0:00:00 > 0:00:02Britain is a nation in love with its animals.
0:00:02 > 0:00:03How are you doing?
0:00:03 > 0:00:06We own 27 million pets...
0:00:08 > 0:00:10..and 900 million farm animals.
0:00:10 > 0:00:12Very frisky one.
0:00:12 > 0:00:13All of them...
0:00:15 > 0:00:16..need vets.
0:00:17 > 0:00:19Over the course of their final year,
0:00:19 > 0:00:23ten students at the prestigious Royal Veterinary College
0:00:23 > 0:00:27in Hertfordshire are taking what they've learned in the classroom...
0:00:27 > 0:00:29and putting it to the test.
0:00:31 > 0:00:32In practices...
0:00:33 > 0:00:36- ..farms... - This is all new territory for me.
0:00:36 > 0:00:38..and state-of-the-art animal hospitals.
0:00:39 > 0:00:42It's a whirlwind of back-to-back work placements.
0:00:44 > 0:00:46Sounds like an unhappy monkey!
0:00:46 > 0:00:48Nice and quick. Good.
0:00:48 > 0:00:51And they can't afford to fail a single one.
0:00:51 > 0:00:54I need to do my job properly. I need to do better.
0:00:54 > 0:00:57- You're going in. - It's the most challenging stretch...
0:00:57 > 0:00:59- Whoa!- ..of a very long journey.
0:01:00 > 0:01:02I have a serious problem with my hand shaking.
0:01:02 > 0:01:03To become...
0:01:03 > 0:01:04- Well done.- Gassy!
0:01:04 > 0:01:06..fully qualified young vets.
0:01:06 > 0:01:08Saved a life today which is good!
0:01:31 > 0:01:34It's late Autumn and our young vets are growing in confidence,
0:01:34 > 0:01:38and learning essential new skills every week.
0:01:38 > 0:01:41But there's still a long journey ahead of them before they qualify.
0:01:42 > 0:01:45I've got big hurdles to jump before I graduate,
0:01:45 > 0:01:47but I am getting to the point where I feel like I want to...
0:01:47 > 0:01:50I want to get out there and start doing the job
0:01:50 > 0:01:52that I've been training to do.
0:01:52 > 0:01:54On this chilly Monday morning,
0:01:54 > 0:01:57Matt Wilkinson is heading to the Queen Mother Hospital for Animals
0:01:57 > 0:01:59for yet another practical placement.
0:02:01 > 0:02:04This week he's working in the specialist neurology department
0:02:04 > 0:02:07where they treat serious brain and spinal injuries.
0:02:07 > 0:02:10We're basically just divvying up who gets what,
0:02:10 > 0:02:11sorting out the new cases and stuff
0:02:11 > 0:02:13and then we'll just get on with stuff, I think.
0:02:13 > 0:02:16Just crack on and start doing things.
0:02:16 > 0:02:18But I have a feeling it's going to be quite a busy day.
0:02:18 > 0:02:21Within an hour, Matt's prediction comes true
0:02:21 > 0:02:24as he's suddenly called to the emergency room.
0:02:24 > 0:02:27A Rhodesian Ridgeback dog called Blue has been rushed here
0:02:27 > 0:02:30because he's had a series of seizures,
0:02:30 > 0:02:33which left untreated could prove fatal.
0:02:33 > 0:02:37This is Blue. Blue is, I think, ten years old.
0:02:37 > 0:02:41Matt's supervisor on the case is vet Johnny Plessas.
0:02:41 > 0:02:45He presented with acute onset of seizures in the last 24 hours.
0:02:45 > 0:02:47He had a previous seizure about six months ago.
0:02:47 > 0:02:49Six months ago, yeah.
0:02:49 > 0:02:53Blue's been given anti-seizure medication by his local vet,
0:02:53 > 0:02:56but what's causing the seizures is still a mystery.
0:02:56 > 0:02:58Yesterday they gave some diazepam
0:02:58 > 0:03:02and they did some emergency bloods, which were relatively unremarkable.
0:03:02 > 0:03:05Blue was brought in by James and his friend Max.
0:03:06 > 0:03:09Terrific dog, I've had him since he was a pup.
0:03:09 > 0:03:12And I remember, I had this picture of him,
0:03:12 > 0:03:15and his head and his paws were bigger than his body,
0:03:15 > 0:03:19so he'd always walk about like that with his head down
0:03:19 > 0:03:22and just, he does mean the world to me, he does.
0:03:22 > 0:03:25- You've got him?- Mm-hm.- All right.
0:03:25 > 0:03:28Johnny and Matt need to do a full neurological examination on Blue
0:03:28 > 0:03:32to see if his brain and spinal cord are functioning normally.
0:03:35 > 0:03:39But for this, they need Blue to stand up...
0:03:39 > 0:03:40and he can't.
0:03:40 > 0:03:43- I don't think he's going to stand. - No, I'm supporting him mostly.
0:03:43 > 0:03:46- OK. All right.- Good boy.
0:03:46 > 0:03:48OK. All right, all right.
0:03:48 > 0:03:50I don't know if he's like that
0:03:50 > 0:03:53because he has a significant neurological problem
0:03:53 > 0:03:57which is causing him to be quite daunted and sedated,
0:03:57 > 0:03:59or if it's just the seizures.
0:04:00 > 0:04:03Meanwhile, James is hoping that there's a simple explanation
0:04:03 > 0:04:05for Blue's seizures.
0:04:05 > 0:04:08Blue will just eat absolutely anything he can get his hands on.
0:04:08 > 0:04:11Cos he did actually eat some insulation.
0:04:11 > 0:04:15You know, loft insulation with fibre glass and stuff like that.
0:04:15 > 0:04:17Yeah, he ate some of that.
0:04:17 > 0:04:19And that's what hopefully is the problem.
0:04:19 > 0:04:22But it's dawning on Johnny and Matt
0:04:22 > 0:04:24that the problem could be a lot more serious.
0:04:24 > 0:04:26- He's not really responding.- No.
0:04:28 > 0:04:30- Is this dog neurologically normal or abnormal?- Abnormal, yeah.
0:04:30 > 0:04:32He's abnormal. He's quite obviously abnormal.
0:04:32 > 0:04:36The fact that he was missing some reflexes on his face
0:04:36 > 0:04:40was a bit worrying to us because that can be fairly indicative
0:04:40 > 0:04:43of a fairly serious neurological condition.
0:04:43 > 0:04:45What are your top differentials for this dog?
0:04:45 > 0:04:47He could have a full brain lesion of some kind.
0:04:47 > 0:04:50Neoplasia is definitely quite high on the list.
0:04:50 > 0:04:53Unfortunately, one of the things that's quite high up on our list
0:04:53 > 0:04:56at the moment due to his age and the signs that he's having is...
0:04:56 > 0:04:58One of them is a brain tumour...
0:05:00 > 0:05:03..which obviously is not ideal.
0:05:03 > 0:05:05Would you like to come through, please, and we can have a chat.
0:05:05 > 0:05:08James' parents are out of the country,
0:05:08 > 0:05:12so it falls to him to tell Johnny more about Blue's seizures.
0:05:12 > 0:05:15So I'm going to start with a few questions first,
0:05:15 > 0:05:18just to see exactly what happened with Blue.
0:05:18 > 0:05:20You said also that he has eaten something.
0:05:20 > 0:05:23Yeah, the fibreglass insulation.
0:05:23 > 0:05:26I must admit, I'm not 100% sure if that can cause seizures,
0:05:26 > 0:05:28I need to investigate that a little bit.
0:05:28 > 0:05:31You mentioned that he had a seizure, but I didn't actually ask you
0:05:31 > 0:05:34to describe a little bit exactly what you saw there.
0:05:34 > 0:05:37Yesterday, he was, like, dribbling from his mouth,
0:05:37 > 0:05:40and then he just sort of collapsed, didn't he?
0:05:40 > 0:05:42Yeah, you could see, it looked like he was getting weak.
0:05:42 > 0:05:45It must have lasted about two or three minutes,
0:05:45 > 0:05:47and then it was about...
0:05:47 > 0:05:50- Another five or ten minutes after... - He had another one.
0:05:50 > 0:05:53- Did you see the sort of seizure? - Yeah, I did.- OK.
0:05:55 > 0:05:58- Are you OK?- Right.
0:06:01 > 0:06:03It's all right, mate.
0:06:04 > 0:06:08I know it's all a bit upsetting, but at least he's stable at the minute.
0:06:08 > 0:06:11Are you sure you don't want to go out
0:06:11 > 0:06:13just to get some fresh air or something like that?
0:06:13 > 0:06:14Do you want to go out for two minutes?
0:06:14 > 0:06:16- No, I'll be all right.- OK.
0:06:16 > 0:06:18So I guess the first thing will be to just figure out
0:06:18 > 0:06:21if there's something outside his head causing the problems.
0:06:21 > 0:06:24If we don't find anything there, we need to look into his brain
0:06:24 > 0:06:26to make sure he doesn't have any problems there.
0:06:26 > 0:06:29If there is a problem inside the head, I think the number one is...
0:06:29 > 0:06:34I don't want to give you bad news, but I think the number one I've got,
0:06:34 > 0:06:36considering his age, there is the possibility of a brain tumour.
0:06:39 > 0:06:42Do you like to ask me anything? Is everything clear so far?
0:06:42 > 0:06:44- Can I see him before I go? - Yes, sure.
0:06:44 > 0:06:47He's just behind the door anyway, so let me see if we can move him.
0:06:47 > 0:06:51You never know if an owner is going to be tearful or really upset,
0:06:51 > 0:06:52or angry.
0:06:52 > 0:06:56It's not just dealing with animals, you have to deal with clients.
0:06:56 > 0:06:58You've just got to be comforting
0:06:58 > 0:07:01and appreciate that they're seeing their animal in such a state
0:07:01 > 0:07:05that they're not used to and they might think the worst.
