Patients with respiratory distress are, regardless of the underlying cause, emergency patients and the initial approach to these patients determines prognosis and survival. Animals with respiratory distress are stressed which makes most diagnostic procedures impossible or counter-productive. By localising the respiratory problem using the initial clinical exam of the animal, the clinician can narrow down the causes of respiratory distress. Looking at the type of breathing, type of dyspnoea and using auscultation findings and information from the history, the problem can be localised, limiting possible differential diagnoses. This allows institution of not only supportive measures such as oxygen supplementation, stress-free handling or analgesia but also a more specific therapy of the problem causing respiratory distress. The stabilised animal can then undergo further diagnostic procedures and receive specific treatment.