- 10 hours ago
Category
📺
TVTranscript
00:01Professor Noel Fitzpatrick
00:03All right, Mrs. Cuddle Monster incoming.
00:06is the super vet.
00:08We have issues.
00:09I knew I should have got chihuahuas.
00:11At his unique vet practice, he merges mechanics and biology.
00:16Past the point of no return now.
00:18Don't be pulling apart my repair, Mrs.
00:21to heal the nation's pets.
00:23Sorry 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.
00:34Noel imagines the impossible.
00:36Oh, my little baby gives a leg.
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!
00:56Bionic doggo!
01:00Yes, mate.
01:01I love you too.
01:05I need a nurse or vet, please.
01:07Emergency cases that have been referred to Fitzpatrick referrals.
01:10She's taking him.
01:11Are often challenging, as well as unpredictable.
01:16When an accident happens, it can take time for us to understand the true extension of the trauma.
01:22Can we get a circuit?
01:23So, there's definitely some very obvious and clear to the eye.
01:28Laryngoscope.
01:29But there are others that, depending on how ill they are when they arrive, that might remain hidden until we actually get to the bottom of it.
01:38We've got a femoral.
01:39We've got a femoral.
01:40We've got a femoral.
01:41Can you feel?
01:42Yeah.
01:43Okay.
01:44It's fine.
01:45It's fine.
01:46We're breathing.
01:47Hey, gorgeous man.
01:50It must have been a pretty horrendous last few weeks.
01:53Hopefully, this is the beginning of turning the corner.
01:57Four weeks ago, Angus, a five-year-old golden doodle, went through a terrifying ordeal and sustained life-changing injuries.
02:06We've come because Angus fell off a cliff in the Forest of Dean.
02:11He's definitely got some big problems and he can't carry on as he is because he's in lots of pain and he can't really go anywhere.
02:19So, we're hoping to show him some kindness by bringing him here and see what we can do for him.
02:27Zoe lives in Northamptonshire with her four children.
02:31Thirteen-year-old Coco.
02:33It'd be nice.
02:34No, Coco, thank you.
02:35No.
02:36Okay.
02:37Eleven-year-old Bertie.
02:38Super careful on the steps, Cakes, okay?
02:40Eight-year-old Purdy.
02:42And ten-year-old Serafina.
02:45Plus a menagerie of other animals, including Hamish the Spaniel.
02:57Three hens and four baby hens and a cockerel.
03:01Go!
03:02Most of our leisure and lives revolve around the animals and we are very outdoorsy.
03:07Come on, babes!
03:09From the moment Angus arrived, Zoe knew he was the ideal dog for her boisterous brood.
03:15Angus, hey, he has the most amazing character.
03:19If anyone's a bit down, he knows.
03:21He's always the first one to turn up with a big, heavy, soft Angus head to give someone a cuddle.
03:27Last month, Zoe and boyfriend Paul took the two dogs with them for the weekend to the Forest of Dean.
03:38And so on the Saturday morning, we set off to do a really long walk.
03:43It was fantastically wet and gloomy.
03:46Hamish and Angus were running all over the place.
03:49And unbeknownst to me, obviously, they'd gone up to the top of the cliff.
03:55And I was sort of like wandering along and having an amazing time.
03:59I literally just then started to count my blessings.
04:02And literally 20 seconds later, the terrible noise.
04:07Both dogs had tumbled down the cliff.
04:10Angus had fallen 20 metres and suffered catastrophic injuries.
04:17Zoe and Paul eventually managed to get Angus to an emergency vet.
04:22Angus had gone into respiratory distress because of the impact and trauma.
04:29He couldn't breathe.
04:30And the vet felt that he may need to be put to sleep.
04:35I didn't really want to consider that.
04:40Against the odds, Angus's breathing stabilised.
04:43But investigations revealed a broken right wrist and severe nerve damage to his left front leg.
04:50At the moment, he can barely move predominantly because he's just in so much pain.
04:55And when you part his fur, he's black and blue.
04:58We do have them on painkillers.
05:01The vet has told Zoe if the nerves in Angus's left leg don't recover, the leg will have to be amputated.
05:08Angus is in such a mess.
05:10And we're really worried that he's not going to be able to get a viable quality of life.
05:15Would you like to come through?
05:17Zoe and Coco have come to ask Noel what can be done for Angus.
05:22It's all right.
05:23To give him a chance.
05:25Good morning.
05:26Oh, what a beautiful dog.
05:27Hello.
05:28Please come in.
05:29My understanding is that there is paresis of the left front leg in the sense that the nerves have been damaged.
05:35And that the right front leg carpus is busted.
05:38Yeah.
05:39Okay.
05:40So we're just...
05:41Mary, if you come this side for me, please.
05:43That's it.
05:44I just want to double check that there's nothing neurologic with his back legs.
05:48When was the accident?
05:49It'll be four weeks from Saturday.
