Noel attempts a rare operation which has only been carried out on two other dogs before. Ianto, a nine-year-old corgi, has an infected cancerous growth which is eating away his foot. For Ianto's owner Gillian, it's heartbreaking: he's her sole companion and she can't imagine life without him. Noel decides that the only way to save Ianto's life is to amputate the diseased paw and give him a custom made prosthetic foot. We also find out whether the groundbreaking surgery to correct puppy Jolly's bone growth deformity has been successful and whether he can now walk pain free. There's a rare visit from an unusual patient and a barn owl with a broken wing, plus the story of a stray Jack Russell terrier, Jade, who needs treatment on a dislocated elbow.

There's no let up at the referral centre as the cases continue to flood in. Noel is presented with another major surgical challenge. Seven-month-old puppy Jolly has a painful bone deformity in both his front legs. His owner, Christine, agonises over whether it's fair to put him through an operation in which Noel proposes to use a new technique to treat the bone growth deformity.

Puppy Ice is sent to Noel's referral centre having been trampled by a horse. There is also an update on Lottie.

Border collie cross, Sasha suffers a set back after being given a total knee replacement when in a totally unrelated incident, a disc blows in her spine. Noel is forced to perform life saving surgery on her. A four year old cat called Lottie needs restructive surgery after being hit by a car.

Noel manages to get rid of Charlie the Labrador's tumour and he replaces it with an implant.

Noel manages to help helps a cat with two missing feet. The X-Men inspire him to save a Labrador.