- 6 days ago
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00:01Professor Noel Fitzpatrick
00:03All right, Mrs. Cuddlemonster incoming.
00:07Is the super vet.
00:09We have issues.
00:10I knew I should have got chihuahuas.
00:12At his unique vet practice, he merges mechanics and biology.
00:17Past the point of no return now.
00:19Don't be pulling apart my repair, Mrs.
00:22To heal the nation's pets.
00:24Sorry about coronavirus.
00:25Oh, because you're responsible?
00:26I'm responsible for almost everything else.
00:30Even in the darkest days.
00:32I'm so sorry this has happened to you.
00:33Noel imagines the impossible.
00:36Oh, my little baby.
00:38Oh, my God.
00:39Let's go.
00:41Sometimes you have to bend the rules of mechanics to fit the biology.
00:45And offers hope.
00:47We've definitely made the right decision.
00:49Good boy.
00:50We've got my boy back.
00:52For families and their friends.
00:55Look at you.
00:56Why are you dog-o?
00:57Yes, mate, I love you too.
01:02You get such a wide range of animals here.
01:09We get, you know, your family pets.
01:12Some are people just best friends and their only companions.
01:16Come on, sweetheart.
01:17Good girl.
01:18But of all the animals that check in at Fitzpatrick's, working dogs have a special place in everyone's
01:25heart.
01:26When we are dealing with service dogs, there is that little bit of extra responsibility
01:30just to take that extra good care of them.
01:33The thing is that when a working dog is in my care, I'm not just treating the patient.
01:39I'm supporting a vital partnership as well.
01:42So, for me, it's a privilege to be entrusted with their care and trying to get them back to work.
01:48Big day, it's D-Day for the little man.
01:55He's got no idea, has he?
01:57No idea what's about to happen to him.
01:59Poor little sod.
02:00Two-year-old police dog Trigger has come to the practice for surgery on his spine.
02:06The main thing is he ends up pain-free because he is more and more wincing with pain.
02:11It's clearly getting worse and needs sorted.
02:15Poor little man.
02:18Rob's a dog handler with the Metropolitan Police.
02:22And he's responsible for training Trigger.
02:25His main purpose is to find people and they can follow the centre along grounds, over fences
02:30and just follow the track of where someone's gone till they find them.
02:33Or, if that person was to try and get away, then he's trying to bite them.
02:36Good boy!
02:38The bond between the dog and the handler is amazing.
02:54The only time I'm not with him is when he's asleep.
02:57He absolutely worships the ground I walk on and the feeling's mutual as well, you know.
03:02He's my best pal. He's a great dog.
03:05Trigger went to live with Rob when he was eight weeks old.
03:09And he's very much part of the family.
03:12Trigger gets on really well with the wife and kids.
03:15Sometimes it's so easy to forget that he is actually a police dog because he is a real big softy at home.
03:19Yeah.
03:20But when he is at work, his whole demeanor changes.
03:23And when he's in aggressive mode, the teeth, the snarling, the spitting,
03:27and then when he finds somebody, you find him hanging off of their arm and they're screaming in pain,
03:31you think, my little Trigger's doing that.
03:34Yeah.
03:36But Trigger may not be able to continue to work.
03:41Eight months ago, he had an operation for a stomach torsion.
03:45Whilst he was recovering, I noticed that when he was cold and he lifted his front legs,
03:49he would cry out in pain.
03:51The problem persisted, so then we went to Fitzpatrick and did an MRI scan
03:54and then it was quite clear that he had quite a serious problem with his lumbar sacral.
03:58And that was pinching the nerves that were running down his legs and causing him excruciating pain.
04:03Good boy.
04:07Trigger has been having hydro and physiotherapy sessions to strengthen his core before surgery.
04:13Fung, they're gone. Good boy.
04:16But if the operation isn't a success, Trigger won't be able to go back to work.
04:21And Rob, who already has two other dogs, will have some tough decisions to make.
04:27It would break my heart and the kids and the wife if he wants to go,
04:31but it wouldn't really be fair to keep a three-year-old dog at home.
04:34He will always have that drive to come to work.
04:36See you later, sir.
04:38See you later.
04:39If we keep him and then I get another working dog,
04:41he will make a hell of a racket every time I leave.
04:44For Trigger to be able to come back to work is everything.
04:48And just fingers crossed that it happens.
04:55Police dog, please.
04:57Hi there, you all right?
04:59Yes.
05:00Good morning.
05:01Rob, grab a seat.
05:03Now.
05:04So tell me what his work does.
05:05He's tracking, finding people, biting people, finding property.
05:09So he's attack as well?
05:10Yeah.
05:11OK.
05:12All right, big guy.
05:13I'm hopeful that you're not going to go into attack mode when I do the physical exam,
05:16but I need to track three things.
05:19I'm going to press on his back here to check the nerves here at the top.
05:23I'm going to check the nerves as they run down the back of his legs.
05:26Yeah.
05:27And the third test, I'm going to stick my finger up his bottom, and I'm going to touch that nerve in there.
