Episode 1 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...

SHRIEKING 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 better.

It's the most challenging stretch...

Whoa!

..of a very long journey.

I have a serious problem with my hand shaking.

-To become...

-Well done.

-Gassy!

..fully qualified young vets.

Saved a life today which is good!

LAUGHTER

It's midsummer, and after four long years of study,

these students from the Royal Veterinary College

have at last reached their final year of vet school.

I think veterinary is probably one of the few things

that I could do every day and still be passionate about it every day.

It's such a big career, you know.

It's a lifestyle, it's not necessary just a job.

The end of their training is almost in sight,

so they can finally put their textbooks to one side

and get hands on with real animals.

Today I get to do consults all day, erm...

which is pretty daunting.

They have just two weeks to master each area of practical knowledge...

-Morning!

-..before they move on.

This final year is so important for them,

they have worked hard for four, five years and now it's time to see

if they can cut it in the real world of veterinary medicine.

Lives are at stake here, so they have to get it right.

On the first day of a new rotation,

every one of them feels like a total beginner.

Hi, I'm Judy one of the vet students.

I'm just going to take you to a consult room...

Mature student Judy Puddifoot

is starting at the Beaumont Sainsbury Animal Hospital

with what should be an easy test of the most basic vet skills.

An 8-week-old puppy called Bess

needs vaccinations and flea treatment.

She's lovely.

So she's not got any kind of diarrhoea, vomiting,

any problems like that?

-Nothing at all like that.

-No.

-No? Wonderful. Eating well?

-Absolutely.

-Urinating fine?

-Yeah.

-Everywhere.

-Everywhere? Yeah.

It might be a simple consultation

but there's a lot to remember if Judy wants to impress.

Wonderful. All right so if you just want to wait here for a bit,

I'll be back in couple of minutes.

OK? Excellent. Good girl, make sure she doesn't drop off.

I am obsessed about being assessed, it has to be said.

The clinicians are watching you at every moment

and assessing you on everything so it can be difficult, yeah.

So we need to ask about the food management

when we go back in, just so you can find out what diet she's on.

Do you know whether she has any insurance or anything like that?

-No, I didn't ask I can check that too.

-Yeah. That's perfect.

You've got to behave how you would round your grandma's house,

all the time.

Best game face on, all the time. Don't let it drop. Ever.

Unless you're in the toilet with the door locked,

then you can look at your phone

but until that point professional all the way.

What would you suggest that we give her

in terms of flea treatment?

It's a little bit more comprehensive, it does thing like ear mites as well.

Oh, um... I've completely forgotten the name of it...

It begins with an S.

Stronghold. Yay. Very, good.

As students, we're not responsible.

Someone else will take the flak if it goes wrong.

OK. So I've got Bessie's worming and flea treatment here...

The day before you graduate, you're not responsible.

24 hours later, bang, you're responsible.

The buck stops with you.

That...is a terrifying thought.

Any questions or anything?

-No. You've covered the lot there.

-Wonderful.

Very professional job.

-SHE LAUGHS

-Thank you very much.

Whether it's first opinion practice or complex surgical procedures,

every discipline of veterinary medicine

must be mastered by the students.

24-year-old Elly Berry is at the Queen Mother Hospital For Animals

starting a two week rotation in one of the trickiest

and potentially the most dangerous disciplines of them all.

So, welcome to anaesthesia, it is a good rotation,

it's a very hands on rotation.

It's very different to human anaesthesia

where you do really no anaesthesia as an undergraduate,

whereas you are expected to go into practice on your first day

and to give a good basic anaesthetic

so it's really important that you are confident.

With anaesthesia, you hit the ground running.

You're in at the deep end straightaway.

You have your induction and then you get a case and you go.

Elly's first patient is a Russian Blue kitten

with a serious breathing problem.

-This is the kitten!

-You've got a kitten?

I've got a....but is that a good thing?

I don't think it's a good thing.

It's really cute though we can go find him. He's very sweet.

I saw him earlier, he's very sweet. Okey dokes.

I'm going to go visit said kitten.

If you'd like to come with me now...

What's his actual name?

Morris! He's called Morris!

He's 17 weeks old. Oh, Morris!

The deal with the cat, well, it says its significant history

is that it's got breathing abnormalities and it's failing to thrive...

I dunno, I've just listened to its heart.

Um, just to get a heart rate really

and it's going really, really fast, so it's quite hard to assess!

Morris needs a CT scan on his lungs to find out what's making him ill,

so to make sure he lies still, he will have to be sedated.

I need to see if there's anything I think is physically wrong with him

and then make an anaesthetic plan based on my findings,

both of which are things I'm not really very confident in.

And just made a slight realisation

that I'm going to have to put a catheter in him.

How's that going to work? All right, mate. OK. Right.

To a book.

In just 30 minutes, Elly has to present Morris's case at rounds,

a meeting with the supervising clinician

who expects her to know exactly which drugs the kitten needs.

I honestly, I've no idea of what I'm doing.

This is a very new situation. I need to read books.

Books. I need books!

What would you give a kitten?

Anything? Just normal?

What's the problem with it? What's it for?

-Kitten.

-Are you...

'With anaesthesia, there are all the different drugs'

and each drug you have to give in a certain amount to an animal

because you don't want to overdose.

-Because...

-This is kittens?

This is very potent so kittens may be too complicated.

Sadly, on that first day, I came in

and it didn't matter how much I had learnt,

I still didn't know what I needed to know.

But that's the way it goes.

