0:00:01 > 0:00:04Britain is a nation in love with its animals.
0:00:04 > 0:00:06How are you doing?
0:00:06 > 0:00:10We own 27 million pets...
0:00:10 > 0:00:13and 900 million farm animals.
0:00:13 > 0:00:14Very frisky one.
0:00:14 > 0:00:16All of them...
0:00:16 > 0:00:19need vets.
0:00:19 > 0:00:21Over the course of their final year,
0:00:21 > 0:00:24ten students at the prestigious Royal Veterinary College
0:00:24 > 0:00:29in Hertfordshire are taking what they've learned in the classroom...
0:00:29 > 0:00:32and putting it to the test
0:00:32 > 0:00:36in practices, farms...
0:00:36 > 0:00:38This is all new territory for me.
0:00:38 > 0:00:41..and state of the art animal hospitals.
0:00:41 > 0:00:45It's a whirlwind of back-to-back work placements.
0:00:45 > 0:00:48MONKEY SCREECHES Sounds like an unhappy monkey!
0:00:48 > 0:00:50Nice and quick, good.
0:00:50 > 0:00:53And they can't afford to fail a single one.
0:00:53 > 0:00:56I need to do my job properly. I need to do it better.
0:00:56 > 0:00:58It's the most challenging stretch...
0:00:58 > 0:00:59Oh!
0:00:59 > 0:01:02..of a very long journey.
0:01:02 > 0:01:04I have a serious problem with my hand shaking.
0:01:04 > 0:01:06- To become... - Well done.
0:01:06 > 0:01:09..fully qualified young vets.
0:01:09 > 0:01:11Saved a life today. Which is good!
0:01:28 > 0:01:30It's late summer and fifth year students
0:01:30 > 0:01:34at the Royal Veterinary College have just 11 months to go
0:01:34 > 0:01:38until they qualify as vets. They've embarked on a long year
0:01:38 > 0:01:40of practical placements called rotations -
0:01:40 > 0:01:44and they need to pass them all or they won't graduate.
0:01:44 > 0:01:46Not everybody does pass the year.
0:01:46 > 0:01:49It's very intense and the students
0:01:49 > 0:01:51have to show a consistent level
0:01:51 > 0:01:54of both professionalism, skill and knowledge.
0:01:55 > 0:01:58'Starting new rotations, aw, man.
0:01:58 > 0:02:02'Every Monday or every other Monday is like going to a new work place
0:02:02 > 0:02:04'or going to a new school.
0:02:04 > 0:02:06'It's really stressful, to be honest.'
0:02:06 > 0:02:10You're just kind of finding your feet for the first two, three days.
0:02:10 > 0:02:13You're just run around like little puppy dogs following the clinicians.
0:02:13 > 0:02:15"What can I do? What do you want me to do? How do I do this?"
0:02:15 > 0:02:18So...you look like a bit of an idiot for couple of days.
0:02:18 > 0:02:22Judy Puddifoot from Hertfordshire is spending the next two weeks training
0:02:22 > 0:02:27in the neurology department of the Queen Mother Hospital for Animals.
0:02:27 > 0:02:31OK. That is mahoosive. We'll take that.
0:02:31 > 0:02:34And it's not all brain surgery.
0:02:34 > 0:02:37I think a lot of people go into veterinary medicine thinking,
0:02:37 > 0:02:40"It's professional, it's glamorous." No, it's not.
0:02:40 > 0:02:45It's five years of anal glands, diarrhoea and vomiting.
0:02:45 > 0:02:48So, if you don't like spending half your day on your knees on the floor,
0:02:48 > 0:02:51I really wouldn't become a vet if I were you.
0:02:51 > 0:02:54You've got a misconception if you think it's glamorous.
0:02:55 > 0:02:58You can't have too much bedding, I think.
0:02:58 > 0:03:01Neurology is the brain communicating to the rest of the body,
0:03:01 > 0:03:04- 'going through your spinal cord and into your muscles.'- Come on.
0:03:04 > 0:03:06This isn't weight watchers. Get all your body on there.
0:03:06 > 0:03:09'And what we are looking at is if those things go wrong.
0:03:09 > 0:03:12'When you have a condition of the nervous system,
0:03:12 > 0:03:14'it can look very scary.'
0:03:14 > 0:03:17When you get a patient in with seizures, when you get a patient in
0:03:17 > 0:03:20which is disoriented, it's really frightening.
0:03:22 > 0:03:25'Last night, all I could think about was I was trying to remember'
0:03:25 > 0:03:30how to do a neurological exam on an animal. I had my head...
0:03:30 > 0:03:32I feel asleep with my face in a book
0:03:32 > 0:03:34trying to remember all the cranial nerves.
0:03:34 > 0:03:36Lola!
0:03:36 > 0:03:39Look, mastiff. Shoelaces.
0:03:39 > 0:03:43No. No. No, Lola. We're not going out for a walk today.
0:03:43 > 0:03:45'It's remarkably quiet this week.'
0:03:45 > 0:03:47Lola, sit.
0:03:48 > 0:03:49Good girl.
0:03:49 > 0:03:51It's like the calm before the storm.
0:03:51 > 0:03:54I'm sure something's is going to kick off pretty soon.
0:03:56 > 0:04:00Neurology specialises in serious trauma.
0:04:02 > 0:04:03Good girl!
0:04:03 > 0:04:07Just one hour into Judy's first day, a Border collie called Holly
0:04:07 > 0:04:09has been rushed to the hospital.
0:04:09 > 0:04:14She's had a serious fall and can't walk or even stand up on her own.
0:04:14 > 0:04:18Her local vet has referred her here to be seen by the neurology team.
0:04:18 > 0:04:21It's her only hope, as the alternative would be
0:04:21 > 0:04:23to have her put to sleep.
0:04:23 > 0:04:26Yeah, fallen over a cliff. Hit the sides and can't move.
0:04:26 > 0:04:29That was last night about 5.30, I think, five o'clock.
0:04:29 > 0:04:33Super brave. Super brave.
0:04:35 > 0:04:38Before the team can treat Holly, a neurologist needs to examine her,
0:04:38 > 0:04:40but she seems to be in a lot of pain.
0:04:40 > 0:04:43All right, baby.
0:04:43 > 0:04:45Don't, don't, don't wriggle. Don't wriggle.
0:04:45 > 0:04:48Got to go and find Joe,
0:04:48 > 0:04:50the neurologist who's dealing with this case,
0:04:50 > 0:04:54just so that we can find out if we can give the dog some pain relief
0:04:54 > 0:04:57before he can examine it.
0:04:57 > 0:05:00Sometimes they like to examine them before pain relief because
0:05:00 > 0:05:02the pain relief can mask the true pain
0:05:02 > 0:05:05so we can't localise it properly.
0:05:07 > 0:05:09You're OK.
0:05:09 > 0:05:12The team fit a catheter so Holly can be given pain relief
0:05:12 > 0:05:14as soon as they get the green light.
0:05:14 > 0:05:17You got to stay still. You've got to be still.
0:05:17 > 0:05:19No, no, no, we don't do that.
0:05:19 > 0:05:22Brave girl.
0:05:22 > 0:05:24DOG WHIMPERS
0:05:24 > 0:05:27She is looking stable enough.
0:05:27 > 0:05:30It's unfortunate we can't assess what's going on back here.
0:05:30 > 0:05:34She seems to be really painful...
0:05:34 > 0:05:37so the neurologist will be here soon.
0:05:38 > 0:05:41But the neurologist has told Judy they need to wait.
0:05:41 > 0:05:43Good girl. Good girl.
0:05:43 > 0:05:46He said no pain relief. He wants to examine it first.
0:05:46 > 0:05:49But he's literally going to be down in two minutes, he said.
0:05:49 > 0:05:51Sorry. Sorry, Holly.
0:05:51 > 0:05:53All right I am going to go start taking the history
0:05:53 > 0:05:57if they've finished doing their forms now. OK, all right? Great.
0:05:57 > 0:05:59Holly's owners are in the waiting area
0:05:59 > 0:06:03and Judy needs to find out exactly what happened.
0:06:03 > 0:06:05Holly's been taken through to ER,
0:06:05 > 0:06:07they're assessing her now, just to make sure she's stable
0:06:07 > 0:06:10and if she needs anything immediate. I've been asked by the neurologist
0:06:10 > 0:06:13to come out and just take you through to a room
0:06:13 > 0:06:15and to take a bit of a history of what happened.
0:06:17 > 0:06:20'I've never actually done a consultation for an emergency.'
0:06:20 > 0:06:23I've triaged patients when they've have come in quickly
0:06:23 > 0:06:26and just got a really brief history off of the owners.
0:06:26 > 0:06:28But this is a little bit different.
0:06:28 > 0:06:33'Just trying to keep them reassured is the best thing and be positive.
0:06:33 > 0:06:36'Be positive.'
0:06:36 > 0:06:37Come in. Take a seat.
