Episode 2 Young Vets

Britain is a nation in love with its animals.

How are you doing?

We own 27 million pets...

and 900 million farm animals.

Very frisky one.

All of them...

need vets.

Over the course of their final year,

ten students at the prestigious Royal Veterinary College

in Hertfordshire are taking what they've learned in the classroom...

and putting it to the test

in practices, farms...

This is all new territory for me.

..and state of the art animal hospitals.

It's a whirlwind of back-to-back work placements.

MONKEY SCREECHES Sounds like an unhappy monkey!

Nice and quick, good.

And they can't afford to fail a single one.

I need to do my job properly. I need to do it better.

It's the most challenging stretch...

Oh!

..of a very long journey.

I have a serious problem with my hand shaking.

-To become...

-Well done.

..fully qualified young vets.

Saved a life today. Which is good!

It's late summer and fifth year students

at the Royal Veterinary College have just 11 months to go

until they qualify as vets. They've embarked on a long year

of practical placements called rotations -

and they need to pass them all or they won't graduate.

Not everybody does pass the year.

It's very intense and the students

have to show a consistent level

of both professionalism, skill and knowledge.

'Starting new rotations, aw, man.

'Every Monday or every other Monday is like going to a new work place

'or going to a new school.

'It's really stressful, to be honest.'

You're just kind of finding your feet for the first two, three days.

You're just run around like little puppy dogs following the clinicians.

"What can I do? What do you want me to do? How do I do this?"

So...you look like a bit of an idiot for couple of days.

Judy Puddifoot from Hertfordshire is spending the next two weeks training

in the neurology department of the Queen Mother Hospital for Animals.

OK. That is mahoosive. We'll take that.

And it's not all brain surgery.

I think a lot of people go into veterinary medicine thinking,

"It's professional, it's glamorous." No, it's not.

It's five years of anal glands, diarrhoea and vomiting.

So, if you don't like spending half your day on your knees on the floor,

I really wouldn't become a vet if I were you.

You've got a misconception if you think it's glamorous.

You can't have too much bedding, I think.

Neurology is the brain communicating to the rest of the body,

-'going through your spinal cord and into your muscles.'

-Come on.

This isn't weight watchers. Get all your body on there.

'And what we are looking at is if those things go wrong.

'When you have a condition of the nervous system,

'it can look very scary.'

When you get a patient in with seizures, when you get a patient in

which is disoriented, it's really frightening.

'Last night, all I could think about was I was trying to remember'

how to do a neurological exam on an animal. I had my head...

I feel asleep with my face in a book

trying to remember all the cranial nerves.

Lola!

Look, mastiff. Shoelaces.

No. No. No, Lola. We're not going out for a walk today.

'It's remarkably quiet this week.'

Lola, sit.

Good girl.

It's like the calm before the storm.

I'm sure something's is going to kick off pretty soon.

Neurology specialises in serious trauma.

Good girl!

Just one hour into Judy's first day, a Border collie called Holly

has been rushed to the hospital.

She's had a serious fall and can't walk or even stand up on her own.

Her local vet has referred her here to be seen by the neurology team.

It's her only hope, as the alternative would be

to have her put to sleep.

Yeah, fallen over a cliff. Hit the sides and can't move.

That was last night about 5.30, I think, five o'clock.

Super brave. Super brave.

Before the team can treat Holly, a neurologist needs to examine her,

but she seems to be in a lot of pain.

All right, baby.

Don't, don't, don't wriggle. Don't wriggle.

Got to go and find Joe,

the neurologist who's dealing with this case,

just so that we can find out if we can give the dog some pain relief

before he can examine it.

Sometimes they like to examine them before pain relief because

the pain relief can mask the true pain

so we can't localise it properly.

You're OK.

The team fit a catheter so Holly can be given pain relief

as soon as they get the green light.

You got to stay still. You've got to be still.

No, no, no, we don't do that.

Brave girl.

DOG WHIMPERS

She is looking stable enough.

It's unfortunate we can't assess what's going on back here.

She seems to be really painful...

so the neurologist will be here soon.

But the neurologist has told Judy they need to wait.

Good girl. Good girl.

He said no pain relief. He wants to examine it first.

But he's literally going to be down in two minutes, he said.

Sorry. Sorry, Holly.

All right I am going to go start taking the history

if they've finished doing their forms now. OK, all right? Great.

Holly's owners are in the waiting area

and Judy needs to find out exactly what happened.

Holly's been taken through to ER,

they're assessing her now, just to make sure she's stable

and if she needs anything immediate. I've been asked by the neurologist

to come out and just take you through to a room

and to take a bit of a history of what happened.

'I've never actually done a consultation for an emergency.'

I've triaged patients when they've have come in quickly

and just got a really brief history off of the owners.

But this is a little bit different.

'Just trying to keep them reassured is the best thing and be positive.

'Be positive.'

Come in. Take a seat.

What happened exactly?

We were just cycling on a cycle path and for some reason she was off -

she'd been on the lead the whole time, virtually, but I took her

off the lead because we were five minutes from the car.

And there weren't any other dogs around and she's run up the slope

on the side, which is like a sea wall.