I'm going to Google "kitten" plus "anaesthetic protocol,"

that's what I'm going to do.

I'm not looking forward to rounds, it's got to be said.

Rounds is a unique situation

because you are there with your rotation group and a clinician

and you are on the spot and they know your name and they know your face

and they can say, "Right, you. You were not very impressive."

Today, Elly's reporting to the head of anaesthesia, Ian Self.

-Which cases have you actually seen?

-I've seen mine.

-Which one was yours?

-It's Morris, the little kitten. Erm, CT.

-The Russian Blue?

-Yeah.

-Yes, OK.

I'm not trying to make excuses, cos I really am not very good,

but I did just see it at 16:30, so it's been a bit of a panic...

-I've heard that you're not very good.

-Yeah, I heard that, it's on the grapevine.

'I don't know. In situations like that'

you hope that some knowledge will bubble up from somewhere

and you can somehow impress.

OK, Morris.

I gave him a look over...

Was this the one that was too dangerous to sedate?

It was pretty nice cuddling him. It seems fine.

Yeah, no, no, not dangerous as in... but as in clinically,

they are worried about sedating this dog, this cat, sorry.

I'd say his breathing difficulties were my main concern.

So, what's your plan?

Well, my original plan which I could have not told you about

but it was to do the triple thing.

Triple thing?

Medetomidine-butorphanol-ketamine

but probably not any of that now.

So...ACB Methadone?

Possibly?

Mmm. OK.

How much do you want to give? What doses?

That I'm not so sure of sorry,

cos I just plucked that out of my head.

But, um...

I could look.

This one's going to have to be quite open-ended

because we don't know exactly what the result of the CT is going to be

and where it's going to go.

Hopefully it will go to recovery and then go home

with couple of pills and be better for the rest of its life.

It might go to surgery and have major invasive stuff.

I've a feeling about this one, yeah.

Her challenges are perhaps more than she actually realises at the moment,

unfortunately.

This is quite a young kitten, it's quite small,

so we've got problems with physically handling

and dealing with such a small patient

and on top of that it has a respiratory problem.

We could find that when we give it anaesthetic drugs,

it could decompensate and become quite sick very quickly.

So this is a case that I'm certainly going to be watching

very, very closely, and I'm not going to leave this one.

Everything is new,

I really don't know about the drugs we are supposed to know about

and that is key with all this and, um...

it's usually all right if other people don't know

but they seem to know and I don't know how they know.

They probably did reading when I should have done reading...

But I will do the reading

and by the end of the two weeks I'll be a pro but right now, it feels...

I feel...uh..I've not done my best, I don't like that...

(I've not done well.) It's all right.

After a long and testing day, Elly heads off home to her boyfriend,

Matt, an aspiring barrister.

-Hello.

-Hi, are you all right?

-I'm all right, how are you?

-Yeah, not bad.

-Cool.

They've been together for three years.

So, how did it go? SHE GROANS

-Well, then?

-Yeah.

-Really well?

-It was a classic.

Good, what was today's body count?

-Luckily none!

-Well, that's always good.

-Yes!

-A successful day.

Everyone else seems to know more of the answers than me.

Maybe they've done more of the reading than me.

Yeah, but everyone else is just as terrified as you

that they don't know the answers.

Yeah, so don't worry about it.

Elly was telling me about her timetable for this year.

I think it came down to being a 56 week year

which just doesn't sound right to me.

It kind of just puts in perspective

how much they have to do in such a short period of time

and I think she's incredibly brave

to carry on in the way that she does.

She enjoys doing it, so it makes perfect sense in the long run, really.

-CAMERA: Going to do a sync clap, is this in shot for everyone?

-Yep!

CLAP No, no.

-Oh, we...

-THEY LAUGH

Yeah, I don't like the thought that I'll get caught out

and someone will be like, "You! Why are you in vet school. Get out!"

That's true with every day you encounter something

where you're a bit like, "Oh, OK, I'm not very good at that."

You know what? I think the skill is learning how to deal with it.

Oh, it's the whole, erm "swan phenomenon" thing.

You are fine. You are serene. You are beautiful.

You're gliding along on the surface,

frantically paddling underneath!

Literally not being able to deal with it.

That is so true! That is so true.

-DOG BARKS

-Whoa!

Thank you. Rooney, come on. Aw... you're OK.

In Hendon, Charlie Tewson from Norfolk

has been thrown in at the deep end.

Come on. Rooney. Oh, Rooney. Come on.

There we go.

-CAMERA:

-Is this a busy practice?

Er, yeah. Really busy. It's actually the busiest I have been to.

Erm, you only have about 10 minute slots per consult...

Er, how is she in herself? Does she seem quiet?

She's all right.

For the next two weeks, he's at the PDSA...

-OK. Er, meant to ask, any vomiting or diarrhoea?

-No.

..a charity who provide vet care for owners on low incomes.

Erm, so other than the throwing up,

how has he been?

Each case is very different.

You have to sort of switch your mind

from suddenly having a vomiting dog to having a cat with urinary disease.

-She's eating and drinking normally...

-No. Drinking? No, she won't.

She's not drinking at all?

The team treats up to 140 animals a day...

OK, release the hound.

..and Charlie needs to help head vet Lucy Gardiner

get through the case load as quickly as possible.

I think the pace and the volume of work load

that we have here sometimes can be a little bit

of a shock to the system but they invariably get stuck in straightaway

and their first day skills, they get to use really from day one here.

Obviously it is quite hard fitting me into the busy schedule.

