Episode 3

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0:00:02 > 0:00:04Britain is a nation in love with its animals.

0:00:04 > 0:00:06How are you doing?

0:00:06 > 0:00:08We own 27 million pets...

0:00:10 > 0:00:13..and 900 million farm animals

0:00:13 > 0:00:14Very frisky one.

0:00:14 > 0:00:16All of them...

0:00:17 > 0:00:19..need vets.

0:00:19 > 0:00:22Over the course of their final year,

0:00:22 > 0:00:25ten students at the prestigious Royal Veterinary College

0:00:25 > 0:00:28in Hertfordshire are taking what they've learned in the classroom...

0:00:29 > 0:00:31..and putting it to the test...

0:00:33 > 0:00:35..in practices,

0:00:35 > 0:00:38- farms... - This is all new territory for me.

0:00:38 > 0:00:41..and state of the art animal hospitals.

0:00:41 > 0:00:44It's a whirlwind of back-to-back work placements...

0:00:46 > 0:00:49Sounds like an unhappy monkey!

0:00:49 > 0:00:51..and they can't afford to fail...

0:00:51 > 0:00:53a single one.

0:00:53 > 0:00:55I need to do my job properly.

0:00:55 > 0:00:56I need to do better.

0:00:56 > 0:00:58It's the most challenging stretch...

0:00:58 > 0:00:59Whoa!

0:00:59 > 0:01:01..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...

0:01:06 > 0:01:09- Gassy!- ..fully qualified young vets.

0:01:09 > 0:01:11Saved a life today, which is good!

0:01:24 > 0:01:26LAUGHTER

0:01:32 > 0:01:35With several months of hands-on training still to come before

0:01:35 > 0:01:39they graduate, our young vets are facing new challenges every week.

0:01:40 > 0:01:42Honestly, I have no idea what I'm doing.

0:01:42 > 0:01:44And for mature student Judy Puddifoot,

0:01:44 > 0:01:47the challenges don't come any bigger than today's.

0:01:47 > 0:01:49It's ridiculously early on Monday morning

0:01:49 > 0:01:52and I am starting an anaesthesia rotation today.

0:01:52 > 0:01:56This smile belies what I actually feel because I'm really frightened.

0:01:56 > 0:01:59- Morning!- Oh, you're back! Judy!

0:01:59 > 0:02:01DOG BARKS

0:02:01 > 0:02:03Anaesthesia is an essential skill,

0:02:03 > 0:02:06which, like it or not, Judy has to pass.

0:02:06 > 0:02:10So, what's gone on? Basically, your animal's stopped breathing?

0:02:10 > 0:02:13- OK, so what do you need to do for it?- Breathe for it.

0:02:13 > 0:02:14Breathe for it. OK.

0:02:14 > 0:02:17The rotation is very difficult in the anaesthesia process.

0:02:17 > 0:02:20We'll be testing their knowledge to see how well they are versed

0:02:20 > 0:02:22with the drugs they are using,

0:02:22 > 0:02:25what is going on with their patient while it's been anaesthetised,

0:02:25 > 0:02:28so at every point in time, we'll be testing them.

0:02:28 > 0:02:29So that's all you're doing.

0:02:29 > 0:02:32Just think of that as a door and if you don't close the door

0:02:32 > 0:02:35the O2 is going to take the obvious route out.

0:02:37 > 0:02:39- OK. How are you doing, all right? - Yeah, good, you?

0:02:39 > 0:02:43Despite already having two degrees before becoming a vet student,

0:02:43 > 0:02:46Judy's had a rocky ride on this course.

0:02:47 > 0:02:54Unfortunately, I failed third year by one single solitary percent.

0:02:56 > 0:02:59So you go through this whole appeal process, you're trying to fight

0:02:59 > 0:03:02your corner and, you know, luckily, I got back on the course.

0:03:02 > 0:03:06They felt I was worth taking a punt on, so that's good.

0:03:06 > 0:03:08As part of that whole appeal process,

0:03:08 > 0:03:11I got a proper assessment for dyslexia

0:03:11 > 0:03:16and, yeah, the assessor said that I was classically dyslexic.

0:03:16 > 0:03:18I see, that's meant to go in there.

0:03:18 > 0:03:20So, yeah, that was a bit of a shock.

0:03:20 > 0:03:25Judy's hoping for a gentle start to her placement, but no such luck...

0:03:25 > 0:03:27I get the noisy dog.

0:03:28 > 0:03:29Hello, doggie!

0:03:29 > 0:03:33Her first patient is a seriously ill Border collie called Megan,

0:03:33 > 0:03:35who's having a major operation today.

0:03:35 > 0:03:40Hello. Hello! Oh, you're lovely, aren't you? Good girl.

0:03:40 > 0:03:42Not making that easy for me, are you?

0:03:42 > 0:03:44Megan has a large tumour embedded in her ribcage

0:03:44 > 0:03:47which needs to be removed.

0:03:47 > 0:03:48Good girl. Just about here?

0:03:48 > 0:03:50Yep.

0:03:50 > 0:03:54- Good girl.- Perfect. That's enough. - Is that enough?- Yes, that's perfect.

0:03:54 > 0:03:58OK. Oh, you're such a good girl, aren't you?

0:03:58 > 0:04:03Today, Judy's working with anaesthetist Diego Castineiras.

0:04:03 > 0:04:04OK, sorry.

0:04:04 > 0:04:07- Judy, this is Diego. Diego, this is Judy.- Hello!

0:04:07 > 0:04:10- Hello, Judy, how are you? - Yeah, I'm good thanks. You?

0:04:10 > 0:04:13I'm afraid you're stuck with me today.

0:04:13 > 0:04:15Kennel 17, ICU.

0:04:15 > 0:04:20- It's a thoracotomy for a mass removal tumour from her rib.- OK.

0:04:20 > 0:04:23Think about what you would use and why...

0:04:23 > 0:04:27I picked up a case straightaway today so I guess the sooner

0:04:27 > 0:04:29I get a case, the quicker I can learn how it all works but it's not

0:04:29 > 0:04:33really been the slow introduction into, "How do we do this?" that I would have liked.

0:04:37 > 0:04:38Megan!

0:04:40 > 0:04:45We've given her her pre-med which is kind of a sedation drug

0:04:45 > 0:04:47just to calm her down a bit,

0:04:47 > 0:04:52but she's a little bit stressed and so we're just waiting for her

0:04:52 > 0:04:56to calm down sufficiently for us to then induce her into anaesthesia.

0:04:56 > 0:05:00We don't want her to be too distressed.

0:05:04 > 0:05:09Removing Megan's tumour is a complicated procedure, which could take hours.

0:05:09 > 0:05:12Judy's job is to keep a record of every drug administered.

0:05:16 > 0:05:19So, what's that then? 12.45.

0:05:19 > 0:05:24What we gave... Propofol was 20 milligrams in total.

0:05:25 > 0:05:27Is she on four and a half there, or five?

0:05:29 > 0:05:31Judy gets off to a good start.

0:05:31 > 0:05:36But it soon becomes clear that it's a lot harder than it looks.

0:05:36 > 0:05:38Maths is a big part of anaesthesia,

0:05:38 > 0:05:44working out calculations of drugs quickly and I don't do maths quickly.

0:05:44 > 0:05:45I just can't.

0:05:47 > 0:05:49- So 2 micrograms dose Fentanyl. - I think so.

0:05:49 > 0:05:51Oh, God, right.

0:05:53 > 0:05:55It gets me really frustrated that I can't just,

0:05:55 > 0:05:58bang, work out maths in my head. A lot of people can.

0:05:58 > 0:06:01I can tell jokes, other people can do maths.

0:06:02 > 0:06:05Oh, my God! Fluids. I didn't write that down either.

0:06:05 > 0:06:07What was that?

0:06:07 > 0:06:11- Ketamine of 0.5mg per k.- 0.5...

0:06:11 > 0:06:14'Initially, it is panic.

0:06:14 > 0:06:17'And then the panic leads to frustration.'

0:06:17 > 0:06:20And when you put panic and frustration together,

0:06:20 > 0:06:21you get nothing.

0:06:21 > 0:06:25Nothing inside your head. You just... I just go blank.

0:06:25 > 0:06:28So you don't want that one, do you? You want...

0:06:28 > 0:06:30No. No. Don't make a mess.

0:06:30 > 0:06:33This has been given, I gave him all the Fentanyl,

0:06:33 > 0:06:37give the dose of Ketamine, and then we'll do a CI of Fentanyl,

0:06:37 > 0:06:38and a CI of Ketamine.

0:06:38 > 0:06:41- OK?- OK... God.

0:06:43 > 0:06:46So... Oh, God, what do I do? Just re-write it?

0:06:48 > 0:06:51Oh, God. This is ridiculous. This is the first time I've ever seen this sheet.

0:06:51 > 0:06:53- I don't know where everything goes. - That's fine.

0:06:53 > 0:06:55But if I tell you this happened,

0:06:55 > 0:06:58don't cross it out because it happened.

0:06:59 > 0:07:03During the surgery, Megan needs antibiotics to prevent serious infection.

0:07:03 > 0:07:07And Judy is given the job of measuring up the next dose.

0:07:07 > 0:07:10Which, unfortunately for Judy, involves maths.

0:07:10 > 0:07:15Calculate 20 milligrams per kilo for that.

0:07:15 > 0:07:1720 milligrams per kilo.

0:07:17 > 0:07:20100mg per k... 100mg per mil, even.

0:07:20 > 0:07:22OK, thank you very much.

0:07:24 > 0:07:26Darn it. Darn it. Darn it.

0:07:26 > 0:07:29It's time to call on a student's best friend -

0:07:29 > 0:07:31a veterinary nurse.

0:07:31 > 0:07:33I need to draw up some Zinacef.

0:07:33 > 0:07:35And, one, I've never done it before,

0:07:35 > 0:07:37and it's in a dilution like that.

0:07:37 > 0:07:39- So, she's 20.1, right?- Yeah.

0:07:39 > 0:07:42- Times... He wants a 20mg.- Yep.

0:07:42 > 0:07:45Fine. Then divide it by a concentration of 100.

0:07:46 > 0:07:51- 4. OK, so just write 100? - Yep, that's fine.

0:07:51 > 0:07:53- Done.- So then everybody knows.

0:07:53 > 0:07:58Fine. OK. Great. Done.

0:07:59 > 0:08:01Although it's very frustrating and it's very scary,

0:08:01 > 0:08:04I want to face it head on, you know, I can't walk away from it,

0:08:04 > 0:08:06it's something that I'm going to need to do,

0:08:06 > 0:08:09and so I want to stay in that situation and work it out.

0:08:10 > 0:08:14Antibiotic in hand, it's back to Megan's surgery.

0:08:14 > 0:08:16So...yes. So, it's 400ml.

0:08:16 > 0:08:18And back to the paperwork.

0:08:18 > 0:08:21Give another 5ml per kilo.

0:08:24 > 0:08:27After a gruelling three and a half hours in theatre,

0:08:27 > 0:08:30Megan's tumour has been successfully removed.

0:08:32 > 0:08:34But, for Judy, her first day in anaesthesia

0:08:34 > 0:08:36has been a real struggle.

0:08:36 > 0:08:40It's just so many balls to juggle and try and keep them

0:08:40 > 0:08:44all in the air, and it just wears you down, eventually,

0:08:44 > 0:08:46and I'm rapidly getting to burn out.

0:08:46 > 0:08:48I need to just stop, take a break.

0:08:50 > 0:08:53But you can't take a break so we'll see how it goes.

0:08:54 > 0:08:58Yeah, difficult. Stop because I'm going to cry!

0:08:58 > 0:08:59God!

0:09:02 > 0:09:04SHE CRIES

0:09:14 > 0:09:17It's probably not the best case to have on the first day.

0:09:17 > 0:09:20In critical moments, there are a lot of things that are happening

0:09:20 > 0:09:23and it's difficult to keep up to speed.

0:09:23 > 0:09:26I mean, she did OK. Especially it being the first day.

0:09:31 > 0:09:34Hello, what's this?

0:09:35 > 0:09:38After a much needed night's rest,

0:09:38 > 0:09:41both Judy and Megan are feeling a lot better.

0:09:41 > 0:09:44Are you going to get up? Do you want to get up?

0:09:44 > 0:09:47She's doing very well. She's doing fine.

0:09:47 > 0:09:49She's not in pain.

0:09:49 > 0:09:54She's doing much better than I was expecting more quickly, so, good.

0:10:03 > 0:10:04Anaesthesia.

0:10:04 > 0:10:10It's a really scary rotation because the pressure is quite a lot on you

0:10:10 > 0:10:14to know the stuff, to pass the rotation generally.

0:10:14 > 0:10:19Yeah, so it was horrible but, you know,

0:10:19 > 0:10:21you have to take the rough with the smooth, so...

0:10:28 > 0:10:31I find, even now, that people will say, "Judy, can you do so and so?"

0:10:31 > 0:10:35And I'll go, "Yeah, I'll do that," and I'll get halfway across the room and go,

0:10:35 > 0:10:37I don't actually know how to do that.

0:10:37 > 0:10:39You have to subtly ask a nurse!

0:10:39 > 0:10:42"Sorry, can you just explain to me what that was?" It's ridiculous!

0:10:42 > 0:10:45The worst thing is when they say something really quickly

0:10:45 > 0:10:47and you don't hear, so you ask again, and they say it again,

0:10:47 > 0:10:50and so you're sort of, like, OK, I'm going to ask one more time,

0:10:50 > 0:10:53so they say it, you still don't hear it, and you're like, "Yep,

0:10:53 > 0:10:57"I'll get right on that," and then you just go and try and think about what it was they asked you to do.

0:10:57 > 0:10:59What is the most likely thing they'd want?

0:10:59 > 0:11:02I think he said PCV so I'm probably just going to go and do that.

0:11:02 > 0:11:04Yeah. Yeah. That is frightening.

0:11:05 > 0:11:08HE PANTS

0:11:10 > 0:11:11Hey!

0:11:12 > 0:11:15You know when you're running late and you're just like, "Crap!"

0:11:15 > 0:11:18Student Amy Clithero is running late.

0:11:19 > 0:11:23She's midway through a placement in emergency and critical care.

0:11:25 > 0:11:27After years in the classroom,

0:11:27 > 0:11:30Amy's relieved to be finally hands-on with real animal patients.

0:11:30 > 0:11:32Sorry.

0:11:32 > 0:11:34Hiya. Hello.

0:11:34 > 0:11:37'The last few months of third year, I was really struggling.

0:11:37 > 0:11:40'I just lost all my motivation.'

0:11:40 > 0:11:42It was, like, I'm learning all this stuff,

0:11:42 > 0:11:45I'm not getting to do any hands-on things,

0:11:45 > 0:11:47what's the point of being here? Why do I want to be a vet?

0:11:47 > 0:11:49And then when you start rotations, you're just like,

0:11:49 > 0:11:51"This is why I want to be a vet."

0:11:51 > 0:11:55Today, she will be supervised by vet Myfanwy Hill.

0:11:55 > 0:11:58A lot of the animals we see in here are quite sick

0:11:58 > 0:12:01so a lot of the time they're emergency patients.

0:12:01 > 0:12:05What's the normal thing to precipitate a ketoacidotic crisis?

0:12:05 > 0:12:06Erm...

0:12:06 > 0:12:09We'll be pushing her to make sure she can get the most out of

0:12:09 > 0:12:10her time today on a busy shift.

0:12:12 > 0:12:15Amy's patient is a critically ill cocker spaniel called Tyler.

0:12:15 > 0:12:18He's been admitted to the emergency room after collapsing.

0:12:19 > 0:12:22Her first job is to run through Tyler's medical history

0:12:22 > 0:12:24with his owner, Linda.

0:12:25 > 0:12:28Shall we just work through one at a time what he's got?

0:12:28 > 0:12:29Of course. Hip dysplasia.

0:12:31 > 0:12:33Cataracts, both eyes.

0:12:33 > 0:12:34Okey dokes.

0:12:34 > 0:12:38He's on insulin twice a day.

0:12:38 > 0:12:43The lady who does his beauty treatment

0:12:43 > 0:12:46found a suspicious lump

0:12:46 > 0:12:49in his anal gland, and she says to me,

0:12:49 > 0:12:51"I think you ought to get it checked out."

0:12:51 > 0:12:55And it turned out to be cancer, unfortunately.

0:12:56 > 0:13:01He had the... Yes, he had the lump removed from the back passage

0:13:01 > 0:13:04and then they found cancer...

0:13:04 > 0:13:06In his lymph nodes?

0:13:06 > 0:13:09Lymph nodes, that's it. Lymph nodes.

0:13:09 > 0:13:12Right, OK, and is he on chemotherapy at the moment for that?

0:13:12 > 0:13:14He's just finished his chemotherapy.

0:13:14 > 0:13:18This Friday, he's going back to see if the cancer's gone.

0:13:23 > 0:13:27Eight-and-a-half-year-old male neutered cocker spaniel,

0:13:27 > 0:13:30he's got a little bit of history, if I'm honest.

0:13:30 > 0:13:32A left anal gland...

0:13:32 > 0:13:35anal sack adenocarcinoma which has spread to lymph nodes,

0:13:35 > 0:13:39he's had five lots of chemo treatment every three weeks,

0:13:39 > 0:13:41and he finished that back in April,

0:13:41 > 0:13:43and he's due to go for a check up on Friday.

0:13:43 > 0:13:46So, his blood glucose is 1.7.

0:13:48 > 0:13:51That's a bit low, isn't it? So is he hydrated OK?

0:13:53 > 0:13:56- Touch the skin to tell. Yeah, that's fine.- Yeah.