0:06:38 > 0:06:41What happened exactly?
0:06:41 > 0:06:45We were just cycling on a cycle path and for some reason she was off -
0:06:45 > 0:06:48she'd been on the lead the whole time, virtually, but I took her
0:06:48 > 0:06:51off the lead because we were five minutes from the car.
0:06:51 > 0:06:54And there weren't any other dogs around and she's run up the slope
0:06:54 > 0:06:58on the side, which is like a sea wall.
0:06:58 > 0:07:00- Right.- I guess, is what it is.
0:07:00 > 0:07:03I mean, she just never does. She just always stays by us.
0:07:03 > 0:07:05She's gone up there and suddenly jumped over the top.
0:07:05 > 0:07:09Literally jumped over and hit the stairway that comes down
0:07:09 > 0:07:14and just hit that side with her back and then landed on the floor
0:07:14 > 0:07:17where she has kind of broken her teeth.
0:07:19 > 0:07:21I'll just relay the information.
0:07:27 > 0:07:31They were down in Kent going along a cycle path and the dog jumped
0:07:31 > 0:07:35apparently off the edge, dropped 20 feet and landed on its back.
0:07:35 > 0:07:38Bounced off, hit another thing and then landed on the ground.
0:07:38 > 0:07:41- So, kind of three impacts, really. - OK.
0:07:43 > 0:07:45A big one, is the answer.
0:07:45 > 0:07:47The neurology team examine X-rays
0:07:47 > 0:07:51that Holly's referring vet sent with her to the hospital.
0:07:51 > 0:07:55That...intervertebral disk space is potentially
0:07:55 > 0:07:58traumatically narrowed, but you don't know anything about
0:07:58 > 0:08:01whether or not there's any spinal cord injury or compression there.
0:08:03 > 0:08:07Good girl. Good girl. Good girl. Good girl. OK. OK. Good girl.
0:08:07 > 0:08:12Before she can be treated Holly must undergo a neurological exam to
0:08:12 > 0:08:16discover the extent of her injuries and check her response to pain.
0:08:16 > 0:08:19Are you all right to jot down what we're finding in the exams?
0:08:19 > 0:08:21Yeah, yeah, sure.
0:08:21 > 0:08:23DOG WHIMPERS
0:08:23 > 0:08:25Aw. Good girl.
0:08:27 > 0:08:30She's affected from her lower back down hence why her hind limbs
0:08:30 > 0:08:35are not working and her right hind limb is worse than her left.
0:08:35 > 0:08:40But we need to do further imaging to see exactly what is going on
0:08:40 > 0:08:44and then we can further knock down our list of possibles from that.
0:08:46 > 0:08:48Before Holly goes for a CT scan,
0:08:48 > 0:08:51her owners get the chance to say their goodbyes.
0:08:51 > 0:08:54Do you want to just see her quickly before you go?
0:08:54 > 0:08:56Oh, is she heavily sedated?
0:08:56 > 0:09:00She's not heavily sedated, no. I mean, she's had pain relief.
0:09:00 > 0:09:01It's completely up to you.
0:09:03 > 0:09:05You're not going to see her? I'd like to see her.
0:09:05 > 0:09:07OK, she's just in here.
0:09:15 > 0:09:19I know, I know, all right.
0:09:19 > 0:09:24We'll come and get you soon. We will. We will.
0:09:24 > 0:09:27OK, all right. See you in the morning.
0:09:36 > 0:09:40A CT scan uses X-rays to produce images of structures
0:09:40 > 0:09:43inside the body, including the spine.
0:09:43 > 0:09:45It should pinpoint Holly's injury.
0:09:47 > 0:09:50'When we're looking at the scans, as a student,
0:09:50 > 0:09:54'it can be difficult to look at that and access it in minute detail,
0:09:54 > 0:09:59'and unless there's something quite obvious there - there's sometimes
0:09:59 > 0:10:03'I can miss things on it but when there's a screaming broken bone
0:10:03 > 0:10:06'on there, it's pretty damn obvious what's going on.
0:10:06 > 0:10:08'So, yeah, looking at her scans,'
0:10:08 > 0:10:12we localised the problem and the problem was she'd broken her back
0:10:12 > 0:10:14falling off that cliff.
0:10:16 > 0:10:19Without surgery, Holly will have to be put to sleep.
0:10:23 > 0:10:25DOG WHIMPERS
0:10:27 > 0:10:30TOY SQUEAKS
0:10:30 > 0:10:33Before rotation started, I was really looking forward to it.
0:10:33 > 0:10:36A little bit of dread. But I was actually
0:10:36 > 0:10:39- really looking forward to it.- I was fairly apprehensive.- Were you?- Yeah.
0:10:39 > 0:10:42But at the same time I was really looking forward to it
0:10:42 > 0:10:46because it's so much of what we're going to do.
0:10:46 > 0:10:48And also the fact that every week was different.
0:10:48 > 0:10:51You kind of just rotate, literally rotate around.
0:10:51 > 0:10:54- I wonder why it's called rotations(?) - Oh, my God, yeah.- You've cracked it.
0:10:54 > 0:10:58- You're genius.- I've cracked the code.- You've cracked the QMH code.
0:11:02 > 0:11:06Come on, then. Bobby. In.
0:11:06 > 0:11:08In! Yeah, yeah.
0:11:11 > 0:11:14Charlie Tewson from Norfolk has opted to spend this week
0:11:14 > 0:11:17on a placement near his home town of Shotesham.
0:11:19 > 0:11:23I've not got as much farming experience as I do in small animals,
0:11:23 > 0:11:26so I'm a little bit more rusty but that's the purpose
0:11:26 > 0:11:30of what this week is for - to try and get that up to scratch.
0:11:33 > 0:11:37The guy I am with is entirely a farm vet,
0:11:37 > 0:11:41and I am going out in his car and he is a particularly a good teacher.
0:11:41 > 0:11:46He's really good at making sure I know what he's doing,
0:11:46 > 0:11:49that he knows what I am doing and when he feels confident
0:11:49 > 0:11:54that I'll be able to have at least a crack at something
0:11:54 > 0:11:58then he tends to let me have a go which, is pretty good.
0:11:58 > 0:12:01He's working at Chapelfield Veterinary Partnership,
0:12:01 > 0:12:06where he'll be supervised by farm vet Steve Trickey.
0:12:06 > 0:12:11He has certainly got his uses that, yeah, he, I sort of - he is
0:12:11 > 0:12:14very good at making teas and coffees and that is the first thing
0:12:14 > 0:12:19we teach them to do, to make sure they know where the kettle is.
0:12:19 > 0:12:22- Hydration is very important. I've learnt that this week.- Yeah.
0:12:24 > 0:12:29If Charlie becomes a farm vet, he'll spend most of his time on the road.
0:12:29 > 0:12:33Just heading off to one of our clients
0:12:33 > 0:12:38where we do a weekly routine.
0:12:38 > 0:12:41Don't know what cows they'll put in front of us.
0:12:41 > 0:12:44They only have about a hundred cows.
0:12:44 > 0:12:49Normally not too many cows to see.
0:12:49 > 0:12:51There's a certain element of being thrown in at a deep end
0:12:51 > 0:12:53but that's kind of how I like to be.
0:12:53 > 0:12:55This is lube,
0:12:55 > 0:13:01just to make rectalling cows that little bit more comfortable.
0:13:01 > 0:13:03- For both human and cow. - CHARLIE LAUGHS
0:13:03 > 0:13:05'And so in a way it's actually easier'
0:13:05 > 0:13:07to just get those nerves out of the way
0:13:07 > 0:13:10and just be thrown in and just go for it.
0:13:10 > 0:13:12COWS MOO
0:13:12 > 0:13:18I'm putting on a glove so that I can do a rectal examination on this cow
0:13:18 > 0:13:22to find out why she is standing to be mounted,
0:13:22 > 0:13:25to be mated, more than she should.
0:13:26 > 0:13:31In veterinary medicine, this cow's problem is known as nymphomania
0:13:31 > 0:13:34and can be caused by ovarian cysts.
0:13:34 > 0:13:37If you do a vaginal examination first.
0:13:37 > 0:13:39Yep, slap the lube on.
0:13:42 > 0:13:45Just go in. Feel the cervix.
0:13:47 > 0:13:51- See if its opened and then...- Yep.
0:13:51 > 0:13:55- Cervix is about a width of my little finger.- Feel rectally.
0:13:55 > 0:13:58If she has got a cyst, Charlie,
0:13:58 > 0:14:01what would you feel hopefully on one of the ovaries?
0:14:01 > 0:14:05Hopefully a bulge that will be more than two and half centimetres.
0:14:07 > 0:14:10Is there a trick to finding an ovary? Do you literally, just...?
0:14:10 > 0:14:18- Are you having difficulty or...? - Well...a little bit.- Yeah, fine.
