Episode 7 Young Vets

-Britain is a nation in love with its animals.

-How are you doing?!

We own 27 million pets...

..and 900 million farm animals.

Very frisky one.

-All of them...

-DOG YELPS

..need vets.

Over the course of their final year,

ten students at the prestigious

Royal Veterinary College in Hertfordshire

are taking what they've learned in the classroom...

and putting it to the test

in practices...

-farms...

-This is all new territory for me!

..and state-of-the-art animal hospitals.

It's a whirlwind of back-to-back work placements.

MONKEY SHRIEKS Sounds like an unhappy monkey!

-Nice and quick. Good.

-And they can't afford to fail a single one.

I need to do my job properly. I need to do better.

-Going in.

-It's the most challenging stretch...

-Whoa!

..of a very long journey...

-I have a serious problem with my hand shaking.

-..to become...

-Well done. Gassy!

-..fully qualified young vets.

Saved a life today, which is good.

LAUGHTER

BIRDSONG

Christmas break is over at The Royal Veterinary College

and our young vets have just three more months of clinical placements

before they face their all-important final exams.

That means only three more months to master all the skills

they need to go into practice flying solo as fully-qualified vets.

The pressure's on and every placement is just that bit tougher.

COW MOOS METAL CLANGS

And they don't get any tougher than the one Elly Berry's facing

this week at the Queen Mother Hospital

working in small animal surgery.

I think probably one of the most stressful things

that new graduates have to do is walk into the operating room

for the first time in sole charge.

This is a whole new layer of complexity to the training

and a whole additional layer of expectation

that's placed on new-graduate vets.

With so little time left to hone those vital skills,

Elly must make the most of every opportunity to gain experience and confidence.

She's under extra pressure to impress this week

as her supervisor is world-renowned surgeon Dan Brockman.

He's just basically a bit of a legend when it comes to the QMH and surgery.

And to get to shadow someone with that much experience

is just...amazing.

Elly's first patient, golden retriever Finn,

is in the waiting room.

We've had him for eight years

and from a puppy.

And he's the friendliest, cuddliest dog,

but I'm sure everybody says that.

But he loves cuddles and loves walks

-and loves everybody and loves every other dog.

-SHE LAUGHS

Finn's recovering from an operation

to treat a dangerous build up of fluid around his heart.

But, mysteriously, fluid is still building up and Finn's struggling.

It's been a bit of a long journey,

but...hopefully, they'll be able to do something about it.

Unfortunately, the dog is still making so much fluid in the chest

that he can't drain it all,

so I think we're getting to the point now where we will want to do a more thorough exploration.

Dan believes Finn's last hope is an operation

to remove the membrane around his heart called the pericardium.

This is a rather unusual scenario and there's no guarantee that what we're going to do is going to help,

but also, in the same breath, the dog can't go on as it is right now.

And if anything's going to work this is probably it.

Hello, Finn. Oh, isn't he handsome!

He was the most beautiful dog. I was sitting there in the consult

and, you know, trying to ask all the right questions,

trying to be all nice and professional for a lovely owner,

and he was just there and his face was like this little golden bear!

He was just...just beautiful, just one of those classic golden retriever...

honey delicious, beautiful squidgy, lovely, lovely dogs.

So you went to the vet's on Christmas Eve? This was again for the breathing?

This was for the... Yes.

-So the heavy breathing?

-Yes.

And Elly finds out that Finn has also had treatment for cancer.

He's had three small mastic sub-tumours removed.

-Were they all over his body, then?

-Three in different places, yes.

He'd been having these recurring problems

for quite a protracted long history by that point

and this was sort of last-chance-saloon situation really.

The best outcome would be that we remove this

-and it results in a fluid production lower that he can cope with.

-Yes.

And, I'm afraid, the worst would be that we do uncover this time

that it's something to do with either his previous mast cell tumours or tumours that have been unknown to us.

-The plan would be to operate on him in the morning.

-Yes.

Good boy. I know you're in the best hands.

What we really need is a haematology, a biochemistry,

a urine sample, should do for now.

Elly's first task, getting a urine sample from Finn,

is a lot trickier than it sounds.

Not many people have experience of this, but you're waiting for your dog to wee.

"Are you going to do it?" You're looking for signs of a leg cocking.

Sometimes there's no leg cocking. You're like, "What am I going to do?!"

And then suddenly, you're like, "Oh, it's happening!" And then you lunge. Get in!

And you hear that lovely tinkle. Game over. Amazing!

The full ticket!

That's a problem, when you really, really love an animal that you've been given

and...you know, you realise they're here for quite a serious reason.

Let's hope it all goes really well for him.

DOGS BARK

So what we've done so far is we've got the blood samples,

the urine samples, everything that we needed,

so the final bit of fluid, if you like, we wanted to gather was some of the fluid from the chest.

So we're going to do that now.

Finn's condition is so severe

his chest needs to be drained daily or he'll suffocate.

Fortunately, Finn has a port sewn into his chest to make the process easier.

-Is this something you've done before?

-No! Absolutely not.

He must be used to it, he has it done every other day.

Obviously with this fluid around his lungs, his lungs can't expand as much as they would do normally.

So by removing this, this is what's going to make him

much more comfortable and much more stable for his overnight stay.

DOGS HOWL

600mls in the end.

And that's in, as you said, just under 24 hours.

Poor thing.

Imagine how much better he feels having that not on his chest.

Finn, onto your bed.

Come on, Finn. Come on! Come on, boy!

Tomorrow morning, Finn will go in for his surgery

and only then will Dan and Elly know whether his condition is curable.

Tonight is the college's careers fair.

Finals may be looming, but passing exams isn't the only thing

student Judy Puddifoot's worrying about.

After five years of not thinking about anything but going to college every day,

it's quite scary, actually, to think that there's a big change just a few months away.

It is actually getting harder and harder for veterinary graduates to get jobs.

You know, if you just flood the market every July with 700 vets,

there's not going to be 700 jobs every July.

So, you know, it is slightly concerning that some of us may not actually get jobs straight off.

Let's go get a job.

It's very busy! There's lots of people there.

Crikey! I'm not very good at selling myself,

so...I'm a bit worried about that.

The room's filled with potential employers and careers advisors.

What's the going rate for a new grad in the South East, then?

-I would say you're looking for anywhere between 25 and 35.

-OK.

But Judy's got her eyes on a particular prize tonight.

She already volunteers with several dog charities

and her dream is to do charity-based veterinary work when she graduates.

I'm just going to go downstairs,

I believe the PDSA are down here, so...

In addition to providing subsidised vet care,

some charities are also a training ground for new vets.

Found em!

We're looking for individuals

-that not only are animal people...

-Oh, yeah.

-..but people people.

-Yes, OK.

-Talking to them about their animal and what's best for them.

That education, because a lot of our clients don't always know how to look after an animal

and that's why they're with us.

On the graduate programme, what sort of conditions, working hours,

out of hours, et cetera, can you expect?

Nine to five, Monday to Friday.

Oh, my God! Right, fantastic!

-No weekend work.

-What?!

-No weekend work.

-Where do I sign up?

I didn't know what to expect, but I got a lot out of it, to be fair.

I'm really glad that I went and the only downside is that I'm going to be really, really upset

if I don't get on the PDSA graduate programme!

SHE LAUGHS

You do notice when you go out to see practice,

that all the vets have got scars on their arms from trying to handle...

-And they can usually remember which ones they came from.

-That was Suzy, that was the pug.

-This was that ex-lap that was quite painful when we woke her up.

-Yeah.

In the hospital this morning, Elly's patient Finn

is being prepped for major surgery to remove his pericardium, the membrane surrounding his heart.

Surgeon Dan Brockman believes it may be causing fluid to build up in Finn's chest.

So at the moment about a litre of fluid is coming out every day,

which is ridiculous, and that's just limiting his life,

it means he can't breathe.

So the hope is that by doing this surgery,

we'll stop that source of this weird fluid going into his thorax.

But if he doesn't have it,

then he'll have to either continually have it drained every two days

or a decision is going to have to be made about his quality of life, really.

Dan's hopeful that today's operation could make a big difference to Finn.

He's eight years old,

so he could have another four or five years of good quality life

if we can get this right.

One, two, three!

Oh, thank you!

-Are you happy for us to cut?

-Yes.

-OK, cutting.

-Going for an incision?

-How are we doing with the sterno saw?

It's called a median sternotomy, you're drilling right through that chest bone.

Finn was on his back and the saw literally went straight through.

And that's big, that's painful,

you're cutting through a lot of bone.

And they'd opened that up and then you could see this heart beating,

which... Whoar! That's a heart right in front of you beating!

So we're actually inside the pericardium there.

Dan can immediately see that Finn's pericardium looks abnormal.

-Well, it's just...this is a massive amount of inflammation.

-Yeah.

Or...something else that is very unusual.

Painstakingly, piece by piece the team remove the abnormal tissue from around Finn's heart.

-One more thing before we go...

-They were just about to close

and Dan was like, "No wait!"

He was like, "Elly, give me your hand."

And he was like, "Just put this here."

And...I put my hand on Finn's heart.

Tell him you had his heart in your hand.

And I can't tell you, I know it sounds really cliched,

but it was such a profound moment.

The strength of that beating,

I might have had a bit of a tear beneath the surgical mask

cos it was just...

I couldn't quite believe it. It did take your breath away.

-All right, we're done. Thank you very much.

-Thank you very much.

Thanks, everyone.

That was quite challenging because there was so much unusual abnormal tissue in there.

We've removed as much of the pericardium as we can,

so I don't think we could have done more.

After three long hours in surgery,

Finn is transferred to intensive care.

Over the next few days, Finn's tissue samples will be analysed for signs of cancer.

It's an anxious wait for Elly and the team.

FINN WHIMPERS

You look a bit sad, don't you?

It's now four days since Finn's operation

and Elly has become a regular visitor to his cage in intensive care.

You can be hopeful! You're so handsome!

I often just try to get in there and keep him company.

I think cos I did it quite a lot,

he ultimately started to get to know me a bit.

But the news for Finn is not good

and it hits Elly hard.

His histology results came back from all the samples we sent off,

from what we cut out inside and, basically, every single one

has cells in it, cancer cells.

It's possibly maybe the end of the road.

ELLY SOBS

In the end, Finn's owners made the difficult decision

to have him put to sleep.

If I fell that much in love with that dog in a week,

they had him for eight years.

It's just heartbreaking.

It's an early start at the hospital for Charlie Tewson.

With so little time left before he graduates,

he needs to make sure his surgical skills are good enough to go straight into practice.

So he's about to start a long and arduous slog in the hospital's surgery departments.

This is the first of a six-week block I've got coming up,

continuous work, early starts, late nights.

And I think sort of socially it... because of the on-call and stuff, it really has an impact on you.

I might be going a bit crazy by the end of it.

And today it's straight in at the deep end for Charlie.