The people here really want me to learn

but they're also really busy themselves

and they're not getting a huge amount out of me being here, so yeah,

but I am having a really good day.

I don't know whether the vets are.

HE LAUGHS Come on then, Rooney.

He is a little bit reluctant.

A busy day at the PDSA is not just a test of stamina.

-DOG GROWLS

-Oh, it wasn't that bad!

-Good dog. Good dog.

-It wasn't that bad!

Aw! Was it bad?

All trainee vets need to develop the confidence

to deal with stroppy patients.

Have I got Shadow Whitely? Brilliant.

She is not very keen on strangers so I might have to muzzle her...

-Or men.

-OK.

Shadow, a German shepherd, has a chronic skin condition,

and is in today for her regular check up.

So Shadow is not very keen on men?

No, and I normally have to muzzle her. Since she's had her operations done on her ears,

she really doesn't like the vets going anywhere near her so...

I understand. I don't think I would either.

So is she snappy or just growly?

-Erm. Both.

-OK. So you would rather...

If you've got a nylon one, I will put it on her.

Shadow...come here.

Is she going to get really scared of me? I'm OK.

-Oh, you are... aren't you?

-Good girl.

Good, so what's the main problem today?

Basically she is here for a check up on her skin.

Good girl.

Let's have a quick look on your face before you get really angry.

Yep. SNARLING

OK. OK. We are going to stay away from your head.

-But, um, she keeps getting hot spots on her skin.

-Yeah.

Because I am a vet student,

it means that I have got the kind of the atmosphere of a vet for a dog,

without the confidence.

Erm, and obviously I am a rather large man.

-So any vomiting or diarrhoea?

-No.

-Coughing or sneezing?

-No.

-And she's eating and drinking all normally?

-Yep.

Brilliant. See if she'll let me feel her lymph nodes there...

GROWLING No. No. OK.

-OK.

-She's like, "I don't think so."

No, I don't think today is the day.

OK, so I think I've got enough to report to Lucy

and then see if she wants to take a crack.

If you can just held her head while I squeeze past and hopefully...

-You are all right, aren't you?

-Hey. OK. That was fairly difficult!

It doesn't matter what size who you are, a dog's teeth will bite

and that bite wound could be lethal, could get infected.

Erm, there's all manner of things that can go wrong

and just the fact that I'm quite a big guy doesn't mean that

I should forget about those risks.

-Very difficult to clinically exam.

-OK, yeah.

-Muzzled and still snapped

-so I couldn't do sort of mucus membranes.

-Of course.

Maybe the lymph nodes, I can't find, generally fine in itself,

but it started getting really angry at me.

OK. Previous appointments, they were concerned

about just general itchiness so obviously we can assess that as well

have a little look over Shadow and go from there.

-Awesome.

-OK. Great stuff.

Hello, this way...

Fortunately, Lucy has years of experience dealing with pets

who don't like vets.

Good. Oi, oi, oi, you are a real scamp, you are.

Right. Just general itchiness, how are we doing?

Um, that's stopped again.

The steroids seem... but her skin is so dry.

She's pretty scurfy, isn't she?

As regards to the slight dry skin scurfiness,

um, a little bit of omega 3, omega 6 can just help out.

Some fish oil can just help that...

-Have a great day, take care now.

-Bye!

I love coming here. I really do.

The girls are really, really friendly, it's cool. Nice bunch.

-CAMERA: But she doesn't like men though.

-No...

-THEY LAUGH

Don't blame her.

It's nothing to do with the way we've taught her either.

But even his run in with Shadow

can't put Charlie off becoming a vet.

Aw, Olly! (Hey!)

He's cute.

There's quite a lot of competition to go to PDSA amongst students.

But, yeah, I'd go back as a student

and I think if they offered me a job, I'd probably take it.

Hint! HE LAUGHS

At the Beaumont Small Animal Practice,

Judy's first day nerves are disappearing

as she starts to find her feet.

OK, so basically, he's had his vaccination.

First vaccination and that was about two weeks ago today, wasn't it?

-I think so.

-Yeah, the 20th?

-Yeah.

You really don't know what's coming through the door.

You could have a happy-go-lucky puppy

and then the next consult that comes in could be a serious one.

And then how long after that did he start to get a bit poorly?

I don't know. It's probably a week and a half he's been like this. But I just thought he was quiet.

I have never had a cat so I don't really know.

Her patient, a 10-week-old kitten called Leon,

has been brought in by his worried owners.

He was OK for a couple of days, you think,

and then he started to get... What was it? Lethargic? Diarrhoea?

-Vomiting?

-He just, erm... No.

He just sits on, like, on the window, but doesn't move.

So he didn't have diarrhoea before his vaccination though?

-No, it's always been like that.

-He has always had diarrhoea?

-Yeah.

And you say about his appetite he's not really interested.

You really have to entice him to eat, do you?

Well, I put him there and he'd eat a little bit

and never, never finish it or it's kind of always in the bowl.

He shouldn't be this down.

You know, this is kind of more of a generalised

"Oh, I feel really icky."

Yeah, depressed and icky as opposed to, "I want to run around

"but my leg hurts" kind of feeling.

Right. If you want to just hold on to him for a bit,

keep him nice and warm, and I'll go out

and just have a quick word with Michelle, the vet,

and we will pop back in.

So he's, er... this is Leon Goodrick.

He's a 10-week-old entire male kitten.

He had his first vaccination two weeks ago today.