0:14:18 > 0:14:21- Which one?- At the moment, the left I can't quite find.
0:14:21 > 0:14:26I'll take over now, Charlie. If you want to turn on the monitor on,
0:14:26 > 0:14:29- then you will be able to see what I'm seeing.- Yep.
0:14:29 > 0:14:31Steve has the latest in farm vet technology
0:14:31 > 0:14:35so he can show Charlie exactly what he was looking for.
0:14:35 > 0:14:39A uterine horn there just at about nine o'clock,
0:14:39 > 0:14:43just wiggling it slightly, so... 11 o'clock.
0:14:43 > 0:14:47- And there we've got a three centimetre follicle.- Yeah.
0:14:47 > 0:14:52Which, like you said, greater than two and a half centimetres,
0:14:52 > 0:14:55so that is a follicular cyst.
0:14:55 > 0:14:58So, how are we going to treat that?
0:14:58 > 0:15:01We want it to ovulate.
0:15:01 > 0:15:04- Yes.- So we want to give it GNRH?- Spot on!
0:15:04 > 0:15:07It's quite a hard thing to get practical experience, that's why
0:15:07 > 0:15:10it's so important to come to farms and find really good vets
0:15:10 > 0:15:15at good farms cos farmers have to be willing to let you
0:15:15 > 0:15:17essentially do the job twice.
0:15:17 > 0:15:20So quite a lot of students don't get a lot of chance to rectal
0:15:20 > 0:15:22more than couple of more times, which is why I am so grateful
0:15:22 > 0:15:25for this place because they do let me do it if there's time.
0:15:25 > 0:15:29They'll let me do couple each day and just to get my eye in.
0:15:30 > 0:15:34It's not just practical skill Charlie must demonstrate.
0:15:34 > 0:15:38Steve also constantly tests him on the theory.
0:15:38 > 0:15:40You're trying to make a diagnosis of why
0:15:40 > 0:15:44she has gone off-colour and whatever.
0:15:44 > 0:15:46Other things that you can pick up,
0:15:46 > 0:15:51things like wires or whatever, so how can you test for a wire?
0:15:51 > 0:15:57If the wire's ruptured is it's traumatic rumenal...
0:15:59 > 0:16:01- ..something.- Yep.
0:16:01 > 0:16:06- You're halfway there. - Traumatic rumenal peritonitis?- Close.
0:16:06 > 0:16:11- Abbreviate it. So, traumatic... - Traumato...- Well, traumatic,
0:16:11 > 0:16:12and then sort of...
0:16:12 > 0:16:16- Rumino...- Rumen, or what's the first stomach called?
0:16:17 > 0:16:19'They learn a lot of stuff'
0:16:19 > 0:16:23at Vet school, sort of reams and reams and it is just sort of
0:16:23 > 0:16:26quite often fed to be them sort of parrot-fashion.
0:16:26 > 0:16:28'I know he knows it and it's in there somewhere.'
0:16:28 > 0:16:34It's just getting him to remember it and put it into a practical context.
0:16:34 > 0:16:37Reticulo...reticulo peritonitis...
0:16:37 > 0:16:40Yeah, and abbreviate it a wee bit more -
0:16:40 > 0:16:43- inflammation of the reticulum. - Reticulitis.
0:16:43 > 0:16:46- Traumatic reticulitis. - Traumatic reticulitis. OK.
0:16:50 > 0:16:52One of the benefits of his week-long rotation in the country
0:16:52 > 0:16:56is that Charlie can go home at the end of each day.
0:16:56 > 0:16:57You can do the honours with that!
0:16:57 > 0:17:00'He's wanted to be a vet since he was tiny.'
0:17:00 > 0:17:03We use to have guinea pigs
0:17:03 > 0:17:07and kittens and puppies and we got sheep
0:17:07 > 0:17:12and chickens and it was chickens, funnily enough, he really took to.
0:17:12 > 0:17:14Judging by Charlie's bedroom,
0:17:14 > 0:17:16his passion for animals is as strong as ever.
0:17:16 > 0:17:19I think it was my twelfth birthday present. They told me
0:17:19 > 0:17:22I'd get a choice of what I'd get painted -
0:17:22 > 0:17:24a jungle or Sonic the Hedgehog
0:17:24 > 0:17:28and I still regret not getting Sonic the Hedgehog.
0:17:28 > 0:17:31No. I love it actually, still.
0:17:31 > 0:17:33My mum sometimes comes in and says sort of,
0:17:33 > 0:17:37"Oh, are sure you don't want it painted a sort of more adult colour?"
0:17:37 > 0:17:40I'm actually like, "I really like it."
0:17:40 > 0:17:43It's my childhood room, it's still home and love it.
0:17:54 > 0:17:57In London, it's Amy Clithero's turn
0:17:57 > 0:17:59to start a rotation she's been dreading.
0:18:02 > 0:18:05It's her first day at the Beaumont Sainsbury Animal Hospital,
0:18:05 > 0:18:09the college's general vet practice in North London.
0:18:09 > 0:18:12The smaller the animal for me, the less I trust it.
0:18:12 > 0:18:17No, but I trust - I'd rather be around a shire horse than a cat,
0:18:17 > 0:18:19to be honest.
0:18:19 > 0:18:22The day starts with a briefing from head vet Louise Allum.
0:18:22 > 0:18:26Well, morning, everybody. I am Louise Allum, I'm the head vet here.
0:18:26 > 0:18:28Welcome to The Beaumont. What I do to start off and see
0:18:28 > 0:18:31if you're awake on a Monday morning, is we go round, do introductions,
0:18:31 > 0:18:33tell me what your name is
0:18:33 > 0:18:36and what you'd like to get out of the rotation.
0:18:36 > 0:18:40I'm Amy. I'd like to just get more confident at consults, really,
0:18:40 > 0:18:42and knowing what drugs to use when.
0:18:42 > 0:18:45I think that's - basically I just want to get good
0:18:45 > 0:18:47at what the public can see.
0:18:47 > 0:18:50Hopefully you're going to get your rubbish bit out of the way here.
0:18:50 > 0:18:52I am sure you won't be rubbish at all, and when you go to
0:18:52 > 0:18:54your first job and you are going to be fantastic.
0:18:54 > 0:18:57'The students are here for two weeks as a final year
0:18:57 > 0:18:59'to learn their first day skills.'
0:18:59 > 0:19:02The students are given a lot of responsibilities here,
0:19:02 > 0:19:04they're going to be seeing cases themselves, operating -
0:19:04 > 0:19:06a lot of them for the first time -
0:19:06 > 0:19:08so I think that is quite a frightening thing.
0:19:08 > 0:19:11This rotation is the closest they are going to get
0:19:11 > 0:19:12to their first day on the job.
0:19:12 > 0:19:16Amy will take case histories from the owners of walk-in pets.
0:19:16 > 0:19:19Her clinical reasoning will be carefully scrutinized
0:19:19 > 0:19:21by Doctor Jill Maddison.
0:19:21 > 0:19:24She's being assessed during all of her rotations,
0:19:24 > 0:19:27and at the end of every rotation she will be given a grade.
0:19:27 > 0:19:31We can give them as many lectures as we like about diseases,
0:19:31 > 0:19:34but it's actually what they learn on the clinic floor
0:19:34 > 0:19:38and bring it all together and really increasing her confidence
0:19:38 > 0:19:41and understanding why she is asking the questions.
0:19:41 > 0:19:45- Chiggy Garett-Adams. Hello.- Hello.
0:19:45 > 0:19:47If you'd like to come through.
0:19:47 > 0:19:49Sorry. I'm Amy, I'm one of the vet students
0:19:49 > 0:19:52and I'll just be having a look at Chiggy.
0:19:52 > 0:19:55Amy's patient is an 11-year-old black spaniel called Chiggy
0:19:55 > 0:19:57who's been struggling to walk.
0:19:58 > 0:20:02He starts stiffening up and I got a bit worried about him
0:20:02 > 0:20:04at the weekend.
0:20:04 > 0:20:08Yeah, I don't want him to do down hill quickly.
0:20:08 > 0:20:10But they're just dogs, aren't they?
0:20:10 > 0:20:12But it's easy to love a dog, isn't it?
0:20:12 > 0:20:14Right, so if you just want to turn him round for me
0:20:14 > 0:20:16and just walk up and down again.
0:20:16 > 0:20:18Which of his leg did you say is normally his worse?
0:20:18 > 0:20:21- Both his back legs.- Yeah.
0:20:21 > 0:20:25- We think we can feel his hips clicking.- Mm-hm.
0:20:25 > 0:20:28'The very first thing they should be doing is defining the problem
0:20:28 > 0:20:29'and refining the problem,'
0:20:29 > 0:20:32you know, what is it? How long has it been going on for?
0:20:32 > 0:20:35You know, how can you actually characterise it?
0:20:35 > 0:20:38How long to do you say this has been going on for, do you think?