He's working in orthopaedics, where a specialist team of surgeons

treat broken bones and damaged joints

with the help of some hardcore power tools.

So as a kid, I always really liked Meccanos and K'Nex and building things.

And I think the same thing is kind of true...orthopaedic surgery is a lot of carpentry.

It's essentially drilling and banging things back together.

And the first candidate for Charlie's DIY skills

is Ruby the toy poodle who's broken her leg.

Poor Ruby took a nasty tumble coming out of the hairdresser's.

She'd just been to the poodle parlour.

And it happened just as we came through the door.

Yes, we love her very much.

Normally, a broken leg can be treated by a local vet,

but Ruby's broken both of the delicate bones in her foreleg

and because she's so tiny,

she needs the specialist skills of the surgeons here at the hospital.

Without surgery, she won't be able to walk again

and might lose her leg altogether.

These operations, they can take a really long time,

and...it's very important to get them right the first time.

-How is it displaced?

-Mildly?

It is completely displaced, but you can actually describe it in a bit more detail if you wanted.

Orthopaedic surgeon, Richard Meeson, is looking after Ruby's case

and keeping a close eye on Charlie.

Kind of moving through the final year now, so I'd expect him to be pretty good, pretty knowledgeable,

come up with sensible decisions, sensible clinical plans that make sense at this stage.

So, yes, we do expect quite a lot of them, but it's not unreasonable, I don't think.

Ruby's tiny leg will need to be repaired using a metal plate,

but the surgery will be very fiddly, using state-of-the-art technology normally used in human operations.

You are dealing with a very small piece of bone,

and you're actually using the human plating sets

they use to fix little fractures in your fingers or your hands.

With the plan decided, it's time for Ruby to head into theatre.

You're ruining its haircut.

And time for Richard to find out if Charlie's done his homework.

So, have you looked up the muscles that are in that area?

-I've... Yep, a little bit!

-OK.

-CHARLIE LAUGHS

Charlie, if you come round this side.

Ruby's legs were absolutely tiny.

I mean, imagine a chicken drumstick, the bone in that. Imagine that being broken

and you have to put a plate the same length of the bone on it

and...it's a two-person job.

And it turns out person number two...is Charlie.

And his role couldn't be more crucial.

What we need you to do now is to hold this fracture reduced

and then you've got to try and hold it so you can see barely any opening in the fracture.

You've got to hold these in exactly the right place

and it does get tiring, your fingers get knackered.

But you can't move, because you know that Ruby's ability to walk

and make use of her leg is depending on this.

With Charlie holding the fractured bones exactly in place,

Richard positions the metal plate.

If Charlie moves even a millimetre, it could be disastrous.

DRILL WHIRS

-But you only put one or two screws in the compression.

-Right.

Once the screws are in,

Richard invites Charlie to assess the results.

OK, go and have a little feel of the leg, make sure you're looking at it.

That'd be great.

Feels stable.

Awesome!

How was that, Charlie?

It was really good. Yeah, a really exciting surgery.

It was a little bit tricky at points cos it's just so small

and, of course, both me and Richard

have quite big fingers, which can be a disadvantage.

After one and a half hours in theatre,

Richard takes another X-ray to make sure the plate is correctly positioned in Ruby's leg.

If it's even millimetres out

the whole operation will have to be repeated.

You can just about see the fracture, really nicely put back together.

All the screws are in place. Yeah, it looks fine, doesn't it?

Thankfully it's good news for Ruby

and a good start for Charlie in orthopaedics.

The X-ray looked fantastic.

It's good to see that the job had been done well.

It's now two days since Ruby's operation

and time for Charlie to see how she's getting on.

Even though she's got a massive plate in her arm,

she's still loving life and running about.

Ruby! Come on, good dog.

She's started to place it, as you can see. She's putting it down.

She's actually... By this evening, she's well enough to go home.

CHARLIE LAUGHS

She is cute.

CHARLIE LAUGHS

I don't think she's really a dog that I could pull off myself,

but she has got a lovely temperament and she's so fluffy and soft.

CHARLIE LAUGHS

RUBY WHIMPERS OK. Sh!

Hey!

Following her epiphany at the college's careers fair,

Judy's convinced her future as a vet lies at a charity practice.

Today she gets the chance to prove herself,

she's starting a placement at one in North London.

I booked the PDSA placement months and months and months ahead,

because I knew that there were limited spaces

and I knew that I wanted to go.

-I felt like I put even more pressure on myself to be good there.

-DRILL WHIRS

She'll be working under the close scrutiny of head vet Lucy Gardiner.

And Lucy's in no doubt about what she expects from Judy.

That's it, short back and sides. Perfect!

Judy is very close to finishing,

she's not far away from sitting her finals and being let out into the big wide world.

And I'm really just looking for a nice approach with people.

We also want to see that she comes up

with sensible and appropriate treatments.

The other big important thing is obviously practical skills,

taking blood samples, putting catheters in,

knowing how to administer anaesthesia in an appropriate and safe manner.

In this Hendon practice,

a staggering 140 patients come through the doors every day.

And even for an experienced vet, working here would be a test of stamina and character.

-Come here!

-For a student, even one as confident as Judy,

it's a real eye opener.

When I first got there, the moment that Lucy said,

"The doors to the consult room automatically lock behind you."

I thought, "Hello, Toto, we're not in Kansas any more."

This is Riot. He's a pit-staff.

He's got a tattoo. It's there!

Judy's spending today dealing with routine surgical cases.

Jessie. Come on. Good girl!

