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Figure 2.3 Clinical reasoning step‐by‐step: define and refine the problem.

Example: the owner reports that the dog is vomiting. Is the animal really vomiting or regurgitating – or perhaps even coughing or experiencing reflux?

When considering the important clinical signs the patient is exhibiting, it is essential to try to define the problem as accurately as possible. A problem well defined is a problem half solved is a good maxim to work from.

The first question to ask is, Is there another clinical sign that this problem could be confused with? This is a vital step, and failure to define the problem correctly has often derailed a clinical investigation that might otherwise have been relatively straightforward.

Other examples include the following:

 The owner says the dog is having fits – is it having seizures, episodes of syncope or vestibular attacks or other strange episodes? (Chapter 8)

 The owner says the dog has red urine – is it blood, haemoglobin or myoglobin? (Chapter 12)