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 > 0:00:09We 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 > 0:00:15All of them...
0:00:15 > 0:00:17DOG WHINES
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 > 0:00:29in Hertfordshire are taking what they've learned in the classroom...
0:00:29 > 0:00:30Do it.
0:00:30 > 0:00:34..and putting it to the test in practices...
0:00:35 > 0:00:37..farms...
0:00:37 > 0:00:38This is all new territory for me.
0:00:38 > 0:00:42..and state-of-the-art animal hospitals.
0:00:42 > 0:00:46It's a whirlwind of back-to-back work placements...
0:00:46 > 0:00:49MONKEY SCREECHES Sounds like an unhappy monkey!
0:00:49 > 0:00:50Nice and quick, good.
0:00:50 > 0:00:53..and they can't afford to fail a single one.
0:00:53 > 0:00:55'I need to do my job properly.'
0:00:55 > 0:00:57I need to do better.
0:00:57 > 0:00:59It's the most challenging stretch...
0:00:59 > 0:01:00Whoa!
0:01:00 > 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...
0:01:06 > 0:01:07- Well done.- Gassy!
0:01:07 > 0:01:09..fully qualified young vets.
0:01:09 > 0:01:12Saved a life today, which is good!
0:01:29 > 0:01:32In just nine months' time, fifth-year students
0:01:32 > 0:01:37at the Royal Veterinary College face their dreaded final exams.
0:01:37 > 0:01:41So far, in this final year, there've been plenty of highs...
0:01:41 > 0:01:43Bit overwhelmed. Incredible.
0:01:43 > 0:01:45..and lows.
0:01:45 > 0:01:47Oh, my God. Fluids. I didn't write that down, either.
0:01:47 > 0:01:49But their confidence is growing.
0:01:49 > 0:01:51- Enter.- Enter, student.
0:01:51 > 0:01:53Yeah, she's...she's passed.
0:01:55 > 0:01:57For vet student Elly Berry,
0:01:57 > 0:02:00the next fortnight is going to be a huge challenge.
0:02:02 > 0:02:05I'm always nervous. I never seem to be able to fight the nerves
0:02:05 > 0:02:06of doing a new thing.
0:02:06 > 0:02:09I definitely... You know, ask me what a horse is right now
0:02:09 > 0:02:11and I'd be, like, "Oh, it's got legs."
0:02:11 > 0:02:13I can't remember much and until challenged,
0:02:13 > 0:02:16I don't know what I know...which is scary.
0:02:18 > 0:02:20Elly's on her way
0:02:20 > 0:02:23to the college's state-of-the-art Equine Referral Hospital...
0:02:23 > 0:02:25Hello, team.
0:02:25 > 0:02:30..where she's starting a notoriously scary two weeks on equine surgery...
0:02:30 > 0:02:32which she has to pass.
0:02:32 > 0:02:34You need to still do your checks and look after your patients.
0:02:34 > 0:02:36It's your responsibility to keep an eye on them,
0:02:36 > 0:02:39so make sure that they get done. Keep on top of your patients,
0:02:39 > 0:02:41because they are your responsibility.
0:02:41 > 0:02:44When they come and work in the hospitals,
0:02:44 > 0:02:48this is where they get to apply all of the knowledge and information
0:02:48 > 0:02:50that they have acquired over the previous four years,
0:02:50 > 0:02:53becoming properly part of the clinical teams
0:02:53 > 0:02:55and playing a real role in patient care -
0:02:55 > 0:02:58talking to clients and so on -
0:02:58 > 0:03:01is really what pulls all of their experiences together,
0:03:01 > 0:03:05so it's pretty tough. We expect a lot of them.
0:03:05 > 0:03:07What does "double-barrelling" mean?
0:03:07 > 0:03:09Double barrel, as in kick with both back legs.
0:03:09 > 0:03:11- Oh,- BLEEP.
0:03:12 > 0:03:14I'm always a bit nervous with equine,
0:03:14 > 0:03:16just because it's out of my comfort zone
0:03:16 > 0:03:20and, you know, right now, trying to think about anything equine...
0:03:20 > 0:03:22Oh! Nothing. Nothing comes to me. It's just...
0:03:22 > 0:03:24It's always a bit nerve-racking.
0:03:24 > 0:03:28The first test of Elly's equine knowledge is two-year-old Vinnie.
0:03:28 > 0:03:29Luckily for Elly,
0:03:29 > 0:03:34her patient is a much-loved and extremely docile rescue pony.
0:03:34 > 0:03:36He's been brought in by his owner, Emma.
0:03:37 > 0:03:41I have two young children that were showing great interest in riding
0:03:41 > 0:03:45and we thought it'd be a nice idea to adopt one from the RSPCA.
0:03:45 > 0:03:47He's only tiny, he's only 12 hands high.
0:03:47 > 0:03:51But he's got a great personality to make up for the size of him.
0:03:51 > 0:03:53Hello, friend.
0:03:53 > 0:03:54- Where's the lump?- Erm...
0:03:56 > 0:04:00- ..all of that.- Oh! All of that! The big lump on his face!
0:04:00 > 0:04:02But the angry-looking lump on Vinnie's face
0:04:02 > 0:04:04has got the whole team very worried.
0:04:07 > 0:04:10In veterinary medicine, you are kidding yourself
0:04:10 > 0:04:12if you see a lump and you don't think,
0:04:12 > 0:04:15even in the back of your mind, that that could be cancerous.
0:04:15 > 0:04:16That could be fairly sinister
0:04:16 > 0:04:18and I think everyone's heart sank at that point.
0:04:18 > 0:04:21When we picked him up, he was...he was well.
0:04:21 > 0:04:24They'd sort of built him back up from being underweight.
0:04:24 > 0:04:27The other pony that he was brought in with didn't make it.
0:04:27 > 0:04:29I think he had to be put down, unfortunately.
0:04:29 > 0:04:31We're just taking it slowly with him, though,
0:04:31 > 0:04:34since he's not had a great start in life.
0:04:34 > 0:04:35You've got a tiny moustache!
0:04:37 > 0:04:39My biggest worry is he could have cancer...
0:04:42 > 0:04:45Fingers crossed, that's not going to be a possibility.
0:04:45 > 0:04:47We have to wait and see what happens.
0:04:47 > 0:04:49Vinnie needs to have a CT scan
0:04:49 > 0:04:52so the team can see if the lump is cancerous.
0:04:52 > 0:04:55Ready? Come on, then.
0:04:55 > 0:04:56But there's a problem -
0:04:56 > 0:05:00pint-sized Vinnie is a lot smaller than the average patient.
0:05:00 > 0:05:05It would transpire that Vinnie is, in his tininess, too small for the CT,
0:05:05 > 0:05:08cos he has to be tall enough to get his head on a ledge
0:05:08 > 0:05:12and it's...shall we say, regular horse sized, not Vinnie sized.
0:05:12 > 0:05:16So they have sourced some blocks and I believe
0:05:16 > 0:05:20they're raising the platform so that it is now Vinnie sized.
0:05:20 > 0:05:24Vinnie's sedated so he doesn't move while he's in the scanner.
0:05:26 > 0:05:29Elly and the team are anticipating the worst,
0:05:29 > 0:05:32so it's a nervous wait to see the scan results.
0:05:33 > 0:05:37Vet Ben Jacklin is leading Vinnie's diagnostic team.
0:05:37 > 0:05:39When we use the CT machine,
0:05:39 > 0:05:41we're able to image the whole of the horse's head.
0:05:41 > 0:05:43And we can look for all sorts of things.
0:05:43 > 0:05:46We can look for traumatic injuries, fractures of the skull.
0:05:46 > 0:05:49We can look for masses inside the nasal cavities and the sinuses
0:05:49 > 0:05:51and we can look for problems with the teeth, as well -
0:05:51 > 0:05:54fractures of the teeth, tooth-root infections of the teeth
0:05:54 > 0:05:56and we're able to see all of these things very clearly
0:05:56 > 0:06:00using a CT machine. Far more so than if we're using radiographs.
0:06:02 > 0:06:04'I'm just hoping it's going to be good news.
0:06:04 > 0:06:06'I've been dreading it for a week.'
0:06:06 > 0:06:09It's like having one of your children going in
0:06:09 > 0:06:11and having a procedure done.
0:06:12 > 0:06:16The scan results are in and Ben and Elly anxiously scrutinise
0:06:16 > 0:06:18the pictures to see if there's a tumour there.
0:06:20 > 0:06:21And we can slide forward
0:06:21 > 0:06:24and we start to get onto the first sign of the soft tissue swelling
0:06:24 > 0:06:26on the side of the face.
0:06:26 > 0:06:29Vinnie's lump is clearly visible on the scan
0:06:29 > 0:06:32and they can see that he must be in a lot of pain.
0:06:33 > 0:06:36So, yeah, we've got a little bit of gas here,
0:06:36 > 0:06:39which is consistent with an enamel breach.
0:06:39 > 0:06:41But it's a huge relief,
0:06:41 > 0:06:45because it turns out that Vinnie's problem isn't life threatening.
0:06:45 > 0:06:49The cause of the tooth infection...
0:06:49 > 0:06:52This is probably an abscess here.