Next up is staffy Jessie,

who has a growth in her mouth which is causing concern.

There's one or two things it could be.

Epulis, which is an overgrowth of gum, which is fine just to nip off.

Or tumour...which is not fine just to nip off.

With several months' experience behind her,

Judy's grown in confidence when it comes to performing surgery.

But her Achilles heel is maths.

And, unfortunately, the first job Lucy gives her

-is to calculate Jessie's anaesthetic doses.

-Yeah, it is.

Do you want to work out her first protocol for me?

-Yeah.

-And her fresh gas flow rate.

-Right.

-Okey-dokey.

-It's quite simple.

There's that word again, "calculate."

Yeah. Panicking already! Yeah.

'I suppose, because I'm dyslexic,

'I find it really difficult to do mental arithmetic fast.'

Anaesthetic Drugs are potentially lethal,

and any mistakes in calculating them could be disastrous.

This is a skill that Judy needs to get to grips with.

Good girl. She's a good girl!

-OK, Holly, are you happy?

-Yeah.

That was a whole dose, wasn't it?

You tell me, you're the one injecting.

Yeah, it was.

Fortunately, Judy's sums were correct,

and Lucy removes Jessie's growth with a cauterising knife.

Oh, that smell.

Good, OK. That's her, she's all done.

But Judy's next patient, poodle Jake,

is in to have his ears cleaned out.

So he needs an anaesthetic, too.

Do you want to work out a fresh gas flow rate for me?

And this time Lucy needs Judy to work out

the crucial anaesthetic gas flow rate.

Let me just think it through in my head.

Oxygen with anaesthetic gas in needs be given at the right amount,

because if we don't give enough, then they don't get enough oxygen.

It's important that Judy knows how to do this,

which is why we're waiting for her

to think about what she's learnt in the past five years.

I'm trying to...

Don't worry, I'll come back to you.

Come on, Judy!

Even nurse Tempra isn't allowed to help.

-A circle is one.

-Yeah.

Two peaks is 2.5. I'm not telling her.

SHE MOUTHS

An agonising few minutes later, Judy finally arrives at the answer.

2925 to...

-39.

-OK! Do the honours?

-Yeah.

Fortunately, Judy's ear-cleaning skills aren't in question.

Though it's just as well Jake's out cold, because it looks painful.

Oh, mate, I'm so sorry.

Worse is when they've got hairy tongues, it's really horrible.

-Hairy tongues?!

-Yeah.

Sadly for Judy, troubles often come in threes,

and there's one more maths challenge for her today.

Working out a calculation. Don't disturb me!

The next patient is a Rottweiler called Kyla.

And, once again, it's Judy's job to work out the anaesthetic dose.

6ml by ten...

But, for Judy, it seems this is just one calculation too far.

So it's six per ten, we said, didn't we?

-No, nobody's ever said that.

-0.6, sorry...

-No!

The kettle just over boiled, it was ridiculous,

and she kind of just went a bit mental at me.

Right, OK. We've discussed this.

I know, it's written in my pad.

We've discussed this, on more than one occasion,

what is the dose rate of propofol?

JUDY SIGHS

It is... I want to say 6 per 10 kilos.

Nothing is ever per 10 kilos, is it?

Trying to do short cuts when you're new means that you get it wrong.

-Yeah.

-Completely, completely wrong.

-Right.

'She was quite within her rights to be annoyed with me,

'I fully appreciate that and I get it, and it's fine.'

However, queen of sleeping dogs,

I induced all the animals into anaesthesia perfectly,

without any problems.

So it just goes to prove that I can do it, actually.

Just so you know. In case you bring a dog to me!

I can do it.

And with Kyla finally fully asleep,

Judy and vet Lucy can turn their attention to Kyla's sore paw.

Two quite large holes here,

with a lot of serious gangrenous material flowing from it.

And one smaller hole here.

Together, Lucy and Judy flush the wound

and afterwards Judy's expert bandaging skills

even prompt a compliment from the boss.

Lovely! Really happy with that.

Blimey, steady on, girl. Don't go over the top!

Judy may have had a tough day,

but Lucy's unapologetic about her no-nonsense teaching style.

Certainly when I was a student, the things that I remember the most

are the things where I got asked about and quizzed about,

so it helps to get things stuck in your mind,

and it's bits of knowledge that I will never forget,

so thank you to my tutors for that.

-This is revenge now?

-Yeah!

Yeah, I remember some very uncomfortable moments.

"Erm...don't know!"

So, yeah. Yeah.

Is Lucy scary? Good question. No, Lucy's not scary.

She's absolutely terrifying.

Student Dru Shearn is about to start a placement

near his family home in Somerset.

And tonight it's given him the rare opportunity

to catch up with his dad for a quick pint.

I can remember, two and a half or three,

you'd started to bandage the dog's leg.

I can't remember that at all.

You had a little doctor's kit,

one of these little briefcases with bandages and things in.

I think it was your sister's,

-a nurse's kit she'd had for her birthday...

-Yeah.

..and you found it out the cupboard

and you started playing around and bandaging the dog's legs

and you wanted to be a doggy doctor.

And you told the teacher, you announced one day,

"I'm going to be a vet," and of course she said, "Of course you are."

Because everybody wants to be a vet or a fireman or a footballer.

But you said, "No, I will."

And we believed you.

In addition to the pressure of studying hard,

Dru's last few years have been tougher than most

as his mother suffers from multiple sclerosis.

At times, I know he's had an awful lot of outside pressures

with his mum's illness, her health's been pretty poor,

and we reached a point where things became very difficult

18 months or two years ago.