-Right.

-I guess, is what it is.

I mean, she just never does. She just always stays by us.

She's gone up there and suddenly jumped over the top.

Literally jumped over and hit the stairway that comes down

and just hit that side with her back and then landed on the floor

where she has kind of broken her teeth.

I'll just relay the information.

They were down in Kent going along a cycle path and the dog jumped

apparently off the edge, dropped 20 feet and landed on its back.

Bounced off, hit another thing and then landed on the ground.

-So, kind of three impacts, really.

-OK.

A big one, is the answer.

The neurology team examine X-rays

that Holly's referring vet sent with her to the hospital.

That...intervertebral disk space is potentially

traumatically narrowed, but you don't know anything about

whether or not there's any spinal cord injury or compression there.

Good girl. Good girl. Good girl. Good girl. OK. OK. Good girl.

Before she can be treated Holly must undergo a neurological exam to

discover the extent of her injuries and check her response to pain.

Are you all right to jot down what we're finding in the exams?

Yeah, yeah, sure.

DOG WHIMPERS

Aw. Good girl.

She's affected from her lower back down hence why her hind limbs

are not working and her right hind limb is worse than her left.

But we need to do further imaging to see exactly what is going on

and then we can further knock down our list of possibles from that.

Before Holly goes for a CT scan,

her owners get the chance to say their goodbyes.

Do you want to just see her quickly before you go?

Oh, is she heavily sedated?

She's not heavily sedated, no. I mean, she's had pain relief.

It's completely up to you.

You're not going to see her? I'd like to see her.

OK, she's just in here.

I know, I know, all right.

We'll come and get you soon. We will. We will.

OK, all right. See you in the morning.

A CT scan uses X-rays to produce images of structures

inside the body, including the spine.

It should pinpoint Holly's injury.

'When we're looking at the scans, as a student,

'it can be difficult to look at that and access it in minute detail,

'and unless there's something quite obvious there - there's sometimes

'I can miss things on it but when there's a screaming broken bone

'on there, it's pretty damn obvious what's going on.

'So, yeah, looking at her scans,'

we localised the problem and the problem was she'd broken her back

falling off that cliff.

Without surgery, Holly will have to be put to sleep.

DOG WHIMPERS

TOY SQUEAKS

Before rotation started, I was really looking forward to it.

A little bit of dread. But I was actually

-really looking forward to it.

-I was fairly apprehensive.

-Were you?

-Yeah.

But at the same time I was really looking forward to it

because it's so much of what we're going to do.

And also the fact that every week was different.

You kind of just rotate, literally rotate around.

-I wonder why it's called rotations(?)

-Oh, my God, yeah.

-You've cracked it.

-You're genius.

-I've cracked the code.

-You've cracked the QMH code.

Come on, then. Bobby. In.

In! Yeah, yeah.

Charlie Tewson from Norfolk has opted to spend this week

on a placement near his home town of Shotesham.

I've not got as much farming experience as I do in small animals,

so I'm a little bit more rusty but that's the purpose

of what this week is for - to try and get that up to scratch.

The guy I am with is entirely a farm vet,

and I am going out in his car and he is a particularly a good teacher.

He's really good at making sure I know what he's doing,

that he knows what I am doing and when he feels confident

that I'll be able to have at least a crack at something

then he tends to let me have a go which, is pretty good.

He's working at Chapelfield Veterinary Partnership,

where he'll be supervised by farm vet Steve Trickey.

He has certainly got his uses that, yeah, he, I sort of - he is

very good at making teas and coffees and that is the first thing

we teach them to do, to make sure they know where the kettle is.

-Hydration is very important. I've learnt that this week.

-Yeah.

If Charlie becomes a farm vet, he'll spend most of his time on the road.

Just heading off to one of our clients

where we do a weekly routine.

Don't know what cows they'll put in front of us.

They only have about a hundred cows.

Normally not too many cows to see.

There's a certain element of being thrown in at a deep end

but that's kind of how I like to be.

This is lube,

just to make rectalling cows that little bit more comfortable.

-For both human and cow.

-CHARLIE LAUGHS

'And so in a way it's actually easier'

to just get those nerves out of the way

and just be thrown in and just go for it.

COWS MOO

I'm putting on a glove so that I can do a rectal examination on this cow

to find out why she is standing to be mounted,

to be mated, more than she should.

In veterinary medicine, this cow's problem is known as nymphomania

and can be caused by ovarian cysts.

If you do a vaginal examination first.

Yep, slap the lube on.

Just go in. Feel the cervix.

-See if its opened and then...

-Yep.

-Cervix is about a width of my little finger.

-Feel rectally.

If she has got a cyst, Charlie,

what would you feel hopefully on one of the ovaries?

Hopefully a bulge that will be more than two and half centimetres.

Is there a trick to finding an ovary? Do you literally, just...?

-Are you having difficulty or...?

-Well...a little bit.

-Yeah, fine.

-Which one?

-At the moment, the left I can't quite find.

I'll take over now, Charlie. If you want to turn on the monitor on,

-then you will be able to see what I'm seeing.

-Yep.

Steve has the latest in farm vet technology

so he can show Charlie exactly what he was looking for.