05:32And all three of those tests would need to be negative in 12 weeks' time for me to sign them off for work.
05:38I don't want to cause him pain.
05:39Yeah.
05:40But I've got to document the pain, and unfortunately, it's very subjective.
05:44True.
05:45OK, now you're going to hold his head, Rob.
05:47Yep.
05:48I'm going to move your chair over here, please.
05:49I'm going to move relatively close to that wall.
05:51True.
05:52Sure.
05:53All right, big guy.
05:54I'm going to check you out now.
06:00Well, I think it's safe to say that test is positive.
06:02Hold tight.
06:03Second test coming up.
06:04Good boy.
06:08Good boy.
06:09Sorry, mate.
06:10We'll do the other nerve on the other side.
06:12Good boy.
06:17I want something.
06:18Sorry, mate.
06:19This is the worst bit.
06:20All right, I'm on it now.
06:23Turn off.
06:24What?
06:25I'm just going to check his hips.
06:26Please.
06:27It's fine, mate.
06:28I'm finished with it.
06:29I'm finished.
06:30I'm finished now.
06:35Oh, dear.
06:36Yeah, he's in a lot of pain.
06:38It's reflected in all of his back end.
06:41We're done.
06:42So, definitely, from my perspective, all those tests would be definitive evidence of pain.
06:49It's called degenerative lumbosacral stenosis.
06:53So, the cause is believed to be primarily genetic.
06:58And it's believed that this disc loses its tendency to be able to hold onto water.
07:03Yeah.
07:04And has dried out.
07:05Yeah.
07:06And is significantly bulging in its centre.
07:09Yeah.
07:10The bulge gets gradually worse over time, so that it squishes the nerve root, and that is what causes the pain.
07:18Yeah.
07:19Another source of pain is new bone formation on either side of the disc, which is pressing in to trigger sciatic nerve roots.
07:28The objective is to remove movement, so there's no stimulation for that bone to form.
07:33And remove the degenerate disc material that is squishing the nerve, so there's no stimulus for it to come back.
07:38Yeah.
07:39Now, what can go wrong?
07:40Well, clearly, as I'm pulling the nerves around, that could go wrong.
07:43Yeah.
07:44But most dogs are out of pain within two weeks.
07:48Next thing is, can I get this dog doing what police dogs do?
07:51The answer is, most of the time.
07:53He's a super fit young dog.
07:55Yeah.
07:56And he's in this much pain already.
07:57Yeah.
07:58There's no real option, you know.
07:59If, worst case scenario, he doesn't come back to work, at least hopefully he can live out his days pain-free.
08:04The rules always should be if we can get him back.
08:06My goal is work at 16 weeks.
08:08Really?
08:09That's my goal.
08:10Okay.
08:11Yeah.
08:12Wow.
08:13That's what I'm hoping.
08:14All right.
08:15That's it. Anything else?
08:16I don't think so, no.
08:17All right. Bye-bye, Rob.
08:18Say goodbye to Sir Triggs.
08:19It's well done.
08:20All right. Thank you, Isabel.
08:21Hi, Trigger.
08:23Trigger surgery is scheduled for later today, and Rob hopes it will ease the severe pain in his lower back.
08:30Pretty horrific examination of him, which was awful to be on the receiving end of for him and for me to have to watch.
08:36And, you know, that poor little dog's a stoic dog, but he's living through this pain every day.
08:40Just hope we get that phone call to say everything's gone well.
08:48Oh, there's our baby! Hello, gorgeous!
08:51If you want to bond with a dog, you have to be able to communicate with them.
08:58Baby, baby, come here.
09:00It's an important part of the job for the team at Fitzpatrick's.
09:04I think you'd see me boy.
09:06Oh, the big baby!
09:10Look at you. You just go into knots.
09:12One-year-old Sheperdoodle Raven is much more than just a pet to Alan and Jane.
09:19He is our fur baby.
09:21All the children have left home.
09:23Yes, it's just us.
09:24So he is our baby.
09:29Ten months ago, Raven was an early Christmas present for Alan.
09:33He was just a big, fluffy ball of fun.
09:38He was interested in everything.
09:40He wouldn't sit on your lap all the time.
09:42Of course, he was small enough in to do that.
09:44Just sort of brought some more joy into the house.
09:48Sit!
09:49Now they can't imagine life without him.
09:52Good boy.
09:53He's a gentle giant.
09:55Yeah.
09:56He loves everyone.
09:57He loves the kids, he loves the grandchildren.
09:59He's absolutely full of fun.
10:01Good boy.
10:03And his personality is almost as big as he is.
10:09He's very cheeky.
10:10If he can get away with something, he will.
10:18Eight months ago, Jane noticed that Raven was limping and took him to their local vet.
10:24So they discovered that he had double hip dysplasia at literally four months old.
10:28I knew that it would be a very painful life for him if we didn't do something.
10:34And that's when we decided no matter what, we would get him fixed.
10:38Their vet referred them to Fitzpatrick's.
