15:23I think it gives me
15:24reassurance in one way,
15:27but also
15:27complete desolation
15:29in another
15:29that somebody
15:30has been playing God
15:31with other people's
15:32beloved pets.
15:34Thank you very much.
15:39Sarah?
15:40All right.
15:42Well, there's not going
15:42to be any real surprises here.
15:45These images
15:46very clearly show me
15:48that the elbow itself
15:49is destroyed.
15:53Been destroyed
15:54by the operation?
15:55Yes.
15:56The joint
15:58hasn't just collapsed here.
16:00The humeral radial joint
16:01has also collapsed.
16:03So there is no good cartilage
16:05in any of that region there.
16:07I just don't feel
16:08that people this poor
16:11should be allowed
16:11to practice
16:12in the first place.
16:13You can put in
16:14any implant
16:15after a one-day course
16:16with one year
16:17of experience.
16:18The damage
16:20is...
16:21We see
16:21every single week
16:23disasters.
16:25So in my opinion,
16:26the only way
16:27to keep the leg
16:28is to fuse
16:28the elbow solid.
16:29Okay.
16:30It's a plate system
16:32that completely
16:32fuses the elbow solid.
16:34So they use the leg
16:36like that,
16:36but it gets them
16:36out of pain.
16:38We've got to do
16:39something sooner
16:39rather than later
16:40or it's going to get worse.
16:43Hello, baby.
16:44Was he good?
16:48He's been a superstar.
16:50Yes.
16:52Well, the consult
16:53really disclosed
16:54answers that were worse
16:56than we expected.
16:59Come on.
17:00I'm used to doing it.
17:01I really wish
17:02that he'd come
17:03to see Noel
17:04in the first instance
17:05where we could have
17:06discussed all sorts
17:08of preventative
17:09options
17:10before even surgery
17:12would have been
17:13on the cards.
17:14Good boy.
17:23No, no,
17:24no, no, no, no,
17:25there's no need
17:27no fear to Patrick.
17:32You're wasted.
17:34I know.
17:34You should become
17:35like a singer-songwriter.
17:37I think so.
17:38Move over, Adele.
17:39Uh-huh.
17:40Ed,
17:41make way.
17:43But then you go
17:44and tell.
17:48Two-year-old
17:49Boston Terrier
17:50Rogan
17:50is back
17:51for his total
17:51hip replacement
17:52to try to get him
17:53out of pain.
17:57As he's so young,
17:58there's a risk
17:59that a cemented system
18:00may loosen over time.
18:02So he's had
18:02custom implants
18:03made especially
18:04for him.
18:05Is that the right
18:05button?
18:08All right,
18:08we've got to be
18:09on our ballgame now.
18:12First,
18:13the top of the
18:13femur bone
18:14is removed.
18:16The diseased cup
18:17is drilled out
18:18and a titanium
18:19mesh shell
18:20with a cup liner
18:21is screwed in place.
18:24The stem
18:24is inserted.
18:26Then a 3D-printed
18:27jig is used
18:28to drill a hole
18:28into the femur
18:29to secure it
18:30with a pin.
18:33Finally,
18:34the head
18:34is attached
18:35to the neck
18:35of the stem
18:36and re-articulated
18:37within the cup.
18:41After removing
18:42the femoral head,
18:43Noel prepares
18:44the old socket
18:45ready for the new cup.
18:47Right,
18:48this is a cup
18:48that's got
18:49an outer shell
18:50made of titanium
18:51with trabecular metal
18:52into which the bone
18:53will hopefully grow.
18:54This is the first cup
18:56of this specific type
18:57that has ever been made,
18:59designed to exactly
19:00fit Rogan.
19:02Unlike existing
19:03hip implants
19:03for small dogs,
19:04it won't be
19:05cemented into place.
19:07We're going to anchor
19:09the cup down
19:10with these little ears
19:13which take
19:15locking screws.
19:17Noel then drills
19:18out the femoral canal.
19:20There you go.
19:24So we drilled
19:25a hole here
19:26into which we're
19:27placing pegs
19:28which will hopefully
19:29hold the stem
19:29in place
19:30until it's solid.
