Episode 8 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 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...

Do it.

..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 SCREECHES

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.

-You're 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!

It's February and our young vets only have a few months left

before their student days come to an end.

In these final few weeks, they must hone the skills they've learned

working in fields, farms and animal hospitals.

Soon, they'll be the ones making decisions about their patients

with no-one to fall back on.

Completely, completely wrong.

-Take a temperature.

-Cool.

Student Charlie Tewson is from a medical family -

he was brought up in rural Norfolk and always wanted to be a vet.

Now, after almost five years at vet school, he's nearly completed

his training and he needs to start thinking about getting a job.

When you tell people that you are a vet student, they say,

"OK, and when do you have to start looking for jobs?"

And for that year, I've been saying, "After Christmas,

"definitely after Christmas." Now we're after Christmas and...

Yeah, everyone is starting to write CVs.

Charlie wants to work with small animals in general practice -

and emergency care is a vital part of this.

So he's chosen to do his next placement in the intensive care unit

at the Queen Mother Hospital For Animals.

It's crucial he does well.

It's a really important skill to know how to manage an emergency

and manage it with a cool head.

Cos if you don't, then animals will die.

Charlie's first case today is Polly,

a three-year-old flat-coated retriever

who was brought in after a serious road accident.

Come on then, Polly!

One leg was severely damaged and her owners, Diane and Mark,

who rescued her 18 months ago, are really worried about her.

She was knocked over by a car or a lorry, actually, and she was

clearly very, very badly injured and her leg was very traumatised.

It was very shocking to see it.

Come on then, Polly!

Her injuries were so severe

that surgeons had to remove one of her hind legs.

Come on then!

That was a major operation

and a terribly difficult decision for Diane and Mark.

My first reaction on discovering that she was going to lose

the leg was, "I don't think I would entertain the idea

"of a dog with only three legs."

But we were reassured straightaway

that a dog can manage very well actually with three legs,

particularly if they've got the front legs still remaining.

And I think eventually, we felt that she needed a chance,

and we would give her that chance.

Come on then! There you go.

-Come on, baby.

-Come on then, good dog.

There was such massive damage and contamination.

She was dragged along the road so she had grit and gravel and dirt,

and it was some hours before we saw her,

which means there's time for infection to set in.

She's coping well with her amputation,

but there is obviously problems with her wound,

the healing's not straightforward, there's complications.

OK, aw.

Polly's already having to learn to cope with life on three legs.

As if that's not enough, her wound has become badly infected.

If it's not brought under control fast, Polly could die.

Even though we put in a drain, the drain got blocked

and because it's producing so much fluid...

It's, basically, that fluid is stopping the wound

from healing as well.

The team decide to try a new technique -

a negative pressure bandage.

This seals the wound and the fluid is sucked away with a vacuum pump

allowing the wound to heal.

If it works, it could save Polly's life.

-I think they are quite hi tech.

-Yeah, you probably don't see them

that often, you might not see it in general practice.

But there's yet another problem - worryingly, the antibiotics

that should be fighting the infection haven't been working.

Basically, some of the muscle that had been tied together

had become so infected that it had then become isolated.

Which meant that basically it was rotting,

and because it had lost its blood supply,

it meant that the antibiotics we were giving her weren't reaching it.

We cut away all the dead tissue, flushed it, which washes away

most of the peripheral infection away, and her temperature's gone

down a little bit, but it's still in a worrying, infective level.

So she's not out of the woods and we're still very worried about her.

Hi, my name's Charlie,

I'm the student who's been assigned to Polly.

Yes, oh, yes.

Diane and Mark are desperate to see Polly...

Aw, she can recognise you.

..and the feeling is mutual.

Good girl! That's a great improvement.

Yeah, and she really does recognise you.

Yeah, she does, yep.

She brings great joy and amusement she is a very happy-go-lucky,

very playful dog, and she makes you feel young.

Aw, this is a really nice change in there.

-Yes, it is.

-She loves to play...

She'll play push ball, 'Polly push', we call it.

'The moment the owners came in, she literally jumped up.

'And you could see how excited she was.'

We've had a real roller coaster of emotions, with her,

you know, just wondering if we've done the right thing.

To be informed that your dog needs its leg amputation

as the only chance that it can survive,

and even then, there's still very many risks,

I think it's incredibly traumatic,

so I think the owners are very brave to confront that.

Polly! Good girl.

Although Polly is thrilled to see her owners,

she's still dangerously ill

and the next 48 hours are crucial.

All Mark and Diane can do is wait.

DOG WHINES

TOY SQUEAKS

I just find that, when you're taking history

and you just cannot get the information you need out of them.

So I had one this week where they brought it to me cos it was vomiting,

and I was like, "Oh, how long has it been going on?"

"Ugh, about six months".

"And how often - are we talking once a month, once a week?"

"I don't really know...

"I can't remember." And I'm like, "Ahhh!"

That's really stressful!

And genuinely, it comes a point where it's too awkward.

-And I had to stop asking and just give up!

-"Just give me a number."

And then of course, the clinician comes in and they give the answer straightaway.

CAT PURRS

This week, vet student Matt Wilkinson is on an unusual placement.

He's in East Sussex, at a mixed practice with a difference.

They are vets to a local zoo.