10:41And today the couple are meeting Noel to discuss the first of a proposed double hip replacement.
10:48Hello guys.
10:49Please grab a seat.
10:50You're beautiful, aren't you sweetheart?
10:51Oh, look at that beautiful coat.
10:53Oh, it's a little bit wet and soggy today I'm afraid.
10:56No, I can see that and I can also see this walking on eggshells on the back legs.
11:01Both.
11:02He doesn't know which leg to stand on.
11:04No.
11:05Now you've seen my colleague James.
11:07We have.
11:08So James will have spent a lot of time talking to you about that hip dysplasia is a developmental problem.
11:14He was born with the genes that make it.
11:16Yeah.
11:17What happens is the structures that normally hold the head of the femur in the socket don't.
11:22Okay.
11:23The next thing that happens is the socket gets shallow because the head isn't in there.
11:27Then the head rubs on the top of the socket and the joint capsule pulls and new bone forms.
11:33The next step is that the socket infill and the new bone formation on the top of the socket begin to rub on the femoral head.
11:41Oh, doodle.
11:43Okay.
11:44Right.
11:45Just stand him here, Daddy.
11:46Can you hold his head?
11:47There we go.
11:48Okay.
11:49Oh, I know.
11:50Oh, I know.
11:51He's got a very painful hip.
11:53Oh.
11:54Right.
11:55Okay.
11:56So your dog has arthritis now, which is the inflammation of the joint as a result of that rubbing.
12:01The objective is to remove the joint completely so there is no osteoarthritis.
12:06Uh-huh.
12:07The risks in the first week postoperatively include dislocation.
12:10Another risk is mechanical failure.
12:12If the bone were to fracture, the implant were to subside or the bone were to fail to grow into it.
12:18Those are all risks.
12:20And then lastly, infection can happen.
12:22So he must not lick it.
12:24I love your replacements because it gets dogs out of pain.
12:26Oh.
12:27If I do a good job and if you do a good job, you've got a very happy dog within two weeks,
12:32and you've got a dog that's able to run around on that hip by week 12.
12:37Got any questions?
12:38No.
12:39Um, good.
12:40Oh, bye-bye.
12:41Bye-bye, Mum.
12:42Bye-bye, Dad.
12:43Come see Mummy.
12:44Bye.
12:45All right, lovely to meet you guys.
12:46You go ahead and he'll come with me.
12:47Come on, buddy.
12:48Good boy.
12:49Come on.
12:50This way.
12:51Sit.
12:52Raven.
12:53That's it.
12:54That's it.
12:55That's it.
12:56Good boy.
12:57It's tough for such a young dog to be facing surgery on both hips.
13:02The biggest worry is that it doesn't heal properly or it doesn't work.
13:06And having put him through it all, that it doesn't work.
13:09But the couple hope it will allow Raven to live life to the full.
13:14He just wants him to be a puppy.
13:16He's not been able to run and leap and jump.
13:18He's sort of like an old man.
13:20He's stiff.
13:21He just needs that back.
13:32Two-year-old police dog Trigger is having a CT scan before undergoing major surgery on
13:38his spine.
13:40This will show Noel to what extent the nerves are being compressed by the new bone formation
13:46and help him plan the positioning of the implants.
13:49Then Noel spots something he hadn't expected.
13:55This is a fragment of bone which has come out of the vertebra right here and become displaced.
14:02So that white thing is a piece of bone which has come out of here which isn't super clear on the MRI scan
14:07but it is super clear on the CT scan.
14:09This is caused by a genetic disease known as osteochondritis dissecans.
14:14And that spiky bit of bone that is inside the bulging disc is squishing the nerve root.
14:21No wonder he's in so much pain.
14:23Poor fella.
14:24Wow.
14:25This is not going to be easy surgery.
14:27I'll do my best.
14:29Okay.
14:30Here you go.
14:31Incision.
14:32After separating the muscles, Noel will drill the roof off the vertebrae.
14:46He will move the nerves to one side and remove the bone fragment and disc bulge.
14:52Then he will insert a titanium spacer screw between the two vertebrae to push them apart.
14:58Finally, he'll place large specialised screws in the vertebrae on either side
15:03and link them with clamps and rods to stabilise the lumbosacral junction
15:07and push the new bone away from the nerve roots.
15:12Goggles, please.
15:15Thanks.
15:18First, Noel has to get to the disc by removing the roof off the spinal canal.
15:25Once we've cut enough of the roof off, we then just grab it and lift it up.
15:31Then he has to carefully remove the displaced fragments of bone.
15:37There's a piece of spiky bone right here,
15:40which is sticking up through the edge of the disc and squishing the spinal nerves.
15:51Here's the piece of bone coming out now.
15:53It's quite a large piece of bone.
15:55Taking it off in two fragments there.
15:58Trigger has amazing tenacity if he jumped over ten fences to catch a criminal with that sticking in his nerves.
16:07The next step is to cut away the fibrous disc material that's also compressing the nerves.
16:16One slip could be catastrophic.