0:20:38 > 0:20:41Most latterly sort of the last three or four weeks I've noticed
0:20:41 > 0:20:46he is just slowing down. Going up hills, he hates.
0:20:46 > 0:20:48So he drags quite a bit on hills.
0:20:48 > 0:20:52It's like being a detective. It's all clues that add together
0:20:52 > 0:20:57to the picture that you are creating about the patient that helps you
0:20:57 > 0:21:00answer the key questions that are going to help you decide
0:21:00 > 0:21:01where you are going to go.
0:21:01 > 0:21:03It's a bit of a mess, really.
0:21:03 > 0:21:05You're an old boy. You're allowed to be.
0:21:07 > 0:21:09This one doesn't really seem to get anything.
0:21:11 > 0:21:13Good boy.
0:21:13 > 0:21:15Yes, I'll just go to speak to one of the vets.
0:21:21 > 0:21:26Chiggy is 14-year-old male neutered cocker spaniel.
0:21:26 > 0:21:29The past three or four weeks he's really slowed down.
0:21:29 > 0:21:32What do you mean by slowed down?
0:21:32 > 0:21:35Sorry, just in general his demeanour's slowed down.
0:21:35 > 0:21:40On the walk up and down, his hind legs look arthritis-y.
0:21:40 > 0:21:43- No, don't tell me that. Tell me what you saw.- Sorry.
0:21:43 > 0:21:48- He just looks stiff. - OK. Sort of proppy or small steps?
0:21:48 > 0:21:49They're quite small. Yeah.
0:21:49 > 0:21:52Any wobbling? Any sort of ataxia or anything like that?
0:21:52 > 0:21:54Not particularly, no.
0:21:54 > 0:21:57- He has had vestibulitis, I think the owner said.- OK.
0:21:57 > 0:22:00- Tell me what you are observing, not what they said.- Sorry.
0:22:00 > 0:22:04- It looked OK. I wasn't specifically thinking, "It's there."- OK.
0:22:04 > 0:22:08Has he been getting worse over the three or four weeks or he is stable?
0:22:08 > 0:22:11- I don't know.- OK, so you need that, that's important.
0:22:11 > 0:22:14Is this something progressing or is this something that's been the same?
0:22:14 > 0:22:18- Yeah.- So how would you how would you summarise, define his problem?
0:22:18 > 0:22:21Musculo-skeletal in the hind limbs.
0:22:21 > 0:22:24No, that's his system not his problem. If I said to you,
0:22:24 > 0:22:27"What have you observed that is abnormal about this dog?"
0:22:27 > 0:22:29- Stiffness in the hind limbs.- OK.
0:22:29 > 0:22:32So, it's stiffness in hind limbs as oppose to lameness.
0:22:32 > 0:22:34Right, let's go have a look at him. What's his name?
0:22:34 > 0:22:37- Chiggy Garatt-Adams.- Chikky, Chiggy.
0:22:37 > 0:22:39- OK. And we're in five?- Yes.
0:22:41 > 0:22:43Hi, how are you?
0:22:43 > 0:22:46Amy's consultation wasn't thorough enough, and Jill suspects
0:22:46 > 0:22:51there's something more to Chiggy's case than simple arthritis.
0:22:51 > 0:22:54OK. This will sound a bit weird
0:22:54 > 0:22:57- but his reflexes are a bit too good.- Oh, really?
0:22:57 > 0:22:59They're very brisk.
0:22:59 > 0:23:03What happens is when you do the patellar reflex,
0:23:03 > 0:23:07it's an arc and it should go 'dum', like that.
0:23:07 > 0:23:11If there's a bit of damage in the spinal cord above a certain point,
0:23:11 > 0:23:15some dampening messages don't come down and it goes like that.
0:23:15 > 0:23:18Amy jumped to conclusions and failed to spot
0:23:18 > 0:23:22that Chiggy has a spinal nerve problem.
0:23:22 > 0:23:25She forgot to ask some things that might have helped in the assessment
0:23:25 > 0:23:27of it and one of them in particular was,
0:23:27 > 0:23:29"Was it getting worse over the four weeks?"
0:23:29 > 0:23:31She was so convinced that it was going to be arthritis
0:23:31 > 0:23:35and that's the most common presenting or most common cause
0:23:35 > 0:23:42for a dog presenting with abnormal gait, and therefore didn't do
0:23:42 > 0:23:47some core tests about just checking what the nerve function was like.
0:23:47 > 0:23:48I was grilling her
0:23:48 > 0:23:52but hopefully it will have an impact, and a lasting impact.
0:23:52 > 0:23:57- What's his name?- Chiggy.- Hey, Chiggy.- 14-year-old.- Hey, darling.
0:23:57 > 0:23:59Chiggy will be given anti inflammatory medication
0:23:59 > 0:24:03and will be back in two weeks for a check up on his spinal condition.
0:24:03 > 0:24:05I like to get things right.
0:24:05 > 0:24:08Yeah, I've only done one or two consults before but basically
0:24:08 > 0:24:12I need to do my job properly and if am not doing my job properly, then
0:24:12 > 0:24:16I need to do better cos I don't like making mistakes like that.
0:24:16 > 0:24:17It's not great.
0:24:19 > 0:24:22- Yeah.- Cool.- All right, darling.
0:24:22 > 0:24:25When you get the negative feedback,
0:24:25 > 0:24:27you're just like, "I honestly, honestly tried my best
0:24:27 > 0:24:31"and I couldn't have done anything more," that's quite demoralising.
0:24:31 > 0:24:34That's the worse part of it.
0:24:37 > 0:24:42Rotations can be tough, so when she can, Amy heads home to Yorkshire.
0:24:50 > 0:24:53We're really fortunate to live right on the edge of the Moors, like,
0:24:53 > 0:24:55literally open our back gate and we are on the Moors.
0:24:55 > 0:24:58So you can just go and chill out.
0:25:04 > 0:25:06I think I was about 12 or 13 thirteen at the time,
0:25:06 > 0:25:09and my brother came into the kitchen one day and basically said,
0:25:09 > 0:25:12"You need to call a vet for our horse cos it's cut its leg."
0:25:14 > 0:25:17It was a lovely vet called Jamie that came out.
0:25:17 > 0:25:22And basically he let me squirt this wound gel into it
0:25:22 > 0:25:26to help clean it and I just got really excited about doing that
0:25:26 > 0:25:30and he was he was just so lovely that I think he is actually
0:25:30 > 0:25:32quite part of a big part as to why I'm a vet.
0:25:37 > 0:25:41Amy followed her heart, and not necessarily
0:25:41 > 0:25:43what she was intellectually best at,
0:25:43 > 0:25:46and she worked so hard
0:25:46 > 0:25:50and now she has actually achieved what she wanted to in her heart.
0:25:52 > 0:25:54Yeah, it's...
0:25:54 > 0:25:55Makes me really happy, actually.
0:25:55 > 0:26:00Cos sometimes people take the easy option and sometimes it takes
0:26:00 > 0:26:03a lot of bravery to follow the heart and that what Amy's done,
0:26:03 > 0:26:08so that's why I'm really, really proud of her. Really proud of her.
0:26:19 > 0:26:23I think the people side of it is another really big reason
0:26:23 > 0:26:26why I went into it because I really like chatting to people and you are
0:26:26 > 0:26:30going to see loads of people everyday coming through your door.
0:26:33 > 0:26:36- You get to play with their pets. - This is it!
0:26:36 > 0:26:39There's always the bonus of the animal right there.
0:26:44 > 0:26:48It's Judy's second day in neurology.
0:26:48 > 0:26:50Oh, busy!
0:26:50 > 0:26:54Yesterday, Holly the Border collie was rushed in with a broken back.
0:26:54 > 0:26:56The owners have decided that they want to do surgery,
0:26:56 > 0:27:01which is good, and we are going to go in and stabilise her spine,
0:27:01 > 0:27:03so put some pins and cement.
0:27:03 > 0:27:06Those are the words I have heard.
0:27:06 > 0:27:08Holly can't move her hind legs.
0:27:08 > 0:27:12If the surgery fails, she'll have to be put to sleep.
0:27:12 > 0:27:17If you guys at the same time keep her spine straight,
0:27:17 > 0:27:20I'll have my hands round here.
0:27:20 > 0:27:25In charge of this delicate surgery are senior neurologist Patrick Kenny
0:27:25 > 0:27:27and resident Joe Fenn.
0:27:27 > 0:27:30We are going to be putting metal pins into the into the bone
0:27:30 > 0:27:34and Patrick is just trying to work out on the CT scan
0:27:34 > 0:27:37the angle and the length of the pins we want to use.
0:27:37 > 0:27:41Although it's life and death for Holly, for student vet Judy,
0:27:41 > 0:27:45this is an exciting chance to see complex spinal surgery.
0:27:46 > 0:27:49I need to get a stool cos these guys are quite tall
0:27:49 > 0:27:52and the operating table will come to about there on me.
