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00:00Fitzpatrick referrals orthopedics and neurology how can I help it's late July
00:06and Noel is preparing to leave the practice as you can see I've ironed not so good at the ironing
00:14front he's traveling 6,000 miles across the world to South Africa so I've been contacted by a few
00:24vets in South Africa they have incredible animals that they look after every day and that have similar
00:32problems to the animals I see osteoarthritis and all kinds of other issues but they're endangered
00:38they're in danger of extinction Noel has spent the last 30 years developing groundbreaking techniques
00:48to fix thousands of pets now he's hoping to transfer his skills to the treatment of wild
00:55animals to help transform their lives too I'm really well I'm very excited to go but I'm also
01:04a little bit afraid because it's something I've never done before I'm not sure what I'm gonna see
01:10I'm not sure what challenges are gonna meet me I mean there are techniques that I use here that I
01:15simply can't use in South Africa because it's is either not practical or not ethical so I know
01:22that I'm gonna have some intrinsic limitations but all I can do is my best and hope that my best is good
01:29we're here I'm in South Africa slightly different horizon to the hedge road country lanes of Surrey
01:52I've come to Gondwana game reserve which is a reserve for all five big species in South Africa and their
02:05model is sustainable tourism Gondwana is home to several at-risk species Wow as well as the first wild
02:15elephants born in the southern Cape in 200 years it's just extraordinary to get outside the
02:22practice where I spend so much time looking after animals in people's living rooms and backyards to
02:30the great living room backyard of nature Wow that's just incredible first rhino I've ever seen in the
02:40wild absolutely incredible I'm going to meet a vet here called dr. Brendan he's one of the best known
02:50wildlife vets in South Africa and I'm really hoping to learn a lot from him and share anything I might
02:57know which is gonna be a lot less than he knows Brendan has invited no to help with one of Gondwana's key
03:03conservation initiatives Brendan how are you which protects one of Africa's most iconic animals thank
03:13thank you so much thank you so much for having me here I already saw Rhino outside the first time in
03:19my life incredible yeah they're prehistoric with their gentle giants the rhinoceros is one of the most
03:27endangered species on the planet numbers have dropped over 95 percent in the last century and poaching is
03:35often the cause rhino horn sells for more than the price of gold on the illegal market for its mythical
03:45healing properties to deter poachers many reserves remove the horns but not here we made the conscious
03:53decision that we weren't going to dehorn our rhino and we believe that rhino need their horns with
03:57regards to foraging feeding social behavior dominance and we took the the stance that we would protect these
04:04rhinos and develop an anti-poaching unit to be able to do so Gondwana tried to keep the rhinos safe with 24
04:12hours surveillance using tracking bracelets around their legs but one of their oldest males has been
04:19giving the Rangers the runaround fondly known as Bruno he has been a dominant bull on the reserve for
04:27a number of years he really has been part of Gondwana's journey because every youngster that's actually
04:31young Gondwana at the moment has been fathered by Bruno he is very sexually mature so he's often out
04:39and about looking for ladies and he's lost his bracelet a few times so we've decided that we're going to be
04:44doing an implant into the horn of the rhino from a visual point of view you can't see it and the animal
04:50doesn't even know that it's there this is a brand new procedure for the reserve the lines are around
04:59we've got the cheetahs here so we don't want people wandering off Noel will be working alongside Brendan
05:05and the team this will be the first one on Gondwana transmits a signal 24 hours a day and that signal it
05:12can be used to track the rhino can't believe I'm going on a chopper but we are and we're going to go
05:19out and find a rhino this is a unique opportunity for Noel so show me the swinge pretty long yeah
05:31two and a half inch little bit right and what are you aiming for a shoulder no no no brum bruno is
05:40somewhere on the 11,000 acre reserve a male rhino's territorial range is between four and five
05:47kilometers but without his tracker bracelet he's going to be hard to find are we looking for a single