0:06:52 > 0:06:54The good news was that it wasn't cancer at all
0:06:54 > 0:06:56and it was a tooth-root abscess,
0:06:56 > 0:06:59which would have been causing him a lot of pain and this big lump,
0:06:59 > 0:07:02but, luckily, with an abscess, we can definitely solve that
0:07:02 > 0:07:06as opposed to cancer, which is always a bit of a tricky affair.
0:07:06 > 0:07:08Elly will be helping to treat Vinnie,
0:07:08 > 0:07:11so Ben needs to make sure her knowledge is up to scratch.
0:07:12 > 0:07:14And the treatment would be?
0:07:14 > 0:07:17Surgery and the removal of the tooth.
0:07:17 > 0:07:20Yeah, and how can we remove the tooth? What's the best way to remove the tooth?
0:07:20 > 0:07:23Well, you can't go into the sinus, cos it doesn't communicate.
0:07:23 > 0:07:25- So we don't have that option.- No.
0:07:25 > 0:07:27- Cos you can usually tap them down, can't you?- So bash them out.
0:07:27 > 0:07:30Yeah, you certainly can do. Why might we try not to do that?
0:07:30 > 0:07:32Erm, damage to a young skull?
0:07:32 > 0:07:36Yeah, so what's the difference between true love and sinusitis?
0:07:36 > 0:07:39True love and sinusitis?! I don't know. Tell me, please.
0:07:39 > 0:07:41Sinusitis lasts for ever.
0:07:41 > 0:07:42So if we disrupt the sinus,
0:07:42 > 0:07:44by opening it up and banging the tooth ridge,
0:07:44 > 0:07:47then the horse will have a low-grade sinusitis for ever and ever.
0:07:47 > 0:07:50Essentially, what we would always try and do first of all
0:07:50 > 0:07:52is orally extract these teeth.
0:07:52 > 0:07:55- So we've got some wiggling to do. - Brilliant.
0:07:55 > 0:07:58Meanwhile, Vinnie's owner Emma has heard the good news
0:07:58 > 0:08:01and has come to visit him before his operation.
0:08:04 > 0:08:06Little baby! Are you going to assist?
0:08:06 > 0:08:09I'll be there. Yes, I doubt... I don't know what I'll get to do...
0:08:09 > 0:08:11- Will you do suction? - ..but I will definitely...
0:08:11 > 0:08:14I'll definitely be there to stroke him and make sure he's got comfortable.
0:08:14 > 0:08:16Plan now - Vinnie is staying in overnight
0:08:16 > 0:08:20and then tomorrow we'll go into surgery to have that tooth extracted,
0:08:20 > 0:08:23really, so they'll just tug on it.
0:08:23 > 0:08:27It looks like tomorrow will be a big day for little Vinnie.
0:08:27 > 0:08:31When I first started rotations and you're doing your physical exam on animals,
0:08:31 > 0:08:38particularly abdominal palpation, "I'm just feeling the dog's belly!
0:08:38 > 0:08:40"I have absolutely no idea if this is a liver or..."
0:08:40 > 0:08:44- That is so true!- "That feels a little bit lumpy. What could that be?"
0:08:44 > 0:08:47- "I know what should be in here but..."- You're running stuff through your fingers,
0:08:47 > 0:08:50"Yeah, so if nothing's normal in here, I won't know."
0:08:50 > 0:08:53It makes you looks more professional if you do the palpation.
0:08:53 > 0:08:57- That is a bit... Seriously, is it just me or does that actually make you feel like a vet?- Yes.
0:08:57 > 0:08:59Yeah, when're you're doing the palpation, you're just like...
0:08:59 > 0:09:03- "Yes, I do have eyes on the end of my fingers! Yes."- Yeah!
0:09:11 > 0:09:14By the time they graduate, our vets must have learned all the skills
0:09:14 > 0:09:17they need to go straight into practice.
0:09:19 > 0:09:22This includes being able to give a good basic anaesthetic.
0:09:22 > 0:09:26And this week Jo Hardy is at the college's Queen Mother Hospital
0:09:26 > 0:09:28learning how to do it.
0:09:29 > 0:09:32You have absolutely no idea what you're going to get.
0:09:32 > 0:09:34It could be anything that walks through the door
0:09:34 > 0:09:39and the team just kind of goes, "You're doing this case now."
0:09:39 > 0:09:41Because of that, it's really quite stressful,
0:09:41 > 0:09:43cos you just don't know what's going to happen.
0:09:46 > 0:09:51Jo's patient today is a nine-year-old Chihuahua called Rex.
0:09:51 > 0:09:54It really is make or break for little Rex.
0:09:54 > 0:09:58He's swallowed a fish-hook and if the medical team can't get it out,
0:09:58 > 0:10:02he will almost certainly die from blood poisoning.
0:10:02 > 0:10:05We're going to go to endoscopy and hopefully put a camera
0:10:05 > 0:10:08down his throat and retrieve the fish-hook.
0:10:10 > 0:10:13But the risky procedure to get the fish-hook out
0:10:13 > 0:10:17is even more challenging, because Rex has a serious heart murmur.
0:10:17 > 0:10:20My job is to keep him asleep.
0:10:20 > 0:10:22I think he'll be quite a challenging one,
0:10:22 > 0:10:25he's got a few heart issues and so we've got to make sure
0:10:25 > 0:10:31we use the right drugs and keep him nice and quiet and asleep.
0:10:31 > 0:10:35Anaesthetist Jaime Viscasillas is supervising Jo today.
0:10:35 > 0:10:39He expects her to come up with a plan for anaesthetising Rex,
0:10:39 > 0:10:41including which drugs to use.
0:10:41 > 0:10:45- What's your plan? - Maybe a propofol midazolam induction?
0:10:45 > 0:10:50- OK.- And then maintenance. - Why midazolam?
0:10:50 > 0:10:53- Well, it's a muscle relaxant.- OK.
0:10:54 > 0:11:00And so I suppose it will help relax the muscles in the oesophagus.
0:11:00 > 0:11:02We'll do it as you're doing the endoscopy.
0:11:02 > 0:11:05- OK.- Good. Shall I calculate some doses?- Yeah.
0:11:07 > 0:11:09Right, come on, then.
0:11:09 > 0:11:12First of all, Jo needs to give Rex a sedative.
0:11:17 > 0:11:18Very small.
0:11:18 > 0:11:21Then comes the difficult task of getting the anaesthetic tube
0:11:21 > 0:11:24into Rex's tiny throat.
0:11:24 > 0:11:26Push gently and twist.
0:11:29 > 0:11:32- Push a little bit harder.- OK.
0:11:32 > 0:11:37- Yeah. Oh, there we are. - Good. Very good.
0:11:37 > 0:11:39Good pulse.
0:11:39 > 0:11:41Once little Rex is fully under,
0:11:41 > 0:11:45there's no time to lose getting him to the endoscopy suite,
0:11:45 > 0:11:49where vet Chris Scudder is waiting for him.
0:11:49 > 0:11:51So what we hope to be able to do is
0:11:51 > 0:11:54we're going to use one of our fibre-optic cameras
0:11:54 > 0:11:57and we're going to pass that through the dog's mouth
0:11:57 > 0:11:59and into the dog's gullet, the oesophagus,
0:11:59 > 0:12:01which is currently where the fish-hook is situated.
0:12:04 > 0:12:09It wasn't a healthy dog, even minus the fish-hook incident.
0:12:09 > 0:12:14He had this whopping, great, big heart murmur which is an awful thing
0:12:14 > 0:12:18to have playing on your mind when you're doing anaesthetic,
0:12:18 > 0:12:21because that really affects how the drugs work.
0:12:22 > 0:12:25'It was really difficult to keep stable.
0:12:25 > 0:12:27'Because of that, it was so stressful.'
0:12:30 > 0:12:33There it is.
0:12:33 > 0:12:35We're going to retrieve the hook
0:12:35 > 0:12:39and then implant the hook into the tube and then pull the tube out,
0:12:39 > 0:12:43so that the hook then doesn't get reattached back inside the dog.
0:12:45 > 0:12:47But what they thought would be a tricky procedure
0:12:47 > 0:12:51is turning out to be extremely dangerous for Rex,
0:12:51 > 0:12:55because Chris has spotted a problem with the position of the hook.
0:12:57 > 0:12:59It didn't look like it, no, no.
0:12:59 > 0:13:01But it looks like it might be through.
0:13:01 > 0:13:03It looks well and truly through.
0:13:04 > 0:13:06It's not in his oesophagus...
0:13:08 > 0:13:10..it's through his oesophagus.
0:13:12 > 0:13:14It was really well wedged
0:13:14 > 0:13:19and so everybody was just so emotionally involved
0:13:19 > 0:13:23in what was going on and was willing them to try and get it out.
0:13:24 > 0:13:26We have to attempt to try.
0:13:42 > 0:13:43With his heart murmur,
0:13:43 > 0:13:47it's dangerous for Rex to be under general anaesthetic for long.
0:13:47 > 0:13:50But pulling the hook out too fast could tear Rex's oesophagus,
0:13:50 > 0:13:52which would be fatal.
0:13:52 > 0:13:55Above all, the team need to stay calm.
0:13:56 > 0:13:59Yeah. We've not got hold of it at the moment.
0:13:59 > 0:14:03Grab it here and push, rather than pull.