Um, and he's had a one and a half week history of diarrhoea,

lethargy, temperature was 40.1.

OK, so what do you think about that?

Well, I think he'd obviously got some sort of infection,

viral, bacterial, or something going on.

He's got something systemic illness going on for sure.

Very good.

Such a small kitten with a temperature of more than 40 degrees

could be in serious danger.

The first step to try and diagnose Leon

is to test his blood glucose level.

We're worried about him being hypoglycaemic

because he's not eating properly,

so that could partially explain his lethargy.

And that is something we can address

and we can get his glucose levels back to normal

and then we can assess how he is getting on at that point.

So that's really what the point of this test is.

You know, you look at him.

He just, ooh, he's just down and he's a really sick little kitten

and he's was literally on a knife edge.

He's going to be really difficult to get blood from.

So we'll use a little insulin syringe

we just need a drop of blood.

Just a drop. OK, Mr!

Perfect so you just need to stabilise what you're doing.

-Good boy.

-Right. That's it.

(Lordy Lord.)

Perfect.

Ohhh. Have we got it? Brilliant.

If Leon's glucose levels are normal,

he will need more tests to determine what is wrong with him

and these could be expensive.

So we managed to get a little drop of blood out of his leg

and we put it on the machine to measure his blood glucose level

and its actually normal so as we were saying before...

-Something else wrong.

-Yeah. It indicates that there's perhaps something else going on

so it would need to be worked up a bit further and investigate

and find out what's actually going on.

-Look, he's shaking.

-Yeah.

I think it's a combination of his high temperature

and the fact that he does seems to be in quite a bit of pain as well.

He really does need to have further investigation

to have any chance of pulling through this.

So we're going to get him sent straight over to the Harmsworth Hospital

where he can have x-rays, further blood tests

and potentially a scan of his abdomen as well.

Leon's owners don't have insurance

but the Harmsworth is an RSPCA hospital,

where he can be treated at low cost.

And then that will give him the best chance

of being able to pull through this.

-OK.

-Thank you.

-No worries. You're welcome.

All right. We'll keep everything crossed for him.

-OK.

-Thank you so much.

-Not a problem.

Unfortunately, he was that sick

that he did actually die later that evening.

-OK.

-Thank you. See you later.

-Thank you.

I wish I could be apathetic.

You know, there are people who see that little kitten

and go "It's a kitten, get another one."

What?! No!

So, yeah, it does, it does upset you because you think

"Oh, crikey, this animal's suffering" or "it's in pain"

or "it's sick" or whatever

and you think "I want to help it, how do I help it?"

It can be hard. Yeah, just difficult.

I like a dog when it's in, or I like a cat and, er,

and I'm rooting for it to do well

but I think you can't get too attached because you just go through so many,

you go through so many, animals all the time

and not all of them are good outcomes.

I think if you get too attached, then it's quite difficult.

No, it's when you think,

when you think that they are basically going to be cured

and then something else pops up and you are just like, "Oh, no."

-We forget how attached people are to their pets and how they are part of their family.

-So true.

Most young vets go on to work with small animals and pets after graduation...

Come on, Carlo. Steady. Come on.

..but learning to treat horses is still compulsory for every student.

Yes! Good boy.

One of my mum's friends said, "The only 100% predictable horse

"is a dead horse," so if they've got a heart beat, don't trust it.

Awesome!

Fortunately, Amy Clithero is in her element with horses.

No matter how comfortable you are

you've still got to bear in mind they're ten times the weight of you

and they can easily splatter you.

It's to see if was something you'd have to bandage or cast up...

Her mum runs a riding school on the Yorkshire moors,

so for one of her elective placements,

she's chosen to spend two weeks at the Bell Equine Centre....

-OK.

-Chill out, dude.

..a specialist hospital for horses

needing clinical treatment or surgery.

How can you not be excited about doing some of it?

Like, yeah, you might get stressed out

but you're going to be stressed in any job really.

Amy's first major case is a 16-year-old Shetland pony

called Babs.

OK, if you just want to bring her down and then we'll take her through to the consultation room.

She's suffering with colic,

a painful and potentially lethal disorder of the gut.

Right. We just, erm. This is um, Nat. Nat the vet, coming up now.

She is looking a lot better than she was earlier so...

So arrived at about one o'clock-ish, she was down on the floor

with her leg stretched right out at the side of her.

Erm, panting, very, sort of, distressed.

45 minutes later the vet arrived, he's given her, he's told you what he's given her,

all the drugs and that sort of thing.

In terms of shape, is that how she usually is? Is she a bit bloated?

-She is bigger than she should be...

-Right.

Her heart rate is quite high, it's 56,

normally in a pony of this size we would expect sort of 40/44.

She's quite puffy as well is that something she's been doing all day?

Um, yeah, she was clearly quite struggling to breathe,

this is a lot better than she was...

Colic is the leading cause of premature death in domestic horses

so owner Kate is understandably worried.

I'm kind of hoping today goes all right.

I don't like seeing her as poorly as she is now,

she's always been there, I've had her forever, I love her dearly,

I don't want anything disastrous to happen to her...

So obviously I can only get in to just past my wrist

because she is so small but there is something very tight in there,

so normally, you know, the large intestine will sit,

there should be plenty of space in the abdomen,

I can feel a displaced large intestine there,

which is kind of curling up and very, very tense and taut.

For the next two weeks Amy's knowledge and practical skills

will be constantly tested by hospital director Tim Mair.

So what's your overall impression of this animal

in terms of circulatory status, pain?