05:51So it's...
05:52Okay.
05:53From my initial clinical examination, I can tell you the following.
05:55The back legs seem okay, which is good news.
05:57That's great.
05:58The spine seems okay, which is good news.
06:00Now, leaving the left front leg to the side for the moment.
06:03Yeah.
06:04The right front leg has a dramatically disrupted carpus.
06:09Okay.
06:10Meaning that all three levels are disrupted.
06:12One, two, three.
06:15But I think it's saveable.
06:17Okay.
06:18I have had dogs manage quite happily on a wrist fusion, but they bounce.
06:24And the downside is there's a lot of pressure in the elbow and the shoulder.
06:28So I'm going to need to look at an x-ray picture of the elbow and the shoulder to make sure that they're okay.
06:32We're going to do a few checks.
06:34Yes, please.
06:35I'll come and find you soon.
06:41Before he's scanned, Joanna, a neurologist, double checks for any remaining nerve function in Angus's left front leg.
06:49Ready?
06:50Muscular cutaneous.
06:51There's nothing.
06:52Something there.
06:53You can see he's trying to pull them.
06:56Well, we can wait up to six weeks, but the way this is going, even if he recovers these parts, he's never going to put any weight back again.
07:08It's completely contracted already.
07:09This is a losing battle and it's going to give them more pain trying.
07:13Thanks so much for your time.
07:14All right.
07:15Okay.
07:16Yeah.
07:17Thank you, Joe.
07:18That's it.
07:19Noel also needs to investigate Angus's right shoulder, elbow and wrist.
07:23That's better.
07:24It's crucial the joints are strong enough for him to bear weight on one front leg if the wrist is fused.
07:31Okay, Zoe, Coco, come on back in, please.
07:33This is the study that we've just done.
07:37The wrist is indeed disrupted at all the different levels.
07:42There are splinters that have come off this impact because it goes like a nutcracker.
07:45Gosh.
07:46Okay.
07:47And crushes the front of the bone.
07:49Ow, ow, ow.
07:50Exactly.
07:51I think he does have some degree of developmental elbow disease, but it's low grade.
07:57Do we still in the ballpark of what it's worth doing this?
07:59Correct.
08:00Exactly right.
08:01However, what I felt about Angus's left front leg, those muscles are never going to work again.
08:06This muscle's never going to work again.
08:08This muscle's never going to work again.
08:10Okay.
08:11So the left front leg justifies removal.
08:14He's already tripping up on it, even with it just dangling when he's trying to move around.
08:18Yes, indeed.
08:19It's a hindrance to him.
08:21And it's controversial whether you take the leg off first and then fuse the wrist second.
08:25But my professional opinion is that if the wrist fusion didn't work, why put him through the amputation?
08:30Because we'd end up having to put him to sleep.
08:32Therefore, I would recommend that we do the wrist fusion first.
08:35Okay.
08:36Great.
08:37As a quick question, you feel that with a successful fusion of the wrist and a well-working back end, that he can have a good life?
08:46To be brutally frank, I think it is a decision between euthanasia and a three-legged dog with a fused wrist, because we can't leave him as he is.
08:54Oh, crikey, no.
08:55Thank you so much.
08:56Okay.
08:57No worries.
08:58Cheers.
08:59Thank you, Angus.
09:00Well done.
09:01Come on, handsome.
09:02Noel and his team will design a custom-made implant for Angus's wrist to give the fusion surgery the best chance of success.
09:09You can't go after him.
09:10No.
09:11We're very relieved that it looks like we've got a really good chance of not losing him.
09:16He's been hobbling around the kitchen for a month almost now, hasn't he?
09:20Yeah, so I think we're sort of slightly worried that we'd be going home with broken hearts, which we're definitely not.
09:26We've got hopeful hearts.
09:29Poor old Angus.
09:33Rocky!
09:35Come on.
09:37Rocky.
09:38Rocky, a nine-year-old Springer Spaniel, has arrived at Fitzpatrick referrals with Tanya and Ian.
09:44He's looking very smart, very smart.
09:47No, stop it.
09:49Despite his enthusiasm for life, he's coping with severe pain after a failed operation on his elbow.
09:57Rocky.
09:59He had an unfortunate incident with another vet.
10:03Instead of just going into the bone to stop a little fissure, he managed to put a screw right through the middle of the joint itself.
10:10So he's really, really badly limping.
10:14Rocky!
10:15Rocky shares his home with Sasha, the couple's other dog.
10:19But there's no doubt who's the more energetic of the two.
10:23Poor.
10:24Good boy.
10:25Even though Rocky's getting on a bit, you wouldn't believe it to look at him.
10:29I mean, he even clams trees.
10:31You can't help but think of Winnie the Pooh's Tigger.
10:34He is a Tigger dog.
10:35Good boy.
10:36Irrepressible Rocky arrived in their lives two years ago when they found him in a nearby animal shelter.