0:07:11 > 0:07:15He's just a little bit sleepy but he's stable, he's OK,
0:07:15 > 0:07:17and we expect him to be sleepy anyway.
0:07:23 > 0:07:26We're going to keep him in the intensive care department for now,
0:07:26 > 0:07:28just to be closely monitored
0:07:28 > 0:07:30especially because he's quite sedated.
0:07:49 > 0:07:53For James it means leaving his beloved Blue at the hospital.
0:07:54 > 0:07:58I was hoping they would say it's just, like, the fibreglass.
0:07:58 > 0:08:01- He's just had like... - Too much of that.
0:08:01 > 0:08:04Or, I don't know, poison or something like that.
0:08:04 > 0:08:07But I never thought it'd come to, like, a brain tumour
0:08:07 > 0:08:10or something to do with his heart or something like that.
0:08:18 > 0:08:20For Blue, the future is uncertain.
0:08:24 > 0:08:27It's surprisingly difficult to catch a dog as they're moving
0:08:27 > 0:08:28when they're peeing.
0:08:28 > 0:08:31You're trying to get right in there with the bowl,
0:08:31 > 0:08:33but then they can't move their legs,
0:08:33 > 0:08:35so then they end up peeing all over your hand.
0:08:35 > 0:08:37But that's when you catch it in your glove.
0:08:37 > 0:08:39When it runs down your arm, you catch it in the glove
0:08:39 > 0:08:41and then take the glove off carefully.
0:08:41 > 0:08:43- You never done that?- Judy!
0:08:43 > 0:08:44Just me on that, then?
0:08:45 > 0:08:51Student Judy Puddifoot knows exactly what kind of vet she wants to be.
0:08:51 > 0:08:54Yeah, I prefer companion animals. Yeah, cats, dogs, guinea pigs,
0:08:54 > 0:08:56ferrets even at a push, yep.
0:08:56 > 0:08:59I prefer those. Small animals.
0:08:59 > 0:09:02If you can pick it up, and not ride it or eat it,
0:09:02 > 0:09:03they're my favourite animals.
0:09:05 > 0:09:09- Morning, Judy!- Morning. - Fit and fresh?- Oh, yes.
0:09:09 > 0:09:12But this week she's on less familiar territory,
0:09:12 > 0:09:14working at a large animal practice near Luton.
0:09:16 > 0:09:18Her first challenge is at a local dairy farm
0:09:18 > 0:09:20to do one of a vet's key jobs -
0:09:20 > 0:09:24checking to see if the cows are pregnant.
0:09:24 > 0:09:29This is a unique outfit, especially for farms.
0:09:29 > 0:09:32Judy, would you nip round over to the far side of the scanner
0:09:32 > 0:09:33and plug it in for me, please?
0:09:33 > 0:09:37She's working under the scrutiny of the senior vet, James McFarland.
0:09:37 > 0:09:40This is entirely to try and bring on the next generation
0:09:40 > 0:09:42of the veterinary profession, so that they're capable,
0:09:42 > 0:09:48comfortable that they can look after our farming folks as best they can.
0:09:48 > 0:09:50And it's time for Judy to get stuck in.
0:09:51 > 0:09:53I'm getting lube.
0:09:53 > 0:09:55This is one of the most important things
0:09:55 > 0:09:57in farm veterinary life - lubrication.
0:09:57 > 0:09:58Very important.
0:09:59 > 0:10:02I'm just setting up the ultrasound scanner
0:10:02 > 0:10:06to allow me to do rectal examinations on the cows.
0:10:06 > 0:10:08We'll just work through them one by one.
0:10:08 > 0:10:10Each one will have its own situation
0:10:10 > 0:10:13and I don't know what they are yet until we get started.
0:10:13 > 0:10:16But first, she's got to catch herself a cow.
0:10:17 > 0:10:20And this lot are giving Judy the run-around.
0:10:20 > 0:10:24They know when there's a rookie in the...in the yard, I think.
0:10:25 > 0:10:28Go on, one of you. Any volunteer?
0:10:28 > 0:10:31These wild cows!
0:10:31 > 0:10:33Straight off the moors, these, ain't they?
0:10:33 > 0:10:35Go on, go.
0:10:35 > 0:10:36That's the way to do it!
0:10:39 > 0:10:41These are made for people with ridiculously big hands,
0:10:41 > 0:10:43can I just say that?
0:10:43 > 0:10:45Look, it's ridiculous.
0:10:47 > 0:10:50If I was having a calf, I wouldn't want a hand that size inside me.
0:10:51 > 0:10:52Full of dung.
0:10:52 > 0:10:55Yes, if you can just clear all that out for when I have a go.
0:10:55 > 0:10:57You want me to get rid of that? Thank you very much.
0:10:57 > 0:10:59Before a dairy cow can produce milk,
0:10:59 > 0:11:02she needs to get pregnant and produce a calf.
0:11:02 > 0:11:06And it's the farm vet's job to pregnancy test the whole herd,
0:11:06 > 0:11:08one by one.
0:11:08 > 0:11:11- OK, there we go.- Hey! - There's the embryo.
0:11:11 > 0:11:13And with the help of his ultrasound scanner,
0:11:13 > 0:11:17James can see that it's good news for cow number one.
0:11:17 > 0:11:19This is an eight-weeker.
0:11:19 > 0:11:22You can see the little bits of the embryo skeleton in the black.
0:11:22 > 0:11:24The black is fluid,
0:11:24 > 0:11:26but the bit in the middle is little skeleton that's...
0:11:26 > 0:11:29Oh, jumping around! Did you see him move? That's him not me.
0:11:29 > 0:11:30Mm, lively.
0:11:30 > 0:11:34It's not glorious technicolour, but there's little legs.
0:11:34 > 0:11:36See the two little legs coming down to the end?
0:11:36 > 0:11:38Here there's little feet at the bottom.
0:11:38 > 0:11:40- So this is definitely pregnant. - She's definitely lively.
0:11:40 > 0:11:43She's done the job and I'm going to leave her alone
0:11:43 > 0:11:45- and not jeopardise the pregnancy. - Yup.
0:11:46 > 0:11:48But as a crucial part of her training,
0:11:48 > 0:11:52Judy needs to learn how to feel for a pregnancy without ultrasound.
0:11:52 > 0:11:55It's time for James to put her to the test.
0:11:55 > 0:11:57If you want to put some lube on your hand,
0:11:57 > 0:11:59see if you can find that left ovary.
0:12:00 > 0:12:01Thank you.
0:12:04 > 0:12:06When people find out you're at vet school,
0:12:06 > 0:12:09first thing they ask you is, "Have you put your arm up a cow's bum?"
0:12:09 > 0:12:13Yes, I have done that. "What does it feel like?"
0:12:13 > 0:12:16Imagine what it feels like. It pretty much feels like that!
0:12:18 > 0:12:22Just found the cervix, so I'm sweeping along the pelvis
0:12:22 > 0:12:26until I can find the cervix below my hand.
0:12:26 > 0:12:29Then I'll follow that along,
0:12:29 > 0:12:34then that should branch off into left and right horns of the uterus.
0:12:35 > 0:12:38I managed to feel an ovary, actually.
0:12:38 > 0:12:39I think it was an ovary.
0:12:39 > 0:12:41You just go on what it feels like.
0:12:41 > 0:12:43And he says, "Well, is it firm? Is it walnut sized?"
0:12:43 > 0:12:46Yes, yes. And it sounds like it's in the right place. So...
0:12:46 > 0:12:48If it walks like a duck and sounds like a duck,
0:12:48 > 0:12:50it must be an ovary, I guess.
0:12:52 > 0:12:55That was fine, managing animals that weigh 650, 700kg.
0:12:55 > 0:12:58These are not pussycats. These are big guys,
0:12:58 > 0:13:00and you need to be able to handle them safely,
0:13:00 > 0:13:01properly, comfortably and well.
0:13:01 > 0:13:04She's coming on fine. She's made steady progress
0:13:04 > 0:13:07and whether she ever sees a cow in anger, I don't know,
0:13:07 > 0:13:10but the experience of managing and working around
0:13:10 > 0:13:12has got to be good for students.
0:13:12 > 0:13:14COW FARTS
0:13:14 > 0:13:16Gassy! It doesn't bother me. It really doesn't bother me.
0:13:16 > 0:13:19If you don't like poop, don't become a vet.
0:13:19 > 0:13:21That's my advice cos there's a lot of poop!
0:13:37 > 0:13:40At the Queen Mother Hospital, Matt is helping vet Johnny
0:13:40 > 0:13:44with Blue, the Rhodesian Ridgeback, who's been having seizures.
0:13:44 > 0:13:49The neurology team are worried that Blue might have a brain tumour.
0:13:49 > 0:13:52To find out whether or not their hunch is correct,
0:13:52 > 0:13:54Blue needs to have an MRI scan.
0:13:54 > 0:13:57For this, he'll need to be anaesthetised.
0:13:57 > 0:14:01- And this...this murmur, a recent finding?- They're not sure.
0:14:01 > 0:14:05But Blue also has a heart murmur, which means a general anaesthetic
0:14:05 > 0:14:08could be extremely dangerous for him.
0:14:08 > 0:14:10So, first of all, the team need to check
0:14:10 > 0:14:12that his heart is strong enough.
0:14:12 > 0:14:18And it's up to cardiologist Adrian Boswood to make the decision.
0:14:18 > 0:14:20- Can we grab the lights?- Yeah.
0:14:20 > 0:14:23What we needed to do was do an ultrasound of his heart.
0:14:23 > 0:14:25You know, with the question, is he safe to anaesthetise?
0:14:25 > 0:14:28You're waiting for a yes or no answer, you know?
0:14:28 > 0:14:30"Yes, Blue is safe to anaesthetise"
0:14:30 > 0:14:32or "No, Blue is not safe to anaesthetise."
0:14:32 > 0:14:35And you really want the yes answer, because you need to go ahead
0:14:35 > 0:14:38and you need to go ahead and do that MRI and see if there's a problem.