0:13:56 > 0:14:00Tyler's seriously ill and all Amy and vet Neil Smith can do is

0:14:00 > 0:14:02stabilise his blood sugar level

0:14:02 > 0:14:05while Linda waits nervously for news.

0:14:05 > 0:14:07So, we've done some blood tests...

0:14:07 > 0:14:09Yep.

0:14:09 > 0:14:16..and that shows low glucose and high calcium.

0:14:16 > 0:14:18And the high calcium

0:14:18 > 0:14:22is most likely due to the type of cancer that he's got.

0:14:22 > 0:14:24Oh, that's down to the cancer?

0:14:24 > 0:14:27So, together that makes him feel a little bit weak.

0:14:29 > 0:14:31What we want to do is we want to keep him in

0:14:31 > 0:14:36and monitor his glucose to make sure he doesn't go low again.

0:14:38 > 0:14:41I have to explain about some of the risks.

0:14:41 > 0:14:45There's always a risk of infection whenever you come to a hospital.

0:14:47 > 0:14:50And, unfortunately, I have to mention the risk of death.

0:14:50 > 0:14:53Linda's desperate to help her beloved pet,

0:14:53 > 0:14:55but treatments for Tyler's illnesses

0:14:55 > 0:14:58have already cost her thousands of pounds.

0:14:58 > 0:15:02All this extra expense has been down to me

0:15:02 > 0:15:04because the insurance has run out.

0:15:04 > 0:15:07These operations are very, very expensive.

0:15:08 > 0:15:10Thousands, I would think.

0:15:11 > 0:15:15It's horrible having to make a decision on treatment

0:15:15 > 0:15:19based on money, especially when it is almost a life and death one.

0:15:19 > 0:15:22Some owners just, they want a pet treated no matter what.

0:15:24 > 0:15:28You don't want to see any animal suffer and I will go on

0:15:28 > 0:15:31as long as they can make him well.

0:15:34 > 0:15:37But if I see him really, really in distress,

0:15:37 > 0:15:39then, you know...

0:15:39 > 0:15:41You know it's time to say goodbye.

0:16:01 > 0:16:06Elly Berry is determined to pass her final year with flying colours.

0:16:07 > 0:16:11I don't like getting things wrong, as a terrible perfectionist.

0:16:11 > 0:16:13It's something I try to keep under wraps

0:16:13 > 0:16:14cos it's not a nice quality to have.

0:16:14 > 0:16:17I have got my parents' voices in my head, you know,

0:16:17 > 0:16:18"You can't be right the whole time."

0:16:18 > 0:16:21But I could try. I really could try.

0:16:21 > 0:16:22My dad IS right all the time

0:16:22 > 0:16:25and if he can do it, I can try and do it.

0:16:27 > 0:16:31This week, Elly is in Dorset where the Royal Veterinary College

0:16:31 > 0:16:33trains its vets in farm work.

0:16:39 > 0:16:41With almost two million dairy cows in the UK,

0:16:41 > 0:16:45farmers depend on vets to keep their livestock healthy.

0:16:45 > 0:16:48- I presume they've finished milking, haven't they?- Yes.

0:16:48 > 0:16:50On top of Elly's workload,

0:16:50 > 0:16:53she's opted to take this difficult placement

0:16:53 > 0:16:55as she has a passion for farming.

0:16:55 > 0:16:57I'm a country girl at heart.

0:16:57 > 0:17:00Ideally, I'd love be to move back towards home

0:17:00 > 0:17:03and that area is perfect. It's on the edge of the Cotswolds.

0:17:03 > 0:17:05You've got a wonderful amount of beef and dairy.

0:17:05 > 0:17:08It may not be as romantic as Elly thinks

0:17:08 > 0:17:12getting to grips with 300 dairy cows and 80 calves.

0:17:13 > 0:17:17What if we come across, maybe, just a general infection?

0:17:17 > 0:17:19Maybe like a navel infection?

0:17:19 > 0:17:22Checking calves for signs of disease

0:17:22 > 0:17:25is a skill expected of all farm vets.

0:17:25 > 0:17:29Elly will be assessed by course supervisor Susannah Dyson.

0:17:29 > 0:17:32Like we discussed, we want to check the navel.

0:17:32 > 0:17:33Absolutely.

0:17:33 > 0:17:36We want to check the joints for swellings.

0:17:36 > 0:17:39Then we've got our respiratory scores, so temperature, cough,

0:17:39 > 0:17:42nose discharge, eye discharge.

0:17:42 > 0:17:45- Are you happy with all of those? - Yes.

0:17:45 > 0:17:47Generally cows are very calm and quiet animals,

0:17:47 > 0:17:49but when they've just had a newborn calf,

0:17:49 > 0:17:52you just need to be... Need to be careful around them.

0:17:52 > 0:17:56COW MOOS

0:17:57 > 0:17:59Aw, calfy. Hello.

0:17:59 > 0:18:02Elly's first patient was born this morning.

0:18:05 > 0:18:10Hydration, fine. No discharge, nasally or ocularly.

0:18:10 > 0:18:12Go to your mummy.

0:18:15 > 0:18:20One calf has had the all clear, but there are 79 more to go.

0:18:23 > 0:18:25Right. Go for it.

0:18:27 > 0:18:30Ow. My foot. You're on my foot.

0:18:30 > 0:18:33If I could be a farmer, I would. It's a bit like Sophie from Dick King-Smith.

0:18:33 > 0:18:37I want to be a lady farmer, but I'll be a lady vet instead so that's fine.

0:18:37 > 0:18:39Did you ever read those books? No? Just me.

0:18:40 > 0:18:43Hello! I'm not milk. No, I'm not.

0:18:43 > 0:18:4580... 92 heart rate.

0:18:46 > 0:18:48That's quite high.

0:18:48 > 0:18:51Smaller animals tend to have faster heart rates,

0:18:51 > 0:18:54so what do we think the normal heart rate for a calf would be?

0:18:54 > 0:18:57Have a guess. I am going to tell you the right answer.

0:18:57 > 0:19:00- Don't know, 60 to 100, 150? - A little bit higher.

0:19:00 > 0:19:05Normal heart rate can be sort of 100 to 120 in a calf

0:19:05 > 0:19:09- so her heart rate, 92, is fine. - Normal? Oh good.

0:19:10 > 0:19:1293.

0:19:12 > 0:19:14'The only reason I did get to grips with the calf checks was'

0:19:14 > 0:19:17because there were so many of them.

0:19:18 > 0:19:2099.2.

0:19:20 > 0:19:22'I think I can comfortably say I can go up to a calf'

0:19:22 > 0:19:24and assess its health right now.

0:19:24 > 0:19:26I...I have those skills.

0:19:27 > 0:19:29Kisses, yeah. Lovely.

0:19:29 > 0:19:31Very happy calf. Happy. Happy.

0:19:32 > 0:19:34Come on, then.

0:19:34 > 0:19:35With calf checks barely over,

0:19:35 > 0:19:39Elly's called to an emergency with farm manager Andy Matthews.

0:19:39 > 0:19:43Calf's upside down, backwards, feet first,

0:19:43 > 0:19:46and he's dug in so it's in distress, and going to assist it now,

0:19:46 > 0:19:49and pull him out, hopefully alive.

0:19:57 > 0:20:01If Andy doesn't act quickly, the calf could easily suffocate.

0:20:05 > 0:20:08Ideally, you want them to dive out like that, on their nose,

0:20:08 > 0:20:11and onto the front of their hooves.

0:20:11 > 0:20:14The fact that the hooves are upside down, you can tell it's backwards.

0:20:14 > 0:20:17RATCHETING

0:20:22 > 0:20:26It may look brutal, but, thanks to their prompt action,

0:20:26 > 0:20:29the new calf is delivered alive and well.

0:20:29 > 0:20:31Look, she's licking straightaway.

0:20:32 > 0:20:34She's a good mother.

0:20:34 > 0:20:36That's really good. Happy days!

0:20:41 > 0:20:43The fact that it came out and she's licking straightaway,

0:20:43 > 0:20:46often, especially heifers, they don't really know what's occurred

0:20:46 > 0:20:50something's come out, and they're a bit, like, "Oh! What is this?"

0:20:50 > 0:20:52But the fact that she's licking it straightaway,

0:20:52 > 0:20:55that releases a lot of hormones, both for mother and calf.

0:20:55 > 0:20:57A lot of maternal bonding goes on.

0:20:58 > 0:20:59Look at that!

0:21:02 > 0:21:04SHE MOOS

0:21:07 > 0:21:09CAT GENTLY PURRS

0:21:12 > 0:21:13CAT MEOWS

0:21:16 > 0:21:18At the Queen Mother Hospital for Animals,

0:21:18 > 0:21:21Amy Clithero is still in emergency and critical care,

0:21:21 > 0:21:25where cocker spaniel Tyler has spent the night receiving treatment.

0:21:25 > 0:21:28It's... When I know what I'm doing, it's fine. Sometimes I'm just...