10:43He'd ended up there.
10:45It was a marriage break-up.
10:47The two dogs had to be given up.
10:49And after about seven or eight months, the brother was rehomed and Rocky was left.
10:55So we got him.
10:56You know, it's not like everybody else is lost.
10:58You know, it's our game.
10:59How are you doing?
11:03Since starting his new life, Rocky has become an invaluable part of the family.
11:08Particularly for Tanya, who has multiple sclerosis.
11:12Rocky's just been so great, because should I be having a bad day?
11:17He's there almost like showing you support.
11:20You know, yeah, come on, here's my lead.
11:22You know, take me out.
11:23You know, things to do.
11:25But Rocky's enthusiasm for life started to wane when he developed a limp.
11:30Investigations revealed a small crack in the humerus bone of his left elbow.
11:35We ended up being referred to a specialist vet who said the best solution would be to put a screw through the bottom of the humerus.
11:44But unfortunately, it didn't quite go through the humerus.
11:49It ended up going through the joint pocket.
11:51Come on.
11:52Rocky is now struggling to walk for more than 20 minutes at a time.
11:56And Tanya and Ian are desperate to get him back to his old self.
12:00I feel bad for him, but he's such a brave boy.
12:05And so we're very hopeful that Noel will be able to get him back to feeling good again.
12:18Noel has already performed imaging on Rocky to investigate the damage to his elbow.
12:24So we can see here how Rocky's elbow has collapsed down.
12:30The screw is physically sticking into the joint.
12:33And we can see this particularly clearly in the arthroscopy where the screw has gouged out the joint surface.
12:40The reality here is that Rocky is in significant pain all of the time.
12:44There are very limited options to treat this elbow.
12:49One option would be to take the leg off completely.
12:52The second option would be to fuse the elbow solid.
12:57That would, however, leave the elbow without any movement.
13:01And therefore, Rocky would move in this way, circumducting the limb.
13:07Therefore, we are considering a third option, which is total elbow replacement.
13:13If we could make that work, it would give Rocky a moving, pain-free elbow.
13:18Rocky is so enthusiastic. Every day for him is a good day.
13:25And he's so bouncy. We've opted for a total elbow replacement because we just want to give him every chance to get him back to his pre-op condition.
13:34That's it, good boy. Come on.
13:38After 15 months of managing on his painful elbow, Rocky is having his surgery today.
13:44Hello, how are you today? Nice to see you.
13:48Right, so today is the day.
13:50Today is the day.
13:51Okay, please grab a seat.
13:53How are you doing? How are you doing? So he's been much the same.
13:56I can feel a very, very bad crackling in there associated with the progression of osteoarthritis and also the metal rubbing inside the joint.
14:04I just want to explain the objectives of the surgery today again.
14:09So this is the new implant.
14:11So this part is a tray which fits on the radius and ulna.
14:19And we use a very special cutting guide system for this implant to go in here.
14:25And it's specifically made only for this dog and this implant.
14:28Now, there's a shed load of new bond formed around the periphery of the joint.
14:35When I get in there, that's going to be like a bag of marbles.
14:39So I'll be trying to scoop out much of these bone fragments, but I won't be getting all of them.
14:45And the reason I won't be getting all of them is some of them are intrinsically fused onto the bone.
14:50Right.
14:51So if we fail for whatever reason, we have a fusion plate ready here.
14:55That's our fall back position intraoperatively.
14:58Right.
14:59And that could happen today.
15:01It's a big job, a big, big job.
15:03Any questions about this?
15:05All set?
15:06All set?
15:07All set.
15:08All right.
15:09Big cuddles then for Dad.
15:10Big cuddles for Mum.
15:11All right.
15:13Good.
15:14Well done.
15:15You can go ahead, Johnny.
15:18Good.
15:20God bless.
15:21Take care.
15:22Cheers, guys.
15:23Bye-bye.
15:24Bye.
15:25I realised it was going to be complex.
15:27But then hopefully, you know, at least the pain he's having at the moment will be taken away.
15:32Double fingers crossed.
15:34Good boy.
15:35Good boy.
15:36Angus.
15:37Hey, gorgeous boy.
15:38I know.
15:39Zoe and son Bertie have returned with Angus, who fell 20 metres off a cliff, irreparably damaging
15:57his left front leg and smashing his right wrist.
16:01We've come back today because Angus is having, hopefully, the first of two operations with
16:08Mr. Fitzpatrick.
16:10Angus's life really hinges on the success of today.
16:14So, um, yeah, worst case scenario, doesn't really worth thinking about.
16:19Good boy, Angus.
16:20Steady.
16:21Come on, sweetheart.
16:22Bert is coming.
16:23Now, then, so what the plan is, we have made a very special plate in the factory over
16:34the past week, which is this here, okay?
16:37Oh, wow.
16:38The point of this plate, as you can see, it has special screws in it.
16:41Yeah.
16:42In different positions.