05:53bull the ground team are also on the lookout below there's a bull there there's a runner
06:11they're on your proper clock right now looks like him no color only one small one the ground team confirm
06:22it's Bruno by the marking on his ear okay now it's down to Brendan to dart the 25 miles per hour moving
06:35target
06:38very nice
06:40down here
06:42okay Noel just remember to move forward from the helicopter
06:46these southern white rhino balls weigh around two and a half tons
06:54yeah he's a big boy
06:58wow he's unbelievably beautiful no you want to pop a cap it in sure this is pretty thick
07:08any place you can catheterize is on the ear veins we complain about trying to get a van in
07:12yeah
07:13Bruno's hide is up to five centimeters thick so Noel pierces the thinner skin on his ear flap
07:19to insert an IV line to top up the anesthetic in first time good thank you
07:25thank you didn't look like a total pillock thank you so much might be better to put it in slightly
07:33higher yeah thank you so much Brendan drills into the side of Bruno's horn to insert the tracker
07:45there's no nerve endings in here so there's no feeling it's keratin like my fingernail
07:53you can tidy it up for me no that'd be great
08:00despite the horn being made of the same material as nail or hair
08:04it's so valuable on the illegal market that every shaving has to be weighed and accounted for
08:10so you can see the grain in this like hair fibers growing side by side
08:15it's absolutely and utterly absurd that human beings are chasing this and killing these beautiful animals
08:26unbelievable
08:27the tracker is sealed into the horn using dental acrylic
08:32and that's on all the time as soon as you turn it on you turn on that frequency you'll pick it up
08:39and Bruno is none the wiser
08:42alright sweetheart
08:45you've got your tractor in
08:47to try and keep you safe you gotta stay safe too
08:51bye
08:52you
08:53bye
08:54you
08:55that's wonderful when you're up close with that majesty
09:12It's unbelievable when you're up close with that majesty.
09:21I mean, what a glorious, glorious animal.
09:35Today, there are less than 30,000 rhino left in the wild.
09:39It's actually devastating, you know, on a daily basis to see how many rhinos we're losing.
09:45You know, it's a couple a day.
09:46If you look at the overall numbers of rhinos left, we can't sustain that.
09:50So something has to change and a lot of big effort that's been put in to try and change it.
09:55But it's a tough battle that we're fighting.
09:58We shouldn't really be praising the keratin from the nose of a rhino as a treasure.
10:04We should be praising the rhino as a treasure.
10:07Absolutely.
10:07The thing is, if we give up the fight on one species, what does that mean about the rest?
10:12And so it goes way beyond just the rhino. It's a much bigger picture.
10:17Noel has witnessed the struggle to protect Africa's endangered wildlife.
10:22Tomorrow, he will have the chance to share his skills to help preserve these precious animals.
10:28I can't help but think of the battles that these people are facing every single day to conserve species.
10:36You know, my job back home is to look after the welfare of a cat or a dog.
10:41Their job is to look after a species on the edge of extinction.
10:46I really hope that I can make some kind of difference.
10:48It's Patrick O'Farrell's orthopaedic and neurology, Kate speaking.
10:53How can I help?
10:54Oh, I know. Sorry, Noel's in Africa at the moment.
10:57Noel is a long way from leafy godalming.
11:16The fight for the rhino has brought him to South Africa's capital.
11:25What we're going to look at is a prosthetic for a rhino's foot.
11:29It's going to be very different than what I'm used to, for sure.
11:33Noel has spent the last 15 years pioneering bionic limbs for cats and dogs.
11:40Where I grew up in Ireland, my father made the very first splints that I've ever seen out of
11:46twigs from the hedgerows to support fractures in the legs of lambs or calves.
11:53So improvisation is the culture from which I've come.
11:59Vernis Smit is an animal prosthetist.
12:04He's heard of Noel by reputation and asked if he can help with his unique, super-sized project.
12:11How are you, Noel? Nice to see you. Nice to meet you.
12:14That isn't a human foot. That is not a human foot.
12:18This is actually Khaleesi's prosthetic that we are working with at the moment.
12:24Three-year-old Khaleesi lives at the world's first rhino orphanage.
12:33He was just a few months old when a pack of hyenas attacked him and his mother.