0:21:28 > 0:21:31I don't have a clue what I'm doing and it gets a little bit worrying

0:21:31 > 0:21:34especially when I'm not on top of paperwork at the end of the day.

0:21:34 > 0:21:37Tyler's blood sugar levels are back to normal

0:21:37 > 0:21:40and his owner has arrived hoping to take him home.

0:21:43 > 0:21:47Just want to see him walk in standing up cos, like I said before,

0:21:47 > 0:21:50he kept collapsing so see how it goes.

0:21:50 > 0:21:52I'm going to be upset now.

0:22:00 > 0:22:02- There we go.- Hello!

0:22:03 > 0:22:05Hello, darling!

0:22:05 > 0:22:10- Oh.- That's one happy doggy. There's your insulin for you.

0:22:10 > 0:22:11Oh. Yeah, I need that.

0:22:11 > 0:22:14Most owners I actually really enjoy...just enjoy getting

0:22:14 > 0:22:16to know them and just speaking to them

0:22:16 > 0:22:18cos you've all got a common interest.

0:22:18 > 0:22:21You're interested in animals. You want to make their animal better.

0:22:21 > 0:22:24The owners and their reactions when they're taking them home

0:22:24 > 0:22:25can make the job really good.

0:22:25 > 0:22:29It's been very quiet at home without you.

0:22:29 > 0:22:31DOG YELPS EXCITEDLY

0:22:31 > 0:22:33Tyler's feeling better for now.

0:22:33 > 0:22:38But, with more chemotherapy to come, he has a difficult road ahead.

0:22:38 > 0:22:39Be a good boy.

0:22:47 > 0:22:49CAT MEOWS

0:22:51 > 0:22:53THEY CHAT

0:22:53 > 0:22:57In Potters Bar, student vets Matt Wilkinson

0:22:57 > 0:23:00and Dani Willey have been housemates since their first year.

0:23:01 > 0:23:05- He's very clean, actually, for a boy.- You're very dirty for a girl.

0:23:05 > 0:23:08- Oh, thank you very much. - You wee on the seat...

0:23:08 > 0:23:12- "Oh, my God! I can't believe you said that on the camera!" - I do not! I do not!

0:23:12 > 0:23:16- She doesn't wee on the seat. It's only a little bit true. - Oh, my God! Shut up.

0:23:16 > 0:23:21I hope it's a really easy Monday. That'll be nice.

0:23:21 > 0:23:24Dani's about to start her placement on small animal medicine.

0:23:24 > 0:23:26This is so stressful.

0:23:26 > 0:23:30I think everyone's really apprehensive about small animal medicine

0:23:30 > 0:23:33cos everyone talks about it being like the big scary one,

0:23:33 > 0:23:35they expect you to know everything...

0:23:36 > 0:23:40Yeah, it's mainly they expect you to have a lot of knowledge for it.

0:23:41 > 0:23:43Based at the college's main campus,

0:23:43 > 0:23:47Dani needs to have a working knowledge of all small animals

0:23:47 > 0:23:50because any pet with any disease could walk through the door.

0:23:52 > 0:23:56And Dani's first case is definitely a mystery.

0:23:56 > 0:23:59Three-and-a-half-year-old cat Peppi is having trouble breathing.

0:23:59 > 0:24:02Hi, I'm Daniele. Hiya. Nice to meet you.

0:24:02 > 0:24:05- Nice to meet you. - So, this is Peppi?

0:24:05 > 0:24:08Under the supervision of vet Katarina Hazuchova,

0:24:08 > 0:24:11Dani needs to take Peppi's medical history.

0:24:11 > 0:24:14And what seems to be the problem with her?

0:24:14 > 0:24:16Well, she's had a lot of breathing problems

0:24:16 > 0:24:20because her nose... I've actually taken picture of it,

0:24:20 > 0:24:23she actually had... Her nose was just dripping.

0:24:23 > 0:24:26- Right, OK.- It did sound like she was drowning, didn't it?- Yes.

0:24:26 > 0:24:28It was really bubbly.

0:24:29 > 0:24:32- It's quite a good picture of it. - Oh, yeah.

0:24:32 > 0:24:36Cool. Will it be OK if I just have a quick look at her?

0:24:36 > 0:24:37- Yeah. Of course, yeah.- Thanks.

0:24:39 > 0:24:42'Nasal discharge can either be something to do with

0:24:42 > 0:24:46'a mass maybe in the head, or it can be something maybe

0:24:46 > 0:24:48'lower down in the lungs.'

0:24:48 > 0:24:50Let's see if there's airflow out of it.

0:24:50 > 0:24:52'It's been going on for a while'

0:24:52 > 0:24:54and if the referring vets can't seems to work out

0:24:54 > 0:24:56what's wrong with it, then maybe it's something

0:24:56 > 0:24:58a bit more serious going on.

0:24:58 > 0:25:00- We're just going to take a look. - Thanks.

0:25:03 > 0:25:06Peppi, who is a three year, nine-month-old female

0:25:06 > 0:25:08spayed domestic short-haired cat,

0:25:08 > 0:25:11they've got a picture from their phone of it

0:25:11 > 0:25:14kind of literally dripping from the right nostril.

0:25:14 > 0:25:16Right. How does it look like? Is it mucus?

0:25:16 > 0:25:20It's kinda of browny... Yeah, mucusy.

0:25:20 > 0:25:23There's no... They said they haven't seen any blood in it.

0:25:23 > 0:25:27But she said it smells of, like, rotting flesh.

0:25:27 > 0:25:29- So it's probably virulent.- Yeah.

0:25:29 > 0:25:32So, in Peppi's case, because of the amount of discharge

0:25:32 > 0:25:37and the amount of respiratory noise she had, I think me and Katerina are

0:25:37 > 0:25:40most worried it's probably something quite sinister like cancer.

0:25:40 > 0:25:44Katerina takes the decision to admit Peppi to the hospital.

0:25:45 > 0:25:50I mean, she's a young cat, so just wait for the CT, the biopsies,

0:25:50 > 0:25:54and then we can talk about the treatment, if it's cancer.

0:25:58 > 0:26:02Today, Matt Wilkinson is starting at a general practice

0:26:02 > 0:26:04in Eastbourne, on the south coast.

0:26:04 > 0:26:06It's always nice to be back in Eastbourne.

0:26:06 > 0:26:09The placements in Eastbourne are really close to me

0:26:09 > 0:26:10so I can get up a bit later

0:26:10 > 0:26:13so it's nice to have a bit of a longer lie-in.

0:26:16 > 0:26:18Matt's on familiar territory this week.

0:26:18 > 0:26:21I've been coming here since I was in Year 11,

0:26:21 > 0:26:24just doing all my pre-university work experience here,

0:26:24 > 0:26:28so they've all watched me grow up from yea high.

0:26:30 > 0:26:33It's quite nice actually to have him back as a vet student

0:26:33 > 0:26:35and he's been great. Fantastic.

0:26:35 > 0:26:39One of the first things I learnt when I came here was that if you treat your nurses right,

0:26:39 > 0:26:42- you'll have a happier time. - Absolutely.- There we go. Lesson learned.

0:26:42 > 0:26:43I still boss him around.

0:26:43 > 0:26:46- Obviously.- We're a nurse. Nurses boss them around.

0:26:46 > 0:26:48It's your job. Exactly.

0:26:50 > 0:26:53Keen to make the move from tea boy to graduate,

0:26:53 > 0:26:56Matt is hoping for more hands-on experience this time.

0:26:57 > 0:27:04- 0.5.- Yes. That's right, isn't it? - That's 0.05.- OK. A bit more?

0:27:04 > 0:27:08This is what we'll be doing fundamentally for the rest

0:27:08 > 0:27:12of our lives so this year is incredibly important to get right.

0:27:12 > 0:27:16Matt's about to assist on a particularly challenging patient...

0:27:16 > 0:27:18- Are we ready?- I'm ready.

0:27:18 > 0:27:20..who's arrived in a gravy carton.

0:27:20 > 0:27:22Hello, Cracker. Come on.

0:27:25 > 0:27:28Cracker has a huge tumour on the side of her body

0:27:28 > 0:27:30that needs to be removed.

0:27:30 > 0:27:34Senior vet Ian Mcgill will be performing the fiddly operation.

0:27:34 > 0:27:37The owners of the mouse, Mrs Moore,

0:27:37 > 0:27:39said that they're very, very caring.

0:27:39 > 0:27:42They have a lot of mice, and she's quite prepared to spend

0:27:42 > 0:27:45£100 to have the surgery done on a mouse.

0:27:45 > 0:27:48Not always easy to get a mouse through an operation like that

0:27:48 > 0:27:50cos it's very major.

0:27:50 > 0:27:52Quite a large lump there.

0:27:52 > 0:27:54We don't really often see much surgery on mice.

0:27:56 > 0:27:59So it's fairly interesting when one does come in.

0:27:59 > 0:28:02It may be rare to operate on these tiny rodents,

0:28:02 > 0:28:05but the owner is certain it's the right decision.

