Episode 3 Operation Wild

'We share our world with some amazing animals,

'and sometimes they need our help.'

When wild animals get sick, it takes radical thinking, extraordinary

medical skills and great bravery to treat them and save lives.

What are you doing?

'In this programme, I'll be finding out how vets are using

'ingenuity and dedication to save animals across the globe.'

Good girl, now let's see you swim.

'And vet Steve Leonard will be seeing how human medicine

'can be adapted to transform animals' lives.'

This is real bionic stuff, it's amazing.

'From keyhole brain surgery for a moon bear

'to extreme elephant dentistry...

'This is big animal medicine as you've never seen it before.'

'I'm off the coast of Okinawa, the largest in a chain of

'tropical islands that stretches south from mainland Japan to Taiwan.

'I'm with Dr Keiichi Ueda, who today is going to try out

'an extraordinary invention that's been over a decade in the making.

'It could transform the life of Fuji, a dolphin with no tail.

'Keiichi is a vet here at the Churaumi Aquarium.'

So, this is breakfast?

This is breakfast, yes.

Hello. Hi, darling.

Good girl.

FUJI CLICKS

And you sound like you're laughing. Are you laughing, Fuji?

Yeah.

'Fuji's tail was destroyed by a bacterial infection

'that almost killed her.'

Oh, I see.

-75% of it's gone?

-Yeah.

So she can't balance, and you can see it compared to the other dolphins,

she can't stand up like they do, cos she hasn't got the balancing power.

She can't jump, uh-huh.

'Fuji is missing the end of her tail, which should split into two flukes.

'These propel dolphins through the water...

'..and help them leap into the air.

'They even use their flukes to communicate with each other.

'Losing her tail radically changed Fuji's life.

'The mother of three could barely swim,

'and stopped socialising with the other dolphins.

'For the last 12 years, Keiichi has been trying to find a solution.

'He's been developing prosthetic tails for Fuji,

'and today he's going to try out the latest one.'

This one is the first type.

This is the original.

The last type.

When you first came up with the idea, what did everybody say?

Trial and error, uh-huh - and this is the most recent?

Yes.

And is this actually cast on her tail, so it's made...

-Yes.

-Precision fitting, as it were?

-Yes.

Have you tried this on Fuji?

No, it's the first time.

And do you think she'll be able to swim fast?

I hope.

And will she be able to jump?

-Er, maybe.

-OK.

I hope.

'If this tail works, it could transform Fuji's life.

'The flukes have been modelled on those of one of Fuji's daughters.

'The inside of the prosthetic fits snugly around Fuji's tail stump,

'and is held in place by a brace.

'It needs to be just as strong as the real thing.'

So we'll find out first of all

whether she can swim properly with this, and also whether

she can jump out of the water, cos that will be a really good sign.

Go, Fuji, go.

'The tail seems to fit perfectly...

'..but Fuji isn't swimming any better than before.'

She is nervous.

Come on, Fuji.

Let's see you swim.

Good girl, away you go.

'Keiichi can only hope that Fuji just needs some time to get used

'to her new prosthetic,

'and remember what she's capable of with a fully functioning tail.'

Good girl.

She's warming up.

She's warming up, is she?

-I think she likes it.

-Yes.

She seems really proud of it,

so she's waving it around and she's swimming really strongly.

Good girl, good girl!

Good girl.

Look at her, she's going straight off on her back

and flapping her tail - she's excited, isn't she?

'But the ultimate test is if Fuji can jump out of the water.'

She make a jump.

She's going to try now?

Come on, Fuji.

Ah! Ha-ha!

'At her first attempt, she manages a three-metre jump,

'propelling her whole body out of the water.'

Build up the power.

She's going so much faster with the tail. Oh, yeah!

'Keiichi's determination has paid off.

'Her tail has given Fuji back her strength and speed.

'It means she can leap and play with the other dolphins again.

'It's given her a new lease of life.'

Yeah!

'There's always a chance that innovative techniques won't work...

'..but the risks are even greater

'when you're trying something new out in the jungle.

'I'm in Laos, where vets are going to attempt

'ground-breaking brain surgery.

'These rainforests are home to a species of bear

'that's only found here in Asia.'

These are Asiatic black bears, or they're also called moon bears,

cos they've got this moon shape across their chest.