12:37Khaleesi is such a brilliant rhino. He's got such a good character. He's been here for three years.
12:44He was molded by hyenas. They grabbed him by the hand foot and pulled him everywhere.
12:51Dr. Pierre treated Khaleesi's wounds, but part of his foot bones had been eaten away.
12:57Every male rhino is a precious hope for the future of the species, so the team reached out for help.
13:03And Werner answered their call, designing and building the world's first prosthetic foot for a rhino.
13:12We had a few issues, definitely. It is the first in the world, so you have to come up with solutions yourself.
13:23Werner has had to adapt the prosthetic as Khaleesi has grown.
13:27He is currently working on a new version strong enough to support Khaleesi's growing weight.
13:36I really have challenges, so I would really like to hear Noel's input and I believe that he can
13:44give us some good advice so that we can improve the prosthetic for Khaleesi.
13:49So tell me what you're doing here now.
13:54Yeah, so hyenas caught him and they damaged Khaleesi's growth place. So one paw is now six
14:02centimeters shorter than the other side and that's causing back pain and he's starting to develop
14:07scoliosis. So we want to add six centimeters at the bottom to take the strain off the other side.
14:14I'm absolutely intrigued by the shortness of that tibia. Look at the fibula. Amazing.
14:23Werner has been hunting for the right material to help increase the height of the boot,
14:28to even out the length of Khaleesi's hind limbs.
14:30If we make a four centimeter recess here, we effectively make a silicone pad so that there is
14:41some comfort for that bulging tissue. Definitely. But not hardening like foam would.
14:47Yeah. Yeah? And a bit of stroke absorption. Yeah, well exactly.
14:51Noel and Werner's joint effort should help spread Khaleesi's weight across his hind legs and realign his
14:57spine. So there is going to be a gap to work in here but we're going to have to work from the inside
15:01because the outside must be as strong as possible. Yes. I mean it's not going to be easy, that's for sure.
15:08Werner has a few days to make changes to Khaleesi's boot before he and Noel test it out at the Rhino orphanage.
15:16To work with Dr. Noel is really a big privilege. The way he's thinking is completely different
15:26to the normal. It makes you think and I like that.
15:38200 miles away, the team at Lions Rock Big Cat Sanctuary are also preparing for a visit from Noel.
15:45So everything's in, yeah. Over a hundred big cats live at Lions Rock, rescued from all over the world.
15:52Noel has been asked to see if his experience in the UK can help these wild cats, many of whom are
15:59suffering with limb deformities and osteoarthritis due to mistreatment and captive breeding.
16:05All the big cats which were rescued from really bad circumstances in circuses or in private keeping
16:14or entertainment, it's very hard to believe that people would use such beautiful creatures and treat
16:21them in that way. At Lions Rock, the big cats live in huge enclosures on the 1200 hectare reserve.
16:30And he's a little crocodile. Sometimes he takes my forceps. All these animals, they feel like my animals.
16:39Good boy. They mean the world to me. I want to improve their lives as best as we can.
16:49It's very rewarding to see them rehabilitate and to give them that second chance which they deserve.
16:55Hi guys, how are you? We're fine, thank you.
17:02So when I come and see you, tell me how I can best help you.
17:06Yeah, so we were thinking about two animals. One is Lazis. He's a tiger and he's been lame for quite some time.
17:15And my understanding is that you have a lion that has a deformity of the limbs as a result of some
17:21nutritional issues. Is that right? Yes, that would be Ricky. It was kept as a private pet.
17:29I have some equipment arriving that will allow me not only to see inside the joint but also
17:34to check the level of cartilage where what we're really hoping to do is treat the pain in the joint
17:39with some anti-inflammatory of natural origin. Yeah, that sounds great. We are excited about it.
17:47Hopefully all the stars align and the different pieces of kit. Yeah, there's no point in Batman turning up without his cape.
17:59And this is South Africa, just saying.
18:01I know. We're going to do our best and we're going to cross our paws and everything will be fine.