I mean you can go into work, doing operations in the morning

and then, suddenly, monkeys come in...

So I mean, it's amazing!

The variety that we have here is just incredible.

Here you go!

Matt will be working alongside practice partner Kirsty Turrell.

You're doing very well! Very impressed.

Doing very well and he hasn't got long to go

before he's let loose on the general public!

Matt's veterinary skills are likely to be tested straightaway -

his next patient this morning is a monkey.

MONKEY SCREECHES

The zoo's head keeper Mark Kenward has brought in a red-handed tamarin.

He's covered in some nasty lumps and in a very bad mood.

MONKEY SCREECHES

Sounds like an unhappy monkey!

There we go. All right.

MONKEY SCREECHES

-Oh, you're very noisy!

-Goodness me!

-There we go.

-Yeah, yeah.

So stroppy.

Now he's sedated, the team can take a look at the lesions on his skin.

-They're so demarcated, aren't they?

-Yeah.

Do you want them from directly on the lesion?

Yeah, just take a couple.

Matt takes a skin sample from one of the lumps.

Cheers.

Matt, what are you looking at?

A particular parasite called demodex.

It can get really itchy and cause lesions like this monkey has.

It's actually... I see his legs still moving.

It turns out this monkey has mange.

There, you can see its little feet still moving. There you go.

The best way to treat them is something called Ivermectin.

But Ivermectin can have some nasty side effects to it.

You can get some neurological signs with it or it can kill them.

Often it's the only thing that would get rid of severe demodectic mange.

It's something that you do see in other animals,

but I've never see it in a monkey, so...

Today is a day of firsts for me.

-Bring that with us.

-Yeah.

Despite the tubes, it's still a lot easier

to bath a sleeping monkey than a screaming monkey.

This wash is designed to basically try to decrease the population

of the parasites and hopefully take away those nasty lesions.

The lumps are given special attention.

Now all this tamarin needs is a blow-dry - another first for Matt.

-I have never hair dried a monkey before.

-Really?

How could they not teach you that at college?

They don't, it's a shame, really, isn't it?

I feel like it's one of those things we'll be doing day in, day out

that we really need training on.

When you hair dry stuff, it just fluffs up and these monkeys...

There's just like a big fluffy ball of monkey.

And hair drying monkeys is just for starters.

The next morning, Matt and Kirsty are called out to the animal park

to give some of the other exotic residents the once-over.

Funny little creatures. How cute are they!

The first stop is the penguin pool to meet Slasher,

the zoo's only rockhopper.

He's under the weather and a little bit depressed.

His mate died last year, so he's the only one in there,

he keeps himself to himself a little bit up in that corner.

Being amongst quite boisterous Humboldt penguins,

which we have a number of,

he tends to keep out the way a little bit.

Just over the last week or maybe two,

he's just had a slight disinterest in food which has extended into,

"I don't want to eat at all."

Due to that, he's lost around a kilo of body weight,

which is quite a significant amount for an animal of this size.

I'll bring him to you,

cos there's more people, he might just run in his box.

Here we go!

Kirsty needs to find out why he's off his food.

He's also had quite a lot of problems with his beak.

-Can you see that there?

-Yeah.

-Although it doesn't look as bad as it has done at times, does it?

-No.

Good lad, I know.

-Tongue doesn't look the best, does it?

-No, no, it doesn't at all,

all down that side.

And also, if you look further back, can you see right down there?

-Yeah, is it quite red? Yeah.

-Yeah, it is.

All right, if I hold his beak,

can you just move his tongue to one side for me? Just grab...

This is the first time Matt has been

up close and personal with a penguin.

That's fine. OK. It's all right, it's nothing terrible!

Mm, very cross.

He does feel quite thin though, doesn't he, when you feel him?

-Yeah.

-He's quite bony, isn't he?

I can't feel any obvious lumps and bumps in there, but it's whether

in that mouth there's infection or something more systemic going on...

-Yeah, yeah, sure.

-I mean, you'd obviously worry, in an old penguin,

about his kidneys and his liver

and if that's what causing some of those signs.

-I'm not surprised he's not eating though, it looks really sore.

-No, he smells.

-He does smell.

I mean, they don't smell very nice anyway but...

No, no, he doesn't smell of fish, he doesn't smell well.

-He smells, he smells ill.

-Yeah, he does.

I just wonder if we ought to try and get a drop of blood from him.

-Yeah, OK.

-See what his kidney function is doing.

We can take him up to the hospital, if you need to.

Yep, let's do that.

On the way, Kirsty gives Matt some tips for taking blood

from a penguin.

Is there a wing vein you're taking it from?

Yeah, I do a wing vein, or...a leg.

Oh, you can do a leg, can you? OK.

He's lost quite a lot of condition, lumps and bumps on the abdomen

are always high on the list as well.

And we have had penguins eat silly things.

So they eat - become obsessed with eating stones

or sometimes they'll eat bits of nest-spots and things,

which can cause impactions and obstructions.

So there's quite a few things it could be, but we'll have a

drop of blood from him and see what's going on on the inside.

He came to us nearly 20 years ago,

so he's been with us a long time.

He's a bit of an old boy now.

He's a nice lad, and uh, in situations like this,

he gets a little bit panicked, obviously, as you would.