0:27:52 > 0:27:56So, I am going to have to find a stool about yay big.
0:27:58 > 0:28:01I don't know what half the instruments are called and I am
0:28:01 > 0:28:04pretty sure they are going to ask me to pass them instruments
0:28:04 > 0:28:07and they are going to ask for a... SHE SPEAKS GIBBERISH
0:28:07 > 0:28:10and I'll say, "Which one is that?"
0:28:10 > 0:28:14Because Neuro has got its whole load of instruments that I don't know.
0:28:14 > 0:28:18- Do you want to put your mask on? Scrub up?- Yeah, yeah.
0:28:18 > 0:28:20A spinal surgery is amazing.
0:28:20 > 0:28:25I literally, the first time I saw a dog's spinal cord,
0:28:25 > 0:28:27I was just, well, you couldn't see because I had a mask on
0:28:27 > 0:28:30but the grin was from ear to ear. I think it was quite embarrassing
0:28:30 > 0:28:33for me, actually, because I actually might have pointed and went,
0:28:33 > 0:28:37"Oh, my God, there is the spinal cord." And the surgeons just went,
0:28:37 > 0:28:38"Yes, Judy."
0:28:46 > 0:28:50'The surgeons that worked on her, fantastic. Absolutely fantastic.
0:28:50 > 0:28:53'And I guess I suppose the novelty has worn off for them a little bit
0:28:53 > 0:28:58'but for me, it was brilliant and just to see what they do is amazing.'
0:28:58 > 0:29:02But to scrub in as well - fantastic. Fantastic.
0:29:11 > 0:29:13It's coming along nicely. It's not warm yet.
0:29:13 > 0:29:17During the surgery, Judy is given one important job.
0:29:17 > 0:29:20'She had pins and cement'
0:29:20 > 0:29:21placed in her spine to stabilise it
0:29:21 > 0:29:25and it's very important that the surgeons know when this cement
0:29:25 > 0:29:28they are playing with is going to set. You know it's going to set
0:29:28 > 0:29:30because it starts to go cold.
0:29:30 > 0:29:33And so the very important job that the student is given is to play with
0:29:33 > 0:29:36the piece of this cement and tell the surgeon when it's going to go cold
0:29:36 > 0:29:39cos then they know this is going to set
0:29:39 > 0:29:41and we've got no more time. We need to do it now.
0:29:41 > 0:29:46- How is it, warm?- Yeah. It's slightly warm. Not hot.
0:29:46 > 0:29:50It's a three and a half hour operation to repair Holly's
0:29:50 > 0:29:54damaged spine, and there are no guarantees she will walk again.
0:29:56 > 0:30:00They are going to take her up to CT to get scan to see.
0:30:00 > 0:30:05Make sure the pins are in a sufficiently good place.
0:30:05 > 0:30:08The procedure will only be considered successful
0:30:08 > 0:30:11if the pins in Holly's back are correctly positioned.
0:30:23 > 0:30:26Cool. That's all right. That's good.
0:30:31 > 0:30:32The pins may be in the right place
0:30:32 > 0:30:35but Holly's recovery is just beginning.
0:30:37 > 0:30:41It will be days before they know if she will ever walk again.
0:31:03 > 0:31:05I've got no cases at the moment
0:31:05 > 0:31:08so I am basically dog holder
0:31:08 > 0:31:11and odd jobs man, I guess.
0:31:13 > 0:31:17For the next two weeks Dru Shearn, a student from Somerset,
0:31:17 > 0:31:20is on a placement in the Queen Mother Hospital's
0:31:20 > 0:31:22anaesthesia department.
0:31:22 > 0:31:26You can't practice. Even if it's general practice, from the first day
0:31:26 > 0:31:28without knowing basic anaesthesia,
0:31:28 > 0:31:30so there is a real pressure to know your stuff
0:31:30 > 0:31:33and really learn from the rotation and take away as much as you can.
0:31:33 > 0:31:35No, no, no.
0:31:35 > 0:31:39Anaesthesia involves calculating precise drug doses
0:31:39 > 0:31:42and following strict protocols.
0:31:42 > 0:31:45Any mistakes on Dru's part could mean the difference
0:31:45 > 0:31:48between life and death for his patients.
0:31:48 > 0:31:50I think I'm sat on a wet patch but that's fine.
0:31:51 > 0:31:53This is Jess,
0:31:53 > 0:31:57who is a 25-week-old golden retriever puppy.
0:31:57 > 0:32:01And she's got something called an extrahepatic shunt,
0:32:01 > 0:32:06which means that the blood vessel is basically bypassed,
0:32:06 > 0:32:09there's a blood vessel bypassed in her liver.
0:32:09 > 0:32:11So, she's little bit thin for her age
0:32:11 > 0:32:14and she's kind of not using her nutrients how she should and there's
0:32:14 > 0:32:18lots of other problems that can come with it. She's been quite sick.
0:32:18 > 0:32:23She's going to have surgery today to I think ligate that vessel
0:32:23 > 0:32:27and tie it off so that everything then runs through the liver
0:32:27 > 0:32:30as it should. I'll be giving her all her medication to make her
0:32:30 > 0:32:32anaesthetised, putting the tubes in and the catheters
0:32:32 > 0:32:35and things like that and getting her prepped for surgery.
0:32:35 > 0:32:38But I'm a little a bit in love with her so I hope that she actually
0:32:38 > 0:32:41pulls through. She is really sweet.
0:32:41 > 0:32:43She has amazing ears as well.
0:32:43 > 0:32:46She has fluffiest little ears.
0:32:46 > 0:32:48Although Jess appears healthy,
0:32:48 > 0:32:52without this operation she won't survive into adulthood.
0:32:52 > 0:32:54- WOMAN:- Hi, Puppy!
0:32:54 > 0:32:57Jess was a really cute little puppy and I think
0:32:57 > 0:33:00they're the one that always gets you because as small and fluffy
0:33:00 > 0:33:02as a puppy is, they kind of have a little bit more innocence than
0:33:02 > 0:33:05an older dogs so when something does go wrong, then you feel for them
0:33:05 > 0:33:08a little bit more cos they really can't understand what is going on.
0:33:08 > 0:33:11They've been, like, taken from home, they are stuck in a kennel
0:33:11 > 0:33:14and no-one is there to love them.
0:33:14 > 0:33:16So, yeah, I think puppies is the...
0:33:16 > 0:33:18Puppies get me quite a lot, actually.
0:33:20 > 0:33:24Dru's given responsibility for administering Jess' anaesthetic.
0:33:27 > 0:33:30Throughout the procedure he'll be under the watchful eye
0:33:30 > 0:33:33of anaesthetist Cristina De Miguel.
0:33:48 > 0:33:52There is always quite a lot going on for the first 20, 25 minutes.
0:33:52 > 0:33:55Just getting everything together and it's stable, so once it
0:33:55 > 0:33:58goes in theatre, hopefully everything will be a bit smoother.
0:34:01 > 0:34:02She is quite deep, I think.
0:34:04 > 0:34:06- Yep!- OK.
0:34:06 > 0:34:09It's time we start checking on the monitoring stuff?
0:34:09 > 0:34:13We're going to turn off the isoflorine, flush the bag through
0:34:13 > 0:34:16and then disconnect and turn the oxygen off afterwards.
0:34:16 > 0:34:21The surgery to repair Jess' liver defect could take hours,
0:34:21 > 0:34:25and Dru's job is to monitor her vital signs using a capnograph.
0:34:25 > 0:34:28Probably monitor to see what changes. She's only been moved to see
0:34:28 > 0:34:31if she stabilises in the next couple of minutes.
0:34:36 > 0:34:40Just starring at a capnograph is boring. Really, really boring.
0:34:40 > 0:34:44And anyone that tells you it's not boring is wrong because if nothing's
0:34:44 > 0:34:47happened for five hours, and you are just staring at a screen with
0:34:47 > 0:34:50a little squiggly line that's going up and down
0:34:50 > 0:34:52and there's a beeping as well...
0:34:52 > 0:34:54I had a dream about this machine last night with the beeping.
0:34:54 > 0:34:56I don't know how you do it.
0:34:56 > 0:34:59Maybe you just start to ignore it after a while, I think.
0:34:59 > 0:35:03Beep! Beep! And then every so often it will go, "Boo, boo, beep."
0:35:03 > 0:35:06BEEPING
0:35:06 > 0:35:11There's a lot of other beeps as well but we've turned those off.
0:35:11 > 0:35:15It might be boring but just one hour into the operation
0:35:15 > 0:35:19Cristina spots a problem that Dru has missed.
0:35:25 > 0:35:28Unchecked, Jess' falling blood pressure
0:35:28 > 0:35:31could lead to cardiac arrest.
0:35:36 > 0:35:39How happy would I be to give fluids?
0:35:41 > 0:35:44Not particularly happy about giving fluids but it has to be done
0:35:44 > 0:35:46because the blood pressure is more important, probably.