Unfortunately they're threatened, because their bile is used

in traditional Chinese and Korean medicine.

'The Tat Kuang Si Bear Rescue Centre..'

Hey, Didi, there you go.

'..is run by animal lover Mike Brocklehurst.'

Come on, Mi-Mi.

'Mike and his team currently look after 24 moon bears.

'Four years ago, Mike took in a three-month-old cub called Champa

'who'd been found in a nearby village.'

When she came, she was in a, you know, a very bad way.

She weighed 1.7 kilo, she was all legs and belly.

She was obviously suffering with malnutrition,

she had a big domed head with a pointy noise,

her eyes were bulging out, all her teeth were going brown.

I didn't think she'd survive,

so I used to take her home every day, bring her with me

to the sanctuary, feed her throughout the day and night.

So you were her surrogate dad at the time.

At the time, surrogate mum and dad.

Come on, Champs, come on, Champs.

'Champa never fully recovered.'

Come on, Champs.

At what point did you realise that,

you know, there was something wrong there?

Well, within a month or so she actually stabilised her condition,

and I thought, well, she's going to be a good, healthy little bear,

but I started realising that she wasn't developing

as well as the other bears and she was perhaps losing her sight.

Yeah, and over the last six months she's started to decline.

Yeah, she has - she weighs probably about 20% less

than the other bears of her age.

Some days she'll just want to stay in the hammock all day,

she won't come outside. She doesn't do a lot.

'The sanctuary's medical team think Champa was born with hydrocephalus,

'which means excess fluid builds up in her brain.

'The condition, which can also affect people,

'means her brain hasn't properly developed.

'She has poor vision, and they think the pressure in her head

'could be giving her excruciating headaches.'

It's so hard just to watch her move.

I get migraines, so I know what brain pain feels like,

and she just looks like I feel when I've got a really bad head.

This swinging motion, this dropping of her nose, and really slow,

exaggerated movements, and then the loss of her sight

and having to feel her way around.

She's obviously a really sick bear.

'The Buddhist tradition here in Laos and complex laws surrounding

'endangered animals means putting Champa to sleep isn't an option.'

Good girl.

'Mike is determined that, even if she won't ever have the same life

'as the other bears, she should at least live without pain.'

Good girl, good girl, eh?

-Do you want to give me a hand with this?

-No worries.

'He's called in vet Romain Pizzi.'

Right, can you just grab that?

'Based at Edinburgh Zoo,

'Romain is a pioneer of keyhole surgery for animals...

'..and he thinks he'll be able to relieve

'the pressure on Champa's brain.'

You've brought enough gear with you.

-Well, we are doing brain surgery.

-That is true.

'Romain is going to try to implant a tube into Champa's brain,

'which will drain out the excess fluid as it builds up.'

So, it's a matter of placing the tube into the brain,

then running it into the abdomen, so you can allow that fluid to run.

To drain, yes. There's a little valve that,

when the pressure gets above a normal pressure,

then the fluid flows through that, so we've got

to bury this little tube underneath the skin so she can't chew it out

and then put it in the abdomen where this extra fluid can be absorbed.

'It's a risky operation that was originally devised for people.

'It's the first time anyone's attempted it on a bear.'

Come on.

'But Mike is hoping that, from tomorrow,

'Champa could have a pain-free life.'

What's here, what's here? Come on, it's good stuff.

'Some animals are so well-adapted for the environment they live in,

'there's no way vets can borrow human medical techniques

'to look after them.

'Elephants' tusks are elongated front teeth...

'..used for fighting...

'..digging and moving trees.

'Treating them takes expertise and highly specialised equipment.'

This is a domestic saw.

You have to realise that you don't go and buy

equipment for elephant dentistry,

there is just nothing available, so we have to cope with

what we've got, and all of the other instruments here were purpose made.

My friend is a mechanical engineer and this is their handiwork.

'Big-animal dentist Gerhard Steenkamp and vet Adrian Tordiff

'have been flown in from South Africa to try

'and remove the tusk of a five-tonne elephant.'

I'm going to need most of that.

'Ninio is a 13-year-old African elephant

'who lives at Poznan Zoo in Poland.

'He's cracked his left tusk, and it's become badly infected.

'The team here has tried to treat Ninio...

