This retrospective study aimed to evaluate the efficacy of traditional Chinese veterinary medicine (TCVM) in treating canine heart failure. Thirty-six dogs with heart failure were included based on the following criteria: (1) poor response to Western medicine (WM) after 4 weeks or owners opting for TCVM; (2) treated with TCVM for over 3 months; and (3) had heart ultrasounds before and after TCVM treatment. TCVM treatments included acupuncture and Chinese herbal medicine, tailored to each dog’s TCVM pattern diagnosis. Chinese herbs used included Shen Calmer, Heart Qi Tonic, Breathe Easier B, and Su Zi Jiang Qi, aimed at tonifying Heart Qi, stopping coughing and calming the Shen. Acupuncture points such as BL-15, CV-17, and PC-6 were used to nourish the Heart and alleviate clinical signs like panting and coughing. The outcomes were assessed by improvements in the clinical signs (fatigue, cough, panting, sleep) and ultrasound results [left atrium-toaorta ratio (LA:Ao ratio), mitral valve regurgitation]. The mean (SD) overall clinical score significantly improved from 6.22 (SD 2.66) pre-treatment to 1.42 (SD 1.70) post-treatment (p=2.9×10-11). The LA:Ao ratio decreased from 1.92 (SD 0.32) to 1.67 (SD 0.22), with 36.1% of dogs achieving normal LA:Ao values (p=9.3×10-10). All individual clinical signs showed statistically significant improvement (p<0.001). These results suggest that TCVM may be a beneficial alternative or rescue therapy for canine heart failure when WM is ineffective. Further studies are needed to confirm these findings.