Original subtitles

Mac, a dog rushed in suffering from fits, is faring better.

The anti -seizure drugs given to him by Annette worked.

They won't have cured his meningitis, but the immediate danger has passed.

Sorry, he's a bit tired.

I'm very pleased there were no seizures overnight.

So he's doing actually quite well.

The fits may have stopped, but Mac has been behaving somewhat strangely.

Max circling may just be a temporary after -effect of the seizures.

I just closed the door.

Hello, my dear.

Annette calls to update Mac's owner, Alan, who's been desperately worried

his beloved pet.

Hello. Hello, good morning. This is Annette Westman speaking from the

Vet School.

Hi there. Really quite good news for Mac.

There were no more seizures overnight.

So I'm really pleased with that.

So he responded well to the given treatment.

And at the moment, he's circling to the right.

And a bit spaced out as well.

But in general, I'm really happy that there were no more seizures for now.

Okay. How are you this morning, after the night?

Well, it was great.

My wife was quite upset, obviously.

I imagine it's difficult, those things.

Alan can come in to pick up Mac later on today.

In the equine centre, David's about to start a gastroscopy on Timmy, a horse

who's been causing concern for a year.

Timmy's been lightly sedated in advance of the procedure.

We're about to pass the tube all the way up his nose, and then we're going to

swallow the tube, so it's a camera, so it's an endoscope, and then all the way

down his gullet.

We'll go through his thorax and then into his stomach. So his stomach sits a

long way back, so on the left -hand side of his tear.

David will be looking for something that could be causing Timmy pain and making

him hard to ride.

Timmy's discomfort has been a mystery to riders Vivian and Alexandra.

And I suppose that's one of the things, when an empty stomach, the bile mixes

with the acid, and together they're even a bit more light towards the damage, as

they've got empty stomachs for a long time.

This is last meal with a little bit of grain.

Natural contractions help to push the camera up Timmy's intestine.

He's finally gone through his drink today. We're coming to his small

and all that bile, that poppy -coloured substance, the bile that gets squirted

into his stomach.

It looks like David's found a source of Timmy's problems.

He's just got two ulcers damaged to the edge of the sphincter.

It's likely that they are a little bit painful when he's moving forward. Think

about it, it's a really, really strong muscle, the pelvic sphincter. It's

contracting very frequently, so any small ulcer or inflammation there is

significant as a source of pain.

The sphincter is the muscle which releases food from the stomach into the

intestine.

Probably the worst bit of your stomach to have affected.

Because that's where the acid is also very strong, that's what makes it

for them.

Timmy's ulcers will have caused him pain, explaining his behaviour.

Now, David needs to think of ways to treat them.

Catherine's about to operate on Panther, a dog who's in danger of choking to

death because her larynx keeps blocking her airway.

Catherine's going to stitch the larynx to one side.

It can be quite challenging, and particularly if you get a dog that has

lot of fat laid down around its neck, it can make it very difficult to get at

the larynx in the first place.

And because you're working through a relatively limited approach, a

small incision, it can then just make it physically more difficult to get the

sutures in place.

Probably the single biggest problem with this procedure is people

underestimating how difficult it's going to be.

It's also a challenge for Adam, the anaesthetist.

From his point of view, an animal with breathing problems is about as tough as

it gets.

OK, so you can see at the moment she's not really breathing properly.

And that's partly because she was panting beforehand and partly because

just induced anesthesia. So what I might need to do is just help her breathe to

begin with.

So we'll give her a breath.

It's not just Panther's breathing Adam needs to think about.

Animals' eyes will tend to dry out a little bit during anaesthesia because

they're not producing tears and they're not blinking.

So we need to protect their corneas with some artificial lubricant. So any

animal that's being anaesthetised here will get their eyes lubricated.

So you can see how we need to multitask.

Lots of things all at once.

When Panther's owner Angie brought her in, she had no idea Panther would be

rushed into surgery.

A bit worried, anxious, but hopefully we're in the right place to get a good

result.

Catherine's first task is to get access to Panther's larynx and give some tips

to the trainee surgeons watching this procedure for the first time.

She's a bit overweight.

Catherine needs to feel or palpate.

her way to the larynx.

You can feel the wing of her thyroid right in here.

A lot of this surgery is done by palpation rather than by seeing.