19:35Finally,
19:36the head is positioned
19:36into the titanium cup.
19:39Just put the new head on.
19:41We now put the head
19:42into the cup.
19:50Hold it there.
19:53Just tugging on
19:54the femur
19:56and the femur
19:56to see if I can dislocate
19:57to it,
19:57which I cannot.
20:01Rogan has a new hip joint
20:02but it will be
20:03several weeks
20:04before it's clear
20:05whether this
20:06groundbreaking surgery
20:07has been successful.
20:08All right, Rogan, well done.
20:12Let's go to X-ray now, please.
20:16Good boy.
20:23What you got?
20:24Just a little
20:25something.
20:25Just a little
20:26something.
20:26Something.
20:33That was really cool
20:34how we collected.
20:35That actually scared me.
20:37That was crazy.
20:46The magic is just all right.
20:48It's early afternoon
20:51and a tabby cat
20:52has been rushed
20:52to Fitzpatrick referrals
20:54for assessment.
20:56Hello, I'm Lauren.
20:57We spoke on the phone.
20:58How are you?
20:59Oh, hello, little Vinny.
21:01Do you want to come
21:02and just sit down over here?
21:04How is he doing?
21:05I'm popping up on here.
21:07Hi, mate.
21:08Hello.
21:09You're beautiful, aren't you?
21:11Oh, bless you.
21:12It's been a tough morning.
21:14Tough morning for everybody.
21:15He's had his pain relief
21:17and things, so we can...
21:18Two-year-old Vinny
21:19has been hit by a van
21:20and seriously injured.
21:23She's sat at reception
21:25now with him.
21:27OK, bye.
21:29Zoe is still traumatised
21:31by discovering Vinny
21:32just after the accident.
21:36I just dropped the kids
21:37off to school
21:38and then I had a phone call
21:39from my neighbour
21:40and she said,
21:41she explained that the cat
21:42had just been hit,
21:43literally just been hit.
21:45So, I went running outside
21:47and he was just
21:48by the side of the road
21:49and he was struggling to move
21:52and then I just drove him
21:54straight to the vet.
21:58After taking x-ray pictures
22:00of Vinny's broken back legs,
22:02the vet referred him
22:03for specialist treatment.
22:07Hi there.
22:08Hi.
22:08I'm so sorry
22:09you're going through this trauma.
22:10Oh, my God.
22:12You're gorgeous, aren't you?
22:13Oh, sweetie.
22:14Right.
22:15So, Lauren told me
22:16that we got hit
22:17by a post truck.
22:18Yeah, it went under the wheels.
22:19I saw it on my CCTV
22:20this morning.
22:22Yeah.
22:22Oh, my God.
22:23Oh, my Lord.
22:24Do you mind
22:25if we go through
22:26and assess the injuries
22:28and then talk?
22:30Yep, that's fine.
22:30Once I decide
22:32what's what.
22:33Do you want to give a kiss
22:34and we'll take her?
22:35Okay.
22:36All right.
22:37Now.
22:37Goodbye, Vinny.
22:38I'll see you in a bit.
22:40He's a good boy.
22:42Thank you so much.
22:43Oh, my pleasure.
22:44Pleasure.
22:44Pleasure.
22:54Hello, Vinny.
22:56He's very sweet.
22:58All right, big guy.
22:59Oh, Vinny.
22:59Vinny lives with Zoe,
23:03her husband Simon
23:04and their two teenage children
23:06in Surrey.
23:08The kids love Vinny
23:09so he'd love to lay on their beds
23:12and they're doing their homework
23:13and he's laid across
23:15their homework books.
23:17The family got the handsome tabby
23:19as well as his sister Honey
23:20as kittens.
23:22They were the only two kittens
23:24of that litter.
23:26We walked in
23:27and I put my handbag
23:29on the table
23:29and Vinny just
23:31climbed in my handbag
23:32and was purring
23:33and I just said to Simon,
23:35oh, I've got to have these cats.