'..but the infection won't go away,

'and they're worried it could be spreading into his head.'

Ninio is experiencing pain and major infection in the tusk

and he has this big hole in the tusk and it is really

unpleasant for him, so we must help him and we will do this.

'The vets think the only way to get the infection under control

'is to completely remove Ninio's tusk.

'Before they can operate, Adrian has to anaesthetise him.'

This stuff is incredibly potent,

so one drop will probably pretty much knock down

everyone in this room, you know, and stop them breathing.

Ready to go.

'Adrian doesn't want Ninio to get stressed at the sight

'of the gun, as that would cause him to release adrenaline

'and make it harder for him to go to sleep.

'If Ninio lies down in the wrong position or for too long,

'he could crush his internal organs under his own weight,

'so they're up against the clock.

'Once Ninio is settled,

'Gerhard quickly removes the outer part of the infected tusk.'

Endoscope.

'Now, using a specially-designed endoscope,

'he's able to see what's causing Ninio so much trouble.'

So, that is the pulp, still a little bit alive, so inflamed and infected.

'To clear the infection, Gerhard needs to remove the entire

'root of the tusk...

'..which goes half a metre into Ninio's skull.

'He discovers the infection is so severe,

'it's made the tusk grow in a completely abnormal way.'

The ivory has closed off, there's a wall right here

and I cannot get beyond it.

Give him another two milligrams, OK?

'Ninio's already been asleep for longer than they'd hoped.

'They can't afford to give him any more anaesthetic.

'All Gerhard manages to do is break a small hole

'into the wall of ivory, which he hopes will relieve some pressure

'from the infection.'

So it's not coming out today?

Not today.

So I think we need to wake him up.

It is the first tooth in my life that I cannot get out,

so that is really disappointing.

The operation will allow the infection to drain,

and so Ninio should start feeling better.

I'm just relieved that he's standing and looking OK.

But Gerhard and his team will have to find a way to get that tusk out.

If the infection takes hold again, Ninio might not survive.

The hardest part of helping an animal can be making a diagnosis.

You guys want to jump up there and pull her in?

In Chicago, vets need to find out what's wrong with Tiara.

She's an Amur tiger, one of just 500 left in the world.

Tiara's had a nose bleed and the team here at Brookfield Zoo

are worried that it's a sign of something more serious.

One of the bigger concerns is that we potentially could have a tumour

or a mass or something else in there that's causing the bleeding.

So the main thing we're all going to be very careful about

is not getting our hands in her mouth at all.

It's been impossible for head vet Mike Adkesson to do a check-up with Tiara awake.

There, under her chin.

She's a little on the thin side which is not a bad thing.

We like to see our animals a little bit on the lean side

so that we don't run into issues with them becoming overweight.

He's going to examine her with a CT scanner,

just like you'd find in a hospital.

-Got it. Do you want it back?

-OK. Let's go forward.

This machine's been adapted for animals,

although not all of them are as big as Tiara.

If I could try and wedge her mouth a little bit, to get her jaws open.

The scanner will create a 3D image of inside Tiara's head.

Slide that forward.

So it's basically a giant X-ray machine

that takes sort of cross-sectional images,

so if you think of a loaf of bread being sliced into a bunch of slices,

that's basically the set of images we get out.

Are we set with the anaesthesia?

We're scanning basically from the tip of her nose

all the way to the back of the skull, er, which is going to

give us a look inside the nasal passages, the sinuses.

We're looking for any irregularity or asymmetry between the two sides.

With virtually none of the risks of surgery,

this is the safest way to examine Tiara.

As she begins to come round, timing is everything.

It's too dangerous to be in the same room as her awake,

but they must wait for signs that she's breathing properly on her own.

As she starts coming up, the first thing she'll start doing

is sort of biting this airway tube a little bit

and then in the process of coughing it out,

we'll know she's getting ready to wake up.

It will take Mike and the team the rest of the day to examine

the results of the scan and find out what's behind Tiara's nose bleed.

At the Moon Bear Sanctuary in Laos,

Champa is about to have ground-breaking surgery

to try and relieve the pressure on her brain, caused by hydrocephalus.

Come on.

Mike, who rescued Champa as a tiny cub,

is hoping it's going to be a whole new start for her.

I don't think I slept at all last night.