18:07I'm excited to come and see you guys. Thank you. I'm here. Thank you so much. See you soon.
18:23Are all those rhino? Yeah. Quite a large population.
18:39Before Noel heads to Lions Rock, he has arranged to meet prosthetist Werner at Khaleesi's home,
18:44the rhino orphanage, to test out the new prosthetic boot.
18:48It's an amazing spot, surrounded by forests and mountains. But I'm not allowed to tell you where it is
18:56because if the wrong people were to find out, that would be very bad news for the rhino.
19:05The rhino orphanage is a vital sanctuary for rhino calves who've been orphaned through poaching.
19:11We just try and save as many babies as we possibly can so that they can contribute to saving iconic species.
19:24The orphanage looks after the young rhinos until they are old enough to be released back into the wild.
19:31Hi, gentlemen. How are you? Hi.
19:33Ari, you must be Ari. Lovely to see you. Nice meeting you. Thank you so much. Welcome.
19:37Today, Noel will help fit three-year-old rhino Khaleesi with his new prosthetic foot.
19:43I'm very excited about learning about rhino orthopaedics. It's an extraordinary privilege and
19:49honour to be able to deal with a different species.
19:54Werner and Noel agreed to redesign the boot with a four centimetre padding.
19:59My god, the Paris fashion lines have nothing by comparison to this.
20:04It is one of the strongest boots I've ever made. So it should be very comfortable for Khaleesi to walk in it.
20:13Okay, okay, okay, okay, okay, okay.
20:16But sedating Khaleesi for his fitting...
20:21Come on.
20:23...is a delicate dance of man versus rhino.
20:27He's having a pop.
20:27All right, let's walk him in the shade or...
20:41Come on. Come on, mate.
20:46I enjoy to see them struggling a bit. Wrestling arena. Look at that.
20:50We're going towards you. Towards you.
20:53Yeah.
20:55Sitting on his...
21:04All right, big guy.
21:05You rest for a minute. Good boy. Good boy. Let's look at the foot.
21:09Some of the tendons in Khaleesi's right hind leg were severed in the hyena attack,
21:14and part of his foot bones were eaten away. Noel has studied x-ray pictures of the damage.
21:21As the foot hits the ground, it's supposed to roll over and the three digits spread out like so.
21:27But because the tendons have been ripped, flexor tendons here are not pulling this toe down into the
21:34proper posture for walking. So the purpose of the prosthesis is, number one, to take the pressure
21:39from here and load it more favourably. And number two, to add some limb length.
21:46Let's get it on.
21:47Khaleesi's new boot is made from carbon fibre with leather straps buckled tight around his leg.
21:53Push.
21:56That's the one.
22:01Last one.
22:05I love my job.
22:09I love your job too.
22:11Well done, matey.
22:13The new design needs to support nearly one tonne of rhino.
22:18Just about to wake up now.
22:21Here we go.
22:21And we're out.
22:23Well done, mate.
22:24Okay.
22:26Well done, Khaleesi.
22:34So far it looks good.
22:44His spine looks straighter, doesn't it?
22:46Yeah.
22:46It'll take more or less a day or two to get used to it and walk properly again.
22:53Walk normally.
22:54Look, he's meeting his friend.
22:55Yeah.
22:56The feeling it brings for when fitting and prosthetic on a wild animal is really indescribable.
23:04It makes you feel like you are doing something to better the world.
23:08Yeah.
23:11Running.
23:12Look.
23:12Look, look, look, look, look.
23:13Running.
23:14Oh my goodness.
23:16Oh my goodness.
23:17Wowzers.
23:19Amazing.
23:24Oh, hang on.
23:26Oh man.
23:28Might have come off.
23:29Yeah.
23:31That's everything the straps have broke.
23:32The straps broke?
23:34Yeah.
23:37Despite Werner and Noel's best efforts, Khaleesi's new boot has come apart.
23:42It actually worked too well because he started running.
23:50He was comfortable running with that thing.
23:53And imagine the forces going into while he's running.
23:57I think we should think of a better way to keep it on because the fitting is definitely good.