23:39Vinny Jones is my husband's
23:41favourite sports personality,
23:43I suppose.
23:44He's a big Wimbledon supporter.
23:46Always wanted to call
23:47our children Vinny
23:48and I was never quite sure
23:50so when we got the cat
23:52I said,
23:53you're allowed to call
23:54the cat Vinny.
23:56All right.
23:57He's got a full thickness
23:59de-gloving.
24:01All the skin's gone.
24:03His tibia's sticking
24:04through his skin here.
24:09All right.
24:10Rapid heart rate,
24:11but otherwise okay,
24:12lung's okay.
24:14If we can confirm
24:15that he does not have
24:16internal injuries,
24:17then we're in a race
24:18against time
24:19with infection
24:20in the limb.
24:20If we leave it longer
24:21than the golden window,
24:22which is 12 to 24 hours
24:24before the bacteria
24:25become an infection,
24:27then we've got a problem.
24:29It's okay.
24:30It's okay.
24:31Although both of
24:32Vinny's back legs
24:33are injured,
24:34his left leg
24:35is in a worse condition.
24:36The foot is floating
24:39in the breeze out here
24:40and the ankle
24:40is stuck through
24:41no skin here.
24:43It's literally
24:44not attached to anything
24:45apart from
24:46the tendons,
24:48the blood supply
24:49and the nerves.
24:51He could feel his foot
24:53as far as we can tell.
24:54Wow, okay.
24:56That means that
24:56the main nerve
24:57that goes down
24:58the front and the back
24:59is probably still there.
25:02Okay.
25:03That's hope.
25:03Because if they were dead,
25:06So that would be amputation.
25:07That would be amputation.
25:09What I would try
25:10and do down here
25:11is what's called
25:11an ankle fusion.
25:13A pussycat or a dog
25:15can easily manage
25:16with that
25:16and still keep a leg.
25:18It's a very
25:19recognised procedure.
25:20Okay.
25:22Yeah.
25:23I'm sorry.
25:25I mean,
25:26we're lucky
25:26I'm going here so far.
25:27You are.
25:28Okay,
25:29do you want me to proceed?
25:30Yes, please.
25:31Okay.
25:31All right.
25:32Do you think
25:33you would let us
25:34try and take
25:34some blood from you,
25:35my friend?
25:38Vinny's in a lot of pain
25:40and he's at
25:41significant risk
25:42of infection
25:43so the team
25:44must act fast.
25:47There we go.
25:49Good lad.
25:52I think the kids
25:53are going to be
25:53devastated.
25:55I just feel so
25:56sorry for him.
25:58I'm really sorry for him.
25:59Yeah, yeah,
26:10I'm going to move
26:11all of the leg
26:11and then click
26:12this one first.
26:13Vinny is being
26:14prepared for surgery
26:15after being run over
26:17by a van.
26:19Scans have confirmed
26:20he has no internal injuries
26:21but his right leg
26:23is fractured
26:23and his left leg
26:24needs immediate attention
26:26to try to save
26:27as much soft tissue
26:28as possible.
26:32So there's some tar
26:33left from the road
26:34on here
26:34so we're just
26:35cutting that away.
26:36We just cut off
26:37everything instead
26:38and stitch up
26:38everything that's still alive
26:40and then if we have
26:41enough things still
26:42left alive
26:42the leg will be fine.
26:44If we don't
26:45the leg will die
26:45but I wouldn't be
26:47doing this
26:47if I didn't think
26:48that we had enough.
26:49With the wound
26:50cleaned
26:51Noel begins
26:52the process
26:52of reattaching
26:53Vinny's left foot.
26:56Just flipping the
26:57tail us out of the way
26:58so we can get
26:59to the bone
26:59behind that
27:00which is called
27:00the calcaneus.
27:02There is extensive
27:04damage around
27:04the ankle
27:05so Noel will fuse
27:07it solid
27:07by drilling out
27:08the cartilage
27:09and securing it
27:10with a metal plate.
27:12We've got to be
27:13very careful
27:14not to damage
27:15this blood vessel
27:16which is in here.