'One of the main reasons that I wanted to do this programme'

was so my mum could see what I do on a day-to-day basis,

cos she obviously... I talk to her about it and stuff,

but she can't physically come and see what I do,

so I hope this kind of programme helps a little bit.

Throw your wellies in the back.

Early the next morning,

Dru's at Garston Vets, a large animal practice in Frome.

He's working under the supervision of practice partner Chris Mangham.

-Here's Duncan. You met Duncan yet?

-I haven't actually yet, no.

Life as a farm vet couldn't be more different

from working in the hospital.

I still think cold, dark, frosty, even rainy mornings is better

than waking up and having to go and spend your day inside the QMH,

where you don't really get to see a lot of sunlight, so...

I agree. I mean, you've got a frosty morning like today, it's nice.

I mean, it's a bit different when it's hammering down with rain,

and you're starting at four in the morning,

and all you're doing is TB testing, but you definitely get used to it.

You've got to kind of work with the farmers and their day starts early.

And there's an awful lot to learn about being a rural vet

and the lives of the farmers they work with.

So even during routine pregnancy checks,

Chris continuously tests Dru on his knowledge.

So, remember what four things I'm looking for?

-So either foetus, membranes, fluid or cotyledons.

-Yeah.

So what can we see here, right in the middle?

So is that a membrane?

-Yeah.

-That's membrane.

-So is that membrane coming across here?

-Somewhere down the bottom, there'll be an embryo. Happy?

-Looks good.

Dru's next visit is to a beef farm with Chris' colleague, vet Tom Cook.

One of the cows here has a badly infected eye

which needs to be removed.

She had an oat seed get stuck in her eye.

So, you know, it's got a secondary infection.

But it is bothering... The thing is it's bothering her.

Oh, quite, yeah, yeah.

I mean, it's not something

-that I want to really allow her to suffer from.

-No, I know.

You know, she's a good cow.

But the eye's so infected that

Tom's unwilling to operate on it today.

-The difficulty is infected tissue won't heal.

-Yeah.

We'll try and give it the best opportunity to heal,

so maybe we'd better try and control some of the infection

before we do the surgery to allow it the best chance of success, really.

We can see there's lots of swelling on the top and the bottom,

and this is where we'd normally cut round,

so what we'll need to do is give her some antibiotics for a few days

to see if we can manage that infection

before we perhaps attempt taking the eye out, really.

It turns out that an eye infection

may be the least of farmer Martin Brown's troubles at the moment.

Because one of his calves

has recently tested positive for tuberculosis.

All of the tenants on this estate, there are four farmers including me,

and between us we've got about 1,000 animals.

And every one of us now has had a reactor,

and we've all been shut down.

What does that mean for you? I mean, what's it meant for you?

Well, we've obviously got no income from the cows,

because we can't sell any of the animals at the moment.

To run this...

A small farm of this size costs me about £6,000 or £7,000 a month,

so we're going to have to rely on our cash reserves to keep going.

Martin's difficult financial situation

means being cautious about running up vet bills.

So it's a blow that the infected eye can't be operated on today.

Yeah, but, you know, we're stony-broke at the moment,

because we've got no... We've been closed down.

We can't afford vet visits at the moment, being closed down.

-So... Well...

-So, I'll have to look at it and let you know.

-Oh, that's fine, yeah, yeah.

-Yeah.

'Money for vet bills is a huge problem on farms,

'you can't always do what you want to do because of constraints.'

So, that is... Yeah, it's a huge problem, for us and for them.

Dru's next visit is to another farm nearby,

where TB is also causing huge problems.

Here, some of the older cows have tested positive,

and farm-owner Carrie is feeling the strain.

We've been under restrictions for, I think, about 18 months now,

and one aspect is it's a massively increased workload,

because my dairy cows are having to be injected

in the same way every two months and there's 500 of them.

Today, Dru and Chris have been called in to TB test 117 calves

that Carrie's keeping in isolation.

We do all we can, really, to make the best of a bad situation,

because TB in the South West is endemic,

and an ongoing issue.

It's quite nerve-racking going onto a farm like that,

and knowing that they have to be clear,

because this is her only source of income left.

Five, five.

Each calf is given two small injections into the skin

which will react within a week if TB is present.

If they definitely have TB,

if it's positive, then the outcome is not good

and they've got to be slaughtered, at the end of the day.

Go on!

HE WHISTLES

Only time will tell if these calves are safe from being culled.

In the meantime, it's been a tough lesson for Dru

about the reality of being a farm vet.

'You feel for them and there's nothing you can do about it,'

that's the sad thing about it.

You can't fix anything, really.

You can obviously help them, maybe bring in measures

that might prevent outbreaks to the rest of the herd,

but generally, there's not a huge amount you can do.

You cross your fingers and hope that you don't get any more reactors.

Yeah, it's a big concern for them,

and it's terrible for us to have to break the news to them.

I do sometimes remember specific owners. They come in saying, "I've been on Google..."

and as soon as you hear that word, you're just like,

"OK, what has Dr Google told you?

-"Probably something bad."

-ALL GIGGLE

In her student flat at the college's campus,

Amy Clithero's getting psyched up

to start her crucial anaesthesia placement

at the Queen Mother Hospital For Animals.

It's one of the harder ones,

but everyone says, "You'll enjoy it," you just...

First week's meant to be from hell, then second week's good.

So, let's just get on with it,

and hopefully, get through it in one piece!

I really don't want to re-sit it!