0:35:51 > 0:35:53Maybe four to five mls a kg per hour?
0:35:57 > 0:36:00Her blood pressure was a little bit low.
0:36:00 > 0:36:03So we just put her on different type of fluids to try
0:36:03 > 0:36:06and bring her blood pressure up a little a bit.
0:36:06 > 0:36:08Jess is now stable
0:36:08 > 0:36:13and after three hours the operation on her liver was a success.
0:36:13 > 0:36:18Dru's final task is to hand her over to the recovery team.
0:36:18 > 0:36:22This is Jess who is a 25-week-old female golden retriever.
0:36:22 > 0:36:26She had a GA and venogram and...
0:36:26 > 0:36:29Sorry, because she had an extrahepatic portosystemic shunt.
0:36:29 > 0:36:32She also got sub-aeortic stenosis.
0:36:32 > 0:36:35- Have you done a recent temperature on her?- Yeah.
0:36:35 > 0:36:39- Well, the last one we did was at 25 past, which was 37.7.- OK.
0:36:39 > 0:36:41Good. Nice. Nice and toasty.
0:36:43 > 0:36:47It's quite different to all the other rotations, actually.
0:36:47 > 0:36:50I feel like it's a steeper learning curve.
0:36:50 > 0:36:53I think you need to know a lot more and from so far what I have done,
0:36:53 > 0:36:56a lot more information, and you need a lot of theory
0:36:56 > 0:36:59but also need to be practically on the ball as well.
0:36:59 > 0:37:03But it's all really important stuff, so I'm actually enjoying it.
0:37:03 > 0:37:06I didn't think I'd enjoy it this much but it's really good.
0:37:16 > 0:37:18DOG BARKS
0:37:20 > 0:37:23At the Beaumont General Vet Practice,
0:37:23 > 0:37:25Amy's halfway through her placement.
0:37:26 > 0:37:30Coco Chanel? Hello, poppet.
0:37:30 > 0:37:34After a shaky start she's growing in confidence
0:37:34 > 0:37:37around animals and their owners.
0:37:37 > 0:37:41..apart from she's a little parched. She thinks she is a Rottweiler.
0:37:41 > 0:37:43I've never really done the whole having a hamster when
0:37:43 > 0:37:49I was younger, so my smallest pet that was actually mine was a pony.
0:37:49 > 0:37:53So I have very, very, very little small animal handling experience,
0:37:53 > 0:37:56so normally whenever I go for anything that's even slightly
0:37:56 > 0:37:58strange, I'm like, "Please explain how to hold it."
0:37:58 > 0:38:01Because I'm terrified of breaking them.
0:38:01 > 0:38:03Right, sorted. stand up. Come on, poppet!
0:38:03 > 0:38:05- Just have a feel of your belly. - Stand.
0:38:05 > 0:38:08A bit tense still, aren't you, mate? You're not getting used to that.
0:38:08 > 0:38:11Never does like it. You know he's good but he does sort of tense.
0:38:11 > 0:38:13Yeah, I don't blame him.
0:38:13 > 0:38:17I wouldn't be too keen on someone prodding my belly!
0:38:17 > 0:38:19'Before I went to Beaumont,
0:38:19 > 0:38:22'I was kind of thinking, "Why the heck am I here?"'
0:38:22 > 0:38:24I don't get to really get hands on,
0:38:24 > 0:38:26all I'm doing is watching people do things.
0:38:26 > 0:38:28It's like, "What's the point of me being here?"
0:38:28 > 0:38:31'But when you actually get to meet the owners yourselves,
0:38:31 > 0:38:33'you'd get a rapport with them. You just get talking to them.'
0:38:33 > 0:38:37Their animals are doing well. They're all happy. Everyone is happy.
0:38:37 > 0:38:38Job's a good'un!
0:38:41 > 0:38:44But Amy's next patient, who's in for a follow up appointment,
0:38:44 > 0:38:47is no ordinary pet.
0:38:47 > 0:38:50I've had him for 47 years since I was seven.
0:38:50 > 0:38:54It was a surprise when I got the tortoise - I wanted a dog.
0:38:55 > 0:39:01He was upstairs and one of the cats knocked him down so he fell down
0:39:01 > 0:39:06from upstairs to down and I thought it was just his shell,
0:39:06 > 0:39:09but his leg was swollen.
0:39:09 > 0:39:13And we went and got them X-rayed and they found it was broken.
0:39:13 > 0:39:16But I love him a lot.
0:39:16 > 0:39:18Everyone knows him.
0:39:18 > 0:39:21He's using the Facebook.
0:39:22 > 0:39:25Heat and UV light, anything else?
0:39:26 > 0:39:31Today, Amy is being supervised by teaching vet Nadene Stapleton.
0:39:31 > 0:39:34I'm basically, I'm the sucker that does all the exotics,
0:39:34 > 0:39:38so I have a real interest in exotics species,
0:39:38 > 0:39:41and it means the poor students that get posted with me for the day,
0:39:41 > 0:39:43they get a little bit nervous when they look into my consult lists
0:39:43 > 0:39:47on the computer to see what exactly it is I have in store for them.
0:39:47 > 0:39:49It could be anything, really.
0:39:49 > 0:39:51It's 50 years old! It's like,
0:39:51 > 0:39:55I shouldn't be dealing with pets that are older than me. That's just weird.
0:39:55 > 0:39:57I'm Amy. I'm one of the vet students.
0:39:57 > 0:40:00I'll just be getting a quick history off you
0:40:00 > 0:40:04and then Nadine will come out and see you as well. OK?
0:40:04 > 0:40:08So, do you know what exactly he's been eating at the moment, then?
0:40:08 > 0:40:11He eats half - you know the big tomatoes?
0:40:11 > 0:40:17- The big beef tomatoes?- Yeah, half of one of them with medicine on top.
0:40:17 > 0:40:19Half a lettuce...
0:40:19 > 0:40:22Sorry, I've not really done much tortoise handling before
0:40:22 > 0:40:24so I'm quite careful about it.
0:40:24 > 0:40:27Right, I will be back with you shortly.
0:40:32 > 0:40:34- INTERVIEWER:- So how was that?
0:40:34 > 0:40:36Well, I felt so scared to touch it.
0:40:36 > 0:40:38But nice.
0:40:38 > 0:40:41They're quite pretty animals, really.
0:40:41 > 0:40:45Dealing with a tortoise like Sammy is a totally new experience for Amy,
0:40:45 > 0:40:49but Nadene has been treating his broken leg for almost two months.
0:40:49 > 0:40:53Alrighty, so what we are going today, we are around just over
0:40:53 > 0:40:55the seven week mark, so we'll take the dressing off
0:40:55 > 0:40:58and we'll have a bit of a feel of the leg and we will reapply
0:40:58 > 0:41:02the dressing and we will book you in for a check up appointment with me
0:41:02 > 0:41:04- in a couple of weeks.- Sure.
0:41:04 > 0:41:07Let's um, pop out and I'll take the dressing off and I'll bring him
0:41:07 > 0:41:09out to you in just a minute.
0:41:09 > 0:41:13Sammy isn't eating well so before they re-dress his broken leg,
0:41:13 > 0:41:16Nadene wants to make sure he's hydrated and carry out some tests.
0:41:16 > 0:41:20OK, so what we are going to do is just give him a little bath
0:41:20 > 0:41:23while we have the opportunity. I do like owners of tortoises
0:41:23 > 0:41:26to bath them to we make sure they are getting enough fluid in.
0:41:26 > 0:41:28They actually absorb fluids directly from the cloacae
0:41:28 > 0:41:33into their bladder as a reservoir, and you can plunk him straight in
0:41:33 > 0:41:37and now you get to watch him have a bath.
0:41:40 > 0:41:41Cool.
0:41:43 > 0:41:45That is pretty snazzy.
0:41:45 > 0:41:49Nadene just wanted us to have a quick look at his poo.
0:41:49 > 0:41:51Cos he had a poo on the...
0:41:53 > 0:41:56He had a poo in here and I've never seen tortoise poo before,
0:41:56 > 0:41:59so it'd be quite interesting to see what it's actually like,
0:41:59 > 0:42:02and I think she wanted us to have a quick look as well
0:42:02 > 0:42:06for parasites as well so I think we'll need to pt it on a slide.
0:42:06 > 0:42:07One thing with been a vet,
0:42:07 > 0:42:10you never know what you're going to get the next day.
0:42:14 > 0:42:17Sammy is clear of parasites
0:42:17 > 0:42:19so Nadene uses an old trick
0:42:19 > 0:42:20to get him mobile again.
0:42:22 > 0:42:25When we first out him down, he was going in circles
0:42:25 > 0:42:27but he seems to have been able to navigate pretty well
0:42:27 > 0:42:30with that wheel in place so I think he gets around just fine
0:42:30 > 0:42:32and this is about as fast they go, really.