27:17If we damage that
27:19the foot dies.
27:24So I've just
27:25screwed the two
27:26main ankle bones
27:27together
27:27and now I'm going
27:28to try and align
27:28everything.
27:37So now we've
27:37reattached the foot
27:38it's all solid again.
27:43Sadly this skin
27:44may well die
27:45you can see
27:45there's a blood vessel
27:46ruptured there.
27:48But once you get it
27:49wrapped back around
27:50the lining of the muscles
27:51it's in with a chance
27:53if you can do this
27:54surgery very quickly.
27:58Noel uses a different
27:59technique to stabilise
28:01the fracture in the
28:01right tibia
28:02using two standard
28:04plates.
28:04When you take two
28:05of these plates
28:06so that they're at
28:07right angles to each
28:08other it's incredibly
28:09strong
28:09because you can't
28:11bend the plate
28:12it on its side.
28:17I have seen
28:18hundreds of legs
28:19chopped off
28:20that could have
28:21been saved.
28:22If there is a blood
28:23and nerve supply
28:24most traumas
28:25in my opinion
28:25are fixable.
28:29Noel has completed
28:30the operation
28:31within 15 hours
28:32of Vinnie's accident.
28:33He now has a fighting
28:35chance of avoiding
28:36infection.
28:37Right, let's see
28:42if I can do this
28:43stupid thing.
28:46I can only feel
28:47one hole.
28:47You're putting
28:48this thing up.
28:49I know.
28:51There's two holes.
28:52Oh yeah, yeah, yeah.
28:53And then just push.
28:55Oh yes, I did it.
28:58Oh, was that good
28:59for you?
29:04Here we go.
29:06It's early morning.
29:08Sarah's arrived
29:08with Vizsla Brody.
29:10He's having surgery
29:11to correct a failed
29:12partial elbow
29:13replacement
29:14which has left him
29:15in terrible pain.
29:17At the moment
29:17I'm feeling nervous
29:19because we've waited
29:21so long to try
29:23and get things fixed.
29:25Now, really looking
29:27forward to Noel
29:28being able to work
29:29his magic
29:29and start life again.
29:33Alright, I'll see you soon.
29:36There's been a lot
29:37of animals
29:38put through
29:39enormous pain
29:40and operated
29:41by somebody
29:43that wasn't
29:44as competent
29:44and shouldn't have
29:46been doing the surgery
29:47that they did.
29:48We wanted to have
29:49two opinions
29:50and
29:52no other surgeon
29:54would even consider
29:55looking at somebody
29:57else's poor work
29:58and that was
30:00very traumatic.
30:02The truth is
30:02that any implant
30:04can be put in
30:05by any vet
30:06without an ethics review
30:08of manufacture
30:09or technique.
30:10I think that
30:11any operation
30:12performed by
30:13any vet
30:13should be equally held
30:16to the same
30:17high standard.
30:24Noel takes away
30:26diseased bone
30:27from around
30:27the elbow joint
30:28to gain access
30:29to the disc implant.
30:33But he's hampered
30:35by the effect
30:35of the previous surgery.
30:37So it's highly likely
30:39this bone
30:39is going to
30:40disintegrate in here
30:41as I touch it
30:41because it's infected
30:44and it's eaten away
30:46by debris
30:47from the failed implant.
30:51The original implant
30:53has caused damage
30:54to the bones
30:54and resulted
30:55in likely infection.
31:00This is the implant
31:01coming out.
31:03The problem was
31:04that a bit of bone
31:05on the outside here
31:06wasn't placed properly
31:07and it fell off
31:09and the disc
31:10wasn't placed properly
31:11and it fell down.
31:15Noel and his team
31:15have designed
31:16a new implant system
31:18which will fuse together
31:19the damaged bones
31:20around the collapsed joint.
31:23So this plate's been designed
31:24so that it has
31:25a ski tip here
31:26which is going to go
31:28up the back
31:28of the humerus.
31:30The shape of the new plates
31:31will help to distribute
31:32the load
31:33lessening the chance
31:34of a future fracture.
