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