0:28:05 > 0:28:07What she needs she gets. Whatever she needs,

0:28:07 > 0:28:10treatment wise, she'll get. Same with the other at home.

0:28:10 > 0:28:12INTERVIEWER: And why is that?

0:28:12 > 0:28:15She's a person so you do it for a human child.

0:28:15 > 0:28:17Why wouldn't you do it for your animal?

0:28:17 > 0:28:20Oh, no, you're coming out the other side!

0:28:20 > 0:28:25It's difficult to anaesthetise a mouse because they're very small.

0:28:25 > 0:28:27Oh, starting to go.

0:28:31 > 0:28:32ELECTRIC RAZOR BUZZES

0:28:37 > 0:28:41So you can see from the surface of the tumour that it's quite nasty

0:28:41 > 0:28:43and aggressive. It's quite purple and angry looking.

0:28:43 > 0:28:45So if we didn't do anything,

0:28:45 > 0:28:49it would ulcerate and that would be the end of Cracker.

0:28:54 > 0:28:57You can't check the heart rate because it's too fast.

0:28:57 > 0:28:58Have you managed to work it out?

0:28:58 > 0:29:01It's so difficult to count.

0:29:01 > 0:29:02'Usually with dogs and cats,'

0:29:02 > 0:29:07you assess their eye reflex, you assess their jaw tone, you know,

0:29:07 > 0:29:09none of which are very easy in a mouse.

0:29:09 > 0:29:11Everything's a lot more fiddly.

0:29:11 > 0:29:13You can't exactly take a heart rate very well.

0:29:13 > 0:29:17You need a tiny little stethoscope. I mean, I think...

0:29:17 > 0:29:19I was using my massive stethoscope!

0:29:19 > 0:29:21So you can't really...

0:29:21 > 0:29:24There's no way you can get a rate, really.

0:29:24 > 0:29:26- OK.- Let's do it.

0:29:28 > 0:29:32I've operated on two siblings of this mouse

0:29:32 > 0:29:35so we don't know the history of this mouse but it may well be

0:29:35 > 0:29:42they've come from a lab population at some point so they might be

0:29:42 > 0:29:45little bit inbred so that's why they're getting so many tumours.

0:29:45 > 0:29:47- Can I get some 3-0 catgut, please? - Mm-hm.

0:29:48 > 0:29:51Where have you kept that...

0:29:51 > 0:29:52Everything's changed!

0:29:58 > 0:30:01I'm going to remove as much of the mess as I possibly can.

0:30:03 > 0:30:05We've managed to get all the tumour out.

0:30:05 > 0:30:06The skin has come together well.

0:30:06 > 0:30:09I am just giving some fluids under the skin.

0:30:09 > 0:30:11All right, Cracker's back with us.

0:30:11 > 0:30:16That surgery may have prolonged Cracker's life for three to four months.

0:30:16 > 0:30:20You know mice don't live very long. That's maybe saving a human 20 years of their life.

0:30:20 > 0:30:24Cracker may have had major surgery,

0:30:24 > 0:30:27but in no time she is back on her feet and trying to escape.

0:30:28 > 0:30:30There we go.

0:30:33 > 0:30:36Matt and surgeon Ian are not the only ones who are relieved Cracker's

0:30:36 > 0:30:38operation is a success.

0:30:38 > 0:30:41It's always worth it. It's never not worth it.

0:30:41 > 0:30:44She is going to get good quality of life from it.

0:30:44 > 0:30:47Well, I can't have children so she is the children.

0:30:47 > 0:30:51Brilliant to have you back, isn't it, little one?

0:30:51 > 0:30:56BARKING

0:31:04 > 0:31:06Thank you.

0:31:06 > 0:31:10Back in Dorset, perfectionist Elly is on day two of her farm placement.

0:31:10 > 0:31:12Follow me.

0:31:12 > 0:31:15Cow's hooves are constantly growing

0:31:15 > 0:31:19and foot trimming is a skill which all farm vets must master.

0:31:19 > 0:31:22Yeah, yeah, these are to protect your arms.

0:31:22 > 0:31:26Gloves to keep us as clean as possible per cow

0:31:26 > 0:31:28so as not to give an infection to her.

0:31:28 > 0:31:34And then this, which is awesome, and obviously the hat which is key.

0:31:34 > 0:31:37Sorry, no, it is key. It's very important.

0:31:39 > 0:31:43This placement is particularly tough as Kelly's supervisor today

0:31:43 > 0:31:46is Nick Bell, the senior tutor of the course.

0:31:46 > 0:31:50Foot trimming is one of the most challenging tasks for Elly.

0:31:50 > 0:31:53'She's got to know how to handle the cow and then she's got to'

0:31:53 > 0:31:56execute something that's practically quite challenging.

0:31:56 > 0:32:01So it brings together some really core skills for Elly that will

0:32:01 > 0:32:06stand her in good stead when she's in her first job in practice.

0:32:06 > 0:32:10Foot trimming may be a simple procedure, but it's easy to get wrong.

0:32:10 > 0:32:12Is that bit there OK?

0:32:12 > 0:32:15Don't go too deep.

0:32:17 > 0:32:19No, remember wider, flatter.

0:32:19 > 0:32:22- Can I stop you there? - Please do.

0:32:22 > 0:32:25We don't want to go too deep that we create a new problem for her.

0:32:25 > 0:32:28- So...- You make it look so smooth and amazing.

0:32:28 > 0:32:30It's practice!

0:32:30 > 0:32:33'With anything at vet school, there's usually about four or five

0:32:33 > 0:32:37'people at least watching you and so the pressure was on and then I also'

0:32:37 > 0:32:40felt quite a lot of pressure cos I didn't really know what I was doing

0:32:40 > 0:32:45and I was just trying to remember, which hand do I hold it in and how much do I take off,

0:32:45 > 0:32:49'and how sharp is this? And, "Oh, I actually can't do this."

0:32:49 > 0:32:51'I was trying to lop off the end of one of those toes.'

0:32:51 > 0:32:54No, it keeps slipping off and I am not strong enough.

0:32:55 > 0:32:57- How are you getting on?- Any advice?

0:32:57 > 0:33:02- No...- It's just speed. It takes practice.

0:33:02 > 0:33:06Once you've trimmed a few...

0:33:06 > 0:33:09- Thousand feet.- ..thousand feet, you will be confident.

0:33:09 > 0:33:13It's very easy for people to think it's like peeling a potato

0:33:13 > 0:33:14and that we want to pare away...

0:33:14 > 0:33:16To take all the nasty...

0:33:16 > 0:33:20But we actually want to leave a lot of the functional horn there.

0:33:21 > 0:33:26I don't think I did very well. I am not happy with that.

0:33:26 > 0:33:28I think I could have done better.

0:33:28 > 0:33:31I feel bad - coming to the other side, you see the angle

0:33:31 > 0:33:36that you've been cutting away at... That's not good.

0:33:37 > 0:33:39Practice makes perfect.

0:33:40 > 0:33:42Why are you not happy?

0:33:42 > 0:33:46Because I mean, it's silly, you are only new to it, aren't you?

0:33:46 > 0:33:49Yeah. If I just... If I had taken it a bit slower, maybe.

0:33:56 > 0:34:00Generally today happy and I am quite good at hiding when something's

0:34:00 > 0:34:03wrong, but I think just in that moment I was just genuinely

0:34:03 > 0:34:08disappointed and it was just, for my shame, a bit of a low moment.

0:34:08 > 0:34:13'But I think better to have them now while I'm learning as opposed to when I get there'

0:34:13 > 0:34:17and it's a real farmer, so better to get all this out of the way now.

0:34:19 > 0:34:23'It's quite natural in those high pressured situations that

0:34:23 > 0:34:26'emotions do sometimes overflow

0:34:26 > 0:34:30'and we've seen this on numerous occasions with other people.'

0:34:30 > 0:34:33It's part of being a little bit perfectionist which

0:34:33 > 0:34:35a lot of the students that come here are.

0:34:35 > 0:34:38MOOING

0:34:39 > 0:34:41MEOW

0:34:47 > 0:34:50With a traumatic time in anaesthesia behind her,

0:34:50 > 0:34:55Judy is beginning her next placement in intensive care.

0:34:55 > 0:34:58The unit looks after the Queen Mother Hospital's most

0:34:58 > 0:35:01seriously ill pets who need round-the-clock monitoring.

0:35:03 > 0:35:05We have a cat over there that was crashing

0:35:05 > 0:35:07so Ros had to run over there and help,

0:35:07 > 0:35:10'but I have never seen so many people around one table.'

0:35:12 > 0:35:14'The students are actually...'

0:35:14 > 0:35:16It's sometimes eye-opening

0:35:16 > 0:35:20in the things they are exposed to, what they're expected to be doing.

0:35:20 > 0:35:24What we ask them is to learn from every experience.