24:05You can see the spine is not curving anymore, but the strapping was obviously not strong enough.
24:12It snapped.
24:17It's just the power going into it.
24:19Yeah.
24:19Oh man, I feel so sorry for you.
24:21All the artisan craftsmanship that went into that and then it just blows.
24:26I think we're going to need to get wider straps.
24:29And you know those tent straps that hold up tents?
24:32Yeah.
24:32If we had a ratchet on it, tighten, tighten, tighten.
24:36And then buckle down at the side.
24:38Three or four of those.
24:40It definitely is part of working with wildlife.
24:42Everything is more or less a first.
24:45There's no reference you can go back to.
24:47Dr. Pierre says it's also the first time he ran.
24:49So that is a real good point and we're not giving up now.
24:53You know what, it's actually more familiar to the territory that I normally walk in than
25:05I thought it would be because success and failure are part and parcel of trying to do difficult things.
25:15And every success stands on the shoulders of failure.
25:19And I've spent the last 25 years disproving lots of things that were cast in stone as truth.
25:28Everything's impossible until it happens.
25:31And the worst thing would be not to try.
25:44So we're here.
26:00Lions Rock.
26:01It's with equal measure of intrigue and trepidation that I come in because, of course,
26:08I've never dealt with surgery on big cats before.
26:11The biggest cat I've ever operated on is a main cone.
26:14So it'll be an extraordinary privilege, I think, to be in the presence of these magnificent animals.
26:21Noel will be examining two big cats with the team at Lions Rock.
26:25Hello, how are you?
26:26Working alongside orthopaedic wildlife specialist Peter.
26:30Peter, nice to see you.
26:32The kit has arrived from the UK.
26:35So we're going to see Laziz and Ricky today?
26:38Yes.
26:39Good.
26:39And Noel's first patient is 15-year-old Bengal tiger Laziz.
26:45He's limping quite badly, isn't he?
26:48There are just 2,000 Bengal tigers left in the wild.
26:51Many hunted for the illegal trade in body parts.
26:55If you don't mind, I'm going to video while I can to see his gait.
26:59Laziz has lived at Lions Rock since he was rescued six years ago.
27:03Laziz came from the Gaza Strip in a private zoo.
27:12It became publicly known in the media as the worst zoo in the world.
27:17Animals were starving and died.
27:20And Laziz was the only big cat left.
27:23Laziz and the other tigers were confined to tiny,
27:28concrete-floored cages in the war-torn city for nearly a decade.
27:32But in 2016, Laziz was brought to Lions Rock.
27:42But the conditions in Gaza had left him with more than just mental scars.
27:54He's been lame for about almost two years.
27:57Coming and going, much worse in the wintertime.
28:00Laziz is suffering with severe elbow osteoarthritis associated with growth deformities.
28:08The team are hoping Noel can help.
28:10The hope is that he will have less pain, a better mobility, and we're really hopeful that he has another good five years with us.
28:18Hello, Laziz.
28:20Hello, Laziz.
28:22Good boy.
28:23Good boy.
28:25Yes, I know.
28:26I know it's tough, isn't it?
28:27I'm just here to help, buddy.
28:29So what I'm doing right now is just looking at his gait, much as I would with a dog or a cat,
28:34trying to establish what's going on.
28:37He's got a significant limb deformity on both sides, but especially on the right side.
28:43Do you think that his osteoarthritis is in any way related to a developmental elbow disease,
28:49akin to what we get in dogs?
28:51What I mean by that is the fit between the ulna and the humerus in terms of how that articulation works.
29:00Absolutely. 100% spot on. That's what I've seen a lot in these bigger animals.
29:06Really?
29:06Really.
29:11Ricky is the one which is in the feeding enclosure.
29:14Hello, boy. Hi, boy. I brought you visitors.
29:19Noel has also seen radiographs of Ricky.
29:22Hi, bud.
29:23A 13-year-old lion from Romania who was kept as a pet.
29:28You can see him walking and you can see his paws.
29:32When he arrived at the sanctuary, he had stunted growth and deformed front legs.