-Are you all right there?

-Yeah.

Unfortunately for Kirsty, penguin veins are very small -

it's so they don't lose body heat in arctic conditions.

Steady, steady, steady...

It's in the vein, it's just not getting a sample...

Hey, hey, hey, hey!

Slasher's not enjoying it much either.

-Um, let's have one more go on the other side, Mark.

-OK.

Kirsty's hoping the veins in the wing will be easier...

Well done, mate.

OK, right, release that.

Do you want to stick a finger on there?

That's it like that. There you go.

This is all fairly novel to me. Raising penguin veins.

You've got to just try and keep feeding him, really,

try and encourage him to eat something. We'll send that off.

Anything we can give him for his throat looking sore?

You could give him a bit of antibiotic just to settle that down.

'No, I never thought I'd be doing anything with penguins, really.'

This is... I'm totally out of my element here.

The team hopes Slasher will respond to treatment.

Until then, he's not just off his food,

he's also not much of a rockhopper.

Oops, oh, missed.

Mature student Judy Puddifoot is about to start

a two-week placement specialising in small animal internal medicine

at the Queen Mother Hospital, in Hertfordshire.

You know, you think, "Oh, yeah, I'm at the end, I'm nearly done."

And then you think, "Oh, bum, there's loads of things I don't know yet."

I've only got two weeks to learn it!

She will be back working with cats and dogs

and that's right where she wants to be,

but this hospital is the place other vets refer difficult cases

and Judy finds the problem solving side of things a little daunting.

This rotation is a little bit odd.

In that when you're in surgery, you know what the animal's come in for.

But when you're in internal medicine, you have to go on a little bit

of a hunt to find out what's wrong with this animal.

Bit of a two-week medical mystery tour, I suppose, so...

Fingers crossed I can work out some of the mysteries!

Leave it. Leave it.

Wheeey!

Pretty much everything that we've been taught over the last

four years could come in, and we have to know about it,

so it's a bit worrying, really.

I'm actually expecting not to be very good.

Just cos, you know, I always struggled with the knowledge

side of things, retaining it I find very difficult,

which is a fundamental problem on a course like this.

Expect the worst, hope for the best - that's my motto!

Over the next two weeks, Judy will see a whole host

of small animals that have been referred by their local vets

with problems they've been unable to diagnose.

So Judy needs to turn detective -

ask questions, follow the clues and come up with some answers.

The consult that's coming in this morning is Marnie, which is

a nine-month-old Nova Scotia duck tolling retriever,

we get all the exotic breeds coming in here.

And well, basically, coming in with what we'll call

a pyrexia of unknown origin, which is a posh way of saying

it's got a high temperature and we can't find out why.

So yeah, off we go on another medical mystery tour

to find out why this dog's got a temperature.

Marnie's not been very well recently,

for about the last three months, she keeps getting a temperature

and doesn't respond that well to antibiotics or anything like that.

She gets better and then after a couple of weeks, gets ill again.

Good girl, stay, good girl.

She's got a lovely character, she's very friendly,

the kids absolutely adore her.

Marnie looks lively enough, but she's been very unwell.

She'll be given the once-over first by Judy...

Hi, how're you doing?

..before her supervisor Sophie Keyte does her own checks.

-Looking lovely!

-Hello, Marnie, hello!

Right, do you want to come through?

Judy needs to find out what Marnie's mystery illness is

and she needs to impress Sophie.

-Have you had Nova Scotias before?

-Nope, first time.

First time with a dog, first time with the breed.

Wow, you've jumped right in then!

OK, straight in with a Nova Scotia, that's fine.

She gets lethargic, high temperature,

coat loses all its vitality,

and goes dull, tail drops...

Because normally her tail's up.

Is she a scavenger, by any chance?

-Yes.

-She is. Right, OK. So you say that, obviously, she's done it,

-so what sort of things has she eaten?

-Anything.

OK!

She particularly likes wood.

Wood? Has she eaten anything odd recently that you know of?

Not that I'm aware of.

You don't have any pants or socks missing from around the house?

-No, I don't.

-Any little...?

-Nothing like that?

-No.

-OK. Just have to check these things.

What I'm going to do is have a quick physical exam of her,

if that's all right?

She does bury her head like that.

What I'm expecting from Judy this morning,

I want her to be able to kind of correlate together all

the information that the owner gives her,

to form a sort of chronological plan of what's really been happening.

Simon is worried that she has been showing signs of a stiff neck.

When does she do that, do you say, bury her head like that?

If you're just stroking her, rather than her head up,

-she'll put her head down like that, into her chest.

-OK.

Mainly really it's about communication with the owner,

how she formulates her questioning, what questions she asks

and how she then presents them to me.

What I should do then, like Sophie said, is I will pop out,

discuss all the information with her, she'll come back,

probably asks you lots of questions I've forgotten to ask you,

-and then we'll make a plan from there.

-OK, great!

Excellent!

Judy's picked up lots of clues, but as she reports back to Sophie,

it's clear she still hasn't solved the mystery.

OK, so do you want to tell me about Marnie?

So Marnie is an eight-month-old female,

entire Nova Scotia duck tolling retriever.

Been in the owner's possession since eight weeks old,

direct from a breeder.

