A 7½ years old domestic shorthair feline was presented for treatment of feline hyperesthesia syndrome limited to the left side of the patient. The cat had a medical history of enucleation of the left eye at 3 weeks old, followed by debridement of the surgical site one year later due to chronic drainage. Previous treatments included gabapentin (halted due to adverse reaction), and dry needle acupuncture every two weeks for 3 years, which had provided only limited pain relief. At presentation, the cat had not been treated with acupuncture for several years and had subsequently developed severe self-mutilation of the left ear and left paralumbar region. Initially, the patient was highly irritable accompanied by aggression and would not allow acupuncture. Craniosacral techniques were allowed by the cat, and over a period of time this was followed by progression to acupuncture (dry needle, aquapuncture) and myofascial releasing techniques around the left eye. This approach provided rapid improvement in the hyperesthesia clinical signs of the patient. This case report describes the use of multiple modalities (acupuncture, Chinese herbal medicine, myofascial release, craniosacral/spinal manipulative techniques) to greatly improve a chronic complex clinical case with a difficult to treat syndrome.