I went to bed early, hoping to be rested this morning,

but, yeah, I just, er, kept thinking all night, what, you know,

what does the day hold for us today?

Vet Jonathan Cracknell needs to anaesthetise Champa.

That's great. Very wobbly.

But before they even get her to surgery,

Jonathan realises something is not right.

Can you get me the ambu bag and the tubes...

cos you're not breathing.

-She's stopped breathing?

-Yeah.

Jonathan has just moments to clear her airway.

You in? Her colour's gone very bad.

She's breathing now.

-Yeah.

-Yeah, there you go.

That was a bit tense.

That was a bit tense. She went down quicker than we expected.

Only once they're happy Champa's breathing properly

can the team take her to the sanctuary's on-site clinic.

It's a bit of a steep climb,

but thankfully she's stayed nice and stable.

Romain is going to try and implant a tube

that will run from Champa's brain down to her abdomen.

It will drain away excess fluid as it builds up in her brain.

I'm cutting.

Romain has to drill a tiny hole into Champa's skull.

Let's try and see which...

It's got to be really millimetre by millimetre

and just very, very gently make their way through the skull.

This is the really critical bit because one slip,

one tiny probe too far, and we could do some real damage.

If the drill even touches Champa's brain, she could die on the table.

This bit I'm not going to watch. They're the experts.

I'm going to leave... I really don't want to see the next bit.

Romain is about to implant one end of the tube

into a cavity in her brain where the fluid builds up.

Yeah, definitely in.

He feeds the other end of the tube down towards her abdomen.

He's going to insert an endoscopic camera to find it

and bring it down into position.

To see his way round with the camera,

Romain needs to inflate Champa's abdomen.

Would you switch on the insufflation?

But something's not right.

-I think it's shortening out.

-I think it is, yeah.

-I think it's just the power supply.

There's not enough electricity to power the vital equipment.

The other thing you can do

is see if you can plug it directly into something, Nick.

If they can't get the machine working,

Romain has no chance of finding the end of the tube.

Oh...just keep...any luck?

No, it's still not, um...

He's going to have to improvise.

Get the mattress pump, remember that one.

What we'll do is, er, use this - which is a mattress inflator pump.

It's like for air beds, basically.

It's not ideal but needs must

and, er, when you're in the middle of nowhere,

sometimes you just have to adapt.

OK, can you just all keep quiet for a second?

-Are you happy on the generator?

-Yeah.

-You're happy.

-She's got enough oxygen and she's breathing on 100% 02.

If you put on the light for the room, please.

-Do you want to put the mattress pump on for a short burst?

-Yeah.

Cuff her up again.

His plan works.

There comes the tube, see, there's our stent coming out there.

With her abdomen inflated, Romain can see what he's doing.

That's the other end of the tube

so that's where the fluid will now drain to.

It will disappear in between the liver and the diaphragm

and just be absorbed there.

It's quite a long way to go, from the brain to the belly.

He guides the tube into position.

And a last quick look and reposition.

It will stay inside Champa for the rest of her life.

We'll do the external bits quickly.

Almost done. Almost done. Almost done.

Against all the odds, the surgery's complete.

One of the things that we like to do is let them

come round at their own pace, so we're not going to push her.

She's had a six-hour anaesthetic

and we just want her to come around at her own steady rate.

Hello. All right, darling?

OK, you're pretty good, aren't you?

The next morning, Champa's back on her feet.

But it will be a few weeks before Mike and the team know

if the operation's been a success and Champa's no longer in pain.

Good girl.

Good girl.

Good girl.

It's been five months since Ninio had his last dental operation.

Vets Adrian Tordiff and Gerhard Steenkamp have come back to Poland

to try and remove the infected tusk that last time defeated them.

Hello, boy. There we go.

Ninio's tusk was so deformed that Gerhard has spent the last few months

developing special tools to try and get it out.

These are the cutters that I've had made.

They made me a very nice chisel.

-Oh, yes.

-In Poland.

-To try and split the bone apart.

With Ninio asleep under a general anaesthetic,

Gerhard gets a chance to have a look at the tusk.

There's still a lot of pus coming out of it,

but it's clean in terms of no parasites,

no maggots or anything like that.

There's little bits of movement on some of these tusk pieces

which could be positive.

Gerhard hopes that if he starts by hollowing out the centre

of the tusk, he'll then be able to remove the outer pieces more easily.