0:14:38 > 0:14:42It looks like probably he's got a quiet valvular disease,
0:14:42 > 0:14:44and it's not particularly significant.
0:14:44 > 0:14:49It doesn't seem to be causing his heart to be enlarged.
0:14:49 > 0:14:52Is he safe to anaesthetise? The answer is yes.
0:14:52 > 0:14:55Yeah? Cool, excellent.
0:14:55 > 0:14:58Blue gets the green light for his MRI scan,
0:14:58 > 0:15:01but the team are anxious about what they'll find.
0:15:03 > 0:15:05We're all just stood there, watching the screen intently.
0:15:05 > 0:15:09All of us secretly hoping that he wasn't going to have something nasty
0:15:09 > 0:15:10like a brain tumour.
0:15:10 > 0:15:13It's a very tense moment really, just waiting
0:15:13 > 0:15:15to see whether you were wrong
0:15:15 > 0:15:17or whether your suspicions will be proved right.
0:15:17 > 0:15:20I think everyone is just standing there thinking,
0:15:20 > 0:15:23"Please don't have a brain tumour, please don't have a brain tumour."
0:15:23 > 0:15:25There is definitely something there
0:15:25 > 0:15:28and you can see how it's pushing the cerebellum down.
0:15:28 > 0:15:30Yeah, it's really squished.
0:15:30 > 0:15:31So...
0:15:31 > 0:15:34Hmm, let's see. Let's see what we can find.
0:15:34 > 0:15:39Blue has a mass in his brain,
0:15:39 > 0:15:41which is causing a bit of compression
0:15:41 > 0:15:43on various parts of the brain,
0:15:43 > 0:15:46which would explain why he's had the seizures.
0:15:48 > 0:15:51Not really what we wanted to hear.
0:15:51 > 0:15:54With their worst fears confirmed, they need to work out
0:15:54 > 0:15:57whether surgery is a viable option for Blue.
0:15:57 > 0:16:01If we were to operate on this mass, we'd have to go underneath
0:16:01 > 0:16:05the occipital lobes and try to then scoop this mass out,
0:16:05 > 0:16:08which is quite tricky. It's not easy.
0:16:08 > 0:16:10And obviously it's not without significant risk of haemorrhage.
0:16:10 > 0:16:12It's definitely a quite significant condition.
0:16:12 > 0:16:14If we don't treat him,
0:16:14 > 0:16:16I think it's definitely a quite serious condition,
0:16:16 > 0:16:20that potentially he can pass away. He can die because of it.
0:16:20 > 0:16:25We might just then lose him suddenly because of what we call herniation.
0:16:25 > 0:16:28So, unfortunately, that's what we're going to have a discussion
0:16:28 > 0:16:30afterwards with the owners. Sudden death is a possibility.
0:16:35 > 0:16:38- Hello. I'm Johnny.- Hi, nice to meet you. I'm Matt.
0:16:38 > 0:16:41The following day, Johnny and Matt have the difficult job
0:16:41 > 0:16:43of breaking the news to James's parents,
0:16:43 > 0:16:45who cut short their holiday in America
0:16:45 > 0:16:47when they heard that Blue was ill.
0:16:47 > 0:16:50First of all, I want to let you know that he's stable,
0:16:50 > 0:16:54and that he's brighter compared to what he was the previous days.
0:16:54 > 0:16:58However, I had an idea that there is a possibility
0:16:58 > 0:17:00that we might be dealing with a tumour.
0:17:00 > 0:17:05Unfortunately, we did find that with MRI scan.
0:17:05 > 0:17:07With their beloved dog in such a serious condition,
0:17:07 > 0:17:11Blue's family are faced with a difficult decision.
0:17:11 > 0:17:15If we should consider the possibility of surgery,
0:17:15 > 0:17:18it's a very risky procedure to perform,
0:17:18 > 0:17:20to try to remove the tumour.
0:17:20 > 0:17:23The second one is what I would probably recommend to you
0:17:23 > 0:17:25is radiation therapy.
0:17:25 > 0:17:28I think it's very unlikely that the tumour will go away completely,
0:17:28 > 0:17:31but if we can make it to shrink as much as we can,
0:17:31 > 0:17:35and we can prolong Blue's life for as much as we can.
0:17:35 > 0:17:37That might be one year, that would be great.
0:17:37 > 0:17:39If we can prolong it even a little bit longer,
0:17:39 > 0:17:41I think would be even better.
0:17:41 > 0:17:42That's going to be the best way to go, then?
0:17:42 > 0:17:45I think so. I think, if he was my dog,
0:17:45 > 0:17:47of course, you have all the options
0:17:47 > 0:17:50and, of course, you have the option of not giving any treatment
0:17:50 > 0:17:53and you would like to consider the possibility of euthanasia
0:17:53 > 0:17:55to put him to sleep at this stage,
0:17:55 > 0:17:58if, you know, you cannot accept treating a dog
0:17:58 > 0:18:01with this kind of clinical science. I think this is an option for you.
0:18:01 > 0:18:05I think the radio treatment sounds the best way to go.
0:18:05 > 0:18:07- Yeah.- Yeah.
0:18:09 > 0:18:12With the decision made to go ahead with radiotherapy,
0:18:12 > 0:18:15Blue is reunited with his family.
0:18:16 > 0:18:19Look who is there!
0:18:19 > 0:18:22Aw. There we go.
0:18:22 > 0:18:23That's better, yeah.
0:18:23 > 0:18:25I think he recognised you now.
0:18:27 > 0:18:29Yes, he's like "Oh, hi!"
0:18:31 > 0:18:34He was a little bit slow, but he got there.
0:18:35 > 0:18:37They're discussing a brain tumour.
0:18:37 > 0:18:39A brain tumour is not a nice thing to have to talk about.
0:18:39 > 0:18:42But I think what's nice about that conversation was
0:18:42 > 0:18:44that it wasn't about negatives.
0:18:44 > 0:18:48It was about positives of what you can do for this dog...
0:18:48 > 0:18:49what you can do for Blue.
0:18:49 > 0:18:51What are the possible options?
0:18:51 > 0:18:54And how can we prolong his life and make him feel better?
0:18:54 > 0:18:56QUIET CHATTER
0:18:56 > 0:18:59Good. I mean, I was hoping that they would go
0:18:59 > 0:19:01towards the radiotherapy route,
0:19:01 > 0:19:04because I think that's probably the more appropriate choice for him
0:19:04 > 0:19:07and they have opted for that, so that's really good,
0:19:07 > 0:19:09which means, I mean, it could potentially give him
0:19:09 > 0:19:13s..., you know, up to a year plus potentially of extra life,
0:19:13 > 0:19:17which is really good. So I'm glad they've opted for that, yeah.
0:19:17 > 0:19:22Blue's radiotherapy will take place at a specialist unit in Essex.
0:19:22 > 0:19:25And although it's not going to completely cure Blue,
0:19:25 > 0:19:28it will at least give him and his friend James
0:19:28 > 0:19:30a bit more precious time together.
0:19:30 > 0:19:33When he comes home, I will not let him out of my sight.
0:19:33 > 0:19:35Will I? No.
0:19:35 > 0:19:36I'm not going to let you out of my sight.
0:19:36 > 0:19:40No. No, I'm just going to be there every day,
0:19:40 > 0:19:44feed him, take him for some walks,
0:19:44 > 0:19:48and just smother him with kisses and cuddles. That's what I'm going to do.
0:19:48 > 0:19:50That's my plan of action.
0:19:56 > 0:19:59I think the main problem with cats is that they're so unpredictable.
0:19:59 > 0:20:02- Yeah.- Kind of they'll be, one minute they'll be fine
0:20:02 > 0:20:04and then the next, they'll just be like, "Grr." Just go for you.
0:20:04 > 0:20:07- Yeah, literally!- And so sharp. - Cat... Yeah, so sharp.
0:20:07 > 0:20:09CAT MEOWS
0:20:09 > 0:20:12There are some really lovely cats and then there are some
0:20:12 > 0:20:14which are just a bit crazy, but...
0:20:14 > 0:20:16aren't we all?
0:20:16 > 0:20:18- Aren't we all.- Indeed.
0:20:23 > 0:20:26With just months to go before she graduates,
0:20:26 > 0:20:30Catherine Needham is pleased with the way things are going.
0:20:30 > 0:20:34I definitely feel that I've come a long way through rotations already.
0:20:34 > 0:20:38There's a lot that I am a lot more confident with now than...
0:20:38 > 0:20:41I thought I would be at this stage,
0:20:41 > 0:20:44but there definitely is a lot that I still feel I need to work on
0:20:44 > 0:20:47or that I wouldn't be confident doing.
0:20:47 > 0:20:50But today Catherine's taking a leap into the unknown.
0:20:50 > 0:20:55I'm at the Beaumont Small Animal Hospital in Camden today,
0:20:55 > 0:20:57which is the first opinion hospital that the RVC have.
0:20:59 > 0:21:02A lot of people aren't as knowledgeable on exotic animals,
0:21:02 > 0:21:05and there's a couple of vets at the Beaumont who specialise in exotics,
0:21:05 > 0:21:08so this is one of the days that the exotic vet is in.
0:21:08 > 0:21:12At the moment, I've got very little experience of looking at reptiles
0:21:12 > 0:21:13and tortoises and things,
0:21:13 > 0:21:16so I hope that I'll learn a bit about them today.
0:21:16 > 0:21:19I'm Catherine, and I'm one of the final year vet students.
0:21:19 > 0:21:22His name's Julian and he's about 2.
0:21:22 > 0:21:24And he's from Macedonia.
0:21:24 > 0:21:27He's about this big. He's really cute.
0:21:32 > 0:21:33Oh, he's tiny!
0:21:35 > 0:21:39He's going to be a bit sleepy cos he's cold.
0:21:39 > 0:21:41I didn't realise he was going to be quite this tiny,
0:21:41 > 0:21:44so I'm just going to have to go and get the smaller scales for him.