16:20Cutting with a very sharp blade next to nerves that we must not cut
16:25because if we cut them then Trigger would potentially either not be able to walk
16:30or not be able to urinate or not be able to defecate.
16:33So we have to be very careful here.
16:35You can see here that there's a space where the disc used to be.
16:42Into that gap he'll insert a spacer screw to push the two vertebrae apart.
16:47So this is a Christmas tree spacer because it looks like a Christmas tree.
16:51Okay, so the spacer device is in now.
17:02Finally, Noel stabilises the lumbosacral junction with screws, clamps and rods
17:08to ensure the two vertebrae are kept apart and the pathways for the nerve roots stay open.
17:14There was a good job.
17:18Okay, let's go to CT.
17:22The entire operation has taken almost three hours
17:26and Rob's desperate to find out how it's gone.
17:30Hello, Rob speaking.
17:31Hello Rob, how are you?
17:33Yeah, nervous.
17:34Yeah, I can imagine.
17:36I've done the surgery, it went fine.
17:39Brilliant, I'm tough for that, right.
17:41Right.
17:42Yeah, it was challenging because there was a chunk of bone
17:45that had in fact separated from the end plate of the sacrum
17:51and was sticking into the nerves.
17:53Oh, poor little child.
17:54I'm pleased with the post-operative CT.
17:56Yeah, well that's all we can ask for.
17:58Exactly, and please God we'll get the result we want.
18:00Brilliant, okay, well thank you so much.
18:02No problem, bye-bye.
18:03Although the CT scan shows that everything is in the right place,
18:10there will be an anxious wait to see if Trigger recovers sufficiently
18:14to get back to police work.
18:17As a new day dawns, it's a full house at Fitzpatrick Referrals.
18:36I know.
18:38And Noel's about to do something he rarely does these days.
18:43I'm going to see a little kitten with trauma now.
18:47And I don't do simple trauma cases very often.
18:50But today, everybody's busy.
18:52I have a slot in my diary and I'm about to see a kitten called Fury.
18:58You have to stay.
19:00You have to.
19:01No, no, no, no, no.
19:02You have to.
19:03Ah, ah, ah, ah.
19:04Here.
19:05Oh.
19:06Three-month-old kitten Fury hurt himself when he was playing with his sister Stormy.
19:11We just heard a yelp and saw that he was limping his back left leg.
19:16He was holding it up.
19:17Called our local vet and the x-ray showed that he's got a broken tibia.
19:23Fury and Stormy were a surprise birthday present for Barry's 50th.
19:27From his wife and three sons.
19:30My reaction was actually one of shock.
19:33Because I hadn't been thinking about getting kittens at that point.
19:36And it took me a couple of days to come round to fully appreciating the idea.
19:40But by the time that we picked the kittens up, I was just so excited.
19:44As was all the family.
19:50It was Aidan and his two brothers who came up with the cats' names.
19:56A couple of years ago, we were joking about how if we ever got a pet, we'd name it something silly.
20:01And we came up with Furious Destroyer as it's very aggressive, such a cute and cuddly animal.
20:07And he's lived up to the name, I guess.
20:09Fury's much more dominant than Stormy and Stormy's much more inquisitive and much braver.
20:18So she'll go out and do things first.
20:20He'll watch from a distance.
20:22And then when he thinks it's safe, he'll go and do it and push her out of the way as if he's always been the one in charge.
20:28But sometimes Fury's a bit too dominant for his own good.
20:34So I was working in my office and I heard something just outside the door in the hall.
20:40I came out and saw Fury acting quite strange.
20:44He was meowing like something was wrong.
20:47And the local vet, the vet insisted that he needed to have a referral to go to Fitzpatrick.
20:53Yeah.
20:54Bye, Fury.
20:55Fortunately, Barry is able to get an appointment for the day after it happened.
21:00Now, good morning, sir. What's your first name?
21:03Barry.
21:04Barry, nice to see you.
21:05Here's the seat for you.
21:06This is my colleague, Lisa.
21:07How are you, gorgeous kitten?
21:09Hello.
21:10Oh, I have two cats as well.
21:13Oh, hello, mate.
21:14Hello.
21:15Right.
21:16So what happened?
21:17We got one of those kitten towers and him and his sister were playing on it.
21:22He fell off.
21:23I think he fell off.
21:24Right.
21:25Well, he has a very common injury.
21:26Well, the fractured growth plate.
21:28I've seen it on the x-ray pictures.
21:30And because the bone is actually quite strong, the weakest spot is where the bone is growing
21:36from, which is called the growth plate.
21:38Yep.
21:39So if he fell and twisted at the same time, he sheared off here, which is the weak spot from
21:45which the tibia, which is the shin bone, actually grows.
21:49Right.
21:50Because, and I'll draw it for you now.
21:52Well done, mate.
21:53I'm going to put you safely back in here for a moment.
21:56So, that's what it looks like, the ankle of a cat.
22:02That's the tibia.
22:03That's the fibula.
22:04And then you've got this iron here, which is the growth plate, and that's fractured.