29:38He was mechanically unstable, but now he's showing a slight lump in the left leg.
29:44With lions, they've got an extremely high pain threshold.
29:47So the moment they start showing pain, you know that they've got an advanced situation happening.
29:53They're all calling each other now.
29:58They're having a conversation.
29:59Yeah, that's usually this time of the day.
30:02They're talking to each other?
30:03Yeah. I'm a lion. I'm a lion. I'm a lion. I'm also here.
30:08Yeah, that's very normal.
30:11Tomorrow, Noel will take his first ever x-ray pictures of a lion to see if he can help Ricky.
30:17And he'll perform an arthroscopy on Laziz, an extremely rare procedure for a tiger,
30:23only ever attempted a few times worldwide.
30:27It's humbling just to be in their presence, let alone operate on them.
30:33Every day is a school day for me.
30:35So the fact that we get to share knowledge is just an incredible thing for me.
30:39If I can contribute in some small way, then I can only be a good thing.
30:55It's the morning of the big cat surgery.
31:19This is a safety zone. There's two gates for safety. Both gates will get closed. Then we're in the compound.
31:32First up is Tiger Laziz.
31:33Have you pre-prepped with syringes?
31:37I'm going to load a dart now for drugs.
31:39Okay, fine.
31:41Noel will perform an arthroscopy on Laziz's elbows to investigate his lameness.
31:46He then plans to use a cutting-edge anti-inflammatory treatment to ease his pain.
31:52This has never been used in big cats before, so Noel and the team don't know how successful it may be.
31:57There's a little bit of worry always with new procedures because obviously we haven't done this.
32:05So this is Noel's baby, but not ours. So yeah, we just hope everything works well and the animals are better afterwards.
32:14Six milligrams is 0.3 milligrams.
32:17Well, dealing with the big cats with anesthetic is always a little bit complicated because you have to
32:23estimate the weight of the animal because you can't just weigh him. You've got to estimate what kind of
32:28metabolism it has or she has. Right, here we go.
32:45Once you've immobilized them, you start your stopwatch. You're under time pressure.
32:50We'll see how he responds now when I go there.
32:52Yeah.
32:53You're welcome to come with me. Just stick on my right side, okay?
32:56Understood.
32:58I'm your right hand man.
33:01Yeah, it means I'll be eaten first.
33:05All right, let's sneak in slowly and quietly.
33:15They are dangerous animals. You've got to be vigilant of it all the time.
33:18Because sometimes I can just jump up and be dangerous to all the surrounding people.
33:30I just want to give him some time.
33:31It's quite extraordinary to see such a large animal incapacitated like this.
33:47Sedation is time limited in big cats, so the team must work fast.
33:52I need the head pulled back that way.
33:56I expected to feel completely out of my comfort zone.
34:03But because I was in the presence of a cat, albeit a bigger, bigger cat,
34:06I felt a strange sense of familiarity in spite of the wildness.
34:13Someone grab the drip, the IV.
34:15One, two, three.
34:17This will be Noel's first ever arthroscopic procedure on a tiger.
34:21Not very different to scrubbing for any of the operations back home.
34:25We just have a larger patient. It's not a chihuahua.
34:28Should be relatively easy to get in the joint.
34:31But then famous last words.
34:35You ready?
34:37You happy?
34:37You happy?
34:41Laziz is suffering from inflammation and cartilage wear,
34:45caused by a poor fit of his elbow joint, which results in osteoarthritis.
34:50Noel will insert a large needle called a trocard,
34:54down which he will place an arthroscopy camera to examine the joint.
34:58Then he will inject anti-inflammatory platelet-rich plasma,
35:03followed by a viscoelastic cushioning agent,
35:06which will hopefully relieve the symptoms of the arthritis.
35:12Scope going in.
35:16So this is very, very similar to the anatomy of a dog.
35:20Actually, there's really not much difference at all.
35:22It's like home from home.
35:24I just feel like I'm in a different house with a different wallpaper.
35:29Using the camera, Noel can see how much damage has been done to the cartilage
35:34inside Laziz's elbow.