0:21:44 > 0:21:46- I didn't realise he was quite that small.- Sure.
0:21:46 > 0:21:49So, I'll just leave you and run out for a bit.
0:21:49 > 0:21:52Julian's in for one of his regular worming treatments.
0:21:52 > 0:21:54Do you want to pop him back in the box
0:21:54 > 0:21:55that might be the easiest way to weigh him.
0:21:55 > 0:21:57If the worming is working,
0:21:57 > 0:22:00he'll have gained weight since his last visit.
0:22:00 > 0:22:02One gram more than last time.
0:22:02 > 0:22:03Good.
0:22:03 > 0:22:04I'll leave you with him for a minute.
0:22:04 > 0:22:06I'll just go and speak to Nadine
0:22:06 > 0:22:09and then we'll come back and we'll worm him.
0:22:09 > 0:22:13The exotics specialist at the Beaumont is vet Nadene Stapleton.
0:22:13 > 0:22:16- All right. What was his weight today?- 92 grams.
0:22:16 > 0:22:18Whoo! That's one more gram than last time.
0:22:18 > 0:22:21Worming has obviously done the trick.
0:22:21 > 0:22:22Let's give him his wormer.
0:22:22 > 0:22:25So, this can be a bit of a spectator sport.
0:22:25 > 0:22:27I usually just grab the head.
0:22:27 > 0:22:30They're really strong, so you can't...
0:22:30 > 0:22:33You'll injure them if you're trying to pull the head out
0:22:33 > 0:22:35and they're trying to pull against that.
0:22:35 > 0:22:38So, what you're wanting to do is basically fatigue their muscles.
0:22:38 > 0:22:41You just hold on. You don't try and pull out.
0:22:41 > 0:22:44You just hold on to the head until they kind of go...
0:22:44 > 0:22:45- SHE SIGHS - ..and relax.
0:22:45 > 0:22:48Then you pull the head out a little bit. Any questions?
0:22:48 > 0:22:49Nope, that's fine.
0:22:49 > 0:22:52- Right, let's try and make you look like a fool!- Thanks!
0:22:57 > 0:23:00Very hard, but you're basically just popping fingers in,
0:23:00 > 0:23:03knuckles just to stop him from putting his head back in.
0:23:03 > 0:23:05But you have to be quick!
0:23:05 > 0:23:08Worming little Julian means getting the end of the syringe
0:23:08 > 0:23:10right inside his mouth.
0:23:10 > 0:23:12It's almost working. It's not a lot.
0:23:12 > 0:23:15Not surprisingly, Julian doesn't fancy this at all.
0:23:17 > 0:23:20He was a very small tortoise, which makes handling harder
0:23:20 > 0:23:21than with a bigger tortoise,
0:23:21 > 0:23:24just because there's kind of less of them to actually hold on to
0:23:24 > 0:23:25while you're trying to worm them,
0:23:25 > 0:23:28so that was definitely an experience that I'd not had before.
0:23:28 > 0:23:31Trying to persuade a tortoise to keep its head out of its shell,
0:23:31 > 0:23:34so that we could worm it, was definitely a new one for me.
0:23:34 > 0:23:36Yeah, he's particularly difficult.
0:23:36 > 0:23:39I think we had a lot of trouble with him last time, didn't we guys?
0:23:39 > 0:23:40If you're at the stage now
0:23:40 > 0:23:43where he's pulling his head all the way back in
0:23:43 > 0:23:44and there's just not a chance
0:23:44 > 0:23:48you can wiggle your fingers in behind it, then just let him go,
0:23:48 > 0:23:52pop him back on the table and he'll start walking around again.
0:23:52 > 0:23:55He'll usually pull it back out again. So, pop him down.
0:23:55 > 0:23:58Yeah, I don't think it's... Not happening.
0:23:58 > 0:24:01He's like, "Phew, glad that's over!"
0:24:01 > 0:24:03You'll get another go in a minute.
0:24:03 > 0:24:05All right. So, this time, same thing,
0:24:05 > 0:24:08but what I want you to do is just be a little bit faster
0:24:08 > 0:24:11at getting your fingers and knuckles in behind the jawbone,
0:24:11 > 0:24:12is what you're trying to achieve.
0:24:12 > 0:24:14So, let's see how you go.
0:24:14 > 0:24:17Oh, I think he's gotten a little bit cagier, what do you think?
0:24:17 > 0:24:19I think he's a little bit faster than last time.
0:24:19 > 0:24:22Let's see whether I can have any more luck.
0:24:22 > 0:24:27I think someone needs to invent a lettuce-flavoured tortoise wormer.
0:24:27 > 0:24:30In the end, Nadine took over and she did that bit
0:24:30 > 0:24:33and I actually did the worming rather than holding its head out.
0:24:33 > 0:24:36Just because you can't really argue with a tortoise.
0:24:36 > 0:24:39Yeah, it's got to get all the way down.
0:24:39 > 0:24:41Perfect.
0:24:41 > 0:24:45THEY LAUGH
0:24:45 > 0:24:47Oh, sorted.
0:24:47 > 0:24:49- How did Catherine do?- Oh, fantastic.
0:24:49 > 0:24:51I couldn't have done it without her.
0:24:51 > 0:24:55I would have just been standing there holding his mouth open!
0:24:56 > 0:24:58In your pod, little man.
0:25:00 > 0:25:04DOG WHINES
0:25:15 > 0:25:19Student Charlie Tewson is also having a new experience this week.
0:25:19 > 0:25:21He's experimenting...
0:25:21 > 0:25:22with facial hair.
0:25:22 > 0:25:24I quite like the look actually.
0:25:24 > 0:25:26I don't think I'm going to carry it on after November,
0:25:26 > 0:25:31but I think the '80s is coming back.
0:25:31 > 0:25:33He may be putting on a brave face this morning,
0:25:33 > 0:25:36but he's not looking forward to his next placement
0:25:36 > 0:25:38at the Queen Mother Hospital.
0:25:38 > 0:25:41I've been trying to read up a little bit over the weekend,
0:25:41 > 0:25:45but it turns out that small animal medicine
0:25:45 > 0:25:49maybe covers about half the material we've ever learnt,
0:25:49 > 0:25:53which means trying to revise it in a weekend is pretty difficult.
0:25:53 > 0:25:54Mustn't forget your lunch!
0:26:04 > 0:26:07DOG YELPS AND BARKS
0:26:07 > 0:26:09- Morning.- Morning, guys!
0:26:09 > 0:26:12There's a lot of rumours you hear from other students
0:26:12 > 0:26:14how bad it is or how intense they grill you.
0:26:14 > 0:26:16Some of it's hearsay.
0:26:16 > 0:26:18Some of it's completely true, I've learnt in hindsight,
0:26:18 > 0:26:21but, yeah, I think everyone does work themselves up a bit
0:26:21 > 0:26:22before going into it.
0:26:22 > 0:26:24DOG BARKS
0:26:24 > 0:26:27Small Animal Medicine is a really crucial placement
0:26:27 > 0:26:29for final year students.
0:26:29 > 0:26:30It starts with a pep talk
0:26:30 > 0:26:34from one of the hospital's leading specialists, Professor Hattie Syme.
0:26:35 > 0:26:38The best way to understand what's going on with your cases
0:26:38 > 0:26:41is to be with them right from the very beginning.
0:26:41 > 0:26:45Diagnosing illness is the basis for all veterinary work,
0:26:45 > 0:26:47and every one of our students must develop the skills
0:26:47 > 0:26:49that will help them crack the mysteries
0:26:49 > 0:26:52they'll face every day once they qualify.
0:26:54 > 0:26:55It's all about the diagnosis
0:26:55 > 0:27:00and that's what's so fun about it and what can be so frustrating about it.
0:27:00 > 0:27:03Hattie's preparing the students for a tough fortnight
0:27:03 > 0:27:06discovering their inner Sherlock Holmes.
0:27:06 > 0:27:09It's an intellectual process,
0:27:09 > 0:27:12so there's no reason why the student on the case
0:27:12 > 0:27:16can't be every bit as much the detective as we are,
0:27:16 > 0:27:19just less experienced detectives.
0:27:19 > 0:27:21OK that might be it. Oh, good, nice, thick file.
0:27:22 > 0:27:25Charlie picks up a patient straightaway,
0:27:25 > 0:27:27a Jack Russell called Jack.
0:27:27 > 0:27:28He's having treatment at the hospital
0:27:28 > 0:27:32for a potentially life-threatening problem with his immune system,
0:27:32 > 0:27:35and he's back in today because he's become worryingly lethargic.
0:27:35 > 0:27:39He's a dog that's had ongoing anaemia for quite some time,
0:27:39 > 0:27:41and we don't quite know the exact underlying cause.
0:27:41 > 0:27:45At the moment our presumptive diagnosis is his immune system
0:27:45 > 0:27:46is attacking his red blood cells,
0:27:46 > 0:27:49but unfortunately he's not really having a very good response
0:27:49 > 0:27:50to treatment at the moment.
0:27:50 > 0:27:52So, have you managed to have a chance to...
0:27:52 > 0:27:55I've had a very quick brief glance at the first half...
0:27:55 > 0:27:58Vet Anna Threlfall will be putting Charlie to the test
0:27:58 > 0:27:59on this challenging case.
0:27:59 > 0:28:03He came in last week on the 11th, I think, he was back in.
0:28:03 > 0:28:06And he was doing reasonably well at home,
0:28:06 > 0:28:08so have you taken histories and stuff yet?
0:28:08 > 0:28:11- I've done a few, yeah.- OK, Jack's lovely.- OK.
0:28:11 > 0:28:14Just need to go a bit slow with him. He's a Jack Russell.
0:28:14 > 0:28:17- Hi, guys.- This is Charlie. Charlie's one of our final years as you know.
0:28:17 > 0:28:19Hi, how're you doing?