16:43And each of those screw holes is threaded.
16:45Do you see a little thread in them?
16:47Yep.
16:48And we have special screws that lock in those threads and also lock in the bone.
16:52And that fuses the joint.
16:55Now, so that's the fusion bit.
16:57Now, what I wanted to come on to were the risks.
16:59My main worry always with this is swelling impairing blood supply.
17:03But I obviously do my best.
17:06Infection is also a risk.
17:08He must not lick it.
17:09Are we clear?
17:10Yes.
17:11Yeah.
17:12So give him a big hug now, Bertie.
17:14We're going through now.
17:15Yeah.
17:16Okay.
17:17I'm just going to lift my visor.
17:18Just kiss you for a moment.
17:20Ah, so you go ahead.
17:21That's it.
17:22See?
17:23Now.
17:24There we go.
17:26Okay?
17:27Sorry about the visor.
17:28All right.
17:29Well done.
17:30I'll talk to you tonight, Bertie.
17:32Okay?
17:33See you later.
17:34It's going to be all right, sweetheart.
17:35I promise.
17:37I promise.
17:38I promise.
17:39See you later.
17:43Okay.
17:44Thanks.
17:45I'm very worried about Angus.
17:48It's been a long time, hasn't it?
17:52I haven't got my hanky.
17:53I'm in space.
17:54Oh, no!
17:55I can sleep for a hug.
17:57Want a hug?
17:59You sure?
18:00Do you call for a hug?
18:01If it all goes okay.
18:02Hello.
18:03Can I have a back leg, please?
18:04Angus is being prepared for surgery.
18:05His left front leg is beyond repair, so everything rests on the success of the fusion of his right wrist.
18:25All right.
18:26Let's do it.
18:27Incision.
18:28An implant has been created using 3D modelling based on Angus' CT scan.
18:37First, Noel will remove the cartilage from all of the carpal bones.
18:43Then, he'll pack in bone graft and position the plate using temporary non-locking screws.
18:50Then, locking screws are placed in the radius and the carpal and metacarpal bones.
18:56The design will allow Angus to distribute his weight gradually through the narrower plates to the thicker plate and up towards the elbow.
19:04There's a lot of swelling here as a result of the explosive trauma.
19:11Noel must carefully move the blood vessels, nerves and tendons to one side, preventing any further damage.
19:18The biggest reason for failure in this operation is that the cartilage isn't properly removed from every surface.
19:26With the cartilage removed, the carpal bones will, over time, fuse together.
19:40Okay.
19:41Now we're going to pack bone graft into all of the areas from which we've removed the cartilage.
19:47This is taking it from Angus' left front leg.
19:50I'm going to pop the plate on and have a look.
19:53The plate is designed like a kind of chisel, so it goes down underneath the tendons like so.
20:00Then we just slide the plate back up into place like so.
20:04Noel uses pins to centre the plate on the metacarpal bones, then uses temporary screws to pull the plate against the bones.
20:13Okay.
20:14And now I'm just going to check for alignment.
20:16So it should be that the foot is in the normal standing posture, which is slightly externally rotated.
20:22when Angus is standing, which is what that is.
20:25So that's good.
20:34We placed a temporary screw here before.
20:37We're going to put permanent screws in now.
20:39Yeah, I need two metric monochrome, please.
20:46There we go.
20:48All right, let's go to x-ray and let's pray that it's all fine.
20:54Well done, Angus.
20:55Well done.
20:56Okay, great.
20:57Thank you, everybody.
20:58The first stage of Angus's treatment is complete, but it will be several days before Noel can be sure that the blood and nerve supply to his foot is intact.
21:13Hello.
21:14Hi, Zoe, it's Noel.
21:15Are you okay?
21:16The operation went fine, yes.
21:17Zoe and the kids will be updated on Angus's progress over the next days.
21:30It's one of the most important tasks for the team at Fitzpatrick's.
21:36If I was the mum or dad of the dog at home, I'd be sitting on my couch rocking back and forth.
21:43Like, I'd be an absolute nightmare.
21:45Like, I'd want to know every detail.
21:47What a good boy.
21:49It's equally important to let them know when something good is happening versus when something bad is happening, so they're always kept in the loop and always involved in decision making.
21:57He's comfortable sleeping a lot.
22:00People really appreciate the simplest of things, so just saying, yep, he's eaten his dinner tonight, can really just comfort people more than I think we tend to realise.
22:11Okay, thank you. Take care. Bye-bye.
22:19What was the sock's name? Rocky.
22:44Oh, well, it doesn't look like a rocky.
22:46Can you go me, please?
22:48It's early morning and Noel is preparing for one of the most complex surgeries he performs.
22:55An independent ethics committee has given the go-ahead for the surgery, so Noel is going to attempt to give Rocky a total elbow replacement.
23:05Okay, good.
23:06Hold that.
23:07Concision.