0:35:24 > 0:35:27'Get the most they can from every patient

0:35:27 > 0:35:29'no matter how complicated it may be.'

0:35:29 > 0:35:32There's always lessons to be learned about being a good vet.

0:35:32 > 0:35:34- Steady. Steady. Steady. - Stop it!

0:35:34 > 0:35:40All patients on the unit have either been admitted as emergencies or have been through major surgery.

0:35:40 > 0:35:43Megan... Here's Megan!

0:35:44 > 0:35:48The first patient Judy spots is Megan, the Border collie,

0:35:48 > 0:35:51recovering after her operation to remove a tumour.

0:35:51 > 0:35:52You're a good girl.

0:35:52 > 0:35:56This is the first anaesthesia case that

0:35:56 > 0:36:00I got thrown into. Look at her, she is doing fantastic.

0:36:00 > 0:36:03She is looking really good.

0:36:04 > 0:36:08- Right... Go, go, go, go. - I don't think he's breathing.

0:36:08 > 0:36:13Judy and her fellow students have been given their first emergency of the day.

0:36:13 > 0:36:18Core supervisor Duana McBride will be assessing their skills throughout.

0:36:18 > 0:36:22- Are we seeing anything different with ECG then?- No.

0:36:24 > 0:36:25Is that going to help?

0:36:25 > 0:36:28Is there spontaneous breathing yet?

0:36:29 > 0:36:32All right, do you want to stop there?

0:36:32 > 0:36:33LAUGHTER

0:36:33 > 0:36:35Unfortunately the patient didn't make it,

0:36:35 > 0:36:38but fortunately for Judy, this particular dog is just for practice.

0:36:38 > 0:36:42No. I think you guys did really well and I think when I turned that on,

0:36:42 > 0:36:46you felt a little bit out of your comfort zone.

0:36:46 > 0:36:51Didn't manage to save the animal, Gerry, in our practical, but never mind.

0:36:51 > 0:36:53We did learn a lot.

0:36:53 > 0:36:57I feel a lot more comfortable doing CPR on animals after that so that's

0:36:57 > 0:37:01good, but I don't think Gerry was a very good candidate to be honest.

0:37:01 > 0:37:04I mean he looked pretty flat before we started

0:37:04 > 0:37:05so I need to get a new patient!

0:37:05 > 0:37:10This one down here, this is Biscuit, he's six and a half, Labrador.

0:37:10 > 0:37:15Now he had surgery. He was in surgery for about nine hours yesterday.

0:37:15 > 0:37:20Her next patient, Biscuit, is alive, but critically ill

0:37:20 > 0:37:25after a serious operation to repair his badly damaged spine.

0:37:25 > 0:37:29It was a major disc extrusions with a lot of haemorrhaging involved.

0:37:29 > 0:37:32The main focus when he came back from surgery was the fact that this

0:37:32 > 0:37:37dog could...respiratory arrest because of the nerves impinged.

0:37:39 > 0:37:46This is an MRI of Biscuit's cervical and cranial thoracic spine.

0:37:46 > 0:37:52Neurologist Tom Cardy is showing Judy and her fellow students the extent of the damage.

0:37:52 > 0:37:57- What do you absolutely notice? - That it's missing in this area.

0:37:57 > 0:38:02It's missing in a huge, huge chunk of his spinal cord.

0:38:02 > 0:38:06One of Biscuits' discs had popped and exploded

0:38:06 > 0:38:09and it has just disappeared.

0:38:09 > 0:38:11It's obliterated.

0:38:11 > 0:38:15This is potentially a catastrophic event

0:38:15 > 0:38:20so what we were left with was, unfortunately, a paralysed dog.

0:38:20 > 0:38:24'If you've said to anyone, this dog has got this injury,

0:38:24 > 0:38:28'they would say, "Well, he's not going to walk ever again."'

0:38:28 > 0:38:31He's going to be for all intents and purposes,

0:38:31 > 0:38:34a paraplegic dog, which is not good.

0:38:34 > 0:38:39The operation to relieve pressure on Biscuit's spinal cord was a success,

0:38:39 > 0:38:42but has left him with severe breathing problems.

0:38:42 > 0:38:45His owners have limited insurance,

0:38:45 > 0:38:49but have agreed to keep him on a ventilator for up to 24 hours

0:38:49 > 0:38:52in the hope that Biscuit can start to breathe for himself.

0:38:52 > 0:38:58Biscuit's owners have given us today to see major progress.

0:38:58 > 0:39:00They don't have a lot of disposable income

0:39:00 > 0:39:05and so they are watching very closely, but we're really hoping that he will pull through.

0:39:05 > 0:39:08That's the goal.

0:39:08 > 0:39:12I have heard a rumour it's about £1,000 a day. We will try to wean him off the machine

0:39:12 > 0:39:14and if he does start struggling again, we can put him straight

0:39:14 > 0:39:18back on the machine, but obviously you can't go on doing that forever.

0:39:18 > 0:39:21There comes a point where he's going to have to breathe for himself.

0:39:21 > 0:39:26Yeah, and when they get to that bridge, they will have to make that decision.

0:39:26 > 0:39:30It will be hard, but hopefully Biscuit will make the right choice.

0:39:30 > 0:39:33Do the right thing. So...

0:39:33 > 0:39:39What we should try to do is see if he can have periods where he's doing all the work,

0:39:39 > 0:39:41the work of breathing.

0:39:41 > 0:39:43All they can do is wait and watch.

0:39:43 > 0:39:46'You do feel quite protective over this dog

0:39:46 > 0:39:49'because he's on a ventilator. You feel sorry for him. It's like

0:39:49 > 0:39:54'he's in an induced coma, this dog, so you want to do things for him.'

0:39:54 > 0:39:59I felt like it did make me bond with Biscuit even if he didn't know.

0:39:59 > 0:40:00We got close.

0:40:03 > 0:40:05How is he doing?

0:40:05 > 0:40:08His tongue is... Put your tongue back in.

0:40:08 > 0:40:11Oh, we are going to have to extubate.

0:40:11 > 0:40:15But then nearly five hours later it looks like there could be hope...

0:40:15 > 0:40:17Extubate him, he's awake.

0:40:17 > 0:40:20..as Biscuit has started to breathe independently.

0:40:21 > 0:40:27We knew obviously the time had come to turn the ventilator off

0:40:27 > 0:40:31and wake him up and see what was going to happen, and everybody

0:40:31 > 0:40:36wanted to see what was going to happen because it was touch and go. We didn't know.

0:40:36 > 0:40:42Nobody could predict whether he was going to be fine or whether it was going to go downhill again.

0:40:42 > 0:40:45- Biscuit is back in the room. - Yes! Exactly that.

0:40:51 > 0:40:53Ssh, ssh.

0:40:53 > 0:40:58- The next hour is going to be... - Crucial.- ..absolutely terrifying,

0:40:58 > 0:41:02so we need to make sure he is kept nice and calm.

0:41:02 > 0:41:05Nice and sedated keep his oxygen prongs in,

0:41:05 > 0:41:09definitely pay careful attention to his rate.

0:41:09 > 0:41:12I do want someone literally to be watching him for the next hour.

0:41:12 > 0:41:14BISCUIT WHINES FAINTLY

0:41:15 > 0:41:19You can hear, he is trying to whine now.

0:41:19 > 0:41:23BISCUIT GRUNTS

0:41:24 > 0:41:28We have to watch him like a hawk because if he needs to

0:41:28 > 0:41:32have the tube put down again quickly, we need to be on it

0:41:32 > 0:41:37straightaway, so hence we are all stood here watching him like hawks.

0:41:47 > 0:41:51I do get quite envious of the medics in the fact that humans can

0:41:51 > 0:41:55just stay still. Like when you are trying to sort of just do

0:41:55 > 0:41:59a clinical exam for example, you've got this crazy dog running around

0:41:59 > 0:42:02and you are like, "I just need to listen to your heart beat

0:42:02 > 0:42:06"and your respiratory..." And I can't even see it let alone...

0:42:06 > 0:42:08It's true.

0:42:08 > 0:42:11When I had that Labrador puppy this morning,

0:42:11 > 0:42:13I had saliva in my ear, I had it in my eyes,

0:42:13 > 0:42:16I had it in my mouth and I was just like, "This is so much love

0:42:16 > 0:42:18"all at once, but I just want a heart rate."

0:42:25 > 0:42:27So we are just going to go and see Peppi.

0:42:27 > 0:42:31I think she is going to be induced for anaesthesia soon so...

0:42:31 > 0:42:35Dani's patient, Peppi, was brought into the hospital yesterday

0:42:35 > 0:42:38with breathing problems and nasal discharge.

0:42:38 > 0:42:43The vets are concerned that Peppi could be suffering from cancer.

0:42:43 > 0:42:48So Peppi is going for a CT of her head and thorax today.

0:42:49 > 0:42:54Peppi needs a CT scan to reveal the source of the problem.

0:42:54 > 0:42:57If the scan reveals a cancerous mass it could be fatal for Peppi.

