Although obtaining an accurate diagnosis and then applying a specific treatment are essential components of avian medicine, the clinician must not overlook the importance of supportive care. It is usually far better to have a tentative diagnosis in a live patient than a confirmed diagnosis in a dead one: When the masking phenomenon (hiding signs of illness until the bird is decompensating) is combined with an owner’s approach of ‘waiting a few days to see if he gets better’, the result is often a patient that is presented badly dehydrated, in hypothermic shock and in a catabolic state due to anorexia. Occasionally, some birds will present with severe respiratory compromise, either acute or chronic in onset. In some cases, especially trauma, the patient may be in pain or have experienced significant blood loss. The clinician must recognise the clinical signs of these conditions and deal with them aggressively, often prior to making any diagnostic attempts.