0:14:06 > 0:14:10You had to get it out without the hook grating on the side
0:14:10 > 0:14:12of the oesophagus or damaging the oesophagus further,
0:14:12 > 0:14:17so we had to take it out super slowly, but without dropping it.
0:14:31 > 0:14:35With one last tug, Chris manages to pull the hook into the tube
0:14:35 > 0:14:38and out of Rex's oesophagus.
0:14:38 > 0:14:40CLAPPING
0:14:40 > 0:14:42Right, fish it out.
0:14:45 > 0:14:47All right, let's go back.
0:14:47 > 0:14:50Fantastic that we've got the fish-hook out.
0:14:50 > 0:14:52It's quite big for a little dog.
0:14:52 > 0:14:55Anaesthetically, we still haven't finished yet.
0:14:55 > 0:14:59We'll soon see how he does waking up and how he progresses.
0:15:08 > 0:15:10It could have been really bad,
0:15:10 > 0:15:14because he's not a surgical candidate.
0:15:14 > 0:15:17And so, yeah, saved a life today.
0:15:38 > 0:15:40Even though they're well into their final year,
0:15:40 > 0:15:43the students are still tackling a lot of procedures
0:15:43 > 0:15:44for the very first time.
0:15:46 > 0:15:48And Elly's no exception.
0:15:48 > 0:15:52At the college, she's about to perform her first dental surgery
0:15:52 > 0:15:54on a horse.
0:15:54 > 0:15:56I feel like he's the equivalent of sort of a little toddler
0:15:56 > 0:16:00that's not quite sure what's going on, but he's been very brave.
0:16:00 > 0:16:03You are beginning to feel very sleepy.
0:16:05 > 0:16:08Vinnie the rescue pony has a painful abscess
0:16:08 > 0:16:11and needs to have a tooth removed.
0:16:11 > 0:16:16He's given a local anaesthetic and a sedative ready for the operation.
0:16:17 > 0:16:19Just did an IV.
0:16:19 > 0:16:22Just, you know, just put some sedation in a horse.
0:16:22 > 0:16:24Haven't done that before!
0:16:24 > 0:16:27Elly is working today under the scrutiny
0:16:27 > 0:16:30of senior surgeon Tom Witte.
0:16:30 > 0:16:32So we have to take the tooth out.
0:16:32 > 0:16:34That's where the swelling's coming from.
0:16:34 > 0:16:37We'll be opening his mouth up and putting in various instruments
0:16:37 > 0:16:39to try and loosen that tooth up slowly over the next...
0:16:39 > 0:16:41Probably 45 minutes or an hour, it'll take us.
0:16:41 > 0:16:44It's a square tooth in a square socket with two square teeth
0:16:44 > 0:16:46on either side of it.
0:16:46 > 0:16:48Very tightly opposed to each other,
0:16:48 > 0:16:51so the process of extracting that is fairly tricky.
0:16:51 > 0:16:53We can, if possible, bring that trolley in, as well,
0:16:53 > 0:16:54a little bit closer?
0:16:57 > 0:16:59Couple of minutes' time, Tom.
0:16:59 > 0:17:02- Adequately abducted?- Yeah. Looks good.- Not too abducted?
0:17:02 > 0:17:04No, no, that's good.
0:17:04 > 0:17:07First step in loosening the tooth...
0:17:07 > 0:17:10is to place the separator.
0:17:10 > 0:17:13Might be able to see those spreaders in place.
0:17:15 > 0:17:19- Oh, yeah!- And so we can now start loosening, start wiggling the tooth
0:17:19 > 0:17:22- a little bit from side to side. So like this.- Yes.
0:17:22 > 0:17:25A little bit of stabilisation on here now
0:17:25 > 0:17:28and then you're going against the end stops, essentially.
0:17:28 > 0:17:30'They're quite... What's the word? Brutal.'
0:17:30 > 0:17:34Yeah, they're quite brutal operations.
0:17:34 > 0:17:36Although this looks painful,
0:17:36 > 0:17:40Vinnie's still heavily sedated and can't feel a thing.
0:17:40 > 0:17:42It's very much just a matter of yanking this here,
0:17:42 > 0:17:45pulling that there, pulling it out!
0:17:45 > 0:17:47And it was...
0:17:47 > 0:17:50Every so often, we just give this just a little squeeze
0:17:50 > 0:17:52to make sure we're still tightly gripped on the tooth.
0:17:52 > 0:17:55Yeah. My bicep feels, you know, like, top notch.
0:17:56 > 0:17:59It won't be long now before we've got this out of there.
0:18:01 > 0:18:03This tooth is getting pretty loose within the socket.
0:18:03 > 0:18:05You can see that tooth is getting loose
0:18:05 > 0:18:07in a lot of different directions.
0:18:07 > 0:18:08Tooth fairy's on its way!
0:18:13 > 0:18:18Over an hour of non-stop wiggling may finally be paying off.
0:18:18 > 0:18:22But anyone scared of the dentist, look away now.
0:18:22 > 0:18:26- SQUELCHING - Oh, you hear that?- Heard that.
0:18:26 > 0:18:28Elly, why don't you try and get that tooth out of there?
0:18:30 > 0:18:34- I can't feel it, either.- Really? - Yeah. Where is it?
0:18:34 > 0:18:36Oh, ha-ha!
0:18:43 > 0:18:45She's managed to rotate it towards the...
0:18:45 > 0:18:47ALL: Yeah!
0:18:47 > 0:18:50- Is that all right? Bloody hell. - Very good.
0:18:50 > 0:18:53So, got an intact tooth.
0:18:53 > 0:18:55Let's give it a rinse.
0:18:55 > 0:18:57All Vinnie needs now are some antibiotics
0:18:57 > 0:18:59to get rid of the abscess.
0:18:59 > 0:19:03And it was awesome just, like, reaching in and being, like...
0:19:03 > 0:19:05"Look at this!"
0:19:05 > 0:19:09The key is to check that all the... that the tooth is intact -
0:19:09 > 0:19:11that you haven't left any fragments behind.
0:19:11 > 0:19:13(It's awesome!)
0:19:13 > 0:19:17It's really, really cool. I didn't expect that. That was...
0:19:17 > 0:19:20'Nice to be challenged and to get it right'
0:19:20 > 0:19:23and that was...that was good. Yeah, good.
0:19:23 > 0:19:25Quite proud of myself.
0:19:28 > 0:19:31'Come on, Vinnie. Good lad.
0:19:31 > 0:19:32'Little Vinnie.'
0:19:32 > 0:19:34Little Vincent.
0:19:34 > 0:19:37No, he was...he was tops. He was sort of the perfect patient for me.
0:19:37 > 0:19:40'He was great. He was a little...little soul.'
0:19:44 > 0:19:48Little Vinnie's feeling much better for his visit to equine surgery
0:19:48 > 0:19:51and, as it turns out, so is Elly.
0:19:51 > 0:19:54I've come away from all my equine experience at RVC
0:19:54 > 0:19:56feeling a lot more positive about horses
0:19:56 > 0:19:59and not that I would necessarily go into equine practise per se,
0:19:59 > 0:20:02but if I was to come across a horse, I wouldn't be terrified any more,
0:20:02 > 0:20:04whereas it definitely would have been before.
0:20:26 > 0:20:28- Hi.- Oh, hello. Morning.
0:20:28 > 0:20:33This week, Judy Puddifoot is at a small animal practice in Luton.
0:20:33 > 0:20:36Every final year placement counts, but for Judy,
0:20:36 > 0:20:39this one counts more than most.
0:20:39 > 0:20:43If I was to become a vet, then I would be a small animal vet.
0:20:43 > 0:20:48I like the idea of the romanticism of driving across the moors
0:20:48 > 0:20:50in the sun and going to a calving,
0:20:50 > 0:20:54and you know, everybody thinks that's great, everybody's got that image.
0:20:54 > 0:20:55It's brilliant.
0:20:55 > 0:20:59But when it comes down to it, the reality is I kind of like cats
0:20:59 > 0:21:03and dogs more than large animals, so that's the area I want to go into.
0:21:03 > 0:21:09Today, Judy's doing consults and her first patient is spaniel Harry.
0:21:09 > 0:21:14- He's got a nasty...- Skin problem. - Skin problem on his leg.
0:21:14 > 0:21:16And it's gradually got worse and worse.
0:21:16 > 0:21:20I think it's time a vet had a look at it, basically.
0:21:20 > 0:21:24- He's ten years old now, the light of our life.- Yeah.
0:21:24 > 0:21:28He's been through a serious accident before and nearly lost a leg
0:21:28 > 0:21:32- and he does mean the world to us. - Yeah.- Absolutely.
0:21:32 > 0:21:34Hi, would you like to come through?
0:21:34 > 0:21:36My name's Judy, I'm a final year vet student
0:21:36 > 0:21:40and Katy's kindly asked me to start this consult.
0:21:40 > 0:21:41She's going to be there anyway,
0:21:41 > 0:21:43but if you want to bring Harry on through.
0:21:43 > 0:21:47- Come on, Harry.- This way. No, this way.
0:21:47 > 0:21:51Supervising vet Katy Wragg is expecting a lot more from Judy
0:21:51 > 0:21:53than just sound clinical reasoning.
0:21:53 > 0:21:57The job is probably 10% knowledge when you actually get in there
0:21:57 > 0:21:59and 90% actually how you deal with clients
0:21:59 > 0:22:03and how you use that knowledge to then be able to sort out
0:22:03 > 0:22:07the animals and some people are very good at that stage
0:22:07 > 0:22:09and some people will be more academic.