0:43:04 > 0:43:07When you are looking at the CT, you are just looking for the bone destruction?

0:43:07 > 0:43:11Yeah, because if there is some bone destruction, then this would be more suggestive

0:43:11 > 0:43:14of a tumour, of some cancer.

0:43:24 > 0:43:28It's not a mass because there is not any bony destruction that we

0:43:28 > 0:43:30can see on the CT so it's good news.

0:43:30 > 0:43:33Luckily for Peppi she hasn't got cancer,

0:43:33 > 0:43:38but the vets have spotted something else at the back of her nose.

0:43:38 > 0:43:41We had some findings from the images.

0:43:41 > 0:43:43It looks like a polyp.

0:43:43 > 0:43:45It's a polyp so it's actually something

0:43:45 > 0:43:48we could remove potentially, so that's very good.

0:43:48 > 0:43:50How to explain this in English? I don't know.

0:43:50 > 0:43:54- They said like a mass on a stalk. - Exactly.

0:43:54 > 0:43:59The decision is made to try and remove the suspected polyp to help

0:43:59 > 0:44:03Peppi breathe normally again, but it's a tricky procedure.

0:44:03 > 0:44:06I've never done this so I don't know.

0:44:06 > 0:44:08I think it will bleed quite a lot.

0:44:11 > 0:44:15First the vets use a fibre optic camera to try to find it.

0:44:16 > 0:44:18Just so we can discuss...

0:44:20 > 0:44:25A bulge in Peppi's soft palate tells Katharina that the polyp is right at the back of Peppi's nose.

0:44:25 > 0:44:27- Yeah.- I would suggest...

0:44:27 > 0:44:31Now all they have to do is pull it out.

0:44:31 > 0:44:34The hook is for pulling the soft palate forward,

0:44:34 > 0:44:39- so you want to... You need to get that over the soft palate.- Mm hm.

0:44:42 > 0:44:45Is that large for a polyp or is that kind of normal sized?

0:44:45 > 0:44:49They are always unfeasibly large for the space they're occupying.

0:44:51 > 0:44:55Now what Katharina is going to do is to grab it and pull.

0:44:57 > 0:44:58OK.

0:45:04 > 0:45:06- There you go!- Yes!

0:45:06 > 0:45:07That's gross!

0:45:07 > 0:45:09Thank you.

0:45:09 > 0:45:13That was good to get involved in. It was quite, like, brutal like,

0:45:13 > 0:45:16seeing how they tug on it, cos you are just like, "Oh."

0:45:16 > 0:45:20But as soon as it came out, how big it was was amazing.

0:45:20 > 0:45:24It's kind of a case like you want to get in practice cos it's kind of a nice ending.

0:45:24 > 0:45:28So do you think you could do one of those in practice?

0:45:28 > 0:45:33I'd be a bit scared doing it, especially the pulling bit,

0:45:33 > 0:45:36but it'd be pretty cool to do it.

0:45:46 > 0:45:48MOOING

0:45:50 > 0:45:53This job is anything if glamorous.

0:45:53 > 0:45:58In Dorset, Elly is coming to the end of her two-week farm placement.

0:45:58 > 0:46:02I'm just feeling now for the right ovaries.

0:46:02 > 0:46:07Local vet Tom will be assessing Elly giving pregnancy checks to

0:46:07 > 0:46:08a batch of heifers.

0:46:09 > 0:46:12- And there will be a little... - Nubbin?

0:46:12 > 0:46:17Knobbly bit on the end there, which signifies whether she ovulated.

0:46:17 > 0:46:21So, I have never felt a pregnant uterus before.

0:46:21 > 0:46:25The majority of what I have seen on farm placement has been pregnancy diagnosis.

0:46:25 > 0:46:30It's something I know you have to be able to do and it's been worrying me that I don't know how to do it yet.

0:46:30 > 0:46:35Tom's concerned about one of the cows and he wants Elly to examine her.

0:46:35 > 0:46:38There is another one here on the end.

0:46:38 > 0:46:41She's been calved about a week. Dave's not happy that she's milking that well,

0:46:41 > 0:46:44- so do you want to have a listen? - OK.

0:46:44 > 0:46:49It's called pinging. If you flick... and you hear a sound a bit like

0:46:49 > 0:46:52if you flick terracotta, that kind of "ping, ping".

0:46:52 > 0:46:55It means there is collection of air in there and you've

0:46:55 > 0:47:01got a bit of stomach that probably shouldn't be where it should be...

0:47:01 > 0:47:03Tom?

0:47:06 > 0:47:11Elly thinks the cow's stomach has become twisted into the wrong position after giving birth.

0:47:11 > 0:47:14Yes, so it is a twisted stomach so we'll,

0:47:14 > 0:47:18after we've finished here, we will probably do an operation

0:47:18 > 0:47:20just to make sure - pull that round in the right place.

0:47:20 > 0:47:22Sweet. Thank you. That's brilliant.

0:47:22 > 0:47:24Poor girl.

0:47:24 > 0:47:29This is a serious condition which needs immediate attention or the cow will die.

0:47:29 > 0:47:32But rather than whisk the cow off to a state-of-the-art hospital

0:47:32 > 0:47:39she's going to be operated on right here in the barn and Elly has the opportunity to get involved.

0:47:39 > 0:47:43Situation with this cow is that at the moment, she has had her

0:47:43 > 0:47:49pre-surgical pain relief and antibiotic injections.

0:47:49 > 0:47:55Cut the first layer and then split the second layer with my fingers.

0:47:55 > 0:48:00So you're going in, curtain there, going round the back

0:48:00 > 0:48:06of that and sort of feel the edge of it and sort of work your hand

0:48:06 > 0:48:10around there, there's a kidney sort of hard knobbly thing.

0:48:10 > 0:48:13- Yep.- Are you with me so far?- Yep.

0:48:13 > 0:48:18- Below you is gooey intestines, straight ahead, doughy rumen.- Yep.

0:48:18 > 0:48:22- So go over the top of the doughy rumen and touch the far body wall. - Yep.

0:48:22 > 0:48:24- And then move sort of cranial to that...- There it is!

0:48:24 > 0:48:27- ..and that's your...- Whoopee cushion!- Yes!

0:48:27 > 0:48:32- Awesome.- Now, what I'll do with this, I'll just pull it back underneath

0:48:32 > 0:48:36so the gas can escape back along the intestines...

0:48:36 > 0:48:42When Tom said, "Get in there. Stick your hand in there." That was...

0:48:42 > 0:48:45I wasn't really expecting that at all, but that was great.

0:48:45 > 0:48:50And literally we were right up to your shoulder...in a cow

0:48:50 > 0:48:53hugging the rumen. Crazy.

0:48:53 > 0:48:58With the cow's stomach back where it belongs, it's Elly's job to stitch her up.

0:48:58 > 0:49:00- Just starting to... - Enter student!

0:49:02 > 0:49:03Well done.

0:49:03 > 0:49:07- Snappy snaps.- Yeah, yeah.- Ow! - Steady, girl.

0:49:09 > 0:49:12You little madam!

0:49:15 > 0:49:18She did very well. Yes.

0:49:18 > 0:49:21The stitches... a little bit wobbly,

0:49:21 > 0:49:24but it will hold together. That's the main thing.

0:49:24 > 0:49:25So yep she's passed!

0:49:30 > 0:49:34Leaving behind a happy cow, Elly is meeting supervisor Nick Bell

0:49:34 > 0:49:38for the results of her placement, but she isn't feeling confident.

0:49:38 > 0:49:43It is silly. I know. I know I can't be good at everything first time and I do just

0:49:43 > 0:49:47need to practise and that's pure perfectionism coming out basically.

0:49:48 > 0:49:52- What things do you think could have gone better for you? - Foot trimming!

0:49:52 > 0:49:54- Really?- Yeah.

0:49:54 > 0:49:58I wasn't... I felt... I just felt a bit cack handed and useless.

0:49:58 > 0:50:03Don't feel bad at all because it's very much about practice

0:50:03 > 0:50:05so that's nothing to worry about.

0:50:05 > 0:50:08We are confident you are on track and, yeah, good.

0:50:08 > 0:50:12- Brilliant. That's great.- OK.

0:50:12 > 0:50:14- Thank you.- So, well done.

0:50:14 > 0:50:17'I don't have any concerns about her performance'

0:50:17 > 0:50:19from her knowledge and professionalism point of view.

0:50:19 > 0:50:23There are some areas that she still needs to work on from the practical perspective,

0:50:23 > 0:50:28but we'd expect that for a student at this stage of their training.

0:50:28 > 0:50:33A glowing assessment from Nick means Elly is one step closer to her dream.

0:50:33 > 0:50:36It feels very real when you are out there and you are getting

0:50:36 > 0:50:39covered in poo and I know that's a very basic thing to say,

0:50:39 > 0:50:43but it makes it seem closer to the reality that one day I'll live.

0:51:03 > 0:51:08Matt is still working in Eastbourne but this time he's in a different practice.