22:09Problem number one, there's going to be no more growth from this growth plate.
22:13So inevitably, this leg is going to be slightly shorter than the other one in terms of the
22:18shin bone, the tibia.
22:19In any of these situations, does that bone formation ever recover?
22:23I've not personally seen one that didn't destroy that growth plate when it happened.
22:29Nowadays, the gold standard of care would be to fix this with metal.
22:32Right.
22:33You use what's called a cross-pinning technique.
22:35You line it up, you put a pin in here and drive it through that way.
22:39You put another pin in here, and you drive it through that way.
22:44This is a very friable, very narrow, very tiny piece of bone.
22:49You have to get the hit right first time.
22:51Yep.
22:52You stay sleeping for now, mate.
22:54Bye-bye, Dada.
22:55Bye-bye.
22:56Hey.
22:57Oh, you're tired then.
22:58No.
23:03Noel isn't the only one captivated by the cute little kitten.
23:07Have you broken your leg?
23:09What did you jump off of?
23:11He's in a lot of pain, I can see.
23:14And finding out that Fury's got an injury that could affect his growth is a real worry.
23:18Oh, my God, whose cat is this?
23:20And why am I not taking it out?
23:33Please don't fall, buddy, OK?
23:36Raven, the Sheperdoodle with hip dysplasia, is being prepped for surgery.
23:42He's only a year old, and it's been hard for him to have such a debilitating condition.
23:48It's like a sheep shearing.
23:51So I'm going to put implants in Raven's left hip now, and that's the difference between having a painful hip and not.
23:58Noel's plan is to replace Raven's worn-out hip with a new prosthetic stem, neck, ball, and socket.
24:09A lot of fluid in this joint because it's very loose, and the joint capsule is inflamed, a very arthritic joint.
24:16First, Noel removes the femoral head.
24:21We can see where it's flattened like a mushroom and has lost its cartilage right there.
24:28Noel then inserts a plastic cup into the socket.
24:33Its mesh coating will allow the bone to grow around the implant.
24:36See the plastic liner? Replaces the cartilage.
24:41He then inserts a titanium stem into the femur.
24:47And in its side, he puts a bolt to prevent the stem subsiding.
24:52Through that in till it's tight.
24:56Noel puts the head on the stem.
25:01We pop the head into the socket.
25:03Then he checks the head is firmly in place.
25:07As I tug on it, it doesn't dislocate, which is really good.
25:11We now stitch up, we're done.
25:13This hip will hopefully be pain-free in two weeks' time.
25:17One, two, three.
25:19The whole procedure has taken less than an hour.
25:25I'm very pleased with this one.
25:27It's chalk and cheese, the difference between the two.
25:30That's awesome.
25:33It'll be six weeks of cage rest for Raven.
25:36And then if all goes well, Noel will perform the whole thing again on his other hip joint.
25:49It'll be six weeks of age.
25:53Fury, the three-month-old kitten with a fractured growth plate, is about to go into surgery.
26:04Although a simple fracture, Noel has thought again about how he's going to repair it.
26:09I've had a look at the x-ray pictures and because the little bone on the other side, which is called the fibula, is still intact, we do not need to put a second pin in.
26:18But Noel is drilling the wire into a tiny piece of bone that crumbles easily.
26:24So we can see the fracture is there, and we can see the pin I've put in goes across the fracture here, doesn't move anymore, feels very stable.
26:38So let's hope the post-op x-ray picture looks okay, and I've got that pin in the right spot.
27:04All looks good.
27:05It just needs to be held in place for three weeks.
27:22Come on mate, let's go for a little walk. Good boy.
27:25It has now been two days since Raven's operation.
27:29Well done mate.
27:31And Noel wants to see how the puppy is walking on his new hip joint.
27:35Oh, on a windy day like today, your hair goes everywhere, doesn't it mate?
27:40He's doing brilliantly well on his hip replacement, it's like nothing happened.
27:44He's very comfortable, and he wants to run around, don't you mate?
27:48So he's ready to go home.
27:50At the end of the day, it's all about getting him out of pain and giving him a good quality of life, and that's hopefully what we'll be able to do now.
27:55But this is just the start.
27:59If all goes well, Raven's other hip joint will also be replaced, and it's going to be three months before he's fully recovered.
28:07Until then, Alan and Jane have to keep their boisterous puppy in check.
28:15OK.
28:17OK.
28:18He just wants to go, doesn't he?
28:19So this is how you walk him, right?
28:20Yeah.
28:21This is an insurance policy so he doesn't run.
28:23Correct.
28:24So you understand?
28:25Yeah.
28:26Anything else you need to ask me?
28:27No.
28:28Thank you. Bye-bye.
28:32For the next six weeks, Raven will spend most of his time in a cage.
28:37I think he's going to be a real problem at home.
28:39He's just going to want to be bounding around all the time.
28:41And we've got to try and stop him.
28:42Yeah.
28:43I think for the first few days there's going to be us three in the living room watching telly every night, overnight, on a blow-up.
28:52On a blow-up bed, just to make sure he's OK.