A uterine horn there just at about nine o'clock,

just wiggling it slightly, so... 11 o'clock.

-And there we've got a three centimetre follicle.

-Yeah.

Which, like you said, greater than two and a half centimetres,

so that is a follicular cyst.

So, how are we going to treat that?

We want it to ovulate.

-Yes.

-So we want to give it GNRH?

-Spot on!

It's quite a hard thing to get practical experience, that's why

it's so important to come to farms and find really good vets

at good farms cos farmers have to be willing to let you

essentially do the job twice.

So quite a lot of students don't get a lot of chance to rectal

more than couple of more times, which is why I am so grateful

for this place because they do let me do it if there's time.

They'll let me do couple each day and just to get my eye in.

It's not just practical skill Charlie must demonstrate.

Steve also constantly tests him on the theory.

You're trying to make a diagnosis of why

she has gone off-colour and whatever.

Other things that you can pick up,

things like wires or whatever, so how can you test for a wire?

If the wire's ruptured is it's traumatic rumenal...

-..something.

-Yep.

-You're halfway there.

-Traumatic rumenal peritonitis?

-Close.

-Abbreviate it. So, traumatic...

-Traumato...

-Well, traumatic,

and then sort of...

-Rumino...

-Rumen, or what's the first stomach called?

'They learn a lot of stuff'

at Vet school, sort of reams and reams and it is just sort of

quite often fed to be them sort of parrot-fashion.

'I know he knows it and it's in there somewhere.'

It's just getting him to remember it and put it into a practical context.

Reticulo...reticulo peritonitis...

Yeah, and abbreviate it a wee bit more -

-inflammation of the reticulum.

-Reticulitis.

-Traumatic reticulitis.

-Traumatic reticulitis. OK.

One of the benefits of his week-long rotation in the country

is that Charlie can go home at the end of each day.

You can do the honours with that!

'He's wanted to be a vet since he was tiny.'

We use to have guinea pigs

and kittens and puppies and we got sheep

and chickens and it was chickens, funnily enough, he really took to.

Judging by Charlie's bedroom,

his passion for animals is as strong as ever.

I think it was my twelfth birthday present. They told me

I'd get a choice of what I'd get painted -

a jungle or Sonic the Hedgehog

and I still regret not getting Sonic the Hedgehog.

No. I love it actually, still.

My mum sometimes comes in and says sort of,

"Oh, are sure you don't want it painted a sort of more adult colour?"

I'm actually like, "I really like it."

It's my childhood room, it's still home and love it.

In London, it's Amy Clithero's turn

to start a rotation she's been dreading.

It's her first day at the Beaumont Sainsbury Animal Hospital,

the college's general vet practice in North London.

The smaller the animal for me, the less I trust it.

No, but I trust - I'd rather be around a shire horse than a cat,

to be honest.

The day starts with a briefing from head vet Louise Allum.

Well, morning, everybody. I am Louise Allum, I'm the head vet here.

Welcome to The Beaumont. What I do to start off and see

if you're awake on a Monday morning, is we go round, do introductions,

tell me what your name is

and what you'd like to get out of the rotation.

I'm Amy. I'd like to just get more confident at consults, really,

and knowing what drugs to use when.

I think that's - basically I just want to get good

at what the public can see.

Hopefully you're going to get your rubbish bit out of the way here.

I am sure you won't be rubbish at all, and when you go to

your first job and you are going to be fantastic.

'The students are here for two weeks as a final year

'to learn their first day skills.'

The students are given a lot of responsibilities here,

they're going to be seeing cases themselves, operating -

a lot of them for the first time -

so I think that is quite a frightening thing.

This rotation is the closest they are going to get

to their first day on the job.

Amy will take case histories from the owners of walk-in pets.

Her clinical reasoning will be carefully scrutinized

by Doctor Jill Maddison.

She's being assessed during all of her rotations,

and at the end of every rotation she will be given a grade.

We can give them as many lectures as we like about diseases,

but it's actually what they learn on the clinic floor

and bring it all together and really increasing her confidence

and understanding why she is asking the questions.

-Chiggy Garett-Adams. Hello.

-Hello.

If you'd like to come through.

Sorry. I'm Amy, I'm one of the vet students

and I'll just be having a look at Chiggy.

Amy's patient is an 11-year-old black spaniel called Chiggy

who's been struggling to walk.

He starts stiffening up and I got a bit worried about him

at the weekend.

Yeah, I don't want him to do down hill quickly.

But they're just dogs, aren't they?

But it's easy to love a dog, isn't it?

Right, so if you just want to turn him round for me

and just walk up and down again.

Which of his leg did you say is normally his worse?

-Both his back legs.

-Yeah.

-We think we can feel his hips clicking.

-Mm-hm.

'The very first thing they should be doing is defining the problem

'and refining the problem,'

you know, what is it? How long has it been going on for?

You know, how can you actually characterise it?

How long to do you say this has been going on for, do you think?

Most latterly sort of the last three or four weeks I've noticed

he is just slowing down. Going up hills, he hates.

So he drags quite a bit on hills.