23:08We cut down on the muscles, elevate them from the bones and get into the joint.
23:18This is all the new bone formation around the joint.
23:21Looks like a bag of marbles there.
23:24Effectively, it's mineralisation of the inflamed tissue, which happens through the disease process of osteoarthritis.
23:31We're going to cut off as much of this new bone as we can.
23:34As well as that, this new bone formation on the periphery of the bone is actually attached.
23:43It's also as a result of inflammation as called osteophyte.
23:48Noel opens the joint and accesses the screw that's been causing Rocky so much pain.
23:54These are the tram tracks where the screw has been gouging down into the ulna.
23:59So the correct position for that screw is straight through the condyle there.
24:04Unfortunately, it went into the joint.
24:07This will have been excruciatingly painful for Rocky.
24:12He is an extraordinary dog to tolerate this pain with such grace.
24:21Show me the diagram, please.
24:24It's only low to 1.8mm drill bit.
24:30Guides that fit to bones gauge exactly where to cut in preparation for the replacement implants.
24:39Show me the diagram again.
24:42But there's a problem.
24:47No matter what way I put that, that doesn't want to sit down.
24:51Further deterioration of the bones means the cutting guides no longer fit exactly.
24:56I can't see any way to make both of them fit.
25:00And everything depends on this.
25:05I wonder, should I just proceed to fusion?
25:08Because this is way off.
25:09Noel makes the difficult call to Rocky's family.
25:13Hi Ian, how are you doing?
25:15So I'm in the middle of the operation now.
25:18Unfortunately, the elbow is very collapsed and the tissues around the elbow are very badly affected by osteoarthritis.
25:24And I can't get the elbow into a position where I'm comfortable putting in the total elbow replacement that we've designed.
25:31So I think in Rocky's best interest, I should have bought the mission on the total elbow replacement and fuse the elbow solid with your permission, please.
25:40Thank you. Bye-bye.
25:42Goggles, please.
25:43Goggles, please.
25:47With permission to proceed, Noel will now fuse Rocky's elbow.
25:55These are the two components of the plate with an axle between them.
26:00And it's designed to be at the standing angle for Rocky.
26:02Noel inserts the implant components, which will immobilise the joint, but hopefully get Rocky out of pain.
26:14The thing about surgery is you've always got to think about what's in the best interest of the patient.
26:18And I'm going to go for a second best surgery, which is in between a total elbow replacement and a full limb amputation.
26:29I'm going to try and help Rocky as best I can to get him out of pain.
26:38So that's the plate construct in position now.
26:42That elbow is locked solid.
26:46No matter how well you plan a surgery, you always need a plan B.
26:51The previous surgery didn't work out.
26:55And unfortunately, failure in surgery can happen to anyone.
27:02Sorry I couldn't give you an elbow replacement, buddy, but I've done my best with your poorly anatomy.
27:12It's been 10 days since beloved golden doodle Angus had an operation to fuse his wrist after falling down a cliff, damaging both front legs.
27:35Don't sit on my biscuits.
27:37Mum Zoe and all four children have come to visit him.
27:40I made them the best ones. Bye bye.
27:44We've made them some special dog biscuits.
27:46And they do smell.
27:48Smell beefy.
27:50Right. Gosh, you've got the entire posse.
27:52How are you everybody? Come on in.
27:54I'm very glad you could come in because I wanted to show you.
27:57And that one's for Angus as well.
27:59Well, you can give this to Angus yourself.
28:01Because Angus is going to be on this rug in a minute.
28:03Oh my gosh.
28:04Now, we have done this big operation on the right front leg, which fused the wrist solid.
28:11Now, this is the result.
28:14So he's a week out from surgery now.
28:17And now that I've got this all stabilized and as well as that the swelling after the operation has now come down.
28:27And now that that's done, I feel leaving the left leg just dragging is no good for him.
28:31It's weighing him down, so we must take it off.
28:35So this, this will be the last time that he will have his left front leg.
28:39Yeah.
28:40Okay.
28:41We just want the best friend, don't we?
28:43I'll bring him in.
28:44You can spend as long as you wish.
28:46Now, who's here?
28:49Now, you okay?
28:51Now, take as long as you need, okay?
28:53All right?
28:54Hi, Angus. Hello, baby.
28:56Goodness me, it's lovely to see you.
28:58Good to see you.
28:59Thanks very much.
29:01Who's got a biscuit for Angus?
29:04Like, like pizza do?
29:06Yeah, that's what I love, please.
29:07Dear Angus, I love you so much.
29:09And in the past few days, I've missed you so much.
29:12Hamish is missing you too, and it has been a super long week.
29:15We made you some biscuits.
29:17I can't wait to see you on Sunday.
29:19Lots of love, Serafina.
29:21Do you want another one?
29:23Hi.
29:24He's an amazing boy.
29:26All right, guys, I'm going to bring him now.
29:28Okay.
29:29And we just got to be brave and do the right thing, don't we?