She is a scavenger, she will eat anything.

-Happy as I can be!

-Happy as I can be!

Let's go have a chat to the owner...

-Hello there, thanks for waiting.

-Hello.

-Hello!

An experienced vet,

Sophie already has an inkling of what the trouble could be,

so she's checking Marnie over to see if her hunch is correct.

Now we're going to play a game, look up at the sky.

-Without sitting down.

-Good girl!

Stay there, good girl.

Oh, good girl!

All the way round?

All right, all right...

Good girl!

The stiff neck is another possible clue,

though it may not be the only problem.

-I definitely wouldn't say she was normal.

-No?

OK, and one thing I was concerned about is

whether she had inflammation around her joints or potentially

around her spinal cord, in a place called the meninges.

Why would that be?

So there is a disease that the Nova Scotias

are, I guess, predisposed to,

called steroid-responsive meningitis-arteritis,

-which is an immune-mediated disease.

-Right.

So it's not a virus or a bacteria or anything like that,

-it's an autoimmune condition.

-Right.

SRMA - steroid-responsive meningitis-arteritis -

can be very serious.

It's what we call an immune disease, so basically the animal's own

immune system is kind of not recognising this problem, this disease,

and it's causing damage to itself, which is not good.

Marnie's admitted straightaway.

Good girl, there you go.

And Judy's kicking herself - although she asked all the

right questions about Marnie, there was one thing she forgot.

What I've taken away from it is Google the breed of dog

that's coming in and see what they're predisposed to.

It's a Nova Scotia, it's probably got SRMA.

Marnie now faces two days of tests, as the clues need to be confirmed.

Marnie has had some bloods taken, we're going to run loads

of tests on that, then she's going to quickly have a cysto, which is,

stick a little needle in her bladder and get some wee-wee, and then

tomorrow she's going to have a CT scan of her abdomen and her chest.

Are we worried? Yeah, we're worried,

because you're just worried about unknown,

if you don't know what it is, then you can't do anything about it.

I'm a bit annoyed obviously, with myself that

I didn't clock straightaway what Marnie had when she came in.

It was quite funny when I had to go out and talk to the resident,

and then present obviously Marnie's case and history, etc...

And she kind of had this smile on her face the whole time,

and I thought, "She's being really friendly,

"this is great, I'm doing really well."

And then I later realised the smile was because she knew exactly

what Marnie had the minute she walked in and it was almost

a test to watch and see if the vet student will work it out or not.

Fail!

It's a busy afternoon at the hospital

and not just the patients who are visiting.

Judy spots a group of fourth-year vet students on a tour

who are about to start their placements.

New blood!

They're so happy today, they'll enjoy this weekend,

then Monday night, they'll be like, "I don't want to do it anymore!"

That's the before, that's the after.

SHE GIGGLES

And Judy still has plenty to do before her day ends.

They still don't know exactly what's causing Marnie's problems

and without a firm diagnosis, they can't even begin to make her better.

What's the hierarchy at QMH?

Animals are at the top, I would say, then owners.

-Yeah.

-Then probably...senior clinicians...

-Residents...

-Residents, interns, cleaners, security...

The crap that the animals do, general waste, um...

Then maybe, maybe...

What are we forgetting? Something else, what is it? I know!

Students.

Yup, students, there we go.

Yup, that's it - that's the hierarchy.

In intensive care, Charlie Tewson's praying

that his patient Polly will pull through.

OK. Come on, Polly!

She had a terrible road accident and the team had to amputate her leg.

Now her wound has become infected

and the bacteria have proved resistant to most of the drugs.

If the situation doesn't improve, they may not be able to save her.

Hey, it's OK!

When we got the culture and sensitivity back,

we basically tested which antibiotics

would work, and were left with only one or two that would be effective.

That was kind of her last hope.

Only when they remove the bandage will they know

whether the antibiotics have worked.

While the signs on the outside look very good with Polly,

you never quite know what's going on underneath.

At the moment, she's got this huge piece of foam in the bit

that was hugely infected and necrotic so underneath that foam,

we don't know what's going on...

In a way, this could be make or break.

So we're just going to change Polly's dressing today...

Hopefully the previous infection will have started to clear up,

So we're looking at the nature of the tissue.

Hopefully, the pyrolant discharge that was there before, the puss,

will have gone, and we start to see pink, healthy granulation tissue.

It's an anxious wait as the surgeon checks for signs of infection.

If it hasn't cleared up, there'll be little they can do for Polly.

Lovely.

-Oh, it's beautiful!

-Aw, that looks fantastic, doesn't it?

Can I get some swabs, please?

It's as good as we could have hoped for, so yeah,

if it continues along this rate, then we should be able to close it

and - fingers crossed - Polly's going to be all right.

I'm very pleased with how the wound looks and next week

we can potentially look at closing the wound,

so yeah, good news for Polly.

And Charlie's equally pleased.

He's clearly become very fond of his three-legged friend.

I think there is a huge difference to studying

something in a textbook to actually seeing it in a live animal.

I felt like I got very attached to Polly and partly

because she was an absolutely lovely dog. Yeah, I was really attached.

Aw.

Charlie's done incredibly well, he's engaged with the owners,

he's really gotten involved in the case

and we hadn't really had to prompt him to get involved.