Ooh, I've not actually seen its membranes

and then its heart rate size is obviously uncomfortable.

-Why is the heart rate high?

-Pain.

Can be pain but also... Or stress.

Stress or shock, shock will push the heart rate up,

probably faster than pain.

So we've got high heart rate, we've got abdominal distension,

we've got lack of faeces, we've got recurrence of pain despite analgesia

those are all some of the things that we rely on

to make a decision to go to surgery.

Do you have any idea how much it costs on average?

Is it...? It's about four to six thousand.

Certainly if they need a lot of aftercare

and a lot of intensive treatment after,

especially some of the small intestinal resection cases,

the cost can go beyond five and a half, six, seven thousand sometimes.

It's not clear cut to my mind at the moment

whether this is surgical or not.

With no clear course of action, Babs is put under observation

and Amy is tasked with making the pony comfortable.

She is going to stay in tonight.

They obviously want to keep an eye on her

and let her relax a little bit,

they're going to get a catheter in her for a bit more fluid

because she's got dehydrated.

Good girl, that's it.

People laugh when you say they're like your kids

but you know, as people often remind me I haven't got kids of my own

but I have got ten of these little chaps and several big ones.

Just get yourself comfy.

And you spend a lot of time and effort on them

and they do mean a lot to you,

even when they're as annoying as you are sometimes, hmm?

Yeah.

And you're just like, "I really hope you know we can pull this one through."

Obviously because you want to help the animal

but because the owners are just so attached

and you just want to send the horse home with them again basically.

Has she got any kind of history that we should be aware of

in terms of kind of illnesses or surgery or...?

-She's allergic to carrots.

-OK.

At the Queen Mother Hospital, Catherine Needham,

a student vet from Nottingham,

is nervous about starting her new placement.

The rotation that I'm on at the moment

is emergency and critical care.

I think what I'm worried about with this rotation is

just the fact that I need to know so many things at once.

What system does the angiotensin II receptor act in?

Cardiac?

Yeah, and...?

I feel that I have a good understand of things

but not necessary all at the same time at the moment.

The something angiotensin system?

Kidney, renal.

Renal, so yeah, kidneys.

So I need to know about cardiac disease and renal disease.

Um, I didn't specifically...

You ask Catherine questions and she does know the answer

but she thinks she doesn't

and there's going to come a point in less than a year's time

where someone is going ask her opinion and her advice

and she's going to have to have a bit of courage

of the fact that she has got a lot of knowledge behind her

and that she does know her stuff, so hopefully we do it in a nice way

that makes her realise that she does know what she's talking about...

Emergency and critical care is a 24 hour operation on the front line of animal medicine

and when you're working on the out-of-hours shift,

you never know what's coming in next.

We came home tonight, went out for dinner,

came home tonight and let the bunny in

and we could hear a buzzing noise

and we weren't quite sure which end it was coming from.

He's our son's birthday present, we love him.

-He's actually like a dog.

-He's like a little dog,

he's so lovely, he just loves cuddles.

He sits there, he sits there on the fireplace

with his front arms out and his back legs out.

Yeah, snuggles up on the rug, he's just lovely.

-Literally on his belly.

-Cute, he's cute.

Vet Myfanwy Hill is Catherine's supervisor.

She needs to make sure her student has the basics covered.

Look at the picture in the rabbit manual

of what a male and female looks like so when I ask you to sex it...

Where is it, is that it?

You're not meant to be filming this bit.

-CAMERA:

-Why is that?

I'm looking in the book to work out what I'm doing.

Because they can be really difficult,

quite tricky to differentiate male from female

so you are going to need to identify

whether or not it has got a penis or vulva.

If it's got testicles then it's really easy

but if it's been castrated

then it becomes a little bit more challenging.

OK, happy? Let's go have a look.

Do you want to come on through?

So you've heard a buzzing sound?

I got him out when we got home

and I kept hearing, like, a buzzing.

He kept coming up to me and when I could hear the buzzing,

he was sort of skitting and getting quite irritated.

It sounded like it was coming from his head

and I thought there might be a fly in his ear or something.

So I sort of rubbed round his ears and sort of had a look inside,

see if I could see anything, but I couldn't really see anything.

So we'll have a little look.

Out you come, Harley.

So you think the buzzing sound is coming from his front end do you?

I think so.

It's so hard to tell.

And it's not all the time by the way.

No, I haven't heard it since we've left home.

Is it very loud?

-Yeah, you can hear it, yeah.

-Really loud.

It's a really obvious noise.

We were trying to do all of this earlier

and he was just really kicking.

No hope, no hope!

And a bit of wax down that one but nothing peculiar

that I can see down there, and we're definitely sure he's a boy?

Well, there was a pink thing that I saw

when we were looking round his bottom for flies.

I don't know if that was...

That's fine we can check...

So what sex?

-Yep, he's definitely male...

-That there is his testicle.

Ah, that's, yes, that's the thing.

Ah no, that was what I saw.

That's what I worried was like a maggot inside or something.

Yeah... have you checked his bottom? Think his bottom looks OK?

-Haven't got that far.

-I'll have a look.

But it did look, you said, it looked a little bit red.

Yeah, but that was now what I know to be his...

No, but his bottom...

No, I think I was looking at the ball.

SHE LAUGHS

What if a fly has gone inside his bum,

will you be able to tell?

It's really unlikely for a fly to go inside his bottom

-because there's...

-Oh good, that's what I was worried...