28:55We don't spoil him.
28:56Not much.
29:06After major surgery on his spine, two-year-old police dog Trigger is also ready to be collected.
29:14And Rob's looking forward to having his best pal back.
29:18We're all set up.
29:19We've got the cage set up.
29:20I hope the kids are really excited.
29:21Wife's really excited.
29:22But it's going to be really, really hard.
29:25One slip and we can undo all the good work that Noel's done.
29:28These next 12 weeks and how I manage his recovery is absolutely critical.
29:32In 12 weeks, Noel will repeat the tests he performed initially to see whether Trigger can start fitness training before returning to work.
29:40Morning. How are you doing today?
29:41Morning, Noel. How are you doing?
29:42You all right?
29:43Nice to see you.
29:44Please grab a seat.
29:46We will quite clearly see that on the post-operative CT scan, the spine, the vertebrae are much straighter.
29:53And by placing that screw in, we push the compressive elements away from the nerve.
29:59So that has to fuse across through that device.
30:02And that is going to take 12 weeks.
30:04Yeah.
30:05So for the first six weeks, you're just going to do lead walking only and that's it.
30:08Nothing else.
30:09We just need to let everything settle down.
30:11And I'll see you at week six.
30:12Yeah.
30:13Okay.
30:14He's so sweet, which is extraordinary.
30:16It's amazing.
30:17You can turn...
30:18You're on off switch with him.
30:19It's just...
30:20Unbelievable.
30:21Just with a command word and all of a sudden he's a different dog.
30:24Yeah.
30:25I don't want to know the command word.
30:27I was like thinking to myself, man, I hope I don't say it accidentally, whatever it is.
30:32I'm sure you have to have that secret, that's top secret stuff that you have to have between you and him.
30:36Can't tell you.
30:37No, I don't want to know.
30:38Don't want to know.
30:39I'll get him for you.
30:42Now.
30:43There we go.
30:44He's a little man.
30:46There we go.
30:47So let's just go outside.
30:49Let's take it easy, mate.
30:50You've got to take it easy enough.
30:53And I'll see you soon.
30:54In a few weeks time, you'll be back to catch a nose camera.
30:56Good boy.
30:57Good boy.
30:58Well done.
30:59All right.
31:00Good.
31:01Take care.
31:02You know, a two year old dog with that sort of drive is going to be challenging.
31:05It's going to be really stressful for him and pretty stressful for the family.
31:08He's on.
31:09Yeah.
31:10We think we've got lockdown.
31:11That boy's got a big lockdown.
31:12Yeah.
31:13Yeah.
31:14Poor thing.
31:15Yeah.
31:16Yeah.
31:17Yeah.
31:18Yeah.
31:19Yeah.
31:20Yeah.
31:21Yeah.
31:22Yeah.
31:23Yeah.
31:24Yeah.
31:25Yeah.
31:26Yeah.
31:27Yeah.
31:28Yeah.
31:29Yeah.
31:30Yeah.
31:31Yeah.
31:32Yeah.
31:33Yeah.
31:34Yeah.
31:35Yeah.
31:36Yeah.
31:37Yeah.
31:38Yeah.
31:39Yeah.
31:40Yeah.
31:41Yeah.
31:42Yeah.
31:43Yeah.
31:44Yeah.
31:45Yeah.
31:46Yeah.
31:47Yeah.
31:48Yeah.
31:49It's been two days since Noel operated on Fury's fractured growth plate.
31:52And his family are waiting in reception to pick him up
31:55Whoa the cameras switch and it's now pointing at us. Yes, they're filming us. Oh, I see. Let's see if it follows me
32:11It's not on to you wait will it do it if I walk over no
32:22Come through I've got five chairs in here
32:25Grab a seat over there
32:27Fury is an adorable little kitten like really adorable. You're very lucky to get him back because we're going to adopt him here
32:35This is a very simple procedure
32:37However, it could go badly wrong if he was to get out and run around and twist it because there's only one pin holding it
32:45But if that pin holds it for three weeks, it's healed for life
32:47So your mission is to look after this cat for the next three weeks. No running. No jumping. No slipping
32:53No sliding which is difficult with a cat that wants to run jump slip and slide right you got a cage set up at home
32:59So this is the cage is no bigger than that tape. Yeah, that's perfect. That's perfect. I'll just get him free now
33:09Yeah
33:11He's very very sweet
33:13Hello, Mr
33:14Can I? No
33:16Come on. He's a lovely boy
33:20He's a lovely boy. Good
33:22So he has to stay in the cage for three weeks. Yeah, the minute we get him out. He's just gonna jump his knees
33:27So we can get him out and cuddle him, but we have to hang on to him. Yes. Oh my goodness you poor little thing. Okay. Yeah
33:34You go good boy. It should all be fine if you follow the rules
33:42You take care of that little man
33:51Come on you
33:52After Raven's first hip replacement went well
33:55Noel was able to operate on his second
33:58And once again, he's at home recuperating good boy
34:04Although Alan and Jay no longer have to sleep downstairs with him
34:08This recovery for the second op is it's been a bit longer the first one within a week
34:13It was like he'd never had it done this one. He is still limping and it is the slower process
34:19The boisterous one-year-old doesn't like being cooped up
34:27When he got medication, he's absolutely fine. He will just sleep when he's not he's really hard
34:32One of us has to be with him all the time. Otherwise. He just tries to do naughty things
34:38It's been awful for my neighbors because he's probably barked all the time
34:44Right now quiet
34:46He's been a there are just too many distractions for the pub
34:51They have a love-hate relationship Raven loves the cat the cat loves Raven on his terms
34:56He won't come downstairs when Raven's excited, but every now and again when Raven's asleep. He'll come down and lick his feet
35:06At the moment we have to be really careful because obviously Raven can't run around
35:11But once the time comes I think the cat needs to watch out
35:16Wait wait
35:19It's really difficult taking him for a walk at the moment because he does pull because he just wants to get everywhere and he's used to a long lead
35:28No running eyes on me, but of course he can't run he can't jump he can't do anything than walk sedately
35:34So it's really frustrating for him and for us
35:38So it's just becomes pitting our wits against him and getting through it
35:46People next to us have had tons of food we should have bought more stuff
35:51Well, we didn't know what we were didn't know what to expect. We know next time to bring chips burgers
35:56Maybe we should knock on and say can we have some of your chips, please?