You got your little party hat on!

Yeah. Very good job.

Where's Charlie?

Oh, there, sorry...

Alison, could you get me out?

Thanks.

Polly's not totally out of the woods, but if things go according

to plan, in a week or so, she will be ready to go home.

Horse-mad Jo Hardy has been riding since she was five.

So Jo will be in her element on her next assignment -

she'll be spending the week at the Bell Equine Centre,

near her family home in Kent.

It's really nice being at home, I absolutely adore my family

and so I just love spending as much time with them as possible.

And also it helps on the weekends because I've got horses

that need to be exercised, so it stops them getting fat in the field.

I feel really lucky to get a placement at Bell,

it's got a really good reputation

and it's one of the biggest ones in the south east of England.

At this equine hospital, Jo will get to work on horses

with all kinds of problems.

Equine is something people associate me with,

because I have two horses, I've ridden all my life,

so I feel really comfortable around them

and I think I've had a bit of a head start with them, because

my horses have caused so many veterinary problems over the years.

And it's a chance for her to prove herself in an environment

where she feels completely at home whatever she's faced with.

They're ascarid worms, they've come out in Albert's poo.

I think these are the cause of him having a high respiratory rate

because they can migrate through the lungs.

It's quite nasty, really!

Today she will be assisting vet Ed Knowles

and trying to find out what's wrong with Hughie -

a valuable eventing horse.

He's had a very successful career so far,

but he's suddenly off his food and losing weight

and years of hard work by the horse and his trainer Alex are at stake.

At the moment, trying to get him fit for our first events in March

is a bit of an issue, really.

He hasn't eaten his hard feed properly now for a few days,

and I'm a little bit worried that he might have gastric ulcers.

So we've brought him in today to have a look,

because this is not normal behaviour for him.

If it is gastric ulcers, then it's treatable and manageable,

so I'm not too disheartened if that is the case,

I'd obviously like it if there was nothing wrong with him.

So you've had him last season, and then...

-I've had him for the last three and a half years now.

-OK.

Hughie's been checked in for endoscopy, where a camera

inside his stomach should show them what the problem is.

First, they need to check him over.

I will have a quick listen to his chest, we'll sedate him.

But as Ed listens to his heart, it's clear that something is wrong.

Could you just take him outside? Do you mind trotting him up for me?

He's just got a slightly funny heart rhythm.

There was a bit of an irregularity, sometimes in very fit horses

that's normal and it goes away with exercise,

but then it could also be abnormal and he could have a heart condition.

So we're just trotting him up a few times

to see if the arrhythmia goes away.

He's actually still got a slightly abnormal rhythm.

I think we probably need to put an ECG on him,

if that's all right. It's that OK with you?

If he does have an irregular heartbeat,

it'll be too dangerous for Hughie to take part in any competitions.

While Hughie's condition is clearly worrying, it's a great

opportunity for Jo to get involved in an unusual case.

-Have you had a listen?

-I have, yes.

-What do you think?

There's definitely some beats missing

and then occasionally there is one that comes in too early.

Yeah.

Any heart condition is potentially dangerous, you just don't know how

it can affect the horse, you really don't want to push a horse

with a heart condition, because essentially,

it could just drop over, so it's really important

that we get on top of this and find out why he's got it.

The team carry out an ECG.

-What do you people think, is it regular?

-No.

-No.

-The baseline's quite coarse and oscillating.

-Yeah, coarse baseline. OK.

What the trace is showing is that

he has something called atrial fibrillation,

which is where the electricity isn't really conducted properly

through the top part of the heart.

And so you can see that because the straight line in between the beats

is actually like a wavy line on the trace.

What happened in his case is that the top part of the heart,

where the atria are, which are the smaller chambers,

they're not contracting in a coordinated way,

so instead of beating all together,

the muscle is just sort of wobbling about like jelly, basically,

so it can't efficiently or effectively pump blood.

Using ultrasound, they look for physical heart defects or disease

which could be untreatable.

That would put an end to Hughie's career straightaway.

So, so far, we've not found any disease of the valves,

not found any structural heart disease.

It's good news that his heart is physically OK,

but to continue life as an eventing horse,

Hughie's irregular heart rate has to be fixed.

There's two ways of doing that -

you can either do it with a drug called quinidine,

which you give via a stomach tube, or you can give the horse

a general anaesthetic and you can use electric shock to convert them.

Quinidine is the first-line treatment for most horses.

-OK.

-OK.

-What's the risks?

HORSE NEIGHS

Quinidine is not a very nice drug, any drug that works on heart rhythms

can work in both good and bad ways, so it can cause getting back to

a normal rhythm or actually could make the rhythm worse.

Hughie's owners now need to make a difficult decision -

whether to treat him or not.

Without this drug his eventing career will be over for good,

but there's a chance the drug could kill him.

In Hertfordshire, storms have left the county flooded and Judy

arrives at her placement at the Queen Mother Hospital an hour late.

Oh! Let's hope this is not an omen of how the day is going to go.

I really hope not.

Judy's first job is to check on her patient Marnie.

She has a mystery illness which they suspect is a form

of meningitis called SRMA.

That can be treated with steroids but first they need to check

whether she also has an infection,

as that would make steroids extremely dangerous for her.

Cos Marnie is going to have a general anaesthetic

to have the procedures, we need to put a catheter in her leg.

So, um, there's a bit of a queue at the moment, for catheters,

so I'm just waiting my turn.

I think she's going to be a bit of a wriggler,

I might need two or three people to hold on to her while we do this.

Yeah, I know! I know it's boring waiting, isn't it?

I'm quite confident in my practical skills, so hopefully,

fingers crossed, we'll get a catheter in without any trouble.

I've done it again, haven't I, that's just an omen. Why did I say that?!

Judy certainly doesn't need any bad luck - she wants to work with

small animals, so this is an important placement for her.

Still, putting in a catheter shouldn't be too difficult.

Good girl, sweetie...

Unbelievable, I knew I'd jinxed it!

It's all right, don't worry.

After two attempts, and no success,

the veterinary nurse takes over and the catheter is in within seconds.

Judy is definitely having a bad day.

I think she was a bit frustrated

because last week, on her rotations,

she sort of did all her procedures first time,

everything went really well,

but we did find that patient did have particularly bad veins.

Oh, Marnie, I knew you were going to be trouble

from the minute you walked in.

There's no time for regrets.

It's on with the next challenge - how to construct a buster collar.

You're looking at me as if this isn't how you do it,

this is how Judy does it.

It'll stay on.

If somebody says to me this is wrong...

I think they usually go around that way - in and out.

What? What?! Like I say, medicine's a steep learning curve.

-Could you just write on here?

-Yeah.

-"Really crap at buster collars."

Come on, don't be silly! Shall we write about the attempted catheter?

No, let's not. Could the word 'attempted' not be in there please?

-OK.

-Could you just write...?

I don't know, I've only got ten pounds on me. Write what you want!

The nurses keep track of how bad we are at things and then

when they grade us, the clinicians come and get the sheets

and read what the nurses have written.

So you have to be really nice to the nurses so they write really good things about you.

-Judy's usually good at the practical stuff...

-OK.

..but nothing's going right today.

I'm just calling really to give you an update on Marnie.

She's doing really well, she's really comfortable,

she'll obviously go and have some of that fluid sampled.

Hello? Hello?

One of those days, isn't it, couldn't get in cause of the floods,

phone was cut off, can't get a catheter in,

can't do a buster collar, I said, didn't I, when I came in,

this is going to set the tone for the day...

Thanks for holding the door!

Judy now needs to prepare Marnie for a CT scan so the vets can

find out whether her fever is caused by meningitis

or an infection somewhere else in her body.

Good girl, Marnie!

This may be a hospital for animals

but its state-of-the-art equipment is similar

to that at a human hospital.

Oooh, good girlie.

But Marnie's not impressed by the sophisticated facilities -

she has more pressing concerns.

She's going to have a general anaesthetic.

She's what? Is she pooping?

They do that. Good girl.

Can you get some tissue paper as well, please? Oh, Marnie!

Could have done that this morning, hey? Sums up my morning.

The CT scan's finally completed

and it's on with the detective work with tests on spine and joint fluid

to confirm or rule out meningitis.

Sampling spinal fluid is notoriously difficult,

but Judy is now going to get the chance

to take a sample from the joints.

For normal joint fluid, it is actually quite difficult to

get joint fluid out, cos it's very viscous and it's hard to pull out.

Nervous.

Bend the joint as much as possible,

then the two bones will basically open up, so there is a space

that you can insert your needle into,

and there should be the fluid...

Fetch the bone then pull back from this very direct bit.

Keep going further in?

Good job. You're getting a bit of blood.

So come back a bit...

Success - finally something has gone Judy's way.

One drop... I wasn't expected that, and it was really cool, so...

That's just stick it in, suck it out and off you go.

It was very good, yeah.

But they've also spotted an unexpected problem.

A lump under the skin not in the skin, under it, subcutaneous,

and I can't really move it.

I wonder if it's an abscess or something.

If the lump is an abscess, it means Marnie does have an infection.

That is going to be a huge problem

for a dog that we need to put on steroids,

because the steroids are in such a high dose that they would

suppress her immune system, which is why we wanted to give them to her.

But you need your immune system to fight any infections.

So if she had an underlying infection, and we gave her steroids

to suppress her immune system, then the infection would've taken over.

The team uses ultrasound to examine the lump

and take some tissue samples.

All of that is in this little bag

and it's all going over to the lab right now.

So hopefully, we can get results back today

and find out what on earth is going on with this dog.

DOG BARKS

Deep in the wilds of East Sussex, Matt is still learning

how to treat zoo animals.

Huh, hi!

Today, head keeper Mark has brought in a northern pine snake

who's very unwell.

He's been losing weight for months

and sadly he may have to be put to sleep.

He has the desire to eat, but he doesn't,

he's not able to hold it down.

You can feel...you can immediately feel how thin he is.

-So if you feel, you can feel the spine really well.

-You can feel his spine right the way down.

The zookeepers bred him themselves and have grown very attached to him.

And he's only 14 years old - these snakes can live far longer.

We've tried everything with him, diet wise and...

We've exhausted every option that we can.

-He's in a pretty poor state, isn't he?

-Yeah.

We probably ought to call it a day, really, I'm afraid.