But the ivory is too tough, even for the new tools.

Gerhard decides his only option is to try

and pull the tusk out with a winch.

Yes!

Relieved. Absolutely relieved!

It's feeling nice and smooth in there,

no bone fragments, which is great.

There's no more ivory left

and things are looking really good.

Now Gerhard can clean away the mass of infection

that was trapped behind the tusk.

And after three hours, the operation's over.

The next day, the vets check in on Ninio.

Actually quite remarkable, and now that his trunk is up,

I can look into his empty alveolus and there's just about nothing...

-Coming out.

-..coming out of it.

Nice and clean.

He's eating quite well and moving around well.

The infection has gone,

which means Ninio will soon be out of pain

and can rejoin the other elephants.

In Chicago, Mike has been going through the images

produced by the scan of Tiara's head...

..to see if her nose bleed was the sign of anything more serious.

We're seeing the front teeth come into view,

canine teeth coming into view here.

Now we're getting into some of the nasal passageways.

If we were to see a mass or anything in this area,

we'd lose a lot of this and we'd just have a solid structure

with none of these little fine folds of tissue in there.

It's good news for Tiara.

I think we're really good shape here.

There's really nothing that we're seeing out of the ordinary.

Though the blood we were seeing from the nose was probably

just a, you know, an incidental finding, so to say that, you know,

she had some sort of traumatic event or bumped her nose or just

had a nose bleed for kind of an unknown reason even, but it doesn't

seem to be anything concerning as a long-term problem here.

With the population of Amur tigers critically low,

it's a relief for everyone.

Tiara's been given the all-clear,

without having to undergo invasive surgery.

For big-animal vets, every patient comes with unique challenges.

Galapagos tortoises move so slowly

that their main protection against predators is their shell.

It's the perfect suit of armour,

but it makes them incredibly difficult to treat.

Hello, girls.

Ha-ha! Losing my nerve.

They must have quite sharp teeth, cos they go crunching through those.

It really is quite a powerful bite for a vegetarian.

As part of a programme to save this endangered species,

London Zoo is currently home to five Galapagos tortoises.

And there's one tortoise missing from that group

and she's called Priscilla and the reason

she's not with them is she's been very sick, so they've taken her

to the zoo hospital so that the staff can keep a close eye on her.

Priscilla is being looked after by veterinary nurse Matt Rendell.

So this is Priscilla.

Good girl.

She's so unwell, she's been unable to eat for several weeks.

How did you first know that she was... Oh, darling!

How did you first know that she wasn't well?

Well, normally, tortoises graze all the time

and it was something that she stopped doing

and it was obvious from her weight loss

and the fact she was really kind of down in the dumps

that she really wasn't well at all.

The only thing keeping her alive is a feeding tube

inserted into her neck.

They're worried that not eating is a sign that Priscilla's liver

isn't working properly.

But the problem is getting to it beneath her protective shell

to find out what's wrong.

They've called in keyhole surgery specialist

Romain Pizzi to see if he can help.

This tortoise has been ill but it's difficult to piece everything together

and know what's going on so the easiest way is to look at the organs, so...

The tortoise is in a big box - that makes getting inside very difficult.

Romain hopes that with an endoscopic camera and extra-long instruments,

he might be able to reach Priscilla's liver to take a sample.

Lift, lift, lift, perfect.

The easiest window and the safest place is in front of the back leg,

so there's a little gap there where there's some soft tissue there

that we can make a little cut and we can actually stick the telescope in.

In a person, or most animals, we'd actually puff them up

with carbon dioxide and that makes like a tent so you can see

what's going on, but the tortoise has got a rigid tent, so it's

quite difficult to navigate our way around and see what we need to see.

Romain hasn't tried this on a tortoise Priscilla's size before.

Just be very careful. You're not going to be able to do that.

But his plan to get the biopsy of her liver falls through

before he can even begin.

An ultrasound reveals her bladder is completely full,

blocking his path.

My main risk is sticking the endoscope in,

going into the body and actually puncturing the bladder.

That's what we really don't want to do.

Romain decides that the only way to get to the liver

without damaging her bladder is to tip her onto her side.

I'm hoping what we'll do is, once you tilt it, we may connect,

things will fall down and so you'll have a safe space to go in.