0:22:09 > 0:22:12The rotation bit of that is the bit where you figure out
0:22:12 > 0:22:14whether you're good at that or not.
0:22:14 > 0:22:18- So, it's this lump that we've come about today, isn't it?- Yes.
0:22:18 > 0:22:20When did you first notice this?
0:22:20 > 0:22:24Back in the summer, he come running in the back door
0:22:24 > 0:22:28with his tail between his legs and we thought something had bit him.
0:22:28 > 0:22:31- What would you do?- What would I do? Um...- What would you do?
0:22:31 > 0:22:34- What do you think it is?- I think...
0:22:34 > 0:22:36I wonder if maybe he's got something in there
0:22:36 > 0:22:40- and it might have got infected. - A foreign object?- Yeah. Something.
0:22:40 > 0:22:43A thorn or a little piece of something in there.
0:22:43 > 0:22:47- So, what do you think all of this around here is?- I'm wondering...
0:22:47 > 0:22:49This is all saliva staining, I'm guessing.
0:22:49 > 0:22:52And I wonder if the little bits that are sore around it are
0:22:52 > 0:22:57- because of that.- Yes.- Give him some antibiotics to cover...
0:22:57 > 0:22:59Cos if it's pussy, it's not nice. That's infected.
0:22:59 > 0:23:02- He needs to be covered with antibiotics.- Perfect.
0:23:02 > 0:23:04Sounds like a good plan. Sounds like a good idea.
0:23:04 > 0:23:07- OK, thanks very much.- Nothing serious, that was the main thing.
0:23:07 > 0:23:10- Thank you. - Thanks very much. Bye.
0:23:10 > 0:23:14'Sometimes people feel a little bit maybe scared to go to the vet.
0:23:14 > 0:23:17'It's important they come and feel comfortable'
0:23:17 > 0:23:20when they're talking to us and I do pride myself on that, actually.
0:23:20 > 0:23:22It's something that I think I do quite well.
0:23:22 > 0:23:24It's a natural talent,
0:23:24 > 0:23:28I suppose, being able to talk the hind leg off a donkey!
0:23:31 > 0:23:35Judy's well aware that in a practice like this one,
0:23:35 > 0:23:38vets have to be surgeons, as well as GPs.
0:23:40 > 0:23:44A huge list of things that we have to know on the day we graduate,
0:23:44 > 0:23:47so we all work towards ticking all these things off of our list.
0:23:47 > 0:23:50And being able to do routine neutering, which is
0:23:50 > 0:23:55castrating cats or spaying dogs, or female cats, is a day one skill, so
0:23:55 > 0:23:58there is a lot of pressure to do them right and to do them
0:23:58 > 0:24:01and be confident with them by the time you graduate.
0:24:01 > 0:24:05And today, Judy gets the chance to prove herself.
0:24:05 > 0:24:08We are going to castrate a cat.
0:24:08 > 0:24:10- We...- You are.- I am.
0:24:10 > 0:24:12I'm going to castrate a cat.
0:24:12 > 0:24:16- Under my supervision. - Direct supervision.
0:24:16 > 0:24:19The unlucky patient is Bobek, the ginger Tom.
0:24:19 > 0:24:21Are you going to be naughty?
0:24:24 > 0:24:27This is bread and butter.
0:24:28 > 0:24:34Got to be able to do these in your sleep, hopefully.
0:24:34 > 0:24:37Vet Jennifer Posey is supervising Judy.
0:24:37 > 0:24:41- Yeah.- OK? Any questions before start? You happy?
0:24:41 > 0:24:44This is definitely the right cat that's definitely being castrated?
0:24:44 > 0:24:47- Yes.- That's my only question.
0:24:47 > 0:24:52- How many would you say you've done? - Oh... I don't know if I can say.
0:24:52 > 0:24:55Probably... I don't know. 200? 300, maybe?
0:24:55 > 0:24:59But for Judy, this is number one.
0:24:59 > 0:25:03'It's probably the first time that I got to do a castrate by myself,'
0:25:03 > 0:25:08without having somebody else scrubbed in, as it were, ready to take over.
0:25:08 > 0:25:10- This is always the hard bit.- Yes.
0:25:10 > 0:25:12- Make sure you keep your hands protected.- Yeah.
0:25:14 > 0:25:18That is really just to protect him from anything on the outside.
0:25:18 > 0:25:23God, I hate it. Cack-handed student, can't you?
0:25:23 > 0:25:25I'll get there eventually.
0:25:25 > 0:25:28- You're doing fine, absolutely fine. - God, get out of the way!
0:25:28 > 0:25:31Jesus!
0:25:31 > 0:25:36Depends on the size of the, um...items you're working with,
0:25:36 > 0:25:39as to how fiddly exactly they are.
0:25:39 > 0:25:43Smaller equals more fiddly. Bigger equals slightly less fiddly.
0:25:43 > 0:25:45But fiddly, nonetheless.
0:25:49 > 0:25:52Don't get flustered. You're fine.
0:25:52 > 0:25:55Lovely.
0:25:55 > 0:25:57- Happy with that?- Yeah. Looks perfect.
0:25:57 > 0:25:59- Lovely.- Lovely.
0:25:59 > 0:26:00Very nice.
0:26:00 > 0:26:03Right. You don't need those any more, Mister.
0:26:04 > 0:26:06Lovely Pat Butcher earrings!
0:26:07 > 0:26:10Cat castration. Tick.
0:26:11 > 0:26:14So when we finish doing a cat castrate,
0:26:14 > 0:26:18we put the testicles in a little plastic bag and the owners like to
0:26:18 > 0:26:22'take them home, like a little doggy bag, but it's a little catty bag.'
0:26:22 > 0:26:24That's a deposit for the ball bank.
0:26:26 > 0:26:29I'm joking. That's not true. I'm joking! Sorry!
0:26:31 > 0:26:36And with her first solo castrate successfully in the bag,
0:26:36 > 0:26:40Judy's another step closer to that perfect job.
0:26:40 > 0:26:41Yeah.
0:26:41 > 0:26:45No, I really enjoy it cos ever since I was a kid,
0:26:45 > 0:26:49this was my image of being a vet, doing...
0:26:49 > 0:26:53People coming in, sorting out their cats and dogs and rabbits
0:26:53 > 0:26:57and guinea pigs and...the odd ferret.
0:26:57 > 0:26:59So, living the dream!
0:27:00 > 0:27:03DOG BARKS
0:27:14 > 0:27:19Student Hannah Nevin is about to start her next placement and the
0:27:19 > 0:27:23reality is dawning that qualifying as a vet is only months away.
0:27:26 > 0:27:27I'm really afraid.
0:27:27 > 0:27:31I'm so excited to graduate, fingers crossed it all goes well.
0:27:31 > 0:27:34I can't wait to not be referred to as the student any more,
0:27:34 > 0:27:36but it's still really daunting,
0:27:36 > 0:27:39the fact that we're going to have to make our own decisions.
0:27:39 > 0:27:41You don't have the safety net.
0:27:41 > 0:27:45Oh, well, I didn't know that because I'm a student.
0:27:45 > 0:27:48This week, she's working on the veterinary
0:27:48 > 0:27:52front-line at a busy charity practice in Plymouth.
0:27:52 > 0:27:55- Morning. How's it going? - How are you?- Good, thanks.
0:27:55 > 0:27:59Head vet Robert Newcombe is supervising Hannah and today,
0:27:59 > 0:28:01for the first time in her training,
0:28:01 > 0:28:06she's going to be seeing some patients on her own.
0:28:06 > 0:28:08- Hannah. Hiya there. OK?- Good.
0:28:08 > 0:28:12- The nurse consults, can you do those this morning?- Yeah. That's fine.- OK.
0:28:12 > 0:28:14And follow some of those through
0:28:14 > 0:28:17and if there are some extras that come in, we might be able to
0:28:17 > 0:28:20pass some of those onto you as well, if you're a bit quick.
0:28:20 > 0:28:23You are very good on some of them, but one or two of them
0:28:23 > 0:28:26are just stitches out or weight checks, they may not take that long.
0:28:26 > 0:28:30- Ok?- Yeah. Yeah, sounds good. I'll have a look to see what there is.
0:28:30 > 0:28:32'I seem more confident than I am.
0:28:32 > 0:28:34'I always, whenever I'm in a sticky situation,
0:28:34 > 0:28:36'I do try and look confident.'
0:28:36 > 0:28:39Whenever you do get asked to do something by a vet, you don't
0:28:39 > 0:28:42want to be like, "Oh, no. I'm not sure about that," you know?
0:28:42 > 0:28:45You want to be like, "Oh, yeah. Sure, I'll give that a go!"
0:28:45 > 0:28:47Otherwise you look like a bit of an idiot.
0:28:47 > 0:28:49Right, I'll just ask.
0:28:49 > 0:28:53The PDSA provides free pet care for people on low incomes,
0:28:53 > 0:28:55so here, the vets are always busy.
0:28:55 > 0:28:57Where is his hernia?
0:28:57 > 0:29:01- There.- Sorry, buddy. This is not very dignified.
0:29:01 > 0:29:05And the pressure's on Hannah to work accurately and fast.