It was really the end of the road for the snake

and the zookeepers had really run out of options with him, unfortunately.

I think he still wasn't eating and he was just wasting away,

and there wasn't really anything that anyone could do for him anymore.

They'll use an overdose of anaesthetic to put him to sleep.

But first, they need to find his heart to administer the injection.

If you lay the snake out lengthways and cut it into thirds, it's sort of

over the transition between the first third and the second third.

Which apparently is here, so...

Kirsty checks that Matt really has found the snake's heart.

I feel a lump there, actually, Mark, can you feel it?

Yeah, I can, yeah.

And he's got it right.

It's always important that

when you're putting any animal down to sleep,

that they have a dignified ending and they go in the easiest and nicest possible way,

because you don't want their ending to be horrible

and you don't want the owners or the keepers

to have to see something horrific.

All done.

I don't think you're going to be going anywhere now. Sorry, mate.

So thin...really thin.

It's the worst part of this job.

I mean, we always get a lot of comments

from people who come to visit us at the park saying,

"You must have an amazing job" and, you know, we do and...

But, yeah, it's horrible, every time.

I never get used to it and we spend more time with these animals

than most people spend with their cats and dogs, you know,

so it's not work for us, you know, so you never get used to it.

Yeah, it's horrible.

Things are a little brighter at the animal park, where the mangy

monkeys Matt treated at the beginning of the week

are livelier than ever.

But their scabs are still clearly visible.

It's that one there with the little spot on above the right eye.

They'll need further treatment - but first you need to catch your monkey.

MONKEYS SCREECH

-That was impressive.

-It was.

To catch it first time! She's brilliant at catching them.

But I think the fact they've tolerated it so well,

we should repeat it, definitely.

And really with demodex, what you should be doing is bathing them

every sort of ten days or so, until you get negative scrapes.

You have to have two negatives several weeks apart, don't you?

Absolutely, yeah.

But it's going to take a while for those skin lesions to go down,

-but it's a very odd presentation for demodex.

-It's really strange.

But it doesn't look any worse, which is good.

And again it's the logistics - if you've got to anaesthetise them

every time you bath them, it's quite a big deal, you know.

There you go, well done.

MONKEY SCREECHES

Do you want to put him back, Jody?

I think he's really cross!

Today I've learnt so much.

I've learnt so much about these animals,

and it's been really enjoyable.

I didn't feel like I was really doing any work,

I just felt like I was at the zoo and it was really good

because Mark was giving me my own guided, personal tour.

And it's good news for Slasher the penguin -

he's fully recovered from his sore throat.

His appetite has now picked up, he's improved fantastically.

He's actually out in the pool at the moment with the Humboldts,

swimming around and really looking very good to me,

we are really happy with him.

He's recovered his appetite but the jury's out on whether Slasher

will ever recover from his broken heart.

When penguins mate, they mate for life.

But the zoo is on the lookout for a new girlfriend for him,

so Slasher may yet find love a second time around.

-CAMERAMAN:

-What're you up to?

I'm going to see how Marnie's doing, she's still in recovery,

just recovering from her general anaesthetic.

Judy and the team have been trying

to identify Marnie's mystery illness.

What have they done? There.

The good news is she doesn't have an infection.

We had the results back, which has confirmed our suspicion

that she has got this type of meningitis.

She'll probably stay in for a couple of days,

while we start her on some steroids.

They're really good at suppressing the immune system, and because

it's the immune system that's causing all the pain that she's getting,

hopefully the steroids that we put her on will stop the pain.

On the up side, the great thing for Marnie is that SRMA,

in many cases, is totally treatable. It is the kind of disease she's never

going to get rid of it, because it's an immune disease,

probably it will come back,

but again we just put em back on the good old steroids and it goes away

and so, the cycle continues throughout the rest of her life.

Marnie!

Judy's clearly bonded with Marnie.

Now though, she's going to have to say goodbye

and parting with her patients is another thing Judy will have to get used to as a vet.

Yes, you've been through a lot today, haven't you, hmm?

It's been a long day.

And it's not over yet.

Judy now needs to get her own results back

from senior vet Karin Allenspach.

Last hurdle is we have to go and get our grades and well,

our feedback generally, so we're just queuing up to do that.

How's this week been going for you?

-Good, I've enjoyed it, really enjoyed it, yeah.

-Good, OK.

We have good feedback for you.

Don't be too hard on yourself

-because you do know things, don't you?

-Yeah, yeah.

You're just one of these people -

it's a personality thing, I'm guessing -

but you're one of these people who always feels that you need to defend yourself

if you say something wrong and you don't, just because it's Judy.

Well, I just think, you know, I hate getting things wrong and then...

-Don't think, "Oh, no, I don't know that," because you do.

-OK.

Thank you, Karin. Cheers then, see ya!

Clever lady, saw through me, darn it!

But no, it was really good, I was really happy with that feedback.

Judy's brilliant, everyone knows who she is,

she's always willing to help everybody and she's quite a morale booster as well,

because she always comes in with a smiley face.

I think she will be missed, yeah.

I think one of the weirdest patients I've seen, they've got this kind

of ball of fluff sat on their lap, that looks kind of small dog size.

And brought it in, it turns out it's not a dog, it's a racoon!