0:28:19 > 0:28:21Before Jack had come in, he had already had one
0:28:21 > 0:28:24or two blood transfusions before because of this condition,
0:28:24 > 0:28:26and it was trying to kind of support him
0:28:26 > 0:28:29while his body could mount an appropriate response
0:28:29 > 0:28:30to the drugs we were giving him,
0:28:30 > 0:28:33so that he could then start producing his own red blood cells.
0:28:33 > 0:28:36Have you noticed any days when he's been particularly lethargic
0:28:36 > 0:28:37or he's been about the same?
0:28:37 > 0:28:40I'd like to say Saturday I was very, very concerned.
0:28:40 > 0:28:42He was very lethargic the whole day.
0:28:42 > 0:28:47He'd get sort of like 30 or 40 yards and stop.
0:28:47 > 0:28:50And I'm just like, I'd go, "Come, Jack, come for a walk now." No.
0:28:50 > 0:28:54Just didn't want to walk, you know what I mean?
0:28:54 > 0:28:56- Brilliant. Thanks for this. - Thank you.
0:28:56 > 0:28:59Jack was worse than I thought he was going to be.
0:28:59 > 0:29:01Looking quite slow, quite under the weather,
0:29:01 > 0:29:03essentially which we now know
0:29:03 > 0:29:06because he didn't have enough oxygen going round his body.
0:29:06 > 0:29:09We've had him since he was eight weeks old and he's 10 now.
0:29:12 > 0:29:14You do become rather attached to them.
0:29:14 > 0:29:16I mean, no matter what you do to him...
0:29:16 > 0:29:19You can have a row with him on the night before
0:29:19 > 0:29:21and in the morning he'll come running up to you.
0:29:21 > 0:29:24He's your best mate, you know what I mean?
0:29:24 > 0:29:26Never answers you back.
0:29:26 > 0:29:29When we first brought him in here, it was like...
0:29:29 > 0:29:31- HE SIGHS - We thought he was a goner.
0:29:31 > 0:29:33Like a week and a half ago.
0:29:33 > 0:29:36The emotional attachment of owners to their pets
0:29:36 > 0:29:38is something that really gets to you,
0:29:38 > 0:29:41I mean you could clearly see that in Jack's case,
0:29:41 > 0:29:45where they'd already put him though two transfusions,
0:29:45 > 0:29:49but were just desperately trying to give his the chance
0:29:49 > 0:29:51for his body to respond.
0:29:51 > 0:29:55Anna's determined to get to the bottom of Jack's illness.
0:29:55 > 0:29:58I think we should take him in today and do the blood work
0:29:58 > 0:30:01and keep hold of him until we get all the results back,
0:30:01 > 0:30:03so we're a little bit happier with him
0:30:03 > 0:30:07cos then we can decide what we need to do from here on.
0:30:07 > 0:30:09Good boy. Good boy.
0:30:09 > 0:30:12It's time for Jack's owners to leave him
0:30:12 > 0:30:14and for Charlie to take a blood sample
0:30:14 > 0:30:16to test Jack's red blood cell count.
0:30:17 > 0:30:20Come on, then. OK, good boy.
0:30:20 > 0:30:25If it's low, it means the drugs and the transfusions aren't working
0:30:25 > 0:30:28and Jack's treatment options are running out.
0:30:28 > 0:30:29JACK WHINES
0:30:29 > 0:30:32He's just very scared. I think he doesn't quite know
0:30:32 > 0:30:33what to make of it. I can see...
0:30:33 > 0:30:37He's got that look about him of just...
0:30:37 > 0:30:39definitely doesn't want to be here.
0:30:39 > 0:30:42Hopefully, we'll get to the bottom of it.
0:30:59 > 0:31:02Charlie's not the only student being put to the test
0:31:02 > 0:31:05in Small Animal Medicine this week.
0:31:05 > 0:31:08It's the big one, really. It's always been the big one in my mind.
0:31:08 > 0:31:10It's the one to do well in,
0:31:10 > 0:31:14and it's the one that's been the most terrifying because of that.
0:31:14 > 0:31:16It's all gone a bit...
0:31:16 > 0:31:18There's a lot of client and patient responsibility,
0:31:18 > 0:31:21which is something we haven't actually had that much of.
0:31:21 > 0:31:24Elly Berry's first patient, ten-year-old Labrador, Xander,
0:31:24 > 0:31:26was admitted overnight to the intensive care unit
0:31:26 > 0:31:29with some very serious symptoms.
0:31:29 > 0:31:31He'd collapsed. He was hypothermia...
0:31:31 > 0:31:33So, he was hypothermic with cold,
0:31:33 > 0:31:37Erm, vomiting, and now he's got lots and lots of diarrhoea.
0:31:37 > 0:31:39Oh! It's everywhere.
0:31:39 > 0:31:41Picking him up as a case, you knew he was pretty ill
0:31:41 > 0:31:43and just to look at him, his little face,
0:31:43 > 0:31:46he wasn't... You know, he's a yellow lab.
0:31:46 > 0:31:49You'd imagine him to be bouncing all over the place, but he just wasn't.
0:31:49 > 0:31:51Xander's really poorly,
0:31:51 > 0:31:54but they don't know what's causing his symptoms,
0:31:54 > 0:31:57so he's going to need to have a lot of tests.
0:31:57 > 0:32:00Elly's being supervised by vet Myfanwy Hill.
0:32:00 > 0:32:03Got a lot of diarrhoea. I've managed to avoid it, so far,
0:32:03 > 0:32:06but I wouldn't be surprised if I get covered in it later.
0:32:08 > 0:32:11Elly's first job is to take Xander's blood.
0:32:11 > 0:32:15But choosing the right equipment is more complicated than it looks...
0:32:15 > 0:32:17apparently.
0:32:17 > 0:32:19- One of these?- Yeah, how much blood do you want?
0:32:19 > 0:32:22- Not very much at all.- No.- So, tiny. Erm, blue needle?
0:32:22 > 0:32:26- Green needle, orange needle?- Which needle do you think?
0:32:26 > 0:32:29Erm, needle-wise...
0:32:29 > 0:32:32- Not the biggest one.- Orange one? - He's not a cow.
0:32:32 > 0:32:35Put them on the table for me in order of size.
0:32:35 > 0:32:38How big do you think they are in terms of how wide they are.
0:32:38 > 0:32:42Oh, dear. That's the biggest,
0:32:42 > 0:32:44then that one and that one and that one.
0:32:44 > 0:32:47- So, you think that's the biggest? - No, smallest! And that's biggest.
0:32:47 > 0:32:49Smallest, next smallest, yeah?
0:32:49 > 0:32:52There we go. If I was bleeding him, that's the length I'd choose.
0:32:52 > 0:32:54Oh is it?! Ah!
0:32:54 > 0:32:58Sweating, sweating from the pressure!
0:32:58 > 0:33:01I've seen blood taken so many times. You just... I don't know.
0:33:01 > 0:33:04I just couldn't remember at that point what size needle,
0:33:04 > 0:33:08And, erm, I mean, I know now!
0:33:08 > 0:33:10So, that's the main thing.
0:33:12 > 0:33:14So, if you've got your thumb on the end,
0:33:14 > 0:33:17is it going to be able to go in if you've got your thumb on the end?
0:33:17 > 0:33:21- It's all going so wrong.- There we go, perfect. That's enough.
0:33:21 > 0:33:23I was fingers and thumbs all over the place.
0:33:23 > 0:33:25I just ended up having my thumb over the end,
0:33:25 > 0:33:30so obviously the pressure meant that... I just...
0:33:30 > 0:33:31Yeah!
0:33:31 > 0:33:35A really fun week with me. You're going to have all the LOLs!
0:33:35 > 0:33:38So, we're checking how much red blood cells are in the blood,
0:33:38 > 0:33:42in comparison to how much other fluid there is in the blood.
0:33:42 > 0:33:44Wait 23 minutes on...
0:33:44 > 0:33:47So, it's a measure of how dehydrated the dog is.
0:33:47 > 0:33:49I think it's 56.
0:33:49 > 0:33:52And what do you think of 56?
0:33:52 > 0:33:56- I think that's quite high.- Mm-hm, yep. I'd agree.
0:33:56 > 0:33:59The blood results show that Xander is severely dehydrated,
0:33:59 > 0:34:03so he'll be put on a drip in intensive care overnight.
0:34:03 > 0:34:07But perfectionist Elly isn't happy with her morning's work.
0:34:07 > 0:34:11That was, erm, chronic. That was really, really, really bad.
0:34:12 > 0:34:14Tomorrow can only be better.
0:34:19 > 0:34:22The next morning, Xander's no better,
0:34:22 > 0:34:24and the decision is made to do more tests.
0:34:24 > 0:34:28This time to see if there's something seriously wrong with him.
0:34:28 > 0:34:32He will be having the FNAs, the fine needle aspirates,
0:34:32 > 0:34:34is where you stick a needle into...
0:34:34 > 0:34:36He's having it in his liver and his spleen
0:34:36 > 0:34:40to get a sample of the cells to see if any of them are cancerous.
0:34:43 > 0:34:45Xander lies patiently on the table
0:34:45 > 0:34:48while the team work as fast as they can.
0:34:49 > 0:34:50Are you ready?
0:34:52 > 0:34:54Using ultrasound guidance,
0:34:54 > 0:34:56you can actually insert the needle into the dog
0:34:56 > 0:34:59and you can then see your needle with your ultrasound probe
0:34:59 > 0:35:01and you know you're in the right place.
0:35:01 > 0:35:04And you can actually take a sample of the cells from that organ,
0:35:04 > 0:35:06and then you can examine them to see
0:35:06 > 0:35:09if they have any signs of being cancerous or not.
0:35:09 > 0:35:11They're incredibly sharp.
0:35:11 > 0:35:14It's like us having a jab for flu or something, I think.
0:35:14 > 0:35:19Come on, dude. Thank you very much!
0:35:19 > 0:35:22It's time for Xander to go back to intensive care.