31:37The first plate
31:40is screwed
31:41to the humerus.
31:45Noel uses bone graft
31:46he harvested earlier
31:48from Brodie's humerus bones
31:49to help fuse the joint.
31:52He attaches
31:52a second plate
31:53to the first
31:54and screws it
31:55into the radius
31:56and ulna bones.
32:00I'm just taking
32:01the graft
32:02and I'm packing
32:04it into the gaps.
32:07Every success
32:08stands on the shoulders
32:10of failure.
32:12Every innovation
32:13stands on the shoulders
32:14of frustration.
32:19Alrighty
32:19that's the best
32:20I can do
32:21for you Brodie.
32:22Sorry you've been
32:23through so much buddy.
32:24I was just going
32:31to give him
32:32his methadone
32:320.1 still.
32:35It's 5pm.
32:37Vinnie's condition
32:38has worsened
32:39and he's under
32:40close observation
32:41in the prep area.
32:44Alright big guy.
32:48Hey mate.
32:49Alright buddy.
32:50Good boy.
32:52Four days ago
32:53Noel performed
32:54emergency surgery
32:55to repair his
32:56broken back legs
32:57after being run
32:58over by a van.
33:00Alright big guy.
33:00I'm just taking
33:01this off buddy.
33:04He was doing great
33:05and he had
33:06very good
33:08signs
33:09of recovery
33:10but then
33:12he started
33:13to go downhill.
33:13very soon
33:16it became apparent
33:17that he was
33:18showing signs
33:19compatible
33:19with sepsis
33:21which is
33:21when bacteria
33:22get into the bloodstream.
33:25Yeah so
33:25that doesn't look good.
33:27Now we knew
33:28that this was
33:29always a possibility.
33:30The bacteria
33:31from the road
33:32traffic accident
33:33had somehow
33:34made its way
33:34into the bloodstream
33:35and circulated
33:36in the bloodstream.
33:37Then the immune system
33:38mounts a huge
33:39response to that
33:40and it can be fatal.
33:42so we've been
33:43battling for the last
33:44several hours now
33:45to save his life.
33:49Well short of
33:49taking his leg off
33:50there's nothing
33:50I can do about that.
33:52I don't think
33:52he's strong enough
33:53for an anaesthetic.
33:53I don't think
33:54he is either.
33:55Finney is too weak
33:57to have an amputation
33:58to try and halt
33:59the spread of the infection.
34:01We can't anesthetise him
34:02to take his leg off
34:03so we're going to have
34:03to see how that manifests.
34:07Noel's team
34:08will continue
34:09to give antibiotics
34:10and other drugs
34:11intravenously
34:12in the hope
34:13of fighting
34:13the sepsis
34:14that's threatening
34:15Vinny's life.
34:17We forget
34:17we manage him
34:18overnight
34:19and getting stronger
34:20he might tolerate
34:21an anaesthetic
34:21maybe tomorrow
34:22but I guess
34:23we'll just have to see.
34:23fix patch it referrals
34:40orthopaedics
34:40and neurology
34:41how can I help?
34:42Megan has returned
34:55to pick up Rogan.
34:57Two days ago
34:58he had surgery
34:58to replace
34:59his right hip joint
35:00with a bespoke implant.
35:03We're excited
35:03to have him home
35:05but we're a bit apprehensive
35:06because I know
35:08his recovery
35:08is going to be a lot
35:10so we need to be
35:11extra careful with him
35:12he's only allowed
35:13in a crate
35:14so we've actually
35:15positioned three crates
35:17around the house
35:18in the main room
35:19so he doesn't have to
35:20do any kind of
35:21walking at all.