..because there's a muscle that sits around the outside

of his bottom that keeps it closed

and that will stop anything flying up there.

LAUGHTER Stop!

Yeah, so I wouldn't worry too much about that.

I can't see anything in his ears,

I can't see anything around his bottom,

I think there's no reason for us to expect there to be a problem

in that sort of area.

-There we go...

-Thanks so much.

-Thanks so much.

-No problem. See you.

Cheers, bye-bye.

Annoyingly for them it wasn't doing the buzzing.

It hadn't got the buzzing noise and it wasn't being skittish when it was in the consult room,

so we have to just, sort of, check what we have got in front of us

and we couldn't hear the noise and we couldn't find any reason for the noise,

so whatever may have been causing it may have stopped now,

so we've just advised them if it occurs again

to try and get a video recording of it on their phone or something

and then they can take it to their vet and their vet can make a judgment.

Other than that at the moment he seems to be doing fine.

Certainly learnt a lot about the anatomy, didn't we?

-That we didn't really know...

-Learnt about the anatomy of a rabbit.

-CAMERA:

-So you know for sure he's a male now?

-Yeah.

-Yeah.

-Oh, yeah.

If that's what you mean, have you learnt anything,

that's what we've definitely learnt, that he's male, yeah.

In the anaesthesia department of the Queen Mother Hospital,

Elly is preparing Morris, the Russian Blue kitten, for his treatment.

He's here at the moment

because his owners reported breathing difficulties

and he's here for a CT scan of his lung region.

My job is to organise a good anaesthetic for him.

Elly has now researched the appropriate dose to give Morris,

and head anaesthetist, Ian Self, wants her to fit a catheter in the kitten's leg.

We have to administer drugs intravenously

but securing that catheter is going to be very difficult.

This is a 1.24 kilogram cat,

the size of its legs are smaller than my little finger

and we have to persuade this cat to sit still

and allow us to put this big catheter through its skin and into its vein

and not object about it.

Good boy.

Don't wriggle. Morris. Don't wriggle.

Don't worry. Go in.

Come out?

But Morris is so small, Elly can't fit the catheter.

I know, I know, I'm sorry sweetheart. I know.

Generally you want to do your best for anyone

so to try and put a catheter in and fail and have a little leg

all sort of bandaged, I don't feel very proud of myself right now.

One of the senior nurses has managed to fit Morris's catheter,

and Ian has taken charge of the case.

Before they can take tiny kitten for his scan,

they need to ensure he can cope with the powerful drugs they've given him.

-Not very good at all.

-OK.

But the state-of-the-art monitoring equipment

quickly shows that Morris is struggling to breathe.

I think this SpO2 is real.

About 65/70.

Really? Oh, dear.

Morris's blood oxygen, or SpO2 level, is falling fast.

Can you start taking some recordings, guys?

OK, thank you.

With an SpO2 of just 65%, Morris's condition is now critical.

All right, we're ventilation dependant on this...

Ian must now start breathing for him.

At the moment I doubt...

Because he's dependent on us ventilating him

to actually maintain normal function at the moment.

To have to breathe for an animal is incredibly serious.

I appreciated it was a bad moment but I didn't quite realise

he was on the edge of death.

Better.

That's better we're fine.

He's 99 now.

That was a brown trouser moment, just so you know.

Check that you're happy that he's deep enough for us to move

and then when you are, we'll go to CT.

Stable for now,

Morris needs to be rushed into the scanner as fast as possible.

Right, we're going to move quickly to CT.

OK. Let's go.

He's hooked up to a ventilator

in case his blood oxygen level falls again.

Just watch that upstroke, I want to know that the upstroke is up

and not slurred because that would indicate a little bit of obstruction

somewhere in the tube, OK.

Elly's first case is turning out to be as challenging as they come...

I don't know what I'm doing

so I'm just trying to stay out of the way and do what I'm told.

Then you can't go wrong, and I'm trying to watch that line as much as I can.

Have we got a capnograph trace on here?

How's the capnograph looking?

-Is the capnograph straight? Straighter?

-Yeah.

He's really breathing but it's all right.

OK, let's put a little bit more, go to five litres.

While the scanner is firing, Elly and the team must leave the room.

Once it's finished, it's another emergency dash

as Morris is moved to intensive care.

The fact he was recovering in ICU, the intensive care unit,

just showed how critical it was really because he was put in an oxygen cage.

Morris has used up at least one of his nine lives today.

But thanks to the anaesthesia team,

surgeon Nicola Kulendra finally has a diagnosis.

We suspect that Morris has got bronchial pneumonia

so we've just taken a sample from the lungs to see

what type of bacteria so we can give the most appropriate antibiotics.

Remarkably, just 15 minutes later, the anaesthetic has worn off and Morris is up and about.

I am sorry you couldn't do everything at that

but it was one of those emergency cases, but hopefully you learn

a lot from seeing what we do and how we approach it.

That's good, it's a nice outcome.

Happy about that.

You know when you see, like, doctors on TV running around

and it's like ER and George Clooney is doing his thing,

but he's not really doing his thing, this is like that with animals

but without George Clooney, but with Ian who is better and real.

And it's just awesome. I'm just a bit overwhelmed.

Elly did really well, I have to say.

We couldn't let her do much directly with that case

because it was so critical but she was there she never left us,

she followed all the instructions that we gave,

even in quite a tense situation and really in these critical cases

that we can't let the students do directly,

we hope that they still learn quite a bit from our approach

and the treatments that we give.