Get us two more chairs and tie them together.

But getting Priscilla into position isn't easy.

Right, so... so the chairs - turn her lateral

and that is, in essence, a cradle.

One, two, three.

I'll get the legs.

If they crack or damage her shell, it will take years to heal.

OK, watch that leg.

That's the best we can do.

So the team have been pretty inventive and creative.

They've put two chairs together to create a cradle,

so Priscilla can now be sideways and it means that Romain can

get in through that soft bit at the top of the leg.

She's been anaesthetised for an hour and ten minutes now, guys.

Romain makes two incisions - one for the endoscopic camera

and one for the instrument that he'll take the sample with.

He has to make his way carefully towards her liver.

That bladder is absolutely huge.

What is interesting is the length of instruments you are using.

It is what they call bariatric instruments, which is what

they use in very fat people so they are extra length

and that whole length of the instrument is disappearing

inside the tortoise and it's still not...still not getting far enough.

Priscilla's shell means there's very little room for him to manoeuvre.

If you look, it's like fighting with chopsticks inside this tortoise.

Finally, he makes it.

This is the liver - this whole structure here is liver.

We're only just seeing the edge.

The liver is not pretty.

I would say - to me, that doesn't look normal for most reptiles.

Priscilla's liver is a much lighter colour than it should be,

confirming their suspicions.

Quite a reasonable piece there. We'll take a couple from that tip.

He snips a tiny sample,

which will now be sent to the zoo's laboratory to be analysed.

You don't want that in any more, do you?

An hour later, Priscilla's awake.

Everyone's delighted and relieved that Priscilla's come through the procedure so well.

She's come round from the anaesthetic but we've got to wait for the results

from the biopsy tests and then see what happens next.

A week later, the results of the biopsy reveal that Priscilla

has a chronic liver condition called fatty liver.

It's triggered by not eating and means the liver starts

processing fat abnormally, which can be fatal.

Good girl.

In Priscilla, they caught it just in time

and through an intensive feeding programme,

Matt and the team have managed to reverse the damage.

And now Priscilla's back eating on her own.

She's interacting with us much more. She's just pleased to see us now

and comes over and enjoys a fuss

and physically she's much, much stronger now.

She can stand up now. We're really pleased with her progress.

It's been a very rewarding nursing case.

Priscilla's protective shell

made her a more challenging patient than many,

but a few weeks later,

she's well enough to be returned to her enclosure.

21st-century medicine is coming to the rescue of animals

right around the globe - even prehistoric ones.

I'm in the Everglades National Park in Florida.

Alligators and crocodiles have been living in swamps like these

for millions of years and they've changed very little since then.

It's obviously a body shape that works really well.

Although they sit here motionless most of the time,

when they get close enough to grab something,

they can move at amazing speeds.

These opportunistic predators have a fearsome reputation

for most people here in Florida.

But not Bob Freer.

He's been rescuing gators in need of help for over 20 years.

I actually got my first alligator back in 1956.

My father actually went into a gas station, came out and just threw

a little alligator hatchling in the back seat with me.

Er, and when I went to grab it, it actually grabbed me by the finger

and that kind of started the love relationship

that I have with alligators.

Bob's most recent arrival is Martha, who he found suffering

from what looks like a chronic blockage in her guts.

She really isn't right. She's sitting really strangely.

That's the first thing we noticed,

and this little tilting back and forth, you know,

like she's bobbing. She just doesn't have control.

Yeah. So she can't sink at all at the moment, then?

No. She tries to go under to get away,

she just bobs right back to the top again.

-To see an animal suffer, you know, it's a little heart-breaking.

-Hmm.

You can really see the difference between a normal gator

and Martha here - you know, with the sleek aqua-dynamic shape,

this really good swimming position, and then poor Martha

looking like some kiddie's inflatable toy. It's dreadful.

They don't know what's causing Martha's blockage.

But it's so severe, her gut could rupture at any moment.

They need to get her to a vet.

The amazing thing about gators is that although they have

one of the strongest bite pressures in the animal kingdom,

actually the muscles to open the jaw you can hold with just two fingers.

That's why the insulation tape that's going on now

is just enough to keep that jaw from opening up.

Martha is going to be examined by Doug Mader.

-Meow!

-Hello!