It's like being a detective. It's all clues that add together

to the picture that you are creating about the patient that helps you

answer the key questions that are going to help you decide

where you are going to go.

It's a bit of a mess, really.

You're an old boy. You're allowed to be.

This one doesn't really seem to get anything.

Good boy.

Yes, I'll just go to speak to one of the vets.

Chiggy is 14-year-old male neutered cocker spaniel.

The past three or four weeks he's really slowed down.

What do you mean by slowed down?

Sorry, just in general his demeanour's slowed down.

On the walk up and down, his hind legs look arthritis-y.

-No, don't tell me that. Tell me what you saw.

-Sorry.

-He just looks stiff.

-OK. Sort of proppy or small steps?

They're quite small. Yeah.

Any wobbling? Any sort of ataxia or anything like that?

Not particularly, no.

-He has had vestibulitis, I think the owner said.

-OK.

-Tell me what you are observing, not what they said.

-Sorry.

-It looked OK. I wasn't specifically thinking, "It's there."

-OK.

Has he been getting worse over the three or four weeks or he is stable?

-I don't know.

-OK, so you need that, that's important.

Is this something progressing or is this something that's been the same?

-Yeah.

-So how would you how would you summarise, define his problem?

Musculo-skeletal in the hind limbs.

No, that's his system not his problem. If I said to you,

"What have you observed that is abnormal about this dog?"

-Stiffness in the hind limbs.

-OK.

So, it's stiffness in hind limbs as oppose to lameness.

Right, let's go have a look at him. What's his name?

-Chiggy Garatt-Adams.

-Chikky, Chiggy.

-OK. And we're in five?

-Yes.

Hi, how are you?

Amy's consultation wasn't thorough enough, and Jill suspects

there's something more to Chiggy's case than simple arthritis.

OK. This will sound a bit weird

-but his reflexes are a bit too good.

-Oh, really?

They're very brisk.

What happens is when you do the patellar reflex,

it's an arc and it should go 'dum', like that.

If there's a bit of damage in the spinal cord above a certain point,

some dampening messages don't come down and it goes like that.

Amy jumped to conclusions and failed to spot

that Chiggy has a spinal nerve problem.

She forgot to ask some things that might have helped in the assessment

of it and one of them in particular was,

"Was it getting worse over the four weeks?"

She was so convinced that it was going to be arthritis

and that's the most common presenting or most common cause

for a dog presenting with abnormal gait, and therefore didn't do

some core tests about just checking what the nerve function was like.

I was grilling her

but hopefully it will have an impact, and a lasting impact.

-What's his name?

-Chiggy.

-Hey, Chiggy.

-14-year-old.

-Hey, darling.

Chiggy will be given anti inflammatory medication

and will be back in two weeks for a check up on his spinal condition.

I like to get things right.

Yeah, I've only done one or two consults before but basically

I need to do my job properly and if am not doing my job properly, then

I need to do better cos I don't like making mistakes like that.

It's not great.

-Yeah.

-Cool.

-All right, darling.

When you get the negative feedback,

you're just like, "I honestly, honestly tried my best

"and I couldn't have done anything more," that's quite demoralising.

That's the worse part of it.

Rotations can be tough, so when she can, Amy heads home to Yorkshire.

We're really fortunate to live right on the edge of the Moors, like,

literally open our back gate and we are on the Moors.

So you can just go and chill out.

I think I was about 12 or 13 thirteen at the time,

and my brother came into the kitchen one day and basically said,

"You need to call a vet for our horse cos it's cut its leg."

It was a lovely vet called Jamie that came out.

And basically he let me squirt this wound gel into it

to help clean it and I just got really excited about doing that

and he was he was just so lovely that I think he is actually

quite part of a big part as to why I'm a vet.

Amy followed her heart, and not necessarily

what she was intellectually best at,

and she worked so hard

and now she has actually achieved what she wanted to in her heart.

Yeah, it's...

Makes me really happy, actually.

Cos sometimes people take the easy option and sometimes it takes

a lot of bravery to follow the heart and that what Amy's done,

so that's why I'm really, really proud of her. Really proud of her.

I think the people side of it is another really big reason

why I went into it because I really like chatting to people and you are

going to see loads of people everyday coming through your door.

-You get to play with their pets.

-This is it!

There's always the bonus of the animal right there.

It's Judy's second day in neurology.

Oh, busy!

Yesterday, Holly the Border collie was rushed in with a broken back.

The owners have decided that they want to do surgery,

which is good, and we are going to go in and stabilise her spine,

so put some pins and cement.

Those are the words I have heard.

Holly can't move her hind legs.

If the surgery fails, she'll have to be put to sleep.

If you guys at the same time keep her spine straight,

I'll have my hands round here.

In charge of this delicate surgery are senior neurologist Patrick Kenny

and resident Joe Fenn.

We are going to be putting metal pins into the into the bone

and Patrick is just trying to work out on the CT scan

the angle and the length of the pins we want to use.

Although it's life and death for Holly, for student vet Judy,

this is an exciting chance to see complex spinal surgery.

I need to get a stool cos these guys are quite tall

and the operating table will come to about there on me.

So, I am going to have to find a stool about yay big.

