A 12-year-old male severe macaw presented for acute onset of polyuria, regurgitation and lethargy. A complete conventional examination and diagnostic profile were performed, but no definitive diagnosis was obtained. Enrofloxacin and supportive care were prescribed with no resolution of the presenting symptoms. Acupuncture and herbal medication were added to the birds’ therapy. Gradual improvement was noted over the next 48 hours with complete resolution of clinical signs within 72 hours. This case demonstrates the benefit of an integrated approach to treatment in a case with no definitive conventional diagnosis.