35:22So the cup
35:25is specifically
35:26designed for Rogan
35:28look at that
35:28and it's specifically
35:29designed so that
35:31the head is 12 millimetres
35:32which is similar to that
35:33as opposed to
35:35the commercially
35:35available one
35:36which was too small
35:37yes
35:38so he's the first dog
35:39in the world
35:40to have this particular cup
35:41only the best
35:43for my boy
35:43and as you can see
35:45because we brought
35:45that head down
35:46this muscle's now tight
35:48and that means
35:50that the leg
35:51is going to be
35:52held rigid
35:52for a couple of weeks
35:53don't worry about it
35:55so he does this
35:56now
35:56at least it's you
35:57putting a little bit
35:58of pressure on it
35:59yeah he's doing fine
36:00yeah
36:00do nothing for two weeks
36:02just let everything chill
36:04now who've we got here
36:07there we go
36:09we shall miss him
36:15he's such a lovely boy
36:16I'm ecstatic to have him back
36:19the house has been
36:20ridiculously quiet
36:21without him
36:21his Boston brother
36:23has been moping around
36:24the garden
36:25and the house
36:26not knowing what to do
36:27with himself
36:27so everyone will be happy
36:28it's back
36:28yeah his blood pressure
36:39yeah his blood pressure
36:41is around 108
36:44it hasn't gone below 90
36:45the whole time
36:46Vinnie the cat
36:48has been fighting
36:49for his life
36:50after being hit
36:50by a van
36:51this is a disaster
36:54this leg needs to come off
36:55now
36:55he's suffering from sepsis
36:58but the team have managed
36:59to stabilise him
37:00his best chance now
37:02is for Noel to amputate
37:03the leg
37:04are we stable enough
37:05to take this leg off
37:06as gangrenous
37:06all right
37:09all the muscles died
37:10so he must have had
37:12a much more significant
37:14crush injury
37:14we can't have predicted that
37:17that's just
37:18the luck of the draw
37:19if Noel removes
37:21his left back leg
37:22Vinnie will only have
37:23his right leg
37:24to support him
37:25so Noel checks
37:26if it's healing
37:27but it's not good
37:29this one's infected as well
37:31literally everything's infected
37:33so even if we chop
37:36that leg off
37:36that leg may not make it
37:38Noel must now
37:44break the news
37:45to Zoe
37:46there comes a time
37:49when you have to draw the line
37:50and no matter how
37:53emotionally vested you are
37:54you have to let go
37:59if it's the right thing to do
38:01we've battled for three
38:04long days
38:05to save
38:06Vinnie's life
38:07my job
38:09my vocation
38:11is to be the guardian
38:12of the animal
38:14and ultimately
38:16that means
38:18I've got to make a decision
38:20on Vinnie's behalf
38:22hello
38:27Zoe is not
38:30I'm sorry I'm crying
38:33oh no
38:34is he gone?
38:36not yet
38:36but I can't save him
38:39oh ok
38:41I'm so sorry
38:43it's not right
38:44you've done everything
38:45do you want to come in?
38:47he's asleep
38:50he doesn't know anything
38:52he's asleep
38:55yeah he's under anesthesia
38:57I don't know
38:59I think I'm seeing him
39:01like that
39:03my husband will come in
39:06is he sure?
39:07yeah
39:08you sure?
39:10yeah
39:10yeah
39:10come this way
39:26this is Lottie
39:30yeah
39:31noel and his team
39:36did everything
39:37they possibly could
39:38I don't think
39:41I would ever
39:42forgive him
39:43myself
39:43if I hadn't
39:45tried to save him
39:46you rest now
39:49good boy
39:49Vinnie
39:50good boy
39:52Vinnie
39:52you rest now
39:53I'm sorry
39:57I'm so sorry
40:03when it comes to meal times
40:19the service at the practice
40:20is second to none
40:22feeding time is probably
40:23my favourite part of the job
40:25they're just there licking all the food off your hands
40:28and it's a bit messy
40:29but it's nice
40:30I've seen some patients come in with a dietary requirement list longer than I have myself
40:34mum and dad like to bring in very specific snacks and treats
40:40do you want a carrot mate?