0:35:22 > 0:35:23And it's an anxious wait to see
0:35:23 > 0:35:26if his tests come back positive for cancer.
0:35:31 > 0:35:33The day someone brings a snake in to me...
0:35:33 > 0:35:36Like I don't think I've ever held a snake!
0:35:36 > 0:35:39THEY LAUGH
0:35:39 > 0:35:41Don't let it go around here.
0:35:41 > 0:35:43Top tip!
0:35:50 > 0:35:54In Luton, Judy's placement at the large animal practice
0:35:54 > 0:35:55is coming to an end.
0:35:55 > 0:35:57But there's still one big challenge left
0:35:57 > 0:36:00and it's one Judy's never faced before.
0:36:00 > 0:36:01On the menu today,
0:36:01 > 0:36:06we have a ram coming in first thing to be castrated.
0:36:06 > 0:36:07Be interesting.
0:36:07 > 0:36:11I'm a ram castration virgin, so this will be the first one,
0:36:11 > 0:36:16but anyway we'll see what they can...what they can throw at us.
0:36:16 > 0:36:17Morning!
0:36:18 > 0:36:21- OK, you're all set, Barry, with her? - Yep, yep, ready to go.
0:36:21 > 0:36:23All right, let's go get our patient.
0:36:23 > 0:36:26It turns out that castrating a ram
0:36:26 > 0:36:29is not something even vet James does every day.
0:36:29 > 0:36:34This patient is a rare breed sheep, and the owner, sadly for him,
0:36:34 > 0:36:36she's decided he's not good enough to breed for them,
0:36:36 > 0:36:39and therefore he needs to be neutered. It's quite uncommon
0:36:39 > 0:36:42because the vast majority of sheep would be in a commercial situation
0:36:42 > 0:36:45and therefore if they're not needed for breeding, then why keep them?
0:36:45 > 0:36:47But this owner has an interest in each individual,
0:36:47 > 0:36:49so she would prefer to have him neutered,
0:36:49 > 0:36:51and she'll keep them, I suppose, as pets,
0:36:51 > 0:36:56but from the ram's point of view that's probably a good thing!
0:36:56 > 0:36:59- All present and correct?- All present and correct. One, two and no hernias.
0:36:59 > 0:37:01Everything's normal. That's fine. He's quite a big lad!
0:37:01 > 0:37:04Oh, yeah.
0:37:04 > 0:37:06- That's a good lad.- Good boy.
0:37:06 > 0:37:09Normally, when animals are anaesthetised,
0:37:09 > 0:37:10they should have an empty stomach.
0:37:10 > 0:37:13- You can stop him reversing, yeah? - Yep. On stop.
0:37:13 > 0:37:15With a cat or dog you can starve them overnight,
0:37:15 > 0:37:17and therefore their tummy is empty
0:37:17 > 0:37:18whenever you go to do the anaesthetic.
0:37:18 > 0:37:21But with a sheep, we don't have that option.
0:37:21 > 0:37:25They have a multi-chambered stomach, which holds enough grass in there
0:37:25 > 0:37:29to be able to give grass time to be digested.
0:37:29 > 0:37:32The rumen would take three days at least to empty
0:37:32 > 0:37:34and you can't do that,
0:37:34 > 0:37:38so it's just another hazard that you've got to factor in.
0:37:38 > 0:37:42To reduce the risk of Pierre the sheep choking during the procedure,
0:37:42 > 0:37:46it's essential they operate as quickly as possible.
0:37:46 > 0:37:48Get the skin away from the testes themselves.
0:37:48 > 0:37:51Go straight across the bottom. Erm, just take that away.
0:37:51 > 0:37:54After that, the technique is really very similar
0:37:54 > 0:37:56to what you would do with a dog. You'll get those on
0:37:56 > 0:37:59- to crimp your site where you'll put your ligature on.- Yep.- There.
0:37:59 > 0:38:02That's your ligature. Can you see how that is nipped...
0:38:02 > 0:38:04- nipped a nice waist in the cord? - Yeah.
0:38:04 > 0:38:06That's really got a good grip on it.
0:38:06 > 0:38:09'See one, do one, teach one', is the theory of veterinary medicine,
0:38:09 > 0:38:11so I watched James remove one
0:38:11 > 0:38:15and then, all of a sudden he turns round and says,
0:38:15 > 0:38:18"Right, you can take the next one off!" and I'm like, "OK."
0:38:18 > 0:38:22And, erm, it was a handful.
0:38:22 > 0:38:26- Make sure it's firm. Is it firm? Is it right on the cord?- Yeah.
0:38:26 > 0:38:28You have only one chance to get this ligature done
0:38:28 > 0:38:30and now's the time.
0:38:32 > 0:38:36And you need to take the testis off itself, go distal to the forceps.
0:38:36 > 0:38:37- Can you take the testis?- Got it.
0:38:37 > 0:38:40- Got it? Good. I've got the forceps. - Sure.
0:38:43 > 0:38:45Thank you very much, well done.
0:38:45 > 0:38:47Grasp it with both hands, I say.
0:38:47 > 0:38:50And I did!
0:38:50 > 0:38:52You've got a nice waist where your ligature went
0:38:52 > 0:38:56and you've got a good enough gap where the ligature is placed.
0:38:56 > 0:38:57How was that?
0:38:59 > 0:39:01Fast! It's brilliant!
0:39:03 > 0:39:07That was great. I didn't realise I was going to get to actually
0:39:07 > 0:39:09do one testicle, so that's good.
0:39:09 > 0:39:11Don't want any anti-toxin, no?
0:39:11 > 0:39:13- No, I'm too old for that now.- OK.
0:39:13 > 0:39:16She wasn't expecting to actually have hands on in the op,
0:39:16 > 0:39:17but I watched her tie the ligature.
0:39:17 > 0:39:19She's quite dextrous with her fingers.
0:39:19 > 0:39:23The ligatures were good and it's good to let Judy at least have one
0:39:23 > 0:39:25ticked away, under her belt.
0:39:25 > 0:39:28Not quite ready to run off just yet!
0:39:28 > 0:39:30- Ah, boy.- He was a nice little ram, yeah.
0:39:30 > 0:39:33In the back of the van, and it was...
0:39:33 > 0:39:37Ah, that day reminded me of All Creatures Great And Small
0:39:37 > 0:39:41and out he came, out his balls came!
0:39:41 > 0:39:43Done.
0:39:43 > 0:39:47Don't stand still too long cos I'll have them off!
0:39:47 > 0:39:49Just like that!
0:39:59 > 0:40:02In the hospital's Small Animal Medicine Unit,
0:40:02 > 0:40:04the detective work continues.
0:40:04 > 0:40:07Elly's patient Xander is still seriously unwell
0:40:07 > 0:40:11after collapsing three nights ago with a mystery illness.
0:40:11 > 0:40:14His liver and spleen have been tested for cancer,
0:40:14 > 0:40:18and this morning Elly's heard some good news.
0:40:18 > 0:40:20So, when we did the sticky needle thing into the liver
0:40:20 > 0:40:22and the spleen and the peritoneum,
0:40:22 > 0:40:25all those cell samples came back as negative for cancer,
0:40:25 > 0:40:27so that's really, really good.
0:40:27 > 0:40:29But Xander's not out of the woods yet.
0:40:29 > 0:40:33The next step is to do a CT scan to check for cancer
0:40:33 > 0:40:35in other parts of his abdomen.
0:40:35 > 0:40:38For this test, he's been anaesthetised.
0:40:38 > 0:40:40- Is that the beginning of the stomach?- Yes.
0:40:40 > 0:40:42We're looking over those CTs of his abdomen.
0:40:42 > 0:40:45It's that worrying time when you just don't know what's going on
0:40:45 > 0:40:48and you don't want to find something that's big and nasty and malignant,
0:40:48 > 0:40:50but you never know, really.
0:40:51 > 0:40:54CT's done and nothing has been found,
0:40:54 > 0:40:58so that is a good thing in the light that it's not cancer.
0:40:58 > 0:41:02But even though there's no cancer, Xander's still a medical mystery.
0:41:02 > 0:41:05And a frustrating case for Detective Hattie.
0:41:05 > 0:41:07We've been searching very hard basically,
0:41:07 > 0:41:10for different types of cancer,
0:41:10 > 0:41:12but so far we've not found them.
0:41:12 > 0:41:14And the frustrating thing is that
0:41:14 > 0:41:20it can seem really good for the dog that we haven't found cancer,
0:41:20 > 0:41:23but actually if we haven't got a firm diagnosis,
0:41:23 > 0:41:27then we don't have a way to treat.
0:41:40 > 0:41:44DOG BARKS
0:41:44 > 0:41:48Meanwhile, Charlie's patient is proving just as much of a challenge.
0:41:48 > 0:41:51Jack, the Jack Russell, has a serious auto immune disease,
0:41:51 > 0:41:54which is making him severely anaemic.
0:41:55 > 0:41:58Overnight, Jack's had another blood transfusion
0:41:58 > 0:42:01to boost his low red blood cell count.
0:42:01 > 0:42:05But although it's made him feel better, it's not a cure.
0:42:05 > 0:42:07The transfusion is just a temporary measure.
0:42:07 > 0:42:13You're just buying them some time until their body can respond.
0:42:13 > 0:42:17The team think Jack's bone marrow isn't forming new red blood cells.
0:42:17 > 0:42:19But they need to find out why.
0:42:19 > 0:42:22He's going to have a bone marrow biopsy,
0:42:22 > 0:42:25so we're trying to get down to the underlying cause
0:42:25 > 0:42:27for his immune-mediated haemolytic anaemia.
0:42:27 > 0:42:30Though, we always try to get both an aspirate and also a core.
0:42:30 > 0:42:32So, the core will be, hopefully,
0:42:32 > 0:42:35an actual a little piece of the bone marrow.
0:42:35 > 0:42:39Vet Roseanne Jepson is overseeing this complicated procedure.