Unlike humans, animals won't stay still for procedures

like scans and X-rays,

so all graduate vets need to know how to give a good basic -

and safe - anaesthetic.

But learning how to anaesthetise cats and dogs

is only half the story.

Next door in the college's equine unit,

Amy's patient for today, Stuart Little, is waiting for her.

And he's definitely NOT a dog.

It's Stuart's birthday on the 29th February.

So, he is a very special person to begin with.

He is such a character, he is such a big personality,

and he's always been a pet and a friend,

and he's pretty much got us

around his little trotter ever since.

Stuart Little, ironically,

was quite a big sheep that came in.

What he came in for, basically, was he couldn't wee.

So, somewhere in his pipework,

between the bladder and the urine coming out,

there was a blockage somewhere,

and that is really, really painful for animals.

Stuart urgently needs an operation to unblock his urinary tract,

so Amy's going to help anaesthetise him.

But Stuart weighs in at 117 kilos -

that's a whopping 18 and a half stone.

Which means he's roughly twice the weight he should be.

And it turns out, this is no coincidence.

He had a bit of a sweet tooth and he liked his ginger biscuits,

which may have helped to him being such a large sheep, as well.

Supervising anaesthetist Alan Taylor

has some sympathy with Stuart on this.

I quite like ginger biscuits.

Obviously, Stuart Little liked ginger biscuits, too!

So, it's just one of those things.

We don't recommend ginger biscuits for sheep,

that's a wee bit over the top, really.

Just like humans, if animals are overweight,

they're significantly more at risk under anaesthesia,

so the team need to work quickly.

It turns out that Stuart's love of ginger nuts

isn't just making him an anaesthesia risk.

The team think it may have caused his urinary problem in the first place.

If they're getting fed an over-rich diet,

they can get little bladder stones,

and obviously, there's been an accumulation of little stones

and sludge that have actually blocked his urethra,

and stopped the urine continuing to pass down normally.

And so his bladder's got bigger and bigger and bigger, which is why he's ended up here today.

-Ready to do the first incision?

-What suction tape do you want?

Is that urine?

The surgical team cut into Stuart's enormously swollen bladder,

and suck out all the urine and sludge trapped inside -

and there are litres of it.

The oxygenation's low, but it's probably low because of his size.

Meanwhile, Amy and the anaesthesia team

are having to keep a very close eye on Stuart's blood pressure.

Are you a bit worried?

He is slightly hypertensive, so I'm going to give him more fluids now.

On anaesthesia, you don't really get to see much of the fancy stuff

that's going on at the back, but I prefer anaesthesia.

It's more relevant to everyday practice.

With the sludge and stones removed, surgeon Tom Witte closes Stuart up,

and he's wheeled back to recovery.

Because he's so obese,

it's vital that Stuart isn't unconscious

for any longer than necessary.

But, worryingly, he's in absolutely no hurry to wake up.

Come on, mate, come on.

Oh, I know, I know!

Come on.

HE WHISTLES

For safety's sake the team just can't let him snooze,

or the extra weight pressing on his lungs could suffocate him.

So Alan's forced to take a more persuasive approach.

One, two, three!

Come on, mate. There we go.

Come on. Give him the slip...

Shall I get his front end...?

All right, you going to stand for us?

He looks like he's going to fall...

That's OK. I'm holding on to him here.

You have to just...

Sometimes they just need to find their legs.

You'll feel much better standing up, you really will.

That can be the scariest part of anaesthesia,

you know, when they're not waking up how you want them to -

but he was fine, so it's all good.

Come on, Stuart.

A couple of weeks later, Stuart's well enough to head home.

Stu-y!

How does it feel to get him back?

Fantastic!

I honestly didn't think he was coming home.

And there's an added bonus to his stay in the hospital -

he's been on a crash diet.

When he came in you couldn't feel his spine at all,

and you can just...

THEY LAUGH

-..feel his spine.

-I don't think we're taking this terribly seriously!

So, he's gone from 117 to 103, so he's lost a couple of stone.

But even the new slimline Stuart can't get into the back of a pick-up

without a leg up.

You guys lift the front end.

I can't lift the front end on my own!

SHE LAUGHS

Right, OK, where's your hand?

Ready to go?

One, two, three, oof!

ALL LAUGH

He's the Jose Mourinho of the sheep world.

He is The Special One.

Bye, Stuart.

THEY LAUGH

In Somerset, Dru is at a large animal practice

which serves local farms.

But every Wednesday, the vets at Garston

take a walk on the wild side.

One of the things that initially drew me to go to Garston,

actually, was the fact that they serve Longleat, the safari park.

And lucky Dru's along for the ride.

I've always had a massive interest in wild animals

and zoo animals and just exotic species,

so I was really looking forward to getting involved in that.

It's amazing, isn't it?

Like a child in a sweet shop - it was amazing.

But it's more than just a fun day out for Dru,

because vet Chris will be keeping a very close eye on him.

The situations can be a bit dangerous at times.

You know, we don't always have the same control that we would have

with cattle in a race, in a crush.

So I just expect him to follow my instructions

and to get a lot from the day and a lot of experience, really.

Just watch out for the armadillo walking around.

Among Dru's patients are a baby armadillo with a skin problem,

camels that are off their food,

an antelope with a limp...

We'll get her on a course of antibiotics,

see how she responds to that.

..and a constipated skunk.

Last three-four days, no toilet whatsoever.

I was told I needed to stand at the back end,

and I feel like that was orchestrated.

I don't want to go home smelling of skunk.