36:00No, you can hear the birds can't you seven days after his operation?
36:09Fury's back to have his bandage removed
36:12But it sounds like it's been difficult following all knows rules
36:16We've let him out the cage a little watching him very carefully so he doesn't do any jumping and he looks a wee bit sad for himself
36:22The whole thing's been a bit traumatic
36:24We'll take him out every afternoon just so he can get a bit of freedom and live out with us
36:29Hi guys, how are things going?
36:31Good, thanks
36:32Thank you, Lisa
36:33How have things been?
36:36Tough to begin with
36:37Yes
36:37But he settled down and we let him out to wander about without jumping
36:43Sorry, you just said you let him out to wander about?
36:46Basically, he'll sit with us on the sofa
36:48He's definitely, definitely not allowed to wander about
36:51Okay, wander about as in not even walk on a flat surface
36:56No, definitely not
36:58Right, okay, well we've been doing that
37:00That's the whole point of the cage
37:03Right, I thought it was to stop him from jumping but you've explained that and I understand
37:07So I'll need to x-ray him now today in case anything's moved
37:10But I would rather you didn't let him out at all except to cuddle him and put him back in again
37:14But I'll check it
37:15Right, okay
37:16Grab a cup of tea or coffee or whatever
37:19We need to sedate him
37:23And we need to x-ray him
37:26All right, sweetheart, let's have a look
37:36Let's flip so I can see that
37:42He's a good little boy
37:44You're a good boy
37:47You have been taking the mickey, haven't you?
37:49Yes, yes you have
37:51You're not allowed to walk
37:52You're not allowed to run
37:54You're not allowed to jump
37:55Is that okay?
37:56Good boy
37:57It's been a stressful wait for Barry and Aidan
38:01Hi guys
38:04Oh, you're a lucky man
38:05Everything's still okay
38:07Oh, thank God
38:08There is no problem here
38:09Happy days
38:10And I will see you on Monday
38:12Okay, well done
38:13The most beautiful cat
38:16She's in love
38:16They're in love
38:18I'm in love
38:19Everybody's in love
38:20It's the nicest cat
38:21I mean, my cats
38:22When I go upstairs
38:23In my office
38:24They're jealous
38:24Because they can smell
38:25That I've just been cuddling him
38:27Well done, mate
38:29I was actually quite scared
38:32Because the doctor mentioned
38:34That we had actually done something wrong
38:36I'm glad to hear that he's okay
38:38And he'll be recovering
38:39They won't let him back out of the cage again
38:42Hopefully in the next week or two
38:44He'll be recovered
38:44And we'll be out of the woods
38:46It's been 12 weeks since Trigger had surgery on his spine
39:03Noel and his team are carrying out a series of tests to check his progress
39:09If Trigger is still in pain
39:12He may not be able to continue as a police dog
39:15Last night, went to bed
39:16Thinking about it
39:17Then I woke up about 3 o'clock this morning
39:19And that was it
39:20Just, yeah
39:21Just a worrying day, isn't it?
39:23If Trigger can't go back to work
39:25Rob may have to re-home him
39:27So it's a massive day for me
39:29And especially for Trigger
39:30Go here, please
39:36The most important tests are the same as Noel performed during the first consultation
39:41Sorry, mate
39:43If Trigger's still in pain when he repeats the tests
39:48Noel won't be able to sign him off today
39:50That's it
39:51But Trigger remembers how much the tests hurt first time round
40:00And he's not happy
40:02Being silly
40:03Relax, buddy
40:06Good boy
40:06Alright, you ready?