0:29:05 > 0:29:08Um... I don't think so.
0:29:09 > 0:29:12They'll see about sort of 30-40 clients a day, roughly.
0:29:12 > 0:29:16Some days, though, they can make it up to 50.
0:29:16 > 0:29:19Just keep an eye on it and if you have any concerns, just let us know.
0:29:19 > 0:29:21I don't know what this one is.
0:29:21 > 0:29:23Does put you a bit on the spot,
0:29:23 > 0:29:26dealing with the general public cos you don't really know what's
0:29:26 > 0:29:29going to come next and if anything's a bit tricky,
0:29:29 > 0:29:32I try to take them round the back and I'll get someone else to see it.
0:29:32 > 0:29:37And Hannah's next patient is about to test her confidence.
0:29:37 > 0:29:41Shih-Tzu Ruby is recovering from spinal surgery.
0:29:41 > 0:29:45- How is she?- I think she's expressed loads this morning.- Has she, really?
0:29:45 > 0:29:47Yeah, loads.
0:29:47 > 0:29:50- Was that when you were taking her out for a walk?- Yeah.
0:29:50 > 0:29:53Right, I'll take her round the back.
0:29:53 > 0:29:58Hannah's about to discover that students get all the glamorous jobs.
0:29:58 > 0:30:03Because she has spinal problems, she gets a really full bladder
0:30:03 > 0:30:05and isn't able to express it.
0:30:07 > 0:30:09Cheers.
0:30:09 > 0:30:11All right, darling?
0:30:11 > 0:30:15Ruby hasn't done a wee in a while, so there should be
0:30:15 > 0:30:19plenty in there, but finding Ruby's bladder is no easy task.
0:30:19 > 0:30:24So, I have to try and put pressure on it, but gentle pressure,
0:30:24 > 0:30:29cos you don't want the bladder to rupture or bruise the bladder.
0:30:29 > 0:30:32Feels really empty.
0:30:32 > 0:30:33Sorry, darling.
0:30:33 > 0:30:35Can't really feel her bladder.
0:30:38 > 0:30:42So, I might just get Robert to have a...
0:30:42 > 0:30:44That's the easy option, isn't it?
0:30:44 > 0:30:47Definitely. Let's go.
0:30:47 > 0:30:49It's time to ask an expert.
0:30:49 > 0:30:53OK, let's just pop you up and feel your little bladder.
0:30:54 > 0:30:58There is a bit of just knowing how the bladder feels
0:30:58 > 0:31:02and how much you can push on the bladder. And just gently...
0:31:02 > 0:31:06You have to know what limit you can actually apply to the bladder.
0:31:08 > 0:31:11TRICKLING
0:31:11 > 0:31:14There we are, all done.
0:31:14 > 0:31:16That's everything.
0:31:16 > 0:31:21- A tiny few dribbles to finish with. - 'I found it very tricky.'
0:31:21 > 0:31:23But obviously, Robert was very good at it.
0:31:23 > 0:31:25He did it straightaway!
0:31:25 > 0:31:29- There we are. All done. - That's perfect.- OK?- Lovely job.
0:31:29 > 0:31:31There she is.
0:31:31 > 0:31:34That's grand. She had a wee bit in there.
0:31:34 > 0:31:37I just need to work out how to get her tablets up.
0:31:37 > 0:31:41Hannah needs to get the experience and I often say,
0:31:41 > 0:31:43doing it is the best way to get it.
0:31:43 > 0:31:45She still has a little way to go.
0:31:45 > 0:31:49She's still got a little bit of confidence to build in all
0:31:49 > 0:31:51the cases that she sees.
0:31:51 > 0:31:54- All right?- OK, brilliant. Thank you.- No problem at all.
0:31:55 > 0:31:57DOG WHINES
0:31:57 > 0:31:59CAT PURRS
0:31:59 > 0:32:02DOG PANTS
0:32:02 > 0:32:04You are always going to forget things to start with but it's just
0:32:04 > 0:32:07getting into the swing of things and just getting your own style.
0:32:07 > 0:32:10Always forgotten something obvious, like "Aw..."
0:32:10 > 0:32:12I hate feeling like that.
0:32:12 > 0:32:14- Is your dog still eating, mate? - Yeah! Exactly!
0:32:14 > 0:32:16There's a lot of popping your head back through the door,
0:32:16 > 0:32:19"Sorry, just one more question..."
0:32:19 > 0:32:21I have done that so many times.
0:32:28 > 0:32:30It's hard work being a final year vet student,
0:32:30 > 0:32:32and free time is scarce.
0:32:35 > 0:32:39But twice a week Dru Shearn takes time out to unwind
0:32:39 > 0:32:41with a gentle game of rugby.
0:32:43 > 0:32:46I've got to have outside interests otherwise I'd go mad.
0:32:46 > 0:32:48I've got to just kind of get away from it a bit
0:32:48 > 0:32:50and spend time doing something completely
0:32:50 > 0:32:52unrelated to final year stuff.
0:32:52 > 0:32:54So really important to have a
0:32:54 > 0:32:58bit of time out from it and get some exercise and get some fresh air.
0:32:58 > 0:33:00THEY CHANT
0:33:00 > 0:33:05But every Monday morning it's back to the veterinary grindstone,
0:33:05 > 0:33:09and this week Dru's chosen a tough assignment.
0:33:09 > 0:33:12He's opted to do a placement in the specialist orthopaedics
0:33:12 > 0:33:14unit at the Queen Mother Hospital.
0:33:14 > 0:33:16Every day here the expert clinicians
0:33:16 > 0:33:19perform complex surgery on bones and joints.
0:33:21 > 0:33:24Bonnie? Hello. Hi. Hello, I am Dru,
0:33:24 > 0:33:27one of the orthopaedic students. Nice to meet you.
0:33:27 > 0:33:30Dru's first patient is black Labrador Bonnie,
0:33:30 > 0:33:34who's been referred here by her local vet because she's limping.
0:33:34 > 0:33:37They've treated her for suspected arthritis
0:33:37 > 0:33:41but she's not improving, so the problem might be more serious.
0:33:41 > 0:33:44What's the main reason you've brought her here today?
0:33:44 > 0:33:45Initially, she's been limping.
0:33:45 > 0:33:47She was X-rayed as well,
0:33:47 > 0:33:51and she was found to have had some arthritic bits in the joints.
0:33:51 > 0:33:54And he assumed it would be same with the right as well.
0:33:54 > 0:33:57And when did you first kind of notice?
0:33:57 > 0:33:59Was it after a walk? Was it just as she was getting up?
0:33:59 > 0:34:01- In the evenings.- In the evenings.
0:34:01 > 0:34:03From your point of view, in terms of just
0:34:03 > 0:34:07like around the house and exercises, how do you think she's changed?
0:34:07 > 0:34:09She would play ball indoors.
0:34:09 > 0:34:12Now she would do it, but after a couple of more times,
0:34:12 > 0:34:13she doesn't want to do it.
0:34:13 > 0:34:16I'll go to speak to Vincent and he'll come in
0:34:16 > 0:34:19and have a chat with you as well and discuss the plan.
0:34:19 > 0:34:22Dru is under the supervision of vet Vincent Guerin.
0:34:22 > 0:34:26- VINCENT:- What I want to find out is which joint is the problem?
0:34:26 > 0:34:29Vincent has a hunch that Bonnie's limp is caused by a small
0:34:29 > 0:34:31fragment of bone lodged in her elbow.
0:34:33 > 0:34:35But first he needs to examine her
0:34:35 > 0:34:37joints to see exactly where it hurts.
0:34:37 > 0:34:42- VINCENT:- At the shoulder a bit there, a disturbance, well almost.
0:34:42 > 0:34:45Not completely. I just have the feelings in the tips.
0:34:45 > 0:34:48DRU: 'Examining her, Vincent obviously had to try
0:34:48 > 0:34:51'and manipulate all her limps and try and find out where she was painful.'
0:34:51 > 0:34:54And he had to almost push her kind of past her limit to be able
0:34:54 > 0:34:57to find out where she was painful, cos she just wasn't telling us.
0:34:57 > 0:35:01And she did wince a little bit when he then got to that limit
0:35:01 > 0:35:04and you really feel for her because she is obviously hiding it so well.
0:35:08 > 0:35:12So affects the legs in rotation. You've been very good!
0:35:12 > 0:35:15Vincent's able to show Bonnie's owners exactly where
0:35:15 > 0:35:18he thinks the fragment might be.
0:35:18 > 0:35:21So if there is a fragment in there,
0:35:21 > 0:35:24or if the shape is abnormal, then it can be painful.
0:35:24 > 0:35:27OK. Best way to know what is going on
0:35:27 > 0:35:30is to do 3D radiographs so a CT scan.
0:35:30 > 0:35:33- Is it OK with you? - BOTH:- Yeah.
0:35:33 > 0:35:35Bonnie, this way. Good girl.
0:35:35 > 0:35:37The decision's made for Bonnie to be admitted to the
0:35:37 > 0:35:41hospital for a CT scan because this is the only way of knowing
0:35:41 > 0:35:43if there really is a fragment there.
0:35:43 > 0:35:46If there is, Bonnie will need surgery.
0:35:46 > 0:35:47Come on. This way.
0:35:47 > 0:35:50But she's reluctant to be parted from her owners.