Just to finish doing this

is like taking a pee in a public swimming pool

because it makes you feel all warm inside, but nobody really notices.

So I'll leave you with that on film. OK. Good night.

Well done, Elly.

-CAMERA:

-(Will we have to edit him saying that?)

No, keep it in, that was amazing.

I love him!

Have you been asked the cow question yet?

-The cow question?

-Oh.

-Yeah, yeah, yeah.

-Every time.

Every time.

They expect us to just see cows and do it.

Just like, oh, cow! Cool.

Tell us all the interesting stuff you've learnt.

Well, I know how to rectal a cow if that's what you mean.

We will come out of this scarred.

Mentally and physically.

-More mentally.

-More mentally, for sure.

-And emotionally.

And emotionally scarred.

At the Bell Equine Hospital in Kent,

Babs the Shetland pony has taken a turn for the worse.

OK, I think we need to make a decision

whether we are going to do surgery or not.

She is obviously deteriorating and getting more shocked

and she's very distended.

I mean.

She is 16, obviously she's reasonably fit.

What are your views on surgery on a 16-year-old Shetland?

The age makes no difference to us.

They can bounce back just as well,

Shetlands are pretty long-lived normally, so 16 isn't old.

Babs is now in so much pain, the only alternative to surgery

is to put her to sleep.

If she was yours, would you go for it?

I would. Yes, but it's easy for me to say.

-I'm not paying the bill.

-Yeah.

-It is major surgery

and there is a big expense involved, but...

Well, obviously we want to go down the surgery route so...

If you want to be there that's fine but I wouldn't personally recommend it.

No, OK...

Well, we'd better go for it then, hadn't we?

It falls to Amy to help give Babs her anaesthetic.

The big one's the flusher?

Even for a fifth year student,

scrubbing in for complex equine surgery

is a great opportunity for Amy.

Small ones at the front...

In general, there aren't as many equine operations that go on

so if you get to do anything with one,

you're just like, "Oh, my goodness, it's so exciting."

But it's a nervous wait for owner, Kate.

Basically we've got two options,

either have put her down or operate,

and I felt that I owe her a bit more than just putting her down

and the prognosis seemed good in that Tim was quite happy

that there was an 80% chance of it

doing her more good than harm, so for me it was a no brainer.

Fortunately for Babs, Tim quickly discovers the cause of her colic.

It's a hard mass of faeces that has formed like a solid ball

and it's too big to go through there

and it's too hard to break down

and all this gas builds up ahead of it because it can't get out

because this is blocking it

Managed to get rid of more of this gas...

This is a hard mass here.

It's never going to break up naturally.

Just by sort of massaging it probably will break up,

but we try not to open the bowel if we can get away with it

because it increases the risk of complications.

It's a question of whether this will break up easily...

It takes Tim over an hour to painstakingly remove the blockage.

If Babs' recovery goes smoothly,

she has a fighting chance of pulling through.

At the Beaumont in North London, Judy's placement is coming to an end

culminating in the biggest test of her training so far.

Mind your head.

A little bit nervous. I'm not going to lie.

For the first time, she will complete an operation on a live animal,

a young border terrier cross called Ruby.

Not done a proper bitch spay from beginning to end before.

Should be fun.

I'll enjoy it whilst panicking.

Neutering is an everyday skill expected of all fully fledged vets

and Judy will be assessed by surgeon Nadene Stapleton.

So when you say "soon", when will be the best time

to have the lowest risk of breast cancer?

Erm, best time will be before they even have a season.

If you think about the fact that you have got a living animal under there,

people can get quite queasy about that, they can faint,

they can feel a bit you know, quite awful about it and feel sick.

I think the more of them that you do, the more you begin

to just focus on what you have to do as a job

and the less you worry about the peripheral things

like how nervous you are.

Because we just need the surgeon's double throat on the vicryl only.

Correct.

After four years of training and multiple dissections,

Judy's knowledge of dog anatomy should be perfect.

You know you've got to do double throats on the first one...

But closing the wound cleanly is a vital surgical skill

that takes a long time to master...

Right, I'm going to show you one, and I'll let you do one.

..and Nadene wants to be sure Judy's knots are up to scratch.

That one goes that way and this one comes from underneath and has to go the opposite direction,

well out of our way and then you pull your finger in towards your palm

and then the only bit left to grab is that bit.

So you just have to remember which bit there is left to grab

and make sure your knot is formed correctly.

Right. When we spay the animal,

what we do is we take out the ovaries and the uterus

and when we obviously take those out we have to tie those off really, really well,

to make sure that it doesn't bleed.

Actually Nadene has just shown me a slightly different way

and it's actually a lot easier and I wish I'd known that about a year ago.

It would've really helped.

-Okey dokey, anaesthetists, are we ready to go?

-Yes.

While Ruby is being sedated...

Judy takes the opportunity for some last minute knot tying practice.

You learn all this in the clinical skills centre and you do it on...

you start with shoe laces on sand bags

and then you learn to do it on drip lines that are hanging up at funny angles

to get used to it and then you work your way down to thinner and thinner suture material,

but to actually do it on a live, bleeding, breathing animal

is quite scary, but I'm sure it'll all go well.

Famous last words.

Everyone's ready. The time's come for Judy to scrub in.

It's quite exciting I think, going into surgery.

I do enjoy it.

So you know all that, scrubbing in...

Now you're doing it.

You're scrubbing in. you're getting gowned up.

Erm, it's brilliant.

You know. It's a privilege to be honest.