I don't know what half the instruments are called and I am

pretty sure they are going to ask me to pass them instruments

and they are going to ask for a... SHE SPEAKS GIBBERISH

and I'll say, "Which one is that?"

Because Neuro has got its whole load of instruments that I don't know.

-Do you want to put your mask on? Scrub up?

-Yeah, yeah.

A spinal surgery is amazing.

I literally, the first time I saw a dog's spinal cord,

I was just, well, you couldn't see because I had a mask on

but the grin was from ear to ear. I think it was quite embarrassing

for me, actually, because I actually might have pointed and went,

"Oh, my God, there is the spinal cord." And the surgeons just went,

"Yes, Judy."

'The surgeons that worked on her, fantastic. Absolutely fantastic.

'And I guess I suppose the novelty has worn off for them a little bit

'but for me, it was brilliant and just to see what they do is amazing.'

But to scrub in as well - fantastic. Fantastic.

It's coming along nicely. It's not warm yet.

During the surgery, Judy is given one important job.

'She had pins and cement'

placed in her spine to stabilise it

and it's very important that the surgeons know when this cement

they are playing with is going to set. You know it's going to set

because it starts to go cold.

And so the very important job that the student is given is to play with

the piece of this cement and tell the surgeon when it's going to go cold

cos then they know this is going to set

and we've got no more time. We need to do it now.

-How is it, warm?

-Yeah. It's slightly warm. Not hot.

It's a three and a half hour operation to repair Holly's

damaged spine, and there are no guarantees she will walk again.

They are going to take her up to CT to get scan to see.

Make sure the pins are in a sufficiently good place.

The procedure will only be considered successful

if the pins in Holly's back are correctly positioned.

Cool. That's all right. That's good.

The pins may be in the right place

but Holly's recovery is just beginning.

It will be days before they know if she will ever walk again.

I've got no cases at the moment

so I am basically dog holder

and odd jobs man, I guess.

For the next two weeks Dru Shearn, a student from Somerset,

is on a placement in the Queen Mother Hospital's

anaesthesia department.

You can't practice. Even if it's general practice, from the first day

without knowing basic anaesthesia,

so there is a real pressure to know your stuff

and really learn from the rotation and take away as much as you can.

No, no, no.

Anaesthesia involves calculating precise drug doses

and following strict protocols.

Any mistakes on Dru's part could mean the difference

between life and death for his patients.

I think I'm sat on a wet patch but that's fine.

This is Jess,

who is a 25-week-old golden retriever puppy.

And she's got something called an extrahepatic shunt,

which means that the blood vessel is basically bypassed,

there's a blood vessel bypassed in her liver.

So, she's little bit thin for her age

and she's kind of not using her nutrients how she should and there's

lots of other problems that can come with it. She's been quite sick.

She's going to have surgery today to I think ligate that vessel

and tie it off so that everything then runs through the liver

as it should. I'll be giving her all her medication to make her

anaesthetised, putting the tubes in and the catheters

and things like that and getting her prepped for surgery.

But I'm a little a bit in love with her so I hope that she actually

pulls through. She is really sweet.

She has amazing ears as well.

She has fluffiest little ears.

Although Jess appears healthy,

without this operation she won't survive into adulthood.

-WOMAN:

-Hi, Puppy!

Jess was a really cute little puppy and I think

they're the one that always gets you because as small and fluffy

as a puppy is, they kind of have a little bit more innocence than

an older dogs so when something does go wrong, then you feel for them

a little bit more cos they really can't understand what is going on.

They've been, like, taken from home, they are stuck in a kennel

and no-one is there to love them.

So, yeah, I think puppies is the...

Puppies get me quite a lot, actually.

Dru's given responsibility for administering Jess' anaesthetic.

Throughout the procedure he'll be under the watchful eye

of anaesthetist Cristina De Miguel.

There is always quite a lot going on for the first 20, 25 minutes.

Just getting everything together and it's stable, so once it

goes in theatre, hopefully everything will be a bit smoother.

She is quite deep, I think.

-Yep!

-OK.

It's time we start checking on the monitoring stuff?

We're going to turn off the isoflorine, flush the bag through

and then disconnect and turn the oxygen off afterwards.

The surgery to repair Jess' liver defect could take hours,

and Dru's job is to monitor her vital signs using a capnograph.

Probably monitor to see what changes. She's only been moved to see

if she stabilises in the next couple of minutes.

Just starring at a capnograph is boring. Really, really boring.

And anyone that tells you it's not boring is wrong because if nothing's

happened for five hours, and you are just staring at a screen with

a little squiggly line that's going up and down

and there's a beeping as well...

I had a dream about this machine last night with the beeping.

I don't know how you do it.

Maybe you just start to ignore it after a while, I think.

Beep! Beep! And then every so often it will go, "Boo, boo, beep."

BEEPING

There's a lot of other beeps as well but we've turned those off.

It might be boring but just one hour into the operation

Cristina spots a problem that Dru has missed.

Unchecked, Jess' falling blood pressure

could lead to cardiac arrest.

How happy would I be to give fluids?

Not particularly happy about giving fluids but it has to be done

because the blood pressure is more important, probably.