This is the point where in the books they talk about being careful not to

off the articular process. This is the point where they're talking about when

you're dissecting it.

So particularly if you try to pull upwards too much while you're

you kind of have to work within the space that's there. If you keep trying

lift things up towards yourself where you're...

You're kind of bending it backwards and that's where you start running the risk

of snapping things.

They're not the easiest procedure to do.

I think they're a real example of why you need to know your anatomy and how

important it is to know your anatomy.

This is one of your classic deep dark hole surgeries.

While Catherine carefully dissects her way to Panther's larynx.

In the hospital kennels, Max sleeps soundly.

The vets are delighted there have been no more seizures.

Neurology resident Rodrigo comes to tell Max's owner, Alan, that Max is ready to

go home.

If you want to come with me, I will explain everything and then I will bring

Max. The staff here have been wonderful, trying to help him as best they can.

But at this moment in time, we're not sure what's going to happen with him

than the fact that I'm taking him home today.

and hopefully we'll get an idea of how he is as a dog and what his quality of

life is going to be like.

Mac doesn't give Alan his usual welcome because he's still affected by the

drugs.

So the thing is he tends to be walking in circles to the right.

Hopefully, if it's only the side effect of having a lot of seizures, this will

start stopping during the next days.

That's OK. Come on.

That's my boy.

Oh, I don't want to stare at him.

He's a good boy.

Shall we go home?

Shall we?

Come on, pal.

Thank you.

Alan will continue to give Mac his meningitis medication at home.

In the operating theatre, Adam's had to move quickly. A few moments ago,

Panther's haemoglobin levels dropped without warning.

She wasn't the most straightforward of cases in the world, it has to be said.

She had a few issues with her blood pressure ending up on a dopamine

which seemed to do the trick.

While Adam monitors Panther's blood pressure, on the operating table,

has reached her larynx.

and is now stitching it to the side of her airway.

This is the other awkward bit of the surgery.

There's no decent guidelines as to what is the right tightness for these.

So it's sort of something you build up, an awareness of sort of what is the

right, how tight is the right tight.

We're not aiming to get it cranked right open. We just want to have a decent

airway for her to breathe through. Sure. So what we're going to do is just snug

it down but not overdo it.

And because we're kind of working against tension in the cartilage, once

got it to the point where I'm happy with, we'll just clamp it lightly so

doesn't come undone.

Okay.

And then get the subsequent knots snugged down onto that. Cool.

If Catherine left the airway too wide open, Panther could inhale food or water

into her lungs.

What we want is to get a comfortable airway that they can exercise and have a

happy life with, but not overdoing it.

OK,

so that's us done.

Right, so let's get all those towel clamps off.

The 45 -minute operation has been a masterclass for the trainee surgeons.

Avoid poking your eye out with that.

OK, so are you looking there? Can you see how that's fixed partially open? So

we've lifted and rotated, so she's now got a nice airway to breathe through. So

that's about what you want to see.

The surgery may be finished, but Adam's care of Panther isn't over yet.

She is being...

sedated in ICU because she's quite an anxious dog and the last thing you want

for these types of patients to be anxious because they get themselves all

up and have major problems with their airways so she's being sedated and the

sedative that I'm using should help her blood pressure a little bit as well so

we'll see what happens when we go through she's not far off coming round

actually

Panther's not out of the woods yet, but her surgery has gone well.

It's a procedure that can be very satisfying to do because there's a lot

distress for owners as the condition gets worse because they're watching

sometimes increasingly frequent episodes where their dog is really struggling to

breathe or possibly even collapsing and semi -choking. So I think it's nice,

even though it's not the perfect treatment because we're not reversing

gone wrong, we're kind of...

We're managing the signs as best we can, so you kind of know you're not doing

something that's perfect, but it makes a really big difference to quality of

life, and that's the most important thing.

Chico's owners, Gus and Liz, have come to the vet hospital.

They've made their decision about Chico.

There could be procedures we could carry out, but we feel the cats have come to

the end of the road. These procedures would be terribly invasive.

and might not give her very much longer anyway.

So we're back today to say cheerio to Chico and have her food to sleep.

She's so thin now and so slim, and she's worn out, so I think it's time just to

let her go.

Ian collects Chico so Gus and Liz can say their private goodbyes.

We'll miss her terribly.

The big gap in her life, definitely, yes.

And she's 17 and a half now, so it's had a good innings.