29:34All right.
29:35Amazing, amazing, Angus.
29:37Bye, guys.
29:40See you later, guys.
29:42God bless.
29:43I think we should clip a little, would you want to clip a little lower down there?
29:55Because scapula is here.
29:58The next morning, Angus is being prepared for his amputation surgery.
30:02Right, let's go.
30:03I have a syringe and needle.
30:05It takes Noel just over an hour to remove his front left leg.
30:13The final objective of full limb amputation is to prevent infection.
30:21And we do that by obliterating all dead space so there's no free fluid at all.
30:28So I'm making sure that there's a nice skin seal with a small wound.
30:33Okay, Angus, good boy.
30:36With both front legs now treated, Angus should be well enough to go home in 48 hours.
30:42Okay, wake up, please.
30:52Oh, look.
30:55Good boy.
30:57You're such a heartbreaker.
31:03Come on in, darling.
31:06Well done, mate.
31:07Well done.
31:08You're such a good boy.
31:10It's been a week since Rocky had the surgery that resulted in Noel fusing his left elbow.
31:16Today, Tanya and Ian are taking him home.
31:20I'm quite excited.
31:21Excited, yes.
31:22It's been a long time since we've seen him, so we're really looking forward to it.
31:27All right.
31:29Now.
31:31Wow.
31:33Now.
31:35Look at that, look at that, look at that.
31:37Exocet missile.
31:38Ladies, can you mind him for a moment while I speak to mum and dad?
31:42No.
31:43So, yes, it was disappointing that I had to ring you during the op and say, look, I can't put an elbow replacement in.
31:48Yeah.
31:49It was a mess.
31:50I mean, it's a big screw to begin with, wasn't it?
31:52And when it's in the wrong place, it does a lot of damage.
31:55Yeah.
31:56So we made that different choice, and this is what that different choice looks like.
32:01And that should grow into solid bone over the next 12 weeks.
32:05Now.
32:06Come on outside, Tavs, please.
32:09Grab that tight, grab that tight.
32:12And I will see you in, er, I'll see you in five weeks.
32:16Oh, you know, easy, easy.
32:17Yep, that's it.
32:18There you go.
32:19It feels brilliant having Rocky back.
32:21Absolutely fantastic.
32:22Yeah, I mean, we were expecting sort of the worst, that he'd be barely hobbling and just, you know, slowly moving his arm out like a penguin or something.
32:30But it was almost as if there was nothing wrong with him.
32:33Our superstar has returned.
32:35Do you guys, do you guys have a thermometer?
32:49Angus is due to go home today following amputation surgery.
32:54But routine checks have revealed his temperature has spiked.
32:59Can I have a scissor, please?
33:01We have some really bad news with Angus.
33:05All of a sudden, his wound became quite swollen.
33:08And then a discharge began from the bottom extent of his amputation wound.
33:15And that can only mean one thing, which is infection.
33:19So this is special irrigation fluid that breaks down the complex structures that bacteria produce to act together as an army.
33:29We're packing swabs into this now to suck out residual infection.
33:35All infections like this can be life threatening.
33:39So sadly, it's still possible that we may lose Angus's life.
33:42Noel calls mum Zoe.
33:43Hi Zoe, Noel here.
33:53So, we do have problems, I'm afraid.
33:57Angus, he has a bad infection.
33:59And having done probably hundreds of amputations, I've never seen one like this.
34:05It's aggressive.
34:07And we won't have the culture result anyway for four days or five days.
34:12Okay, I don't want the children to see him as he is, but may I come and see him?
34:19Sure.
34:20Is that okay?
34:21Yes.
34:22Yeah.
34:23Okay.
34:24All right, try and keep the faith.
34:25Okay.
34:27God bless.
34:28All right, bye-bye.
34:29Bye.
34:46Angus will be carefully monitored and kept in the isolation ward.
34:50There have been times such as with Angus where we've been in 24-7 with him making sure that he's okay.
34:57Hey baby, what happened?
34:59I sometimes like get a lump in the back of my throat when I'm with patients that are that gravely ill.
35:04Imagining what the poorer family at home are going through and you're just hoping that the medication works.
35:10Because it's either that or they'll have to be euthanised.
35:21How's it going?
35:22We have weather times.
35:25Angus's wound is now dressed every six hours and flushed every day.
35:31Get me an NF kit.
35:34She's taking off some dead tissue here.
35:37The bacteria has killed.
35:39This is called debridement.
35:41The hope is that over the next couple of days with the intravenous antibiotics, Angus will turn the corner.
35:47This is still life threatening at this point.
35:55Zoe arrives on her own to visit Angus.
36:01It is cold.
36:02I'm very worried that it's where we're asking too much of him.
36:08I'm very worried that we'll carry on doing this and then he still won't be okay.
36:13And there is still, even if we get over this, there are still so many ifs and buts.
36:18If the pan-carpal fusion is a success and if...