As well as being a small-animal vet,

he's a world renowned reptile specialist.

Hey, Bob, what have you got here?

Er, well, we've named her Martha,

and basically you can tell from its stomach there

she's not feeling very good.

She's not feeling good. She's really bloated.

All right, kiddo, you're in the right place.

So what we're going to do is try and give her a look-over.

She is packed.

Most likely she's probably swallowed something she's not supposed to.

Can you actually feel anything in there?

-You can. Want to feel it?

-Yeah, I'll have a quick feel.

-She feels like she's got a brick in there.

-Oh, my God, that is solid.

-So we'll take her in and let the nurses get the X-rays.

-OK.

The X-rays reveal just how unwell Martha is.

-Her head is up here.

-Yeah.

-OK. This is her lungs.

This is her stomach here

and these large masses are not supposed to be there.

-She can't go on, can she?

-No.

-This is enormous.

-No, and you can see, the pelvis is here.

-Yeah.

And even the smaller masses, they'd never fit through the pelvis.

They're not coming out the normal route, no.

Martha's only hope is surgery to remove these blockages.

We're using a 21st-century technology to save an animal

that's been around since the dinosaurs.

-Are we ready?

-That's it.

-OK, here we go.

At last Doug can find out what's causing Martha's blocked gut.

-She may jump, she's not awake.

-She's not feeling it?

That's normal twitch of the abdominal muscles.

He sees immediately that things are much worse than he was expecting.

What I need to do is figure out what I'm looking at.

-So you're just trying to tease in between those areas.

-Yeah.

-Obviously you can't even see what to cut, so you're just...

-Not yet.

There's been so much trauma inside the abdomen,

so much inflammation that's caused the actual guts themselves

to start to stick and scar together

and scar to the abdominal wall

and everything is just a big, sticky, horrible mess.

Doug manages to separate out one of the huge lumps he saw on the X-ray.

Oh, yuck.

We wouldn't see this degree of change

in a patient of mine.

There's no way that, you know,

a dog or cat could tolerate this degree of abdominal mess.

It would be dead long before it could get to this stage.

Doug can clear out Martha's intestines

but he discovers they've become completely sealed off.

Bob, come over on my left shoulder so you can see, this is your animal.

Hmm.

Look, the whole pelvis is scarred over.

There's no connection between the colon, where the faeces were,

-and the outside.

-Yeah.

-Bob...

-Yeah.

I hate to say this, but I think we made a try.

No amount of surgery can help Martha.

We'll put her to sleep. We'll euthanise her before she wakes up.

Not the way we want it to end,

but it's part of our job as veterinarians.

-Sorry, Bob.

-Yeah.

I know you care about your animals.

I wouldn't have been able not to try.

We had to give it a try.

And I was hoping for better results than this.

Martha was just too unwell for Doug and Bob to save her.

But their efforts have at least put an end to her suffering.

BIRDS CALL

In Laos, it's been six months

since Champa the moon bear had keyhole brain surgery.

I'm just putting in a few branches for Champa.

She likes anything new that comes into her enclosure, to check it out.

She particularly likes the banana tree

or anything with leafy branches, cos they're quite destructive.

She loves to just sit there and break it up.

Champa! Champa! Come on, girl.

The tube which runs from Champa's brain down to her abdomen

means excess fluid is no longer building up in her brain.

Having this operation has, you know, transformed her whole life.

She's gone from a bear which was virtually 24 hours a day

in terrible pain...

She had no quality of life, she...

she could hardly eat, she was in so much pain.

But since then, she's a different bear.

She'd never do this before.

She'd never even have her head up.

While Champa will never be able to live with the other bears,

Mike's seen a huge change in her behaviour.

Yeah, what is that?

Oh, you cheeky bear, you cheeky bear.

This is how bears play with each other.

They like to mouth each other and swipe each other.

You, you're a bad girl!

What are you doing?

HE MAKES CLUCKING SOUND

He hopes Champa will go on to lead a full life,

free from the pain that tormented her for so long.

You're a funny bear.

You're a funny bear, aren't you?

You're a good bear, though.

You! You!

CLARE: In this series we've seen how life for many animals is changing

and how they face great challenges to their survival.

But advanced diagnostics, innovative surgery

and the dedication of vets around the world,

mean we can now look after them in ways we never could before.