That's what students are for, you know, the first line of defence.

There's a few of the "pinch yourself" moments,

thinking, "I'm two feet away from a male adult gorilla,

"watching him drink squash out of a bottle

"so we can watch him cough."

Dru's next patient, however,

is going to need something a bit stronger than squash.

We're going to head back to the vet room now,

which is where we keep the guns and the dart gun

and all the dangerous drugs.

This is 14-year-old Saga, who's suffering from sinusitis.

She may look cute, but Dru knows this is just a front.

They are not stripy horses.

They are angry, bitey, kicking...

Chris thinks Saga might have an infected tooth,

so she needs to be sedated for an X-ray.

During his training Dru's done this dozens of times -

but never to a zebra.

So, you remember what it is we're using?

Yeah, we're using M99.

A normal horse, you can put a metal gag in its mouth,

open its mouth up, have a look inside,

and that'll probably give you quite a good idea of what's going on.

But there's not a chance of doing that with a zebra -

you're going to lose fingers, arms.

ZEBRA BRAYS

Zebras can be angry and unpredictable,

and the anaesthetic drug they're using is so strong

it comes with a serious health warning.

It's not to be messed with.

Other mammals seem to cope relatively well,

but humans - it's particularly potent,

and we're talking about a little bit,

aerosolised and in your eye, or scratch your finger with a needle.

And it basically shuts down respiratory

and cardiovascular function,

so, you know, you'll just go to sleep.

With this in mind,

the team keep their distance from the tranquiliser gun.

But 15 minutes later, Saga's still fighting the anaesthetic,

and Chris plucks up the courage to inject a second dose -

this time, by hand.

We've given it a fair old shot.

She's had enough anaesthetic agent

for pretty much half her weight again,

so if this doesn't do the job,

I'll accept defeat and we'll come back another day.

You happy?

I'm pretty happy.

So that's the technical test, is it?

That is the technical test, yeah. An expensive piece of blue pipe.

Fortunately, this time Saga falls asleep

and the team can proceed with the X-ray.

If she wakes up, someone drag that machine out,

cos it's expensive.

Even student Dru's given an important job to do.

120...

It's so exciting to even just go in and take a heart rate from it,

because it's a zebra, and it's still a wild animal,

and it was amazing.

Saga doesn't have an infected tooth, so a course of antibiotics

should clear up the sinusitis.

After just ten minutes Saga's back on her feet -

and fortunately, none the wiser about what's just happened.

Can you see yourself doing this sort of thing?

I'd love to do this sort of thing, yeah!

Who wouldn't?

With the work at Longleat over for the day,

Dru and Chris make one last farm visit -

to check up on the calves they tested for TB last week.

Right, send 'em down, Dru.

For farmer Carrie, it's a tense wait to see if any have tested positive.

Tss-tss-tss, go on. Tss-tss-tss.

HE WHISTLES

They're all clear, no lumps.

So, a huge relief for Carrie - all of her calves are healthy.

That's 117 beef cows have all been TB tested,

and they've all been clear today,

so that's a first step in them being free to be sold.

Yeah, I'm pleased about that.

And it's a good result for Dru as well.

He's really impressed Chris and the team at Garston Vets.

What really sort of sets him apart is that he's got some people skills

and some common sense.

You can't teach that or learn that.

He's the sort of chap we'd be looking for if we had an opening.

For definite.

And a couple of weeks later, Dru receives some fantastic news.

I had a call a couple of days ago, from Chris,

offering me a job at Garston,

which I accepted straightaway and I'm pretty excited.

I can't wait to start working there,

so I just feel really lucky, really, that they've offered it to me,

cos it's essentially my dream job.

So - really, really excited.

It's Judy's second week working at the charity practice

in Hendon, where she's hoping to get a job after graduating.

-Can you hear that?

-Yes.

-Yeah, what does it sound like?

Aeroplane.

-An aeroplane?!

-Yeah.

-I hope not!

But her attempts to impress head vet Lucy have gone awry

thanks to her weak spot - calculating anaesthetic doses.

Completely, completely wrong.

Thankfully, there's no maths today.

She's doing general consults -

vital experience for a vet so close to graduating,

and work which should be well inside Judy's comfort zone.

-How is Frodo?

-Well...same, really.

When they're up at the hospitals up at Potters Bar

they see a lot of very complicated and very specialist things,

but here we see a lot of simple things.

We have a high through-put of cases and a real variety,

so they can basically learn their first-day skills,

which is all-important,

so on that first day when they're out in practice,

they can recognise, they can deal with and they can treat

animals appropriately.

All right! Steady, steady, steady! Frodo!

For Judy, this is a chance to get back into Lucy's good books.

So, this afternoon, I'm going to do some consultations,

hopefully, to see what we've got coming in on computer,

and try and hone my consultation skills

to get it done within the allotted ten minutes' time.

So that's the challenge for this afternoon.

Lovely. Ooh, hello, you!

Judy's next patient, Candy,

has recently given birth to a litter of pups.

-For the past five days, she's been having terrible diarrhoea.

-OK.

She doesn't want to feed the babies very often,

I've got to pick up and put her in there,

-cos they'd be left crying for about an hour...

-OK.

..before she goes to see 'em.

One, two, three, four, five, six.

Wow, that is a lot for a little girl.

-Is she up-to-date with her vaccinations?

-Yeah.

Worming treatment?

About eight months.

-Eight months, OK...

-Is that normal? Is that OK?

Er, they kind of need doing every three months,

-and particularly when they're pregnant.