0:35:50 > 0:35:53It's fine. Come on.
0:35:53 > 0:35:56She wasn't particularly happy to be going with me into the hospital,
0:35:56 > 0:35:58which I was a little bit offended by.
0:35:58 > 0:35:59I was happy to be taking her
0:35:59 > 0:36:01but she obviously didn't want to spend the day with me.
0:36:01 > 0:36:02Good girl.
0:36:05 > 0:36:07Come on. Good girl.
0:36:07 > 0:36:10Just dragging them away from what is essentially their mum and dad
0:36:10 > 0:36:12is quite sad.
0:36:12 > 0:36:14This way. Good girl.
0:36:18 > 0:36:20Have you done a saphenous before?
0:36:31 > 0:36:34- FEMALE VET:- I can see a bit of a fine line in there.
0:36:34 > 0:36:37It could be consistent with a fragment.
0:36:37 > 0:36:39The CT scan results have Vincent's hunch -
0:36:39 > 0:36:43that the problem is in Bonnie's elbow.
0:36:43 > 0:36:45If this is the left leg here and this is the right leg,
0:36:45 > 0:36:48it's kind of a view as if you chop your arm in half
0:36:48 > 0:36:49and looked down the end of it.
0:36:49 > 0:36:53You can see on the right that, as you move backwards,
0:36:53 > 0:36:56there is this little kind of fragment here - just there.
0:36:56 > 0:37:01And they think there might be a little fragment in there as well.
0:37:01 > 0:37:05So there's a little line where that's probably a fragment.
0:37:05 > 0:37:06Anything that is going to be
0:37:06 > 0:37:09within your joint that is hard and solid,
0:37:09 > 0:37:11it's going to cause a hell of a lot of pain,
0:37:11 > 0:37:15even the tiny, tiny things that you think, "What is that going to do?"
0:37:15 > 0:37:17really can be massive problems.
0:37:25 > 0:37:29The following morning, Bonnie's getting a short back and sides.
0:37:29 > 0:37:32Quite a lot of these instruments I've never used before.
0:37:32 > 0:37:35So we just had a quick run through then, of what they are
0:37:35 > 0:37:39and what their names are so hopefully I won't forget.
0:37:39 > 0:37:41She's having keyhole surgery on her
0:37:41 > 0:37:44elbow using the latest camera technology.
0:37:44 > 0:37:46If you aren't straight...
0:37:46 > 0:37:49you don't see straight, you see with an angle.
0:37:49 > 0:37:54OK. See if you turn the scope, you can see 180 or even 360.
0:37:55 > 0:37:58It was amazing to be able to just like get
0:37:58 > 0:38:00involved in something that advanced.
0:38:00 > 0:38:02It's a really advanced surgery
0:38:02 > 0:38:05and to be able to be part of it was amazing.
0:38:05 > 0:38:08Dru's job is to hold Bonnie's leg absolutely still
0:38:08 > 0:38:11while Vincent operates the tiny camera inside the joint.
0:38:15 > 0:38:18- VINCENT:- So we have fragmentation in situ.
0:38:18 > 0:38:21- FEMALE VET:- That is the fragment. It just popped out.
0:38:21 > 0:38:27So the game is to detach this fragment without detaching
0:38:27 > 0:38:29too much and lose it and never be able to remove it.
0:38:29 > 0:38:32'There was a few hairy moments during the surgery when...
0:38:32 > 0:38:35'there's a possibility of just losing it and it will...'
0:38:35 > 0:38:38It's gone, and once it's gone, you can't get it back and it's
0:38:38 > 0:38:42still floating round in there. So it was a really difficult surgery.
0:38:42 > 0:38:44Look at that.
0:38:45 > 0:38:50So I need to detach it a little bit so I can grab it.
0:38:57 > 0:39:00Just pull the camera a little bit out.
0:39:01 > 0:39:02Wow, you have a piece.
0:39:04 > 0:39:06No, no, it's here.
0:39:06 > 0:39:10Oh, yeah. Two millimetres, but that was cool.
0:39:13 > 0:39:16It was really cool to be able to see the little fragment afterwards.
0:39:16 > 0:39:19You don't often get to remove something and actually see it
0:39:19 > 0:39:22afterwards and appreciate what the problem was.
0:39:22 > 0:39:24With the tiny bone fragments successfully removed
0:39:24 > 0:39:26from Bonnie's elbow...
0:39:26 > 0:39:29- OK? Happy?- Yep.- OK. I'm happy.
0:39:29 > 0:39:32..it's time to close up the wound,
0:39:32 > 0:39:35and Dru gets a chance to test his suturing skills.
0:39:35 > 0:39:37Yes, please.
0:39:38 > 0:39:42'I wasn't expecting to be asked to close up.
0:39:42 > 0:39:45'Here obviously we are offering such a high level of care that they
0:39:45 > 0:39:48'have to trust your ability to do that.'
0:39:50 > 0:39:53It's the only thing that the person who the dog is going home to
0:39:53 > 0:39:56is going to see, so doing it on live animal is a little bit different -
0:39:56 > 0:39:59with everyone watching you as well there is quite a lot of pressure.
0:40:05 > 0:40:08- Great!- Same again?- Yes!
0:40:08 > 0:40:10In this pot, you can see a couple of fragments
0:40:10 > 0:40:12we've taken out from the right elbow.
0:40:12 > 0:40:14And you can see there's
0:40:14 > 0:40:18a tiny little kind of alligator teeth, a grabber on the end,
0:40:18 > 0:40:21and we've just got behind the fragment and pulled it out.
0:40:23 > 0:40:26Although the team are pleased they got the fragments out,
0:40:26 > 0:40:30there isn't a 100% success rate with this kind of surgery.
0:40:30 > 0:40:34So only time will tell if Bonnie will make a full recovery.
0:40:45 > 0:40:48At the charity practice in Plymouth, the ever-cheerful Hannah is
0:40:48 > 0:40:53spending the day seeing surgical cases with vet Erin Beale.
0:40:53 > 0:40:56We are as busy I think as we've ever been,
0:40:56 > 0:40:59so that means we have an enormous number of cases come
0:40:59 > 0:41:01through the door every day,
0:41:01 > 0:41:04- so for students, that is absolutely brilliant.- Sorry, Erin.
0:41:04 > 0:41:07Hannah's first procedure today is, surprisingly,
0:41:07 > 0:41:12even more unpleasant than expressing urine from a Shi-Tzu.
0:41:12 > 0:41:15This is Freddie. He's just come in to
0:41:15 > 0:41:19empty his anal gland, which is one of the perks of the job in veterinary.
0:41:19 > 0:41:22Whenever they get full, they get like really irritating, erm...
0:41:22 > 0:41:26So every so often, they need to get emptied
0:41:26 > 0:41:28so it's just like two little glands round the back
0:41:28 > 0:41:33and sometimes they can be really filled with unpleasant stuff.
0:41:33 > 0:41:35Good boy. So, put some gloves on.
0:41:35 > 0:41:39Right. Being a vet is by no means a glamorous job.
0:41:39 > 0:41:41If you want to look lovely at your job
0:41:41 > 0:41:43and have your nails painted and wear pencil skirts,
0:41:43 > 0:41:45this is not the right thing to do.
0:41:45 > 0:41:49Insert a finger. You imagine about here and here.
0:41:49 > 0:41:52If I give you some tissue, you can milk it into the tissue,
0:41:52 > 0:41:56not into your face and then milk it out for me from the other direction.
0:41:56 > 0:42:01- Right.- OK. That looks like it's the right one that is going to explode.
0:42:05 > 0:42:08Right. OK.
0:42:08 > 0:42:09I'm sorry, man.
0:42:09 > 0:42:10Good boy, Freddie.
0:42:13 > 0:42:14Can you feel it?
0:42:14 > 0:42:17- It might be very empty already. - I have to say...it's not very...
0:42:17 > 0:42:19It smells pretty bad.
0:42:19 > 0:42:23The smell of anal glands is a really weird one.
0:42:23 > 0:42:27It does smell like poo but like worse - like much, much worse!
0:42:27 > 0:42:29It's not just very nice at all.
0:42:29 > 0:42:31Sorry, darling.
0:42:31 > 0:42:32I think that's gone.
0:42:32 > 0:42:35So if you give it a really good clean and I'll give you some...
0:42:35 > 0:42:37Yeah.
0:42:37 > 0:42:40- OFF-CAMERA:- How do you cope with those sort of things?
0:42:40 > 0:42:42To be honest, I am not overly squeamish.
0:42:42 > 0:42:45I think if you go into veterinary you can't really be.
0:42:45 > 0:42:47There are so many gross things that you have to do
0:42:47 > 0:42:51and I think you just have to...
0:42:51 > 0:42:54It does help if you've not got a very good sense of smell.
0:42:54 > 0:42:58It was a smelly job, but at least it was simple.
0:42:58 > 0:43:01I'm awake. Good boy.
0:43:01 > 0:43:03Now it's time for Hannah to step up a gear.
0:43:04 > 0:43:08Erin's going to watch her wield a scalpel on Marley the staffy,
0:43:08 > 0:43:12in a procedure she's never tackled before.
0:43:12 > 0:43:16We've got a dog in that's just got a few lumps to get removed.