40:41everything that you could possibly imagine
40:43from steak to boiled egg
40:47is that nice
40:49you don't have to eat it all at once
40:51but Vizsla Brodie
40:53is not tempted
40:54by the practice's five star menu
40:56he's recovering from revision surgery
40:58to fuse his elbow
40:59after a previous operation failed
41:02but as Noel suspected
41:03the joint was already infected
41:05after the original surgery
41:07hello
41:08hi Sarah Noel here
41:10Brodie's fine
41:12you'll be very much aware
41:14that I thought Brodie had an infection
41:15from the outset
41:16so that's why I started intravenous antibiotics
41:19and ostensibly it hasn't worked
41:21so we now start on a different IV antibiotic
41:26yep
41:27so we can only hope that the situation turns a corner in the next few days
41:33what I think we should do is get you in to feed him
41:36because his appetite has been zilched today
41:39yes
41:40so I need you to bring whatever he normally eats please
41:44okay
41:45Sarah heads straight in with something she hopes will tempt Brodie
41:52now who's here
41:55hello baby
41:57hello
41:58give him a sausage
42:02should I give him a sausage
42:03yeah that sounds good
42:05that sounds good
42:06do you want to try a sausage
42:07do you want to try a sausage
42:07yeah
42:08can you come in
42:09I need to bring it to you
42:10look what I've got
42:11what have I got
42:12what have I got
42:13oh what have I got
42:14oh look at this
42:16and they said you've won't eat me
42:19oh
42:21oh oh oh
42:23all right take your time
42:24do you want to know
42:25do you want to know
42:26you just didn't like what they were giving you did you baby
42:35he says these sausages
42:36these sausages are it
42:37we'll make sure we'll get some sausages for it
42:41Brodie will stay at Fitzpatrick's for another week
42:45while he continues treatment for his infection
42:48it's now three months since Boston Terrier Rogan's right total hip replacement
43:08and the family are not only celebrating his recovery
43:12but a new addition to the fold
43:14quite a snuffly one
43:15initially he started barking and growling
43:24he's never been around a baby before
43:27both of the dogs are good with kids
43:29but never been around a newborn before so
43:32it was interesting wasn't it
43:34yeah
43:34it's been difficult to try and juggle
43:38Rogan being in a crate
43:40with us needing to look after the baby
43:42we're keeping an eye on him
43:44to make sure he's not doing too much
43:46and giving him as much freedom as we can
43:48to try and keep him happy as well as us happy
43:52look at Rogan rolling around
43:55it's nice to see him going around again isn't it
43:58yeah
43:59the operation has been successful
44:02his hip is fully healed
44:04the thing is with him he bounces back really really fast
44:06he bounced back too fast I think
44:08because we had to up his sedation medication
44:10oh yeah that was a bit of a worry wasn't it
44:14boys
44:15enough
44:20we've still got quite a long road ahead of us
44:24he's still got a diseased hip on the other side that still needs surgery
44:28I'm not looking forward to it
44:30no not at all
44:31but I'm hoping he might take to it better because
44:34he has got a good hip now
44:37yeah
44:37I think now Rogan's getting more freedom
44:39and is able to move around a lot more
44:41I think he's a lot happier
44:42yeah definitely
44:43no regrets
44:45no regrets at all
44:46just a lot more sleepless nights
44:48before we had the baby
44:49than what we hoped for
44:50yeah
44:51at home in Surrey
44:58hello
44:59Vizsla Brody's infection has cleared
45:02since his operation
45:03Brody's been much more joyful
45:06it's as though he's come out of a depression
45:09after a year of pain
45:11he's not only able to walk on his right front leg
45:14Brody
45:15he's running
45:16come on
45:17this way
45:18is this fun
45:24is this fun
45:25he's really enjoying walking and running and playing with his brother
45:30they are inseparable
45:31so being able to take them for a walk together
45:34it's very exciting
45:36feels like we're getting back to normality
45:39gently
45:40good boy
45:41there we go
45:42I'm incredibly grateful to Noel
45:46and the team at Fitzpatrick
45:48he's running
45:50and he's with us
45:51and that's happened because of us fighting
45:54and no fighting
45:55and that means everything
45:59and that means everything
45:59המע
46:07and that means everything
46:08and that means everything
46:10can help us
46:11and that means everything
46:14single
46:15of course
46:15doing
46:16and just
46:17Transcription by CastingWords
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