-Right, OK.

-No, I haven't done it recently.

-OK.

It's a quick consult,

and Judy thinks she's covered all the bases with Candy's owner.

But, as she's about to find out, not necessarily in the right order.

She had diarrhoea but it went away.

Now it came back five days ago, with blood.

So when did she have diarrhoea?

-WHEN did she have diarrhoea?

-Yeah. Initially.

Er, I think just after she'd given birth to the pups.

-Right.

-Then it went away - it's come back again now.

Any other clinical signs that Candy's showing, any vomiting?

-No, no.

-So let's just concentrate on the fact that she's got diarrhoea

-at the moment.

-OK.

-So, that's obviously...

She's not been wormed for about eight months either.

Right, OK.

-Fine.

-That's a bit random, sorry.

-Yes!

-LAUGHS:

-It is a little bit random!

-So just try and get things in a bit more of a logical order.

-Yeah.

It will just help you in the future as well.

Yeah, yeah.

Let's go and have a little look, see what we're going to do.

All right?

Lucy takes over, and Judy can only watch and learn.

She... Is this the first litter that she's had?

-Yeah.

-And any problems with her waterworks?

-Is she struggling to pass water?

-No, that's all normal.

Feeling her tongue, looking her over,

she's certainly not dehydrated at all, her temperature's OK.

I'd like to send her home with some medication now.

-All right, lovely.

-Thank you very much.

No worries.

Just one thing I want to say is,

that was probably the most scatter-gun approach.

-I know.

-So, just try and...

-if you organise it in your head, it just makes...

-Yeah.

..organising your thoughts a lot easier,

-you know, logical, clinical problem-solving.

-Yep.

It's different here -

they've got such a high turnover of consults

that when you present a case,

you have to get to the point quite quickly.

They don't want the whole, "How long have you owned the cat?

"What does it eat? What did it do when it was a kitten?"

As a student that's a little bit more difficult,

because I don't have that kind of experience,

and the knowledge isn't as cemented into my head as it should be.

So, it tends to be a little bit random.

Judy's next ten-minute challenge is Diego the Alsatian pup.

OK. Bye, doggie! Bye-bye!

So, let's start from the beginning,

-how long have you had this little man?

-Er, three weeks.

And how old is he exactly?

He's nearly 12 weeks.

Nearly 12 weeks...

-And is he scratching at these, I assume?

-Yes.

How long has he been doing this scratching for?

-Er...

-Just over a week.

-Just over a week?

Yeah.

All right, if you two just wait here for a couple of minutes,

I'll speak to the vet and then come back, we'll make a plan. All right?

Judy's not sure what's wrong with Diego...

Hello, Diego! Hello, you're a big lad!

..but for Lucy, it's a clear-cut case.

I'm concerned, actually, that you might have mange,

-which is...

-That's what I thought from the beginning.

Oh, I KNEW you'd have to bring the mange up.

Lovely. Great, yeah.

-Grab a seat, I'll give you a shout shortly, all right?

-Bye.

That was pretty classical sarcoptic mange, there.

Yeah, I know how to spot a mange dog now, thank you!

After that.

Do you know what? If something walks like a duck and sounds like a duck,

it's probably a duck - but if you've never seen a duck...

how do you know it's a duck?

Judy's last patient of the day is a cat with an unusual compulsion.

This is Jose.

I've brought him in because he won't stop cleaning himself,

making himself sore.

What do you think it could be?

OCD, I reckon, maybe -

cos he constantly cleans himself, like he's not quite clean enough.

Once he's done one bit and made it sore,

he'll move onto the next bit.

It's like he's got OCD - I'm sure of it.

So is there anywhere in particular where he...

All down the back here.

Yeah. OK, fine.

Good lad.

Right...

This time, there's absolutely no doubt in Judy's mind

what's wrong with Jose.

SHE HUMS TO HERSELF

-OCD cat, Judy?

-Not an OCD cat.

Another acronym.

Judy suspects Jose's suffering from flea allergy dermatitis.

Highly suspicious of FAD, possibly.

It's in the right place, and he's scratching quite a lot.

OK, fine.

I think fleas, until proven otherwise.

In the end, it was quite obvious the cat had fleas.

I even impressed myself on that one, to be fair.

Yeah, absolutely perfect. Well done.

-Good. Thank you.

-No worries at all.

Lucy was quite tough on me, I suppose,

but I think it works, because it pushes you to want to be better,

and want to be as good as she is, and I think that helps you.

And so...thanks, Lucy, you made me a better vet.

And Lucy has forgiven Judy her rookie mistakes -

because it turns out that there's a lot more to being a good vet

than maths and an eye for mange.

She has struggled a little bit on occasions

with some of the calculations and that sort of stuff,

but I think her enthusiasm, her helpfulness,

and her attitude has impressed us,

and Judy really has done an excellent job

of getting involved and becoming part of the team.

And actually I think we're going to miss her

after the end of the two weeks, bless her.

She's made herself quite a little niche.

She's going to be grand, she's going to make a good vet. Definitely.

Right.

I'm going home.

See you later.

Working at the PDSA

is definitely, definitely still on my career list, absolutely.

But, having been through those two weeks,

I don't think for me it's the place I would be most comfortable

starting my career.

I would be ready and willing to work at the PDSA,

in, say, five years from now,

when I've got a few years of experience under my belt,

I really know what I'm doing, and I've honed all those skills.

And can diagnose a scabby dog.

Then, I'm definitely asking them for a job, for sure.

Watch out PDSA, I'm coming for ya!