0:43:16 > 0:43:17It has actually quite a few - it's got
0:43:17 > 0:43:20a couple around his eye and then a couple...I think he's got
0:43:20 > 0:43:25one around his shoulder so just going to be removing those.
0:43:25 > 0:43:28The lumps on Marley's face might develop into cancer,
0:43:28 > 0:43:30so Hannah's going to cut them out.
0:43:30 > 0:43:33But she's going to need a steady hand to impress Erin.
0:43:34 > 0:43:37Any time I do anything surgical, at the minute,
0:43:37 > 0:43:40I still get nervous doing it and you know you still feel a bit shaky
0:43:40 > 0:43:42whenever you are doing things like that.
0:43:42 > 0:43:44So just like...round?
0:43:44 > 0:43:48Ellipse probably in that kind of direction.
0:43:48 > 0:43:49Like an eye?
0:43:49 > 0:43:52- Yes.- OK. Right.
0:43:52 > 0:43:55The fact that it was more cosmetic kind of surgery was
0:43:55 > 0:43:58definitely a bit more worrying, because you knew
0:43:58 > 0:43:59these sutures are going to be seen by
0:43:59 > 0:44:02the owners and these were wounds that were going to be on the dog's face.
0:44:02 > 0:44:05You didn't want to make a mess of it.
0:44:05 > 0:44:09- About there?- A bit closer. - A bit closer?- Yeah.
0:44:10 > 0:44:12Have a problem with my hands shaking as well.
0:44:12 > 0:44:14- No matter how nervous I feel. - That's OK.
0:44:14 > 0:44:17- They always shake so much. - The more you do...
0:44:17 > 0:44:21Do you think it will go eventually?
0:44:21 > 0:44:25Should we attach it to her hands and see how nervous she is?
0:44:25 > 0:44:28Erin and Paula were kind of having a giggle to themselves.
0:44:28 > 0:44:32I think they could tell I was pretty nervous with the anaesthetic machine.
0:44:32 > 0:44:34They were saying, "If we put the
0:44:34 > 0:44:36"heart monitor on Hannah, it would be through the roof."
0:44:36 > 0:44:38Which it probably would have been.
0:44:38 > 0:44:41Some of the needles are less sharp than the others, so
0:44:41 > 0:44:43if you're not happy we can...
0:44:47 > 0:44:49It's just they've got really tough skin.
0:44:52 > 0:44:54Looking good. Right.
0:44:54 > 0:44:59She did very well. She'd make a great surgeon.
0:44:59 > 0:45:02She is nice and confident. She is good with the clients.
0:45:02 > 0:45:04She has lots of initiative.
0:45:04 > 0:45:06Encouraged to see vet students like that.
0:45:06 > 0:45:11We are more likely to give them more stuff to do. She is really good.
0:45:11 > 0:45:14The people that you see and the animals that you see,
0:45:14 > 0:45:17the pace of it - I actually I think is definitely stressful,
0:45:17 > 0:45:18but I really, really like it.
0:45:18 > 0:45:21And I like that you see such a variety of things as well.
0:45:21 > 0:45:25I've decided myself that this is something I'd really want to
0:45:25 > 0:45:28do in the future - I really see myself working there.
0:45:40 > 0:45:42In Essex a few weeks later,
0:45:42 > 0:45:45it's clear that Dru's patient Bonnie has been given a new lease
0:45:45 > 0:45:48of life following elbow surgery at the Queen Mother Hospital.
0:45:51 > 0:45:54She's pain-free and her owners are thrilled.
0:45:54 > 0:45:56She is walking so much better.
0:45:56 > 0:46:00The recovery is remarkable. Absolutely remarkable.
0:46:02 > 0:46:04I only get to see Bonnie go home
0:46:04 > 0:46:07when she is actually worse than when she came in.
0:46:07 > 0:46:11So it's really nice to know now that she's a happy, healthy dog,
0:46:11 > 0:46:14and she's not painful any more and we've done our job.
0:46:31 > 0:46:34Oooh, there we go. Yeeeey! Good boy, Teera.
0:46:34 > 0:46:36In Luton, Judy's coming to the end of her
0:46:36 > 0:46:38placement at the general vet practice.
0:46:38 > 0:46:41Lots and lots of distraction.
0:46:41 > 0:46:44Nice rough stroking down there to distract him there for me.
0:46:44 > 0:46:47And she's about to discover that students can sometimes
0:46:47 > 0:46:51come in very handy when an unusual patient comes into the surgery.
0:46:51 > 0:46:53When we got the call to say there was a hedgehog
0:46:53 > 0:46:58on its way down, immediately all fingers pointed towards me.
0:46:59 > 0:47:02"Judy, you can go and see the hedgehog." OK!
0:47:02 > 0:47:05Found this little hedgehog on the school playground -
0:47:05 > 0:47:09I work in the school, and he clearly needed looking at
0:47:09 > 0:47:14so I just went and scooped him up into the box with my jumper.
0:47:14 > 0:47:16Hello. Brought a hedgehog in for us?
0:47:16 > 0:47:20Right, do you want to bring him through and we'll have a look.
0:47:20 > 0:47:23Come on in. So where did you find this little one then?
0:47:23 > 0:47:24In one of our school playgrounds...
0:47:24 > 0:47:27But I noticed when I went to bring him
0:47:27 > 0:47:30home one of his back legs was sticking out.
0:47:30 > 0:47:32He can't walk on his back legs, they are dragging behind.
0:47:32 > 0:47:34OK. Let's have a look at you.
0:47:34 > 0:47:36Do you want to put that box on the floor?
0:47:37 > 0:47:42All right. All right, Mr or Mrs? Oh, no, don't do that to me.
0:47:42 > 0:47:45He wasn't a willing patient that day unfortunately.
0:47:47 > 0:47:49OK. There's apparently a trick.
0:47:49 > 0:47:51Pull your hands back and...
0:47:51 > 0:47:54Yeah. Well, I wouldn't pull him open.
0:47:54 > 0:47:57Look, see how he's just put his spines right up?
0:47:57 > 0:47:59You little moo!
0:47:59 > 0:48:02It turns out that examining a reluctant hedgehog is
0:48:02 > 0:48:04a difficult business.
0:48:04 > 0:48:08I fear that as soon as I start touching him, he's going
0:48:08 > 0:48:09to curl himself back up.
0:48:09 > 0:48:11So let's see what you do, Mister.
0:48:11 > 0:48:14Do you want to open for us?
0:48:15 > 0:48:17I tried.
0:48:17 > 0:48:20I tried my best and, if the hedgehog doesn't want to be unrolled,
0:48:20 > 0:48:22then he's not going to be unrolled.
0:48:22 > 0:48:23Not for me or anybody.
0:48:25 > 0:48:26So you can't fight it.
0:48:26 > 0:48:28Bye.
0:48:28 > 0:48:31But all that's needed is some expert assistance.
0:48:31 > 0:48:34- OFF-CAMERA:- Oh, you've managed to open him up?
0:48:34 > 0:48:35Yeah, we put him in a little bit of water
0:48:35 > 0:48:38and he's not keen on it so he's just trying to walk out of it,
0:48:38 > 0:48:41but he can't use either of his back legs properly.
0:48:41 > 0:48:45All right, mate? And he's covered in ticks and fleas.
0:48:45 > 0:48:49Are you going to walk on here now?
0:48:49 > 0:48:52His front legs doesn't look too good either.
0:48:52 > 0:48:57Are you going to walk? No?
0:48:57 > 0:49:00Some we can fix and treat and get them
0:49:00 > 0:49:04back on the road to recovery and others we can't.
0:49:04 > 0:49:08It really depends on what sort of injuries and illnesses they've got.
0:49:09 > 0:49:12So what is your assessment of the situation?
0:49:12 > 0:49:18Well, my assessment is that he's in quite bad way actually.
0:49:18 > 0:49:22He is very thin, this leg I think is broken.
0:49:22 > 0:49:26Looks quite swollen and possibly infected. He's got toes missing.
0:49:26 > 0:49:29I think he's probably been attacked by a fox or something.
0:49:33 > 0:49:35Yeah, you're right, that is broken by the hook.
0:49:35 > 0:49:38He has a wound on the inside as well.
0:49:38 > 0:49:43He'd be cold, very thin so what would you do?
0:49:43 > 0:49:46Well, unfortunately I think the kindest thing for him
0:49:46 > 0:49:49probably is to put him out of his misery,
0:49:49 > 0:49:52because we couldn't release him back to the wild with three legs -
0:49:52 > 0:49:54- it wouldn't be fair.- No.
0:49:54 > 0:49:58- And he's not really using his other hind leg.- Yep.
0:49:58 > 0:50:01I agree. OK. Bless him.
0:50:01 > 0:50:03There's nothing they can do for him,
0:50:03 > 0:50:06so they make the kindest decision they can -
0:50:06 > 0:50:08to put the hedgehog to sleep.
0:50:08 > 0:50:11So the way we euthanize small animals,
0:50:11 > 0:50:13because we can't get a vein in them generally,
0:50:13 > 0:50:15is we do the kind thing and give
0:50:15 > 0:50:18them a bit of gas burst to put them to sleep.
0:50:20 > 0:50:23So just curl up in there, sweetness.
0:50:23 > 0:50:26And it's a bit nicer to be injected in the tummy rather
0:50:26 > 0:50:28when you are already asleep.