36:23So at the moment it just feels very frightening and very confusing.
36:26Come on in, Zoe.
36:30He's not in here so don't worry.
36:32I just want to brief you beforehand because I know you'll have loads of worries.
36:35Yeah.
36:36Come on in, come on in.
36:38So, we now know that the bug is a bug called Enterococcus.
36:43And I wonder whether it's because he was on antibiotics for a while beforehand,
36:47which suppressed his gut flora and allowed Enterococcus to grow.
36:52Fortunately, we got him on the correct intravenous antibiotics.
36:55But it's still producing?
36:57So, yes, last night there was still discharge coming from the hole.
37:02So you think it's still not quite under control?
37:04It's definitely not quite under control.
37:06So I once again flushed it and packed it with this special cream
37:11and in conjunction with flushing, which dilutes the number of bacteria,
37:16debridement, which takes away their home,
37:19and the antibiotic, which kills the bacterium itself,
37:22one would hope that that does the job.
37:25I think if we can get him through the next ten days,
37:28his long-term prognosis will be good.
37:32I'll bring him in.
37:34Come on, mate.
37:36There we go.
37:37Now, Mama's here.
37:38Now, listen, you take your time.
37:41We'll be back.
37:42Okay?
37:44Oh, sweet love.
37:45Oh, Angus.
37:46Calm down.
37:47Calm down.
37:48Come.
37:49Say hand down.
37:50Oh, I know.
37:51I know.
37:52Angus, Angus, Angus, Angus.
37:53I know.
37:54Shh.
37:55Shh.
37:56Shh.
37:57Shh.
37:58Shh.
37:59Shh.
38:00Shh.
38:01Shh.
38:02Shh.
38:03Shh.
38:04Shh.
38:05Shh.
38:06Shh.
38:07Shh.
38:08Shh.
38:09I know.
38:10Shh.
38:11Shh.
38:12Shh.
38:13Shh.
38:14Shh.
38:15Shh.
38:16Your leg looks amazing.
38:18He looks amazing.
38:20You are amazing.
38:22I'm so sorry.
38:25I'm so sorry this has happened to you.
38:31Poor Bertie burst into tears in school.
38:33He did.
38:34I don't know what to do without you.
38:35Hmm?
38:36I'm sorry.
38:37You must have been so frightened.
38:38Thank you so much for dying so hard for us.
38:47Good boy.
38:48Angus, the golden doodle who fell off a cliff is fighting an infection that took hold
38:55after his left front leg was amputated.
38:56Zoe asked Noel to continue treatment and at last there are signs of improvement.
39:02So the tissue looks a lot better now.
39:03It's a lot less oozy.
39:04Today Noel is hoping to insert a drain which will draw out any remaining fluid helping the
39:05wound to heal.
39:06So the big sharp needle comes through the skin, and then the big sharp needle comes through
39:07the skin.
39:08And now the other thing is to put the blood on a cliff is fighting an infection that took
39:09hold after his left front leg was amputated.
39:12Zoe asked Noel to continue treatment.
39:14And at last there are signs of improvement.
39:19So the tissue looks a lot better now. It's a lot less oozy.
39:25Today, Noel is hoping to insert a drain which will draw out any remaining fluid, helping the wound to heal.
39:32So the big, sharp needle comes through the skin, and we pull it all the way through.
39:38Can I have, please, a 3-metric PDS-NF needle?
39:42Finally, Noel is able to close the wound.
39:47OK, good, last stitch.
39:51If the drain works, Noel will be able to remove the tube in a few days' time, in the hope that Angus will finally be clear of the infection.
40:01OK, Angus, good boy. Thank you.
40:09Rocky! Come on!
40:12It's been six weeks since spirited spaniel Rocky had surgery to fuse his elbow.
40:20Today, Tanya and Ian have returned to discuss how Rocky is adjusting.
40:26Are we ready? Hello. How are we getting on?
40:30His nose is certainly working.
40:31Looks like we're raring to go.
40:33We are. He's so keen to...
40:35He's obviously not in anywhere near as much pain or any pain at all.
40:39I mean, he's still... I think he realises his leg is weak.
40:43Yes.
40:44So, as soon as he's in a hurry to get anywhere, it's shoulder blade up.
40:49Yes.
40:50And leg just moved out of the way.
40:51Well, he's just getting used to having a fused elbow.
40:55Let's take him through for x-ray.
40:56We'll have a look and then I'll have you back in.
40:59Come on, big fella.
41:00Good.
41:01Good.
41:02Well done. Good.
41:03I'll come and find you soon.
41:05X-ray pictures will reveal how well the elbow bones are fusing together.
41:14Hi, guys. Come on in.
41:18There we go. Everything's going fine.
41:20Brilliant.
41:21So, I'm very pleased with how the healing is going.
41:24Excellent.
41:25The implant's working beautifully well as designed.
41:27It's all now about rehab.