0:42:39 > 0:42:42There can be difficulties getting the sample
0:42:42 > 0:42:44depending on what's going on in the marrow,
0:42:44 > 0:42:45so sometimes it's easier than others.
0:42:45 > 0:42:49There are some risks. We've given some local into the site
0:42:49 > 0:42:51to try and make sure the dog's comfortable
0:42:51 > 0:42:53after we've done the procedure.
0:42:53 > 0:42:57First, Anna gets a sample of fluid from the bone marrow in Jack's leg.
0:42:57 > 0:43:01Then comes the really tricky part.
0:43:01 > 0:43:04There is a slightly more violent period
0:43:04 > 0:43:06where we have to try and ensure
0:43:06 > 0:43:09that we have a tube of marrow within our needle,
0:43:09 > 0:43:13so there will be a bit of moving the needle around within the leg.
0:43:13 > 0:43:14You don't have to work out at the gym
0:43:14 > 0:43:17after having done one of these sometimes.
0:43:18 > 0:43:21The red blood cells are produced in the bone marrow,
0:43:21 > 0:43:23so, essentially, what we'd like to do
0:43:23 > 0:43:25is take a sample of the bone marrow
0:43:25 > 0:43:27and check whether in the bone marrow,
0:43:27 > 0:43:30it's producing red blood cells appropriately.
0:43:30 > 0:43:33It looked pretty brutal, but they're asleep,
0:43:33 > 0:43:37so I mean, you do worse things and we needed to know.
0:43:40 > 0:43:44Yeah! Perfect, good job!
0:43:44 > 0:43:46Perfect, close it up.
0:43:47 > 0:43:49We're done, yes.
0:43:49 > 0:43:53While Charlie bottles up the tiny bone marrow sample,
0:43:53 > 0:43:56Jack's beginning to come round from his anaesthetic.
0:43:56 > 0:43:59And he seems none the worse for wear.
0:43:59 > 0:44:01Do you want to have a run around, sweetheart?
0:44:01 > 0:44:03Aw, he does!
0:44:03 > 0:44:07- Go on, then, launch the dog.- Be free!
0:44:07 > 0:44:10It's sometimes quite nice to let them wander round recovery
0:44:10 > 0:44:12and just have some attention, some TLC.
0:44:12 > 0:44:15Even though, as he was wandering around he was a bit wobbly.
0:44:15 > 0:44:18- Aw!- Oh, Jack.
0:44:18 > 0:44:23Essentially, Jack was a little bit drunk, or to that effect.
0:44:23 > 0:44:25THEY LAUGH
0:44:25 > 0:44:31Good work, anaesthesia team. Good work, biopsy team.
0:44:31 > 0:44:33The results of the biopsy show signs
0:44:33 > 0:44:37that Jack's bone marrow is making some new red blood cells.
0:44:37 > 0:44:40But they also show a worrying new development.
0:44:40 > 0:44:42It's OK. Hello.
0:44:42 > 0:44:45Unfortunately, we've identified some fibrosis,
0:44:45 > 0:44:48which is like a type of scar tissue,
0:44:48 > 0:44:50which can form in the bone marrow.
0:44:50 > 0:44:53We are concerned that his prognosis is a little bit worse.
0:44:53 > 0:44:55But animals can recover from it
0:44:55 > 0:44:57and we'd probably give him a 50% chance
0:44:57 > 0:45:01of actually responding to the steroid treatment that he's on.
0:45:01 > 0:45:04When you've had a patient in for a good few days,
0:45:04 > 0:45:06then, yes, of course, you build up a bit of a relationship.
0:45:06 > 0:45:09Jack's been a lovely dog,
0:45:09 > 0:45:12but there are some things that are just outside our control.
0:45:12 > 0:45:15Jack will be going home for now.
0:45:15 > 0:45:17All the team can do is hope that this time
0:45:17 > 0:45:19he responds to his treatment.
0:45:25 > 0:45:27It's now five days since Xander the Labrador
0:45:27 > 0:45:29was admitted to the emergency room,
0:45:29 > 0:45:33severely dehydrated and close to death.
0:45:33 > 0:45:35He's undergone a barrage of tests,
0:45:35 > 0:45:38but his condition is still a mystery.
0:45:40 > 0:45:42But student Elly has come in this morning
0:45:42 > 0:45:46to find Xander looking much more cheerful.
0:45:46 > 0:45:49He's basically just lots better. He's eating loads.
0:45:49 > 0:45:52He's pooing again, bit watery, but better than nothing!
0:45:52 > 0:45:56And, erm, he's had his ECG that he's had strapped to him,
0:45:56 > 0:45:57that's taken off as well
0:45:57 > 0:45:59cos they're not so worried about his heart as much.
0:45:59 > 0:46:03And he's going back to normal wards, so he's doing all right, really.
0:46:03 > 0:46:06And he should be going home either tomorrow or Sunday.
0:46:09 > 0:46:12There's still no diagnosis for Xander's mysterious illness,
0:46:12 > 0:46:16but vet Katarina has her own theory.
0:46:16 > 0:46:18I think my hypothesis at the moment
0:46:18 > 0:46:20is that he just had some allergic reaction probably.
0:46:20 > 0:46:24He has some skin allergy, some skin allergic disease,
0:46:24 > 0:46:25so, maybe, whatever happened
0:46:25 > 0:46:28because, you know, actually, we didn't put him
0:46:28 > 0:46:30on any specific treatment.
0:46:30 > 0:46:32He was not on antibiotics, he wasn't on steroids.
0:46:32 > 0:46:35He just...I think, he just improved by himself, so...
0:46:35 > 0:46:36But it's good!
0:46:38 > 0:46:41I came to realise that Xander, with all his twists and turns
0:46:41 > 0:46:43and his unanswered questions,
0:46:43 > 0:46:45that that is what medicine is mostly about.
0:46:45 > 0:46:50Just a lot of leads and sometimes mostly not a lot of answers.
0:46:50 > 0:46:53But the fact that he got better was fantastic. Was really good.
0:47:05 > 0:47:07In downtown Potters Bar,
0:47:07 > 0:47:10it's an early start this morning for student Dru Shearn,
0:47:10 > 0:47:14who's anxious to at least look like he knows what he's doing.
0:47:14 > 0:47:17I think if you wear shirt, tie trousers, I think
0:47:17 > 0:47:19people take you more seriously
0:47:19 > 0:47:22and they treat you more like a professional.
0:47:22 > 0:47:25If you just turn up, kind of T-shirt, jeans,
0:47:25 > 0:47:27people aren't going to take you seriously.
0:47:27 > 0:47:31Today he starts a surgery placement in the College's Equine
0:47:31 > 0:47:36Referral Hospital, which brings with it some extra responsibilities.
0:47:36 > 0:47:38Most of them are performance animals,
0:47:38 > 0:47:41and people pay a lot of money to keep them that way or to get them
0:47:41 > 0:47:44to that point, so you have to take extra care with them.
0:47:44 > 0:47:47I think the owner seems to have a little bit more of a say in
0:47:47 > 0:47:51treatment options and how they're treated care-wise while they're here.
0:47:52 > 0:47:54Oh! Have we got caught in the tail!
0:47:54 > 0:47:56THEY LAUGH
0:47:58 > 0:48:00Dru's first case is Darcey Bussell,
0:48:00 > 0:48:05a foal bred specifically for a career as a dressage horse.
0:48:05 > 0:48:07Darcey has suddenly become lame.
0:48:08 > 0:48:13This could mean her dressage career is over before it even starts.
0:48:13 > 0:48:18Dru needs to get up to speed by reading through her case notes.
0:48:18 > 0:48:21So how long have we got to read up on the case?
0:48:21 > 0:48:23Ten minutes.
0:48:23 > 0:48:26About ten, 15 minutes, which doesn't really help
0:48:26 > 0:48:28when I can't read this person's writing.
0:48:28 > 0:48:33At just five-and-a-half months, little Darcey is already a handful.
0:48:36 > 0:48:38Still feisty. Good, good to hear!
0:48:38 > 0:48:41Feisty is not a word you want to hear
0:48:41 > 0:48:43when you're looking at an animal's history!
0:48:43 > 0:48:47Along with needy, dribbly, or aggressive.
0:48:47 > 0:48:52Those are probably like, the top four that you don't want to hear!
0:48:52 > 0:48:55But to help her overcome the extra stress of being at the hospital,
0:48:55 > 0:48:58her mum is always kept close by -
0:48:58 > 0:49:01even when she's taken in to have her shoulder X-rayed.
0:49:01 > 0:49:03Cos this is the pouch right, down here?
0:49:03 > 0:49:05This is the end of the glenoid here?
0:49:05 > 0:49:08In the X-rays, surgeon Andy Fiske-Jackson can spot
0:49:08 > 0:49:12a thickening of cartilage and bone within Darcey's shoulder joint.
0:49:12 > 0:49:15Right, guys, the picture looks like certainly it is
0:49:15 > 0:49:22supportive of an OCD lesion. So yep, just that line down there,
0:49:22 > 0:49:26around here there looks to be some disruption.
0:49:26 > 0:49:29OCD is osteochondrosis dissecans. In basic terms,
0:49:29 > 0:49:33it's sort of a degeneration or problem with the cartilage.
0:49:33 > 0:49:35It can be a really big problem,
0:49:35 > 0:49:37especially in your sort of high performance animals,
0:49:37 > 0:49:40it can be the thing that makes or breaks them. If they get this
0:49:40 > 0:49:44disease and it's not treated, that can be the end of their usefulness.
0:49:44 > 0:49:47But the team won't know whether Darcey's lameness can be corrected
0:49:47 > 0:49:51until they open up her shoulder and take a look inside the joint.
0:49:51 > 0:49:53So she's prepped for surgery.
0:49:53 > 0:49:57We've isolated this lameness to the shoulder joint of the foal.
0:49:57 > 0:50:00The aim now is to put a camera into that shoulder joint
0:50:00 > 0:50:03to evaluate the whole joint, and evaluate with
0:50:03 > 0:50:07the amount of damage we have just the prognosis for the foal.