35:36Okay, this is really bad.
35:38Is this the erosive cartilage down?
35:40Yes, so that's raw bone on raw bone.
35:42That's raw bone on raw bone, I see, yeah.
35:44No cartilage at all.
35:46Nothing, yeah?
35:47So this is typically what I will see in dogs that have medial compartment disease,
35:52where the humerus wears away against the ulna because of poor fit.
35:54And this is particularly severe.
35:57If this was a medium-aged dog, for example, six,
36:01I would consider an unloading osteotomy, which is to cut the humerus in half and transfer the load
36:06to the outer part of the joint.
36:07And whilst we could do that in a tiger, he's exerting such extreme load on it that
36:13it is likely he would simply blow it apart.
36:17This is extreme.
36:18However, our objective is to gain a few years of function for Laziz, so that's what we're going to do.
36:25Noel makes small holes in the worn-away joint surface to release stem cells in an effort to reduce inflammation.
36:33We're running long anaesthetic.
36:35Okay, we're good, yeah, we're good.
36:36So give me the PRP, give me the lubricant.
36:39Claytlet-rich plasma, derived from Laziz's own blood, is injected into his elbow.
36:45That's it.
36:49He then adds the lubricating hydroelastic gel that suspends the platelets in the joint for longer.
36:55Look at that gel going in, pushes it back.
36:58Do you see the volume effect there?
37:00We're creating an artificial cushion that will hopefully treat the inflammation and pain inside the joint.
37:05I'm super excited about this.
37:08As far as I know, this procedure has never been done in wild, big cats before.
37:13So I'm excited and elated and can't wait to see what the results are.
37:20So we just put two tiny stitches in and our job here is done.
37:24All right, ladies and gentlemen, that's it.
37:25It's good.
37:25We're out of here.
37:29Quickly, because he's going to wake up quickly, yeah?
37:32Okay, let's go.
37:33Laziz is taken back to recover in an enclosure.
37:36It's incredible to see him waking up because you genuinely feel like you've made a difference.
37:49And I can't tell you how special that feeling is.
37:52All of this technology is the same for a human, the same for a dog, the same for a tiger.
37:57We are all one.
37:59If people could only realise that for a moment, wouldn't the world be such a better place?
38:06Noel's first ever procedure on a tiger is complete.
38:14Now it's the turn of the king of the beasts.
38:17Right, we're going to dart.
38:23Ricky has deformed front legs due to inbreeding and a life in captivity.
38:30Got it, thank you.
38:37Noel is going to do a radiographic workup to see if anything can be done to ease his pain.
38:42It's an extraordinary thing to touch such a magnificent animal up close.
38:45He is truly mind-blowingly gorgeous.
38:51I mean, before I came here, I'd never seen a male lion in the wild.
38:56And now I'm hunched beside one as he goes to sleep.
39:00An extraordinarily humbling experience.
39:03Makes me wonder how we take so much for granted until it's gone.
39:07And my goodness, do we have a moral responsibility to look after this guy.
39:15Get an IV going.
39:18Okay, we're going to do a flex natural.
39:20Because we're interested in the growth deformity as well as the elbow.
39:24What I found the most interesting is how to position for your x-rays correctly,
39:30how to get the most out of it.
39:31Pull, pull.
39:33So remember, it does not matter where the wrist ends up on an antebrachial growth deformity.
39:38You're referencing off the elbow in every single case.
39:41It's a lot for my brain to process.
39:44But yeah, he's like, he's a brilliant man.
39:49Ricky's radius and ulnar bones have grown at different rates,
39:52causing his forearms to twist and splay outwards.
39:56If I was straightening this, I would take a wedge out there and straighten it back.
40:00And I would rotate the paw relative to the elbow to make it into a normal orientation.
40:06At the end of the day, the job of a veterinarian is to care desperately
40:11and to act within the confines of what's available.
40:14We're going to do a similar treatment to what we did with Laziz.
40:18We're going to spin down the platelets from the blood, mix it with the lubricant,
40:22and then inject into both elbow joints.