0:42:32 > 0:42:35- Even without the wheel?- Yeah.
0:42:38 > 0:42:41Beaumont was absolutely brilliant. Absolutely loved it.
0:42:41 > 0:42:44Definitely one of my best rotations.
0:42:44 > 0:42:47Absolutely. I really, really enjoyed those two weeks.
0:42:47 > 0:42:49So, that's definitely why I applied to be a vet.
0:43:01 > 0:43:04You've kind of got to learn to adapt your knowledge to different species.
0:43:04 > 0:43:09Yeah, you try to adapt what you already know to whatever has
0:43:09 > 0:43:11just walked through the door really.
0:43:11 > 0:43:14Definitely a challenge. Slithered through the door.
0:43:14 > 0:43:17No, not slithered. Out of the back door.
0:43:17 > 0:43:19- What about, like, a tarantula? - Ew!- Don't mind tarantulas.
0:43:19 > 0:43:21I don't mind with them, either.
0:43:21 > 0:43:23- I wouldn't know what I was doing with one.- Yeah.
0:43:23 > 0:43:27- All I know is don't drop it. Just don't drop it.- Why?
0:43:33 > 0:43:38At the Queen Mother Hospital, Holly, the Border collie, is in recovery.
0:43:38 > 0:43:41Yeah, she's doing really well, actually.
0:43:41 > 0:43:44She's got her appetite back, which is good. That came back yesterday,
0:43:44 > 0:43:47and apart from her not liking having her catheter changed,
0:43:47 > 0:43:50she is doing really well. So, yeah, she's brilliant.
0:43:50 > 0:43:54She seems to be quite bright today.
0:43:54 > 0:43:58So we'll get some breakfast down her and see how we go.
0:44:00 > 0:44:02More gravy bones.
0:44:02 > 0:44:08This is my life now. Muzzles and chum.
0:44:08 > 0:44:11It's been a week since the operation to fix Holly's spine
0:44:11 > 0:44:15and her progress during the next few days is crucial.
0:44:15 > 0:44:19We are just doing the normal light physio massage
0:44:19 > 0:44:25and a bit of range of motion movement on her back limbs.
0:44:25 > 0:44:31And today, after this, this is kind of warming her up as well,
0:44:31 > 0:44:37so we're going to get her to stand up gently on her back legs.
0:44:37 > 0:44:39See if she can put her feet flat
0:44:39 > 0:44:42and maybe bare a little bit of her own weight.
0:44:42 > 0:44:44Good girl.
0:44:44 > 0:44:46So it's just...
0:44:46 > 0:44:49It's a small step but it's a step in the right direction.
0:44:49 > 0:44:52All right. All right. Sh, sh, sh.
0:44:52 > 0:44:54HOLLY WHIMPERS
0:44:58 > 0:45:00HOLLY CRIES
0:45:05 > 0:45:08Good girl, good girl.
0:45:08 > 0:45:10Put your foot down, it's all right.
0:45:12 > 0:45:16- All right.- Put your feet down, Holly. Good girl. Good girl.
0:45:23 > 0:45:26Remember that? It's called standing.
0:45:26 > 0:45:28Come on, Holly. Good girl.
0:45:28 > 0:45:30I think she just panics more than...
0:45:30 > 0:45:34It's not pain, it's panic. She's like "Oh, my God, I can't stand up!"
0:45:34 > 0:45:37She's been laying down for, what, a week?
0:45:37 > 0:45:41Oh, what a palaver. Yeah, I should think so.
0:45:41 > 0:45:45Now in the second week of her busy neurology rotation,
0:45:45 > 0:45:49Judy is starting to realise what becoming a vet really means.
0:45:49 > 0:45:54- INTERVIEWER:- How're you feeling? - Tired. Really tired.
0:45:54 > 0:45:59I was on call last night but I didn't get called in, which is good.
0:45:59 > 0:46:03But even when I'm on call, I just wake up randomly going,
0:46:03 > 0:46:05"Oh, did I miss a phone call?"
0:46:05 > 0:46:08Its just...I hate being on call.
0:46:08 > 0:46:13I don't think I'll ever get used to it but it's part of the job,
0:46:13 > 0:46:15so suck it up, basically.
0:46:21 > 0:46:23I am bloody knackered.
0:46:23 > 0:46:25You kill my legs, Holly.
0:46:25 > 0:46:28You are killing my legs! Aren't you?
0:46:30 > 0:46:31Oh, Holly.
0:46:31 > 0:46:33Oh, that's better!
0:46:35 > 0:46:39The next day Holly's legs still can't bear weight, but her owners
0:46:39 > 0:46:42have arrived and they're hoping to see her up and about.
0:46:42 > 0:46:44Up we go.
0:46:44 > 0:46:46Good girl, there you go.
0:46:50 > 0:46:52Good girl. Come on.
0:46:52 > 0:46:54Holly, this way. Come on.
0:46:57 > 0:47:00I'm very hopeful of her getting back to been able to walk
0:47:00 > 0:47:02and if that happens, that will be absolutely fantastic.
0:47:02 > 0:47:05She is 11-years-old, I don't expect her to keep going running round now.
0:47:05 > 0:47:10So, if she can get back to walking, that would be absolutely fantastic.
0:47:10 > 0:47:12Good girl.
0:47:12 > 0:47:17There's a big, big prize behind this door. Well done.
0:47:17 > 0:47:19Well done. Come on.
0:47:22 > 0:47:24Good girl!
0:47:24 > 0:47:27EXCITED CHATTER
0:47:38 > 0:47:43Oh, good girl. We'll pop on over to that grass there.
0:47:43 > 0:47:45Oh, good girl!
0:47:45 > 0:47:49Holly will stay in hospital to receive intensive physio
0:47:49 > 0:47:51over the coming weeks.
0:47:51 > 0:47:54But for Judy, her time in neurology is almost over.
0:47:54 > 0:47:58Mind the step. Down the step. Good girl.
0:47:58 > 0:48:02I've really bonded with my patients, actually, and it's quite important
0:48:02 > 0:48:05in neurology to get a good relationship and bond because
0:48:05 > 0:48:08then the patients trust you and they are willing to do more
0:48:08 > 0:48:10and it really helps their physio.
0:48:10 > 0:48:14So, it's going to be hard to say goodbye to Holly but, you know,
0:48:14 > 0:48:18I'll come back in couple of weeks and hopefully she will be much improved
0:48:18 > 0:48:22and hopefully on the road to recovery and going home, which will be
0:48:22 > 0:48:25best thing all around, really. So, yeah.
0:48:25 > 0:48:27I'm not going to cry.
0:48:27 > 0:48:30I promised myself I won't cry so I'm not going to cry.
0:48:30 > 0:48:32So, bye-bye, Holly. I'll see you in a few weeks.
0:48:36 > 0:48:38SHE PRETENDS TO SOB
0:48:38 > 0:48:41Not going to cry, not going to cry. NO, not going to cry.
0:48:42 > 0:48:45My first consult had a Japanese Akita
0:48:45 > 0:48:48that I went to strip and he's like, "Rarr!"
0:48:48 > 0:48:51It was really fine at the start and then I was like,
0:48:51 > 0:48:53- "Oh, this is great(!)" - "Cute dog(!)"- Yeah!
0:48:53 > 0:48:55DOG BARKS
0:48:55 > 0:48:59There's never any appreciation, is there? You fix them and they
0:48:59 > 0:49:02still hate you. They hate you when they come in, they hate you when
0:49:02 > 0:49:04you do stuff to them and they hate you they go home.
0:49:08 > 0:49:12After a week back home in Norfolk, Charlie passed his rotation
0:49:12 > 0:49:14on the farm and today follows Dru
0:49:14 > 0:49:17to the hospital's anaesthesia department.
0:49:17 > 0:49:21Feeling OK. I've had a long time to prepare for it, which is sometimes
0:49:21 > 0:49:25worse because the clinicians know you've had a long time to prepare
0:49:25 > 0:49:27and they can ask you more questions
0:49:27 > 0:49:31and you simply can't learn everything that you need to.
0:49:33 > 0:49:37And it's slightly more difficult one but I think, yeah...
0:49:37 > 0:49:39We'll see how it goes.
0:49:41 > 0:49:46I was really nervous going into anaesthesia because it's the rotation
0:49:46 > 0:49:49that everyone talks about that is the hardest.
0:49:49 > 0:49:53Charlie's got two pets on his case list so he's visiting the dog ward
0:49:53 > 0:49:57to have a look at them before he prepares their medication.
0:49:57 > 0:50:02My patient is London, which is a 9-week-old boxer puppy.
0:50:02 > 0:50:06And it was kicked by a horse, I think two days ago,
0:50:06 > 0:50:08and it's broken its radius.
0:50:08 > 0:50:12It's not completely simple, it's not a healthy adult
0:50:12 > 0:50:16but I think with the protocols we've got in place, it should be OK.