0:50:28 > 0:50:30You know as a profession,
0:50:30 > 0:50:34veterinary medicine actually is very lucky that we have euthanasia as an
0:50:34 > 0:50:38option for animals.
0:50:38 > 0:50:41And it's usually not as bad as people are expecting.
0:51:02 > 0:51:06I think he's gone. OK.
0:51:09 > 0:51:11It's probably nicer just to have a little
0:51:11 > 0:51:12bit of gas, go to sleep.
0:51:17 > 0:51:19Yeah. bye-bye, hedgehog.
0:51:29 > 0:51:31SNAKE HISSES
0:51:35 > 0:51:37DOG BARKS
0:51:42 > 0:51:44HORSE WHINNIES
0:51:45 > 0:51:48Charlie Tewson is in unfamiliar territory this week -
0:51:48 > 0:51:52working with horses on his equine surgery placement.
0:51:53 > 0:51:55A lot of the time with the sort of equine things,
0:51:55 > 0:51:58I am just not as comfortable as I imagined if it was a dog,
0:51:58 > 0:52:03I'd...understand it a lot better.
0:52:03 > 0:52:06My equine knowledge isn't quite as good, in my opinion,
0:52:06 > 0:52:09but I think if you are enthusiastic, you can get by.
0:52:11 > 0:52:13Here at the college's referral hospital
0:52:13 > 0:52:16a lot of the patients are high-value performance animals,
0:52:16 > 0:52:20which means students are under extra pressure not to make mistakes.
0:52:22 > 0:52:25Charlie must do his first consult of the day under the watchful
0:52:25 > 0:52:27eye of vet Rachel Tucker.
0:52:27 > 0:52:29I'm just going to ask him
0:52:29 > 0:52:33to have a little bit of a chat with you, get a bit of history.
0:52:33 > 0:52:38His patient is a young horse called Nanne who's in to be castrated.
0:52:38 > 0:52:41And Charlie - who's never castrated a horse in his life -
0:52:41 > 0:52:43will be performing the op.
0:52:43 > 0:52:48- OK. What is your horse's name?- Nanne.
0:52:48 > 0:52:51It's spelt strange. It's Dutch. OK.
0:52:51 > 0:52:55- N-A-N-N-E.- And what do you mainly use Nanne for?
0:52:55 > 0:52:58- Pardon?- What do you mainly use Nanne for?
0:52:58 > 0:53:01I've only had him since Sunday so...
0:53:01 > 0:53:05OK. Brilliant. Do you know whether his testicles have descended yet?
0:53:05 > 0:53:08Yeah. In the vet, they said it had.
0:53:09 > 0:53:11Hello.
0:53:11 > 0:53:15Yeah, poor guy is going to have his balls chopped off.
0:53:15 > 0:53:19Hopefully he won't know what he's missing.
0:53:19 > 0:53:21HORSE WHINNIES
0:53:26 > 0:53:27In terms of confidence,
0:53:27 > 0:53:31yes, I can sort of pretend to be confident.
0:53:31 > 0:53:34But occasionally the horses can see it.
0:53:34 > 0:53:37Occasionally I don't quite know what they are going to do.
0:53:37 > 0:53:38HORSE WHINNIES
0:53:38 > 0:53:43Before Nanne can be castrated, he needs to be anaesthetised.
0:53:43 > 0:53:44HORSE WHINNIES
0:53:44 > 0:53:48So Charlie's first big challenge is to fit a jugular catheter.
0:53:50 > 0:53:52But only if Nanne will let him.
0:53:54 > 0:53:57- OFF-CAMERA:- How's it going, Charlie?
0:53:57 > 0:53:59Obviously not ideal.
0:54:02 > 0:54:05Nanne here is only 18 months old. He is only a baby.
0:54:05 > 0:54:07He doesn't understand the prospect of standing still
0:54:07 > 0:54:10and that makes a little bit of a moving target for us and that
0:54:10 > 0:54:13makes it more and more difficult for us get a catheter into him.
0:54:13 > 0:54:16Good boy. Good boy.
0:54:16 > 0:54:18Well done.
0:54:18 > 0:54:21He has now got a catheter - it's taken a couple of attempts.
0:54:21 > 0:54:25He was a little bit of a monkey, but, yes, we've got that in place.
0:54:27 > 0:54:30As the team anaesthetise Nanne in the knock down box, vet
0:54:30 > 0:54:34Rachel is talking Charlie through his first ever horse castration.
0:54:36 > 0:54:37So I need you to talk me
0:54:37 > 0:54:39through what you are going to do before you do it.
0:54:39 > 0:54:41OK? OK.
0:54:41 > 0:54:45You always look forward to the opportunity to actually
0:54:45 > 0:54:49get your hands on some practical task that is a genuine clinical
0:54:49 > 0:54:52task that you will be potentially doing once you are a qualified vet.
0:54:52 > 0:54:56You are raring to go really and it just reminds you of what you
0:54:56 > 0:55:00are here for and what you are going to be doing once you've qualified.
0:55:00 > 0:55:04The operation itself - I was only nervous because I hadn't seen one
0:55:04 > 0:55:09done before and I haven't had a huge amount of time to read about what it
0:55:09 > 0:55:14is, and so it was kind of working on a step-by-step basis.
0:55:14 > 0:55:20- Just kind of doing what I was told basically.- One, two, three. Lovely!
0:55:20 > 0:55:24If you'd like to talk me through it. OK.
0:55:24 > 0:55:27If you talk to me throughout, that's easy for me. OK.
0:55:27 > 0:55:30Is it the whole 20ml or do I get 10ml in each ball?
0:55:30 > 0:55:32For this - yeah, 20ml.
0:55:32 > 0:55:34As a vet student basically, you don't
0:55:34 > 0:55:37get to do a huge amount of procedures on horses.
0:55:40 > 0:55:42There's just so many people in the room,
0:55:42 > 0:55:46kind of, not necessarily watching you, but that are working
0:55:46 > 0:55:50together to let you do this thing - means that is an added pressure.
0:55:51 > 0:55:55- Which one are you going to start with?- Errrm, top...bottom.
0:55:55 > 0:55:57THEY LAUGH
0:56:04 > 0:56:06I am just going to hold the testicle for you
0:56:06 > 0:56:09- and let you organise yourself with the emasculators.- Thank you.
0:56:09 > 0:56:12That is the first time I've used emasculators.
0:56:12 > 0:56:16Have used elastrators on newborn lambs,
0:56:16 > 0:56:21which are the rubber ring ones, but they are not quite as slicy.
0:56:21 > 0:56:25Whereas those ones had quite a satisfying crunch to them.
0:56:25 > 0:56:27CRUNCH
0:56:29 > 0:56:31HE LAUGHS
0:56:33 > 0:56:34You can't put that in.
0:56:36 > 0:56:38Come on, Charlie.
0:56:38 > 0:56:41- That's embarrassing!- Did you not have your Weetabix this morning?
0:56:41 > 0:56:42OK. That's all done.
0:56:42 > 0:56:45Just hold on there for three minutes, please?
0:56:45 > 0:56:46Once the emasculator's on,
0:56:46 > 0:56:49the team have to wait for the blood supply to stop.
0:56:55 > 0:56:57Surgery has kind of come to a standstill
0:56:57 > 0:56:59and you've just got to wait in that time,
0:56:59 > 0:57:01just hold the emasculator...
0:57:04 > 0:57:07It can be a little bit awkward to begin with.
0:57:07 > 0:57:11Told them about my weekend and just see how people are.
0:57:11 > 0:57:14- How was your weekend? - Great, thanks. How was yours?
0:57:14 > 0:57:16Really good. I went to see the
0:57:16 > 0:57:20wildlife photography thing at the Natural History Museum.
0:57:20 > 0:57:21It was lovely.
0:57:25 > 0:57:28- MAN:- How is he doing, Rachel? Is he doing OK?
0:57:28 > 0:57:29Doing a good job, yep.
0:57:31 > 0:57:34- Must be a good feeling? - Um...
0:57:34 > 0:57:36THEY LAUGH
0:57:36 > 0:57:37I feel a bit bad for the horse.
0:57:40 > 0:57:43That's great. OK? Yep. Go for it.
0:57:43 > 0:57:46- Can we have two minutes' time, please?- One down.
0:57:47 > 0:57:50We can't stop now.
0:57:50 > 0:57:53Emasculators - they do exactly what they say on the tin.
0:57:56 > 0:57:57OK. Good.
0:57:57 > 0:57:59I was impressed - he didn't get too carried away.
0:57:59 > 0:58:04He listened to direction, was very in control and very slick,
0:58:04 > 0:58:08so I'm very pleased with his practical skills at this
0:58:08 > 0:58:10level of his training. Definitely.
0:58:10 > 0:58:13You've known me two days and you've done this to me already!
0:58:13 > 0:58:17And Charlie is really nice so he's done a good job.
0:58:17 > 0:58:19He looked after my horse.
0:58:21 > 0:58:23Prospect of castration is something that
0:58:23 > 0:58:25you come to terms with very quickly as a vet.
0:58:28 > 0:58:30Yes, it causes some discomfort
0:58:30 > 0:58:33and takes away some of the pleasures of life.
0:58:33 > 0:58:36It's a necessary evil.
0:58:36 > 0:58:40"Some of the pleasures of life!" HE LAUGHS