It feels like I'm... I don't know, going to the moon.

OK. Oh my lord.

It's really not easy. This is ugly.

Really ugly.

You watch surgeons do it and then can just go bang, bang and they are on.

The gloves are on and you think, how did he do that?

I get half of my sleeve in the glove. Yeah.

-A Lot of sleeve went in.

-Yeah. Too much.

I was so embarrassed at that.

That was terrible putting those gloves on.

I've never done it so bad in my entire life.

What I want to see with your incision,

I call it a nice bold incision,

so it's really not possible to make an incision from the skin of a dog

all the way to the abdomen in one fell swoop,

so you can put a bit of pressure behind your incision.

I'd like you to keep your blade on the skin

for the entire length of your incision.

I just thought, this little pink bit of skin,

I have to cut this in the right place.

That's all I was thinking.

Do you hold it like this, are you happy with that?

-Do you have to check with them?

-Are you happy?

And "Judy don't cut your fingers."

That's the other thing I was thinking and "Don't cut Nadene's fingers, for god's sake."

Cut your own but don't cut hers.

Right. We just want to go straight down this.

OK, here goes...

-Wonderful!

-Yep.

-That is fine.

Beautiful. We're going to strike through again.

-The same technique.

-Yeah.

There'll be a little bit of bleeding this time,

nothing to worry about, just smaller vessels...

That was the first time I'd actually made the first incision

into a living breathing animal owned by somebody who wanted it back.

And then trying to break the ovarian ligament and things.

That was odd.

You may feel the colon in front of you

and you just hop over the colon and your uterus is going to be

sitting between the bladder and the colon.

I've lost it.

That's probably it then. The way it usually feels,

you almost grab it and then it flicks up under your finger.

-Yeah, exactly.

-That'll be it.

-Wow.

-It's a toughie, there you go.

-Oh, blimey, there it went.

Isn't that a horrible feeling?

It is. I just broke something in the dog.

You did and you were supposed to so that was all right.

So that's the sensation of breaking down the suspensory ligament.

It doesn't feel very nice but you did a great job.

Oh, I'm gobsmacked, really.

I really enjoyed it.

-I really like surgery, I've just found out.

-Yeah, it's good fun.

Yeah, it's really logical the way it's been taught,

I've got a great teacher, so when you take it step by step

it's not as frightening as you think

when you're just trying to read about it.

The surgery may have gone smoothly

but Judy still has to tie the all-important knot.

So keep that pinched and threaded.

Pass the needle all the way through to yourself, come straight through,

keep it threaded and pull upwards, that's your knot, OK,

so this is the only knot between everything unravelling and that knot there.

-And you just let me do it.

-How are you feeling, pressure's on.

Nice work, so any questions about anything that you may have seen at all?

Yeah, when do I get to do another one?

-Keen as mustard!

-Absolutely, fantastic.

Beautiful.

I'd be happy with a wound like that on me,

it doesn't look messy it's very tidy, very nice.

Brilliant.

Yay! First surgery done. Fantastic. Great!

Loved it.

Time to wipe the sweat off. Great, good.

An hour after Ruby's surgery, Judy goes to check on the patient.

Oh, come on then.

To come and keep an eye on her while she recovered, her habit.

Oh, Ruby, look at you.

She was quite groggy when we went to see her still, she was a bit...

That looks really nice, little bit of swelling

to be expected, but that's good,

-as long as she doesn't pester it.

-It's not painful at the moment?

No, no she's not responding is she to...

It was great. She was none worse the wear

without her little bits inside her.

No more unwanted babies for Ruby.

Come on then, Babs.

In North Kent, Babs's operation for colic was a success.

It's been a scary few weeks, hasn't it?

She's now back at home with owner, Kate.

I don't like to liken them to children

because that makes me sound like a sad Shetland lady

but you get a stronger bond with them

because they appreciate what you've done for them.

You certainly know how to frighten everybody...

and be centre of attention in true Babs fashion, obviously.

It's the end of Judy's two weeks at the Beaumont

and she's on her way to see head vet, Louise Allum.

All right, today is D-Day.

I am going to get feedback for my Beaumont Animal Hospital rotation.

Yeah, it can be worrying, obviously,

when you get one-to-one feedback on a rotation and you just think

"Oh, my God, please God let me pass this."

Particularly on some of the rotations you don't want to repeat

you think, "Please God, let me pass this"

because if you fail it, you have to repeat it

and I really don't want to do that on some of them.

-Hello. OK.

-Thanks for coming.

-That's all right.

-So, personal highlights for me.

Everything really, surgery was definitely top of my list,

loved it and, yeah, of course, you know, cuddling lots of little cute animals.

It's a rough job but somebody has to do it, don't they?

Grading wise...

we were very impressed with your professional conduct

and we'd like to give you a distinction for that so congratulations

and a pass for the other application of knowledge and the surgical skills.

I think you're going to be a great vet and I think come back in a couple of years' time

and we'll give you a job, OK.

Definitely, I'll hold you to that! Can I have that in writing?

All right, lovely to work with you Judy, congratulations, well done.

Brilliant, thanks, Louise. Thanks ever so much.

I passed. Yay!

These students' first steps

in the real world of veterinary practice have been a success.

But over the coming year, the challenges will come thick and fast

and test them to their limit.

They're all tantalisingly close,

only 12 months away from becoming qualified vets.

That's my hope. The biggest hope. That's the goal.

That's the light at the end of the tunnel.

Fantastic. Dream come true, for the rest of my days.