0:50:19 > 0:50:23Charlie's other patient is an altogether different story -
0:50:23 > 0:50:26a Rottweiler called Bella.
0:50:26 > 0:50:29Bella was an incredibly aggressive Rottweiler
0:50:29 > 0:50:32or rather she was a misunderstood Rottweiler.
0:50:32 > 0:50:36I'm going to be anaesthetising for a cruciate repair and I think
0:50:36 > 0:50:38the last time she came here -
0:50:38 > 0:50:40BELLA BARKS
0:50:40 > 0:50:46OK. We might just back out into the hall and just calm her down.
0:50:46 > 0:50:49Cos I think at the moment we're trying to get her settled.
0:50:51 > 0:50:55- INTERVIEWER:- Is this called running away, Charlie?- A little bit, yeah.
0:50:55 > 0:50:58It's running away when it's... when it's allowed.
0:50:58 > 0:51:02The owners made it clear to us that we could muzzle her because
0:51:02 > 0:51:06they didn't want us to get bitten and the repercussion of that
0:51:06 > 0:51:07just don't bear thinking about.
0:51:07 > 0:51:10Luckily for Charlie,
0:51:10 > 0:51:13London the puppy is first in line for treatment.
0:51:19 > 0:51:23Getting the drug doses right is a matter of life and death here.
0:51:23 > 0:51:26- All the way?- No, that's fine. Just like that.
0:51:26 > 0:51:29Fortunately, Charlie's being supervised by the anaesthesia team
0:51:29 > 0:51:32with help from nurse Claire Seddon.
0:51:32 > 0:51:35We've got a cute one and a proper audience.
0:51:35 > 0:51:37Delighted. She's adorable.
0:51:39 > 0:51:41We'll just give her a minute to see what she does.
0:51:45 > 0:51:48She's sticking her tongue out. That's a good sign.
0:51:49 > 0:51:52- She might still be a bit...- Yeah.
0:51:52 > 0:51:56- Let's grab our Propofol. - Extra Propofol? Yep.
0:51:56 > 0:52:01Even though London weighs just three kilos, she needs a bigger dose.
0:52:01 > 0:52:03Well, she's just moving, basically,
0:52:03 > 0:52:06so she's a little bit more awake than we want.
0:52:08 > 0:52:12Just remember, from here to here is point three of a mil
0:52:12 > 0:52:14and that's obviously one milligram.
0:52:17 > 0:52:18Are you happy with that?
0:52:20 > 0:52:21Yep.
0:52:21 > 0:52:26- OK, happy.- Very.- Right, so I think we'll move through to X-ray.
0:52:29 > 0:52:32Once she's fully under, she is ready for an X-ray.
0:52:34 > 0:52:37Fortunately it's good news for little London,
0:52:37 > 0:52:40according to orthopaedic surgeon Richard Meeson.
0:52:40 > 0:52:42There's two bones in the forearm.
0:52:42 > 0:52:45Another break in the radius. There's also a break in the ulna bone
0:52:45 > 0:52:49but it's not actually moved around very much and little dogs
0:52:49 > 0:52:52have quite thick capsules round the bones and that's quite keeping
0:52:52 > 0:52:55this quite stable, so although there's a break on both,
0:52:55 > 0:52:59we can get away with just putting a support dressing on this dog,
0:52:59 > 0:53:02rather than having to take it to theatre and operating on it.
0:53:02 > 0:53:05Two to three weeks probably this will be healed.
0:53:05 > 0:53:07I'm so sorry. You have a big foot.
0:53:10 > 0:53:13Aw, I'm sorry, mate, you're really cold.
0:53:13 > 0:53:15As the anaesthetist, Charlie can hand London over
0:53:15 > 0:53:19to the recovery team once she's awake and stable.
0:53:20 > 0:53:23We'll wrap you all up in a minute. There you go, darling.
0:53:25 > 0:53:27Easy, tiger.
0:53:27 > 0:53:30Now it's Bella the Rottweiler's turn.
0:53:30 > 0:53:32I was just wondering when you wanted to do Bella?
0:53:32 > 0:53:38- Great. We can get going now.- Start pre-med now?- Yes, please.- OK. Cool.
0:53:38 > 0:53:40I don't mind the size. It's more of the temperament.
0:53:40 > 0:53:44If it was a friendly Rottweiler, then it'd be fine.
0:53:44 > 0:53:46Less friendly? Hmm, we'll see.
0:53:51 > 0:53:54Charlie needs to administer a pre-med to calm Bella down.
0:53:58 > 0:53:59Good dog.
0:54:06 > 0:54:08Good girl. Good girl.
0:54:08 > 0:54:09BELLA GROWLS
0:54:12 > 0:54:15Where's the line coming out? Awesome.
0:54:17 > 0:54:18- NURSE:- Good girl!
0:54:21 > 0:54:23Thanks, guys.
0:54:23 > 0:54:26That was actually absolutely fine.
0:54:26 > 0:54:31As you can see, the importance of having great nursing staff.
0:54:31 > 0:54:33BARKING
0:54:36 > 0:54:40Now the plan is to hopefully leave her in peace so the anaesthetic
0:54:40 > 0:54:44can sort of take effect and hopefully she'll calm down.
0:54:44 > 0:54:48That should take about five, ten minutes to work.
0:54:48 > 0:54:49Five minutes later...
0:54:51 > 0:54:54..the sedatives have taken effect.
0:54:54 > 0:54:58And walking Bella to the OR might take a little longer than planned.
0:55:11 > 0:55:14Bella. Come on. Good dog.
0:55:14 > 0:55:18Good dog. Come on. Good dog.
0:55:21 > 0:55:23We may need a trolley.
0:55:26 > 0:55:29All that's left for Charlie to do is intubate her and monitor
0:55:29 > 0:55:33her vital signs throughout the procedure.
0:55:33 > 0:55:36Take the tongue out with your non dominant hand.
0:55:37 > 0:55:40Look, he's looking at me.
0:55:40 > 0:55:43- Push the back of the tongue here, can you see where?- OK.
0:55:55 > 0:55:58'This is one of the harder rotations and there's quite a lot of stress
0:55:58 > 0:56:03'involved in it because while they are supervising you,
0:56:03 > 0:56:07'they also put a lot of responsibility on you.'
0:56:07 > 0:56:11So, I think it is quite stressful that you need to know so much
0:56:11 > 0:56:15and they do ask you questions throughout while you're still
0:56:15 > 0:56:17monitoring the patient, having to do two things at once,
0:56:17 > 0:56:19which I'm not particularity good at,
0:56:19 > 0:56:22but I'm really enjoying it as a rotation, yeah.
0:56:34 > 0:56:37It's now three weeks since Judy left the neurology department
0:56:37 > 0:56:41where she cared non-stop for Border collie Holly.
0:56:41 > 0:56:45Holly was discharged last week, but has returned for a check up,
0:56:45 > 0:56:48and Judy has made a special effort to pay her a visit.
0:56:48 > 0:56:50Aw, she's like, "I think I remember you.
0:56:50 > 0:56:55"I think you gave me some food." How are you doing, Holly?
0:56:55 > 0:56:57Judy was fantastic on Neurology.
0:56:57 > 0:56:59How are you doing?
0:56:59 > 0:57:01You are such a good girl, aren't you?
0:57:01 > 0:57:04'people focus a lot on knowledge but there's a lot of other things.
0:57:04 > 0:57:07'The owner communication, the communication to the pet,
0:57:07 > 0:57:12'to the dog or cat, communication to people in the hospital,
0:57:12 > 0:57:14'and Judy does it very, very well.'
0:57:14 > 0:57:17Look at it, it's amazing.
0:57:17 > 0:57:19You're such a good girl!
0:57:19 > 0:57:23'To see a dog come back and walk back through those doors herself,
0:57:23 > 0:57:28'mostly unaided, was fantastic and it makes all the hard work
0:57:28 > 0:57:31'that everybody puts in, worth it.'
0:57:31 > 0:57:34Absolutely. She walked out pretty much unaided.
0:57:34 > 0:57:38Came in on two legs and went out on four. Fantastic.
0:57:38 > 0:57:41OK. It was good to see you again and you take care.
0:57:41 > 0:57:45And you, Mrs, don't jump off any more bloody cliffs.
0:57:45 > 0:57:49Sheez! Right, I must go. Enjoy your session, yeah? Take care.
0:57:49 > 0:57:53With so much of their final year and exams ahead of them,
0:57:53 > 0:57:57the students' work load won't ease up any time soon.
0:57:57 > 0:57:59'It will be worth it.'
0:57:59 > 0:58:04All the days of lying in kennels and clearing up mess for five years
0:58:04 > 0:58:08will definitely be worth it to see dogs like Holly walk out of hospital
0:58:08 > 0:58:11and go home and have a nice life, because we fixed them.
0:58:11 > 0:58:14So it will be worth it, definitely.