41:29Right.
41:30That is a combination of range of motion exercises.
41:34Mm-hm.
41:35Plus hydrotherapy.
41:36Yeah.
41:37I will bring him through.
41:38Brilliant.
41:40If all else is equal, in six weeks from now he can run around happily.
41:44Good.
41:46God bless.
41:47Take care.
41:48Cheers, guys.
41:49Bye-bye.
41:50You too.
41:52There you go, Mike.
41:56Oh, yeah.
41:57He's definitely a happier dog.
41:59He's doing more of his little smiling.
42:01He might not be smiling just at that moment.
42:02He's a bit dopey.
42:03I suppose it's up to us now to take him to his hydrotherapy and physiotherapy sessions,
42:08so we can all practice together.
42:11When Angus the Golden Doodle arrived at Fitzpatrick's, he had barely survived a 20-metre fall.
42:26Despite Noel managing to save his right front leg, a life-threatening infection took hold after his left front leg was amputated.
42:33You all right?
42:34I think I just missed him.
42:35I missed him.
42:36I missed him.
42:37I missed him.
42:38Yeah.
42:39It's been a long world journey.
42:40I missed him.
42:41I missed him.
42:42I missed him.
42:43Yeah.
42:44It's been a long world journey.
42:47Oh.
42:48Now.
42:49Now.
42:50Yeah.
42:51Yeah.
42:52But after three weeks of intensive treatment, Angus is finally ready to go home.
42:57I've already seen him.
42:58You guys say hi.
42:59Yay.
43:00Oh, wow.
43:01Hello, everybody.
43:02Hello.
43:03I'm so happy to see you all.
43:07Hi.
43:08Hi.
43:09Well done, you.
43:10You're such an amazing man.
43:11Really, the most extraordinary thing is there's still him.
43:12He's just taking it all in his three-legged stride.
43:13I mean, really, he's being incredible, isn't he?
43:14And thank goodness, because I was wavering and it was my team of four who said, no, mommy,
43:18no, please, please, please, please, please, please, please, please, please, please, please,
43:38keep going.
43:39And we did.
43:40And look, it was all worth it, wasn't it?
43:42Amazing.
43:43Amazing boy.
43:45Good boy.
43:48Rocky.
43:51It's been 12 weeks since Rocky had his elbow fused.
43:55And to help him with his mobility, Noel has recommended hydrotherapy.
44:01Rocky's been doing laps of the pool.
44:04And he's also been, had goes on the underwater treadmill.
44:08Good boy.
44:09Go on, you can do it.
44:10Apparently egged on by the reward of cheese from a tube.
44:15Boy, that's better.
44:19Despite making progress, though, Rocky is now facing another hurdle.
44:25He's been diagnosed with cancer and has had further surgery to remove a tumour from his abdomen.
44:31Rocky, come on.
44:36Ever the fighter, Rocky is once again off the ropes.
44:40Good boy.
44:41Go for it.
44:42Currently he's tumour free and we're hoping he stays that way.
44:45And because he's now able to do his hydrotherapy and physiotherapy, he seems to be making great steps forward.
44:52Good boy, Rocky.
44:53Good boy.
44:54Good boy.
44:55It's so good to see him back to his old self and his usual enthusiastic ways.
45:01Now that Rocky's pain free, I just think he's going to be enjoying life to the full, chasing pheasants, partridges.
45:08Rocky loves life so much and just couldn't be more grateful.
45:14What a superstar.
45:15What a good boy.
45:17In Northamptonshire.
45:23Come on boys.
45:24Angus, Hamish.
45:26A three-legged Angus is getting back to life in the big outdoors.
45:32Having Angus back is completely extraordinary.
45:35He's just slowly building his fitness and his physiology is changing to cope with it.
45:40His back end is getting much stronger.
45:43Having survived a 20 metre fall and a life-threatening infection, Zoe is in no doubt that Angus is a very special dog.
45:53Come on.
45:54If I think back now to sort of a few weeks, we had him literally dragging himself around.
46:01It's so extraordinary, the difference.
46:03It's amazing.
46:04It's wonderful.
46:07Daddy, Angus, Hamish.
46:09I'm just deeply grateful that we stuck with it and that he's still here.
46:14And I think we've learnt a lot of lessons from him and from life.
46:39I'm so grateful that we've been here.
46:40I think we're here to learn a lot.
46:42Oh, I'm so grateful that I'm here.
46:44I think we'll have people hope to learn a lot.
46:45You're welcome.
46:46I'm so grateful for that, and I'm resultados.
46:48I'm proud to know you're here.
46:49And I'm hopeful that we've been here and that he is here.
46:50He can't help me.
46:51And I'm proud to meet you and my knowledge.
46:52You're not comfortable.
46:53You're my family.
46:54You're my family.
46:55There's been three families.
46:56I'm happy to join you today.
46:58I'm happy to society.
Be the first to comment