Maybe four to five mls a kg per hour?

Her blood pressure was a little bit low.

So we just put her on different type of fluids to try

and bring her blood pressure up a little a bit.

Jess is now stable

and after three hours the operation on her liver was a success.

Dru's final task is to hand her over to the recovery team.

This is Jess who is a 25-week-old female golden retriever.

She had a GA and venogram and...

Sorry, because she had an extrahepatic portosystemic shunt.

She also got sub-aeortic stenosis.

-Have you done a recent temperature on her?

-Yeah.

-Well, the last one we did was at 25 past, which was 37.7.

-OK.

Good. Nice. Nice and toasty.

It's quite different to all the other rotations, actually.

I feel like it's a steeper learning curve.

I think you need to know a lot more and from so far what I have done,

a lot more information, and you need a lot of theory

but also need to be practically on the ball as well.

But it's all really important stuff, so I'm actually enjoying it.

I didn't think I'd enjoy it this much but it's really good.

DOG BARKS

At the Beaumont General Vet Practice,

Amy's halfway through her placement.

Coco Chanel? Hello, poppet.

After a shaky start she's growing in confidence

around animals and their owners.

..apart from she's a little parched. She thinks she is a Rottweiler.

I've never really done the whole having a hamster when

I was younger, so my smallest pet that was actually mine was a pony.

So I have very, very, very little small animal handling experience,

so normally whenever I go for anything that's even slightly

strange, I'm like, "Please explain how to hold it."

Because I'm terrified of breaking them.

Right, sorted. stand up. Come on, poppet!

-Just have a feel of your belly.

-Stand.

A bit tense still, aren't you, mate? You're not getting used to that.

Never does like it. You know he's good but he does sort of tense.

Yeah, I don't blame him.

I wouldn't be too keen on someone prodding my belly!

'Before I went to Beaumont,

'I was kind of thinking, "Why the heck am I here?"'

I don't get to really get hands on,

all I'm doing is watching people do things.

It's like, "What's the point of me being here?"

'But when you actually get to meet the owners yourselves,

'you'd get a rapport with them. You just get talking to them.'

Their animals are doing well. They're all happy. Everyone is happy.

Job's a good'un!

But Amy's next patient, who's in for a follow up appointment,

is no ordinary pet.

I've had him for 47 years since I was seven.

It was a surprise when I got the tortoise - I wanted a dog.

He was upstairs and one of the cats knocked him down so he fell down

from upstairs to down and I thought it was just his shell,

but his leg was swollen.

And we went and got them X-rayed and they found it was broken.

But I love him a lot.

Everyone knows him.

He's using the Facebook.

Heat and UV light, anything else?

Today, Amy is being supervised by teaching vet Nadene Stapleton.

I'm basically, I'm the sucker that does all the exotics,

so I have a real interest in exotics species,

and it means the poor students that get posted with me for the day,

they get a little bit nervous when they look into my consult lists

on the computer to see what exactly it is I have in store for them.

It could be anything, really.

It's 50 years old! It's like,

I shouldn't be dealing with pets that are older than me. That's just weird.

I'm Amy. I'm one of the vet students.

I'll just be getting a quick history off you

and then Nadine will come out and see you as well. OK?

So, do you know what exactly he's been eating at the moment, then?

He eats half - you know the big tomatoes?

-The big beef tomatoes?

-Yeah, half of one of them with medicine on top.

Half a lettuce...

Sorry, I've not really done much tortoise handling before

so I'm quite careful about it.

Right, I will be back with you shortly.

-INTERVIEWER:

-So how was that?

Well, I felt so scared to touch it.

But nice.

They're quite pretty animals, really.

Dealing with a tortoise like Sammy is a totally new experience for Amy,

but Nadene has been treating his broken leg for almost two months.

Alrighty, so what we are going today, we are around just over

the seven week mark, so we'll take the dressing off

and we'll have a bit of a feel of the leg and we will reapply

the dressing and we will book you in for a check up appointment with me

-in a couple of weeks.

-Sure.

Let's um, pop out and I'll take the dressing off and I'll bring him

out to you in just a minute.

Sammy isn't eating well so before they re-dress his broken leg,

Nadene wants to make sure he's hydrated and carry out some tests.

OK, so what we are going to do is just give him a little bath

while we have the opportunity. I do like owners of tortoises

to bath them to we make sure they are getting enough fluid in.

They actually absorb fluids directly from the cloacae

into their bladder as a reservoir, and you can plunk him straight in

and now you get to watch him have a bath.

Cool.

That is pretty snazzy.

Nadene just wanted us to have a quick look at his poo.

Cos he had a poo on the...

He had a poo in here and I've never seen tortoise poo before,

so it'd be quite interesting to see what it's actually like,

and I think she wanted us to have a quick look as well

for parasites as well so I think we'll need to pt it on a slide.

One thing with been a vet,

you never know what you're going to get the next day.

Sammy is clear of parasites

so Nadene uses an old trick

to get him mobile again.

When we first out him down, he was going in circles

but he seems to have been able to navigate pretty well

with that wheel in place so I think he gets around just fine

and this is about as fast they go, really.