And they've brought a raccoon in, on a lead into the vet's.

As you do.

And what was wrong with it?

It was just coming in for a health check.

I wouldn't even know where to start!

TOY SQUEAKS

A week on, Hughie's owners have made the tough decision to use

a potentially lethal drug to correct his irregular heartbeat.

It's Hughie's only chance of competing again,

so Jo and the vet team in Kent will need to keep a constant watch over him.

It's a really unusual thing to get to see

and I'm really lucky to see it cos I quite enjoy cardiology.

I like how it all works.

It can be a long process,

we give him a dose of a drug called quinidine every two hours and he can

have up to seven doses so that could potentially be a 14-hour day.

I'm going in at 45 degrees and then down, and then pushing my side out.

Also, the drug that we're giving is really quite a dangerous drug,

it can cause some nasty side effects.

Good boy, Hughie! Well done.

Best-case scenario is that he returns to a normal heart rhythm pretty quickly,

so after a few doses of quinidine,

in which case we would hope he would remain in a normal rhythm

and would have a normal life, be able to continue eventing

which is what the rider's hoping to do with him.

But there are occasional instances

when horses have serious reactions to this.

Worst-case scenario is that he dies as a result of the treatment.

The first dose of quinidine

is administered via a sterile plastic glove,

normally used for rectal examinations.

Because it is not a particularly nice drug, if we have that

in a funnel and he starts throwing his head around and starts

spraying quinidine everywhere, then...it's not ideal.

Yeah, lovely.

-CAMERAMAN:

-Where's the tube going?

The tube goes down into his stomach,

so the quinidine is quite irritant to the membranes

in the mouth, which is why we give it straight into the stomach.

-Oh.

-Good boy.

We had to watch him really closely, he had his ECG wires on him 24-7

and they were connected to a transmitter which gave us

an ECG on the laptop in the office.

What will probably happen is that as the quinidine starts to work,

his heart rate will go up and those sort of teeth, if you like,

will hopefully get bigger, so you have a more coarse baseline there.

So rather than sort of wobbling at a high frequency,

they'll start hopefully to contract with lower frequency

and then you'll start to see proper waves of contraction appearing.

He's looking all right, he's not showing any signs of laminitis,

or a low blood pressure, and even though he's a bit miserable,

I'd be miserable too if I was not given any food

and made to stand still for ages.

He's not looking ill or anything like that yet,

so yeah, he's OK to have another dose.

Good boy! Good boy!

Throughout the day, Hughie's given five more doses of quinidine.

There's no adverse reaction,

but Hughie's heartbeat still hasn't corrected.

-Oh, well, bit more time.

-Yep.

It was a little bit frustrating that he wasn't converting after

so many doses he still had an irregular rhythm.

Overnight the team will try just one more dose.

They can only hope that it works, or Hughie's eventing days will be over.

We're kind of betting on whether he's going to convert before

he needs this next dose, so we're keeping our fingers crossed.

But, yeah, there'll be vets here, all throughout the night

to check on him and to give him more doses if he needs them.

It's been a long wait,

but the next morning there's some good news at last.

After one more dose, Hughie's heart rate finally normalises.

Suddenly we have this change from the abnormal rhythm here,

and then suddenly a very regular beat.

It's like a switch, he was back into normal rhythm and the rate

of his heart was very steady, it was about 50 beats per minute.

-Fantastic.

-And he's remained in normal rhythm this morning.

The drug is working its way out of his system and he's much brighter and happier

-and he's tucking into his food again.

-Oh, very good news.

So very good news for me, yes, very good news.

Everyone was so happy!

It was such a long waiting game, but everyone was so happy

when he finally converted back to a normal rhythm.

Just two weeks later, Hughie is back home at Headcorn, in Kent,

and fit enough to ride.

I'm really pleased how quickly his condition is coming back.

So hopefully that will carry on and certainly his appetite is back,

which is one thing I was so worried about.

It did take a few days after he'd had the quinidine,

but now he's eating, and eating like a horse.

Well, my first thoughts were, that's it, and then to find out

that there is something that you can do about it is great,

and then it has worked so I'm really relieved,

he's a very special horse to me.

Hughie's doing really well now,

he's back to his normal athletic self and back in training

and back competing and his heart hasn't caused him any problems since.

Four months after her surgery,

Polly is very much back on her feet -

all three of them.

We're very happy to have her back. On the 19th February,

we couldn't have foreseen that this would actually be the case,

that she'd still be here.

Push, that's our girl!

Mark and Diane rescued Polly when she was 18 months old

and she quickly became part of the family.

But after the accident, they never expected she would come back home

and certainly not as fit and happy as she ever was.

The only concession that we make is that we don't really want her

jumping in and out of the car so we have a ramp for her now,

cos that saves jarring the remaining leg.

Uh, but otherwise, we treat her as a normal dog.

We have got Polly back, definitely, definitely.

-BOTH:

-Polly, come!

And for Charlie, helping to save Polly's life has been

one of the highlights of his final year.

Yeah, I took quite a lot away from Polly's case

and being able to see how well she recovered from her amputation

was really inspiring for me.

SHE WHISTLES

Lovely, isn't it?

She came in completely flat and life-threatening

and then went home fixed!

Minus a leg.