A 14-year-old female spayed Papillon with a Grade II/VI heart murmur was presented for traditional Chinese veterinary medicine (TCVM) treatment of suspected canine cognitive dysfunction syndrome (CDS), and concurrent heart disease. The dog exhibited evening anxiety characterized by pacing, barking, and panting. Prior conventional treatment had been unsuccessful, and the owner declined further Western diagnostics and therapeutics. TCVM evaluation of primary owner concerns supported a pattern diagnosis of Heart Yin and Blood Deficiency with Shen Disturbance. This was paired with Root (Ben) patterns of Liver/Kidney Yin Deficiencies, Liver Blood Deficiency, and Liver Qi Stagnation. Treatment consisted of acupuncture and Chinese herbal medicine formulas (Shen Calmer, Sheng Mai Yin, Heart Qi Tonic) with adjunctive home-based therapies of Tui-na and food therapy. Clinical improvement was observed after the first treatment session, with approximately 90% resolution of behavioral signs by three months. Additional support of Spleen Qi and Kidney Yin/Qi was incorporated using food therapy to nourish Post-natal Essence and conserve Pre-natal Essence for geriatric wellness. This case highlights the potential clinical benefits of utilizing TCVM to treat behavioral manifestations consistent with CDS, particularly those associated with Heart Zang-fu organ imbalance in geriatric canine patients.