-Even without the wheel?

-Yeah.

Beaumont was absolutely brilliant. Absolutely loved it.

Definitely one of my best rotations.

Absolutely. I really, really enjoyed those two weeks.

So, that's definitely why I applied to be a vet.

You've kind of got to learn to adapt your knowledge to different species.

Yeah, you try to adapt what you already know to whatever has

just walked through the door really.

Definitely a challenge. Slithered through the door.

No, not slithered. Out of the back door.

-What about, like, a tarantula?

-Ew!

-Don't mind tarantulas.

I don't mind with them, either.

-I wouldn't know what I was doing with one.

-Yeah.

-All I know is don't drop it. Just don't drop it.

-Why?

At the Queen Mother Hospital, Holly, the Border collie, is in recovery.

Yeah, she's doing really well, actually.

She's got her appetite back, which is good. That came back yesterday,

and apart from her not liking having her catheter changed,

she is doing really well. So, yeah, she's brilliant.

She seems to be quite bright today.

So we'll get some breakfast down her and see how we go.

More gravy bones.

This is my life now. Muzzles and chum.

It's been a week since the operation to fix Holly's spine

and her progress during the next few days is crucial.

We are just doing the normal light physio massage

and a bit of range of motion movement on her back limbs.

And today, after this, this is kind of warming her up as well,

so we're going to get her to stand up gently on her back legs.

See if she can put her feet flat

and maybe bare a little bit of her own weight.

Good girl.

So it's just...

It's a small step but it's a step in the right direction.

All right. All right. Sh, sh, sh.

HOLLY WHIMPERS

HOLLY CRIES

Good girl, good girl.

Put your foot down, it's all right.

-All right.

-Put your feet down, Holly. Good girl. Good girl.

Remember that? It's called standing.

Come on, Holly. Good girl.

I think she just panics more than...

It's not pain, it's panic. She's like "Oh, my God, I can't stand up!"

She's been laying down for, what, a week?

Oh, what a palaver. Yeah, I should think so.

Now in the second week of her busy neurology rotation,

Judy is starting to realise what becoming a vet really means.

-INTERVIEWER:

-How're you feeling?

-Tired. Really tired.

I was on call last night but I didn't get called in, which is good.

But even when I'm on call, I just wake up randomly going,

"Oh, did I miss a phone call?"

Its just...I hate being on call.

I don't think I'll ever get used to it but it's part of the job,

so suck it up, basically.

I am bloody knackered.

You kill my legs, Holly.

You are killing my legs! Aren't you?

Oh, Holly.

Oh, that's better!

The next day Holly's legs still can't bear weight, but her owners

have arrived and they're hoping to see her up and about.

Up we go.

Good girl, there you go.

Good girl. Come on.

Holly, this way. Come on.

I'm very hopeful of her getting back to been able to walk

and if that happens, that will be absolutely fantastic.

She is 11-years-old, I don't expect her to keep going running round now.

So, if she can get back to walking, that would be absolutely fantastic.

Good girl.

There's a big, big prize behind this door. Well done.

Well done. Come on.

Good girl!

EXCITED CHATTER

Oh, good girl. We'll pop on over to that grass there.

Oh, good girl!

Holly will stay in hospital to receive intensive physio

over the coming weeks.

But for Judy, her time in neurology is almost over.

Mind the step. Down the step. Good girl.

I've really bonded with my patients, actually, and it's quite important

in neurology to get a good relationship and bond because

then the patients trust you and they are willing to do more

and it really helps their physio.

So, it's going to be hard to say goodbye to Holly but, you know,

I'll come back in couple of weeks and hopefully she will be much improved

and hopefully on the road to recovery and going home, which will be

best thing all around, really. So, yeah.

I'm not going to cry.

I promised myself I won't cry so I'm not going to cry.

So, bye-bye, Holly. I'll see you in a few weeks.

SHE PRETENDS TO SOB

Not going to cry, not going to cry. NO, not going to cry.

My first consult had a Japanese Akita

that I went to strip and he's like, "Rarr!"

It was really fine at the start and then I was like,

-"Oh, this is great(!)"

-"Cute dog(!)"

-Yeah!

DOG BARKS

There's never any appreciation, is there? You fix them and they

still hate you. They hate you when they come in, they hate you when

you do stuff to them and they hate you they go home.

After a week back home in Norfolk, Charlie passed his rotation

on the farm and today follows Dru

to the hospital's anaesthesia department.

Feeling OK. I've had a long time to prepare for it, which is sometimes

worse because the clinicians know you've had a long time to prepare

and they can ask you more questions

and you simply can't learn everything that you need to.

And it's slightly more difficult one but I think, yeah...

We'll see how it goes.

I was really nervous going into anaesthesia because it's the rotation

that everyone talks about that is the hardest.

Charlie's got two pets on his case list so he's visiting the dog ward

to have a look at them before he prepares their medication.

My patient is London, which is a 9-week-old boxer puppy.

And it was kicked by a horse, I think two days ago,

and it's broken its radius.

It's not completely simple, it's not a healthy adult

but I think with the protocols we've got in place, it should be OK.

Charlie's other patient is an altogether different story -

a Rottweiler called Bella.

Bella was an incredibly aggressive Rottweiler

or rather she was a misunderstood Rottweiler.

I'm going to be anaesthetising for a cruciate repair and I think

the last time she came here -

BELLA BARKS

OK. We might just back out into the hall and just calm her down.

Cos I think at the moment we're trying to get her settled.

-INTERVIEWER:

-Is this called running away, Charlie?

-A little bit, yeah.

It's running away when it's... when it's allowed.

The owners made it clear to us that we could muzzle her because

they didn't want us to get bitten and the repercussion of that

just don't bear thinking about.

Luckily for Charlie,

London the puppy is first in line for treatment.

Getting the drug doses right is a matter of life and death here.

-All the way?

-No, that's fine. Just like that.

Fortunately, Charlie's being supervised by the anaesthesia team

with help from nurse Claire Seddon.

We've got a cute one and a proper audience.

Delighted. She's adorable.

We'll just give her a minute to see what she does.

She's sticking her tongue out. That's a good sign.

-She might still be a bit...

-Yeah.

-Let's grab our Propofol.

-Extra Propofol? Yep.

Even though London weighs just three kilos, she needs a bigger dose.

Well, she's just moving, basically,

so she's a little bit more awake than we want.

Just remember, from here to here is point three of a mil

and that's obviously one milligram.

Are you happy with that?

Yep.

-OK, happy.

-Very.

-Right, so I think we'll move through to X-ray.

Once she's fully under, she is ready for an X-ray.

Fortunately it's good news for little London,

according to orthopaedic surgeon Richard Meeson.

There's two bones in the forearm.

Another break in the radius. There's also a break in the ulna bone

but it's not actually moved around very much and little dogs

have quite thick capsules round the bones and that's quite keeping

this quite stable, so although there's a break on both,

we can get away with just putting a support dressing on this dog,

rather than having to take it to theatre and operating on it.

Two to three weeks probably this will be healed.

I'm so sorry. You have a big foot.

Aw, I'm sorry, mate, you're really cold.

As the anaesthetist, Charlie can hand London over

to the recovery team once she's awake and stable.

We'll wrap you all up in a minute. There you go, darling.

Easy, tiger.

Now it's Bella the Rottweiler's turn.

I was just wondering when you wanted to do Bella?

-Great. We can get going now.

-Start pre-med now?

-Yes, please.

-OK. Cool.

I don't mind the size. It's more of the temperament.

If it was a friendly Rottweiler, then it'd be fine.

Less friendly? Hmm, we'll see.

Charlie needs to administer a pre-med to calm Bella down.

Good dog.

Good girl. Good girl.

BELLA GROWLS

Where's the line coming out? Awesome.

-NURSE:

-Good girl!

Thanks, guys.

That was actually absolutely fine.

As you can see, the importance of having great nursing staff.

BARKING

Now the plan is to hopefully leave her in peace so the anaesthetic

can sort of take effect and hopefully she'll calm down.

That should take about five, ten minutes to work.

Five minutes later...

..the sedatives have taken effect.

And walking Bella to the OR might take a little longer than planned.

Bella. Come on. Good dog.

Good dog. Come on. Good dog.

We may need a trolley.

All that's left for Charlie to do is intubate her and monitor

her vital signs throughout the procedure.

Take the tongue out with your non dominant hand.

Look, he's looking at me.

-Push the back of the tongue here, can you see where?

-OK.

'This is one of the harder rotations and there's quite a lot of stress

'involved in it because while they are supervising you,

'they also put a lot of responsibility on you.'

So, I think it is quite stressful that you need to know so much

and they do ask you questions throughout while you're still

monitoring the patient, having to do two things at once,

which I'm not particularity good at,

but I'm really enjoying it as a rotation, yeah.

It's now three weeks since Judy left the neurology department

where she cared non-stop for Border collie Holly.

Holly was discharged last week, but has returned for a check up,

and Judy has made a special effort to pay her a visit.

Aw, she's like, "I think I remember you.

"I think you gave me some food." How are you doing, Holly?

Judy was fantastic on Neurology.

How are you doing?

You are such a good girl, aren't you?

'people focus a lot on knowledge but there's a lot of other things.

'The owner communication, the communication to the pet,

'to the dog or cat, communication to people in the hospital,

'and Judy does it very, very well.'

Look at it, it's amazing.

You're such a good girl!

'To see a dog come back and walk back through those doors herself,

'mostly unaided, was fantastic and it makes all the hard work

'that everybody puts in, worth it.'

Absolutely. She walked out pretty much unaided.

Came in on two legs and went out on four. Fantastic.

OK. It was good to see you again and you take care.

And you, Mrs, don't jump off any more bloody cliffs.

Sheez! Right, I must go. Enjoy your session, yeah? Take care.

With so much of their final year and exams ahead of them,

the students' work load won't ease up any time soon.

'It will be worth it.'

All the days of lying in kennels and clearing up mess for five years

will definitely be worth it to see dogs like Holly walk out of hospital

and go home and have a nice life, because we fixed them.

So it will be worth it, definitely.