0:51:08 > 0:51:14Set inside a large pet store, Companion Care Vet sees up to 40 animals a day.

0:51:17 > 0:51:20If I end up going into small animal practice this is the stuff

0:51:20 > 0:51:23I will be doing day in day out and it's the kind of stuff you

0:51:23 > 0:51:26really need to get used to doing.

0:51:26 > 0:51:28Good boy. Well done.

0:51:28 > 0:51:32- Puppies at this age, they generally bounce, they are quite bendy.- Yeah.

0:51:32 > 0:51:37The practice is run by former Royal Veterinary College student Warwick Payne.

0:51:37 > 0:51:39- All right, do you want to do the castrate?- Yeah.

0:51:39 > 0:51:42We could race. One at a time.

0:51:42 > 0:51:44Yeah, we can have a castrate race if you want.

0:51:44 > 0:51:49The race will have to wait as his first patient is six-month-old female kitten Gizmo

0:51:49 > 0:51:50who's here to be spayed.

0:51:52 > 0:51:55Tiny cat! You're going to have a tiny vein.

0:51:56 > 0:51:59- Now that's not going to help if you wriggle. - Can I have a towel please?

0:51:59 > 0:52:04Today Warwick is allowing Matt to perform surgery on his own.

0:52:06 > 0:52:12Neutering is an operation which every vet must master and Warwick will be observing Matt's every move.

0:52:12 > 0:52:16I am just here to make sure everything is OK.

0:52:16 > 0:52:19If he gets into any trouble, I'll help out.

0:52:19 > 0:52:25Right, so make your triangle. Yeah. A bit further down.

0:52:25 > 0:52:29So you've got your equilateral triangle.

0:52:29 > 0:52:35Your incision is going to be about there and she is quite fat so, yeah, that's all right.

0:52:38 > 0:52:41'Pressure is always a difficult one because you want to get things right.'

0:52:41 > 0:52:46You don't want to get things wrong. You don't want to look like an idiot in front of the clinicians.

0:52:46 > 0:52:49You want to prove to them that you know what you're talking about.

0:52:49 > 0:52:53This is the bit where a lot of supervising vets get a little twitchy.

0:52:53 > 0:52:58And to try and pass rotations and prove to them

0:52:58 > 0:53:01the last four years have actually been useful to me,

0:53:01 > 0:53:07I do know, kind of, I am starting to know what I am kind of talking about.

0:53:08 > 0:53:11The bottom line is, this is someone's pet, you know,

0:53:11 > 0:53:14Gizmo's got to go home at the end of the day

0:53:14 > 0:53:19looking as well, hopefully, as she did when she came in.

0:53:19 > 0:53:22We make a mistake, that puts an end to it.

0:53:22 > 0:53:26I try not to think about it too much.

0:53:26 > 0:53:29- So that was really helpful then, wasn't it?- Yeah, no.

0:53:29 > 0:53:31If I start feeling too much pressure,

0:53:31 > 0:53:37then I start feeling scared and I don't really want to feel that

0:53:37 > 0:53:39so I try not to think about it really.

0:53:42 > 0:53:46I used to watch surgeons doing their ties thinking, "Whoa."

0:53:46 > 0:53:50They were so quick and fancy and I just thought it was amazing.

0:53:50 > 0:53:54And then you go back into surgery and you're doing the ties

0:53:54 > 0:53:58that you used to watch thinking, "Wow, that's really amazing."

0:53:58 > 0:54:02Just, you know, you go such a long way from work experience days.

0:54:05 > 0:54:08- Yeah, all done.- So how would you say Matt did on that?

0:54:08 > 0:54:09Very well, yeah.

0:54:09 > 0:54:13You know, like I said, I've watched Matt do a few procedures now

0:54:13 > 0:54:17and I'm very confident in his ability to do the job.

0:54:17 > 0:54:19He's actually, for the stage he's at,

0:54:19 > 0:54:20he's actually a very good surgeon

0:54:20 > 0:54:23and it's something that takes a lot of practice but

0:54:23 > 0:54:27he is confident and competent enough to be doing a good job already.

0:54:30 > 0:54:32OK, are we going to stay still?

0:54:32 > 0:54:336.5.

0:54:33 > 0:54:35Yes, she's just got a tiny little wound there,

0:54:35 > 0:54:36probably about that long.

0:54:36 > 0:54:39If she isn't eating, then she'll need to come back.

0:54:39 > 0:54:42Super brave! Well done. There we go.

0:54:42 > 0:54:45For Matt, it's been a successful few weeks

0:54:45 > 0:54:47and it looks like he's made a good impression

0:54:47 > 0:54:50on a possible future employer.

0:54:50 > 0:54:55This time next year, we may be needing another vet.

0:54:55 > 0:54:57We've had a little discussion the other day about whether Matthew

0:54:57 > 0:55:00would be interested should a position arise

0:55:00 > 0:55:03so, yeah, we shall see.

0:55:03 > 0:55:07I was elated when he said, "How would you consider coming to work for me?"

0:55:07 > 0:55:10Because I thought, you know, "This is great."

0:55:10 > 0:55:14Inside it was like fireworks were going off or something

0:55:14 > 0:55:18but, you know, on the outside, cool, calm exterior, sort of,

0:55:18 > 0:55:20"Yeah, that's something to consider."

0:55:30 > 0:55:34Judy's coming to the end of her placement in intensive care.

0:55:34 > 0:55:37She's been looking after her patient Biscuit.

0:55:37 > 0:55:41- How much does it say on the side there?- Over a litre.

0:55:41 > 0:55:42Are you thirsty?

0:55:43 > 0:55:45Oops!

0:55:45 > 0:55:49He's recovering from his surgery to fix a catastrophic spinal injury.

0:55:49 > 0:55:51Right, shall we?

0:55:51 > 0:55:54And 24 hours after coming off the ventilator,

0:55:54 > 0:55:58it's clear Biscuit is beating all the odds.

0:55:58 > 0:56:01You're bored now, aren't you? He's had enough of this cot.

0:56:01 > 0:56:03I glanced over at him, saw him

0:56:03 > 0:56:05and he was up and he had his head around.

0:56:05 > 0:56:10I'm like, "Oh, my God! He's up!" It was amazing. He's a different dog.

0:56:13 > 0:56:17The dog with that level of damage to his spinal cord,

0:56:17 > 0:56:20we weren't that convinced that he would recover.

0:56:20 > 0:56:26The progress in the last 24 hours has been quite frankly astonishing.

0:56:26 > 0:56:29Aw. We don't get you any more.

0:56:29 > 0:56:31Aw.

0:56:31 > 0:56:34They thought he was not going to be able to use his back legs ever

0:56:34 > 0:56:36or for a long time

0:56:36 > 0:56:40but he proved us all wrong.

0:56:40 > 0:56:42That's better. Don't over do it.

0:56:42 > 0:56:44Don't over do it.

0:56:44 > 0:56:47Stay. Behave yourself, Biscuit.

0:56:47 > 0:56:51Biscuit will finally be heading home to recover with his owners.

0:56:51 > 0:56:55He's not walking yet but it's a good start

0:56:55 > 0:56:57and it's been a good week for Judy too.

0:56:57 > 0:57:00I probably went from my worst week ever on anaesthesia

0:57:00 > 0:57:03to my best week ever on ICU.

0:57:03 > 0:57:06Just the way it is. Welcome to rotations.

0:57:15 > 0:57:17You all right, Biscuit?

0:57:17 > 0:57:20Don't do that.

0:57:20 > 0:57:24Four weeks later, Biscuit's back with his owners for a check up.

0:57:25 > 0:57:27How's your paralysis?

0:57:27 > 0:57:30THEY LAUGH

0:57:30 > 0:57:31No, no, no, no.

0:57:31 > 0:57:35When he came back, unbelievable.

0:57:35 > 0:57:36He was walking.

0:57:36 > 0:57:40This dog that looked like somebody had dropped a skip on his neck

0:57:40 > 0:57:43was walking into the QMH.

0:57:43 > 0:57:45Good boy.

0:57:45 > 0:57:47How did you feel when you got the phone call

0:57:47 > 0:57:49to say that he could actually stand?

0:57:49 > 0:57:51I burst into tears.

0:57:51 > 0:57:55- Yeah, I was amazed I think. Definitely.- Good boy!

0:57:55 > 0:57:58Before the surgery, we didn't know whether he'd be able to walk again

0:57:58 > 0:58:02at all but it was worth a shot and even if he was happy and pain free,

0:58:02 > 0:58:06we were happy with that but to have him back to normal is amazing.

0:58:06 > 0:58:09Brilliant. Take care. Take care. Take care, Biscuit.

0:58:09 > 0:58:12Closest thing to a miracle I've ever seen. It was just amazing.

0:58:12 > 0:58:14We were all in awe of that dog.

0:58:14 > 0:58:17He's up there on a pedestal for us.

0:58:17 > 0:58:18Brilliant.