40:25Noel hopes that this new treatment may alleviate Ricky's pain
40:29and also reduce the need for oral drugs,
40:32which can cause stomach and kidney problems in big cats.
40:36You ready with the PRP?
40:37I am, yeah.
40:39Thank you. Got it.
40:43Using the PRP in the joints is a totally different procedure
40:46that I was not aware of that existed.
40:50I'm excited about the prospect of not giving oral medication.
40:54It could be revolutionary for multiple of my clients.
40:59And we're out of here.
41:02Okay, well done, everybody.
41:06As a team, us veterinarians work extremely well together.
41:11You're involved with Wildlife Veterinary Science now.
41:13Yeah.
41:14Congratulations.
41:16I have arrived.
41:18Obviously, because it's a new procedure, we don't know how it's going to affect them.
41:22We'll be monitoring it together, seeing how well they recover.
41:27The bottom line with any first-time effort to transfer technology between species is that
41:33it may not work in the way we hope.
41:35But this isn't documented anywhere.
41:37There's no book you can open and rewrite in the book now.
41:41It's been an absolute honor, truly.
41:48To be able to contribute to his quality of life is an extraordinary privilege.
41:52Yeah, absolutely.
41:54For me too.
41:54Yeah.
41:56It's rewarding.
41:56Oh, very.
41:59You're going to be okay.
42:00Love you, May.
42:01You're a good boy.
42:02It's November, and three months since Laziz and Ricky became the first ever wild big cats
42:17to have anti-inflammatory PRP and viscoelastic lubricant treatment for osteoarthritis.
42:37Since Noel was here, as you can see, even the environment has changed a lot.
42:42It's very green now.
42:43It was a great experience.
42:45It was great to work with Noel.
42:47He has so much knowledge to share.
42:50With Ricky and Laziz, it hasn't been as successful as we were hoping for.
42:55It doesn't mean that we're going to give up.
42:57We know now exactly what the joint, for example,
43:01polysons looks like.
43:03We can maybe use the next type of more gel or think about, you know, including stem cells.
43:10There's a lot more options.
43:12This is why this, you know, collaboration is so great.
43:17Biology is infinitely variable, and we are at the mercy of biology.
43:23But the important thing is we have to keep trying.
43:26I'm working with Christine, Peter, and the other vets to do the very best we can,
43:30because we must progress to provide quality of life.
43:38In Pretoria, Werner has been working to improve Khaleesi's prosthetic boot,
43:43and has added Noel's suggestion of ratchet straps.
43:46We adapted the straps, as Dr. Noel said.
43:50So each strap can take up to a tonne, so it should hold this time.
43:57Three months after the last boot failed, Khaleesi is fitted with his new super-strapped boot.
44:04Come, Khaleesi.
44:12Here we go.
44:13We fit the boot two weeks ago, and he's actually quite comfortable on it, and checked it two weeks
44:22after the fitting, and he runs easily, walks easily.
44:27We fit the boot two weeks after the last boot.
44:28We fit the boot two weeks after the last boot.
44:30We fit the boot two weeks after the last boot.
44:32Meeting Dr. Noel was really a great privilege.
44:35I learned a lot.
44:37He really thinks out of the box, using anything and everything that is available in the world.
44:42He's inquisitive, he's bloody hard-working, he's got passion doing the right thing.
44:51I can't think of anything more precious in the world than being in the presence of the giants of nature,
45:02telling us, come on guys, up your game.
45:04Look after the world a bit better.
45:07And if I could, for one moment, transfer the love that somebody feels for their dog or their cat
45:14in the United Kingdom to these animals, and make us realize that this is our home too,
45:19then that will be enough.
45:24Truly, I have felt more at ease and welcomed by this environment than any place I've ever been in my life.
45:34It's quite, uh, it's, it's overwhelmingly beautiful.
45:43It's going to be hard to go back to the real world after this.
45:55Can I just stay here? Can you guys just go home? Can I just live here?
46:13Can I just stay here?
46:31Can I just stay here?
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