40:08Go
40:09A human patient with nerve pain can say to the doctor, this is where it hurts
40:17But a dog can
40:18And that's why the clinical tests for nerve pain are so important
40:23And the only way that one can tell if a patient responds to surgery
40:29Is to perform exactly the same tests before and after
40:33Alright, great
40:35Sir, can you take him through for imaging, please?
40:37Yes
40:37Thank you very much
40:38Come on, big guy
40:40Come on
40:41So it's good news, really, about Trigger
40:47And I would say that this is as good as it gets at 12 weeks
40:50So that's really good
40:51I was worried you did the checks outside
40:54The pain on one side seemed similar
40:57There was no pain
40:58I literally hadn't touched him
41:01Okay
41:01He was just being silly
41:02When I did the test, he didn't respond at all
41:04Oh, right
41:05Oh, brilliant
41:06So where do we go now pushing him on wise?
41:09The goal is to get him back to full activity within two months from now
41:13Brilliant
41:14Yes
41:14I think he's ready
41:16Hello, true, true
41:19Okay
41:21He's fine
41:23Well done, mate
41:24Thanks very much
41:25Pleasure, pleasure
41:26I can't believe that he did that to me
41:30He was, I think, anticipating the pain he was going to be in
41:32And fell over and acted like a div
41:35So exactly the result that we wanted, yeah
41:38Hopefully we'll have him back out on the streets doing what he loves
41:41Hi, Sherry
41:49I love Fury
41:52Yeah, he's such a good boy
41:55It's now been six weeks since Fury fractured his growth plate
41:59Noel has asked his team to take an x-ray image of the kitten's injury
42:05And he's surprised by the results
42:08I've never actually seen this before
42:12But the growth plate has continued to grow
42:14That's very rare
42:16I'm delights to hear this for the kitten scene
42:19Yes
42:20I mean that's
42:20It's the best possible outcome
42:22Fantastic
42:22Well done
42:23Well done
42:25It's such a joy to meet you
42:26Good luck with the research
42:27At home a month later
42:30Fury's keen to start exploring
42:33After he'd recovered
42:35We let him go outside for the first time
42:37He's been climbing trees
42:40And he's been playing with any other animals that he can find out there
42:43And back to being a normal cat
42:45Which we're really pleased to see
42:46His sister is delighted to have her playmate back
42:52Now that we've got the two cats both running around
42:57Both very happy
42:58It's a good thing
43:00We've got a kitten back to exactly the way it should be
43:04And I'm grateful to Noel and the team for that
43:07One year old puppy Raven has spent the last three months recovering from a double hip replacement
43:19You ready? Let's go
43:21And Alan and Jane were worried that they'd never get the old Raven back
43:26Before we had to be careful what he did
43:28Can't jump on this
43:29Can't go up the stairs
43:31Now no more being careful all the time
43:33We've got our puppy back
43:34Are you ready? Are you ready?
43:37Go on in, go daddy
43:38Go on in
43:39It's a bright future for him now
43:44It's a happy future
43:45He's back to his cheeky self
43:47I'll take him out in the morning
43:49And then he wants another walk by lunchtime
43:52Yeah
43:52He's just getting better by the day
43:58It's been six weeks since Noel signed Trigger off
44:02And Rob's been putting him through his paces
44:05Training him once again to be an attack dog
44:09And so far Trigger's risen to every challenge
44:14Recovery has just come on loops and bounds
44:19And he's genuinely stronger than I think he's ever been
44:21Today marks another milestone
44:24Trigger's first practice bite since surgery
44:33Good boy
44:33Good lad
44:36I've gone from a dog that wouldn't lift his front paws up
44:41To as we've just seen
44:42The dog that will chase somebody
44:43And literally take them at full pelt
44:45With no wincing of pain
44:47I think he will be able to comfortably work
44:49For the rest of his life
44:50Couldn't have been better
44:50And look who's turned up to check how he's doing
44:55Wow
44:56Wow
44:57That's not a chance
45:00There's no way any human being would ever outrun him
45:05Noel's even been persuaded to play the part of the bad guy
45:09I've got my protective sleeve
45:11Should things go wrong
45:14I've got a reward
45:15Should things go right
45:16And we're hoping things will go more right than wrong
45:21Let's see
45:22Yeah, they show yourself now
45:24Tell me about you she lost a chance
45:25As long as Noel stands still
45:32Trigger's been trained not to bite him
45:34Here he comes, here he comes
45:36All right mate
45:43Phew
45:44Yeah
45:46So what has he been up to so far?
45:53So he's only been off lead now for three weeks
45:55We've done one practice bite this morning
45:57Oh wow
45:57Which went really well
45:58And almost a practice bite on me
46:00Almost a practice bite on you, yeah
46:02And he genuinely is having a great day
46:04Absolutely
46:05Well I'm just thrilled to be part of his great day
46:07Thanks mate
46:08Thank you for letting me be part of your great day
46:10You're such a good boy
46:11You're such a good boy
46:13Thanks
46:14Thank you
46:15Thanks
46:15Thanks
46:27Thanks
46:29Thanks
46:29Thanks
46:31Thanks
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