0:50:07 > 0:50:10Dru has been given a crucial role.
0:50:10 > 0:50:13I'm going to be trolley dolly today, which I guess involves
0:50:13 > 0:50:18passing instruments, light refreshments, snacks,
0:50:18 > 0:50:21scratch cards, that kind of thing.
0:50:23 > 0:50:26But he soon realises that it's a lot more complicated than he thought.
0:50:26 > 0:50:29It's hard to be shown 20 instruments
0:50:29 > 0:50:32and then five minutes later be expected to pass the right ones,
0:50:32 > 0:50:35when they look the same and have got similar names.
0:50:38 > 0:50:39So...
0:50:41 > 0:50:45But Dru isn't just getting surgical experience today.
0:50:45 > 0:50:48He's also getting a lesson in the harsh realities of treating
0:50:48 > 0:50:50performance horses.
0:50:50 > 0:50:53Because if the team don't think it's possible to correct little Darcey's
0:50:53 > 0:50:59lameness here and now, she'll be put to sleep on the operating table.
0:50:59 > 0:51:02When Darcey was under anaesthesia and covered in green sheets,
0:51:02 > 0:51:05and you just see a leg sticking out and you're doing something,
0:51:05 > 0:51:08you're concentrating on instruments and passing things
0:51:08 > 0:51:10and that kind of thing, you don't
0:51:10 > 0:51:12necessarily think about what the decision making process is.
0:51:12 > 0:51:15These are, like we say, they are performance animals
0:51:15 > 0:51:18so the decision on whether they're going to live or die
0:51:18 > 0:51:21sometimes is down to, are they going to be a good competitor?
0:51:21 > 0:51:23Which is...
0:51:23 > 0:51:25it's quite difficult to accept, really.
0:51:25 > 0:51:29Pick the leg up a little bit, just pick the leg up a little bit.
0:51:29 > 0:51:33It's not long before the team, led by orthopaedics specialist
0:51:33 > 0:51:36Roger Smith, locate the source of Darcey's lameness.
0:51:36 > 0:51:39There's an area of damage in the cartilage.
0:51:39 > 0:51:41The cartilage is very thickened
0:51:41 > 0:51:43because it hasn't developed properly.
0:51:43 > 0:51:45That's very granular abnormal bone,
0:51:45 > 0:51:47the question is how far down it goes.
0:51:47 > 0:51:50Piece by piece, the team painstakingly extract
0:51:50 > 0:51:51the thickened cartilage.
0:52:02 > 0:52:04OK, so I'm going to close it.
0:52:04 > 0:52:07All we've done is we've removed all that damaged cartilage,
0:52:07 > 0:52:10and also the defective bone underneath.
0:52:10 > 0:52:14Yes, we're pleased with what we've achieved.
0:52:14 > 0:52:16As Dru and the team suture Darcey's shoulder,
0:52:16 > 0:52:19it's clear that the surgery is a success,
0:52:19 > 0:52:22and her future's no longer hanging in the balance.
0:52:23 > 0:52:28And trolley-dolly Dru gets the thumbs up from surgeon Andy.
0:52:28 > 0:52:31Dru did very well. He was very diligent.
0:52:31 > 0:52:34And it's something we don't expect to get bang on right the first time.
0:52:34 > 0:52:36I think what we want is someone who's paying attention,
0:52:36 > 0:52:39understands, and starts to learn a pattern, you know.
0:52:39 > 0:52:41That's what we look for in learning and he certainly did that.
0:52:41 > 0:52:43So, very happy with it.
0:52:52 > 0:52:54Three days later, Darcey's recovering well,
0:52:54 > 0:52:57and her owner Julie has come to take her home.
0:53:00 > 0:53:05Our biggest concern was that they were going to get into the joint and
0:53:05 > 0:53:10find that, actually, even with the surgery, and even with a long amount
0:53:10 > 0:53:15of rehabilitation, she would still be lame, even as a pasture animal.
0:53:15 > 0:53:16If it's successful,
0:53:16 > 0:53:20you will pay any amount of money to have it successful.
0:53:20 > 0:53:24But if we run out of money looking after this one,
0:53:24 > 0:53:27we're going into the winter, we've got
0:53:27 > 0:53:30all these others to pay for, what do you do about feeding them?
0:53:30 > 0:53:35So it does make it really hard, it does make it hard.
0:53:35 > 0:53:39I mean, money isn't everything, but it really, really helps
0:53:39 > 0:53:40when you've got horses.
0:53:42 > 0:53:43I'm glad to have her home.
0:54:05 > 0:54:06- Charlie?- Yep.
0:54:06 > 0:54:09I've just written her for bloods and CPLI?
0:54:09 > 0:54:13Charlie's in the second week of his Small Animal Medicine placement
0:54:13 > 0:54:16and his patient Jack has come in for a check up.
0:54:16 > 0:54:20Jack's being treated for a very serious auto immune condition.
0:54:20 > 0:54:22Hello, Charlie. All right?
0:54:22 > 0:54:26How you doing? Nice to see you again. Aw, hello! Oh, Jack.
0:54:27 > 0:54:30A week since a bone marrow biopsy and blood transfusion,
0:54:30 > 0:54:34it's time to see if Jack's finally responding to treatment.
0:54:34 > 0:54:39Essentially, Jack looks very well. OK, so we think better.
0:54:39 > 0:54:42Any other sort of problems that you've noted?
0:54:42 > 0:54:44No, nothing really.
0:54:44 > 0:54:47He'll eat and then two minutes later he's asking for more food.
0:54:47 > 0:54:49Yeah, that's what steroids do to you, basically.
0:54:49 > 0:54:52What have you been doing for exercise for him?
0:54:52 > 0:54:54I've just been taking him for walks and that...
0:54:54 > 0:54:56And how long do you think the walks are?
0:54:56 > 0:54:59Probably 15-20 minutes or so, he's back to pulling,
0:54:59 > 0:55:01like how he used to be kind of thing.
0:55:01 > 0:55:04Yep, so Jack's demeanour obviously is well.
0:55:04 > 0:55:08We still have to take every day at a time, and it might be that the
0:55:08 > 0:55:11transfusion is still what's really supporting him,
0:55:11 > 0:55:13and it's definitely a good sign.
0:55:13 > 0:55:16Fantastic to see Jack so lively and happy and bubbly,
0:55:16 > 0:55:19and so much improved from when he was here.
0:55:19 > 0:55:21How's Jack doing?
0:55:21 > 0:55:24Really well, owner has absolutely no problems to...
0:55:24 > 0:55:26Oh, fantastic. I'm relieved.
0:55:26 > 0:55:28He says, even better than when he took him home,
0:55:28 > 0:55:29thinks he's got better.
0:55:30 > 0:55:31They're so pink.
0:55:31 > 0:55:33I think he's quite good.
0:55:33 > 0:55:35- He's all good, isn't he!- Yeah.
0:55:35 > 0:55:37OK. Good, well done, Jack.
0:55:39 > 0:55:42We're crossing our fingers and just hoping that everything...
0:55:42 > 0:55:46that it's going to show that his bone marrow is regenerating.
0:55:46 > 0:55:48At this stage, we can't really say.
0:55:51 > 0:55:54LAUGHING: Slow down, Jack!
0:56:01 > 0:56:06- For now, signs are looking good.- He's good.- Yeah, it's really nice to see.
0:56:07 > 0:56:12- LAUGHING: Thanks for everything. Really nice to see you.- Cheers.
0:56:12 > 0:56:14They're still saying 50-50,
0:56:14 > 0:56:18but you wouldn't think it looking at him, would you?
0:56:18 > 0:56:21It's one of those ones where you as well are just really
0:56:21 > 0:56:24rooting for it because he's showing positive signs.
0:56:24 > 0:56:26But you try not to get too excited about it,
0:56:26 > 0:56:29just because, at this point, you don't quite know.
0:56:29 > 0:56:31The signs are looking good,
0:56:31 > 0:56:34but it can always take a turn for the worse.
0:56:34 > 0:56:39It's just one of those wait and see, and keep your fingers crossed.
0:56:46 > 0:56:51It's now springtime, and in Essex, Jack's owners, Lynn and Dan,
0:56:51 > 0:56:52are reflecting on the months
0:56:52 > 0:56:56since Charlie helped to treat their much-loved dog.
0:56:56 > 0:57:00Last time you saw him he'd just had another blood transfusion,
0:57:00 > 0:57:03so his levels were pretty high.
0:57:03 > 0:57:07And then what happened in the weeks following that,
0:57:07 > 0:57:10his levels dropped again quite low.
0:57:10 > 0:57:13We had a number of blood tests, but he didn't
0:57:13 > 0:57:17regenerate any new cells so he was just getting weaker and weaker.
0:57:17 > 0:57:23Talking to Anna and our vets, and amongst ourselves,
0:57:23 > 0:57:26we just thought, "He's suffered enough and..."
0:57:26 > 0:57:30Don't let him lose his dignity. It's never going to happen.
0:57:30 > 0:57:33But don't let it go too far downhill
0:57:33 > 0:57:37before you take him to the vet and basically put him to sleep.
0:57:37 > 0:57:41So that's what happened. That was...
0:57:41 > 0:57:43- 19th December.- Yeah, 19th December.
0:57:45 > 0:57:48Four months on, the loss of their beloved Jack has become
0:57:48 > 0:57:52a little more bearable - thanks to a new addition to the family...
0:57:52 > 0:57:54THEY LAUGH
0:57:57 > 0:58:00That's Alfie!
0:58:00 > 0:58:0216-week-old Alfie.
0:58:03 > 0:58:06And here we go again!
0:58:06 > 0:58:09- It feels like a home again.- I come in from work and he comes running up.
0:58:09 > 0:58:11He does, doesn't he? Comes running up,
0:58:11 > 0:58:14pleased to see you, his little tail going.
0:58:14 > 0:58:15And it is, yeah, it's a home again.