In traditional Chinese medicine (TCM) Five Element theory, the Fire Element has two Zang organs, the Heart and Pericardium. According to TCM Zang-fu physiology, the Heart stores the Shen. A Heart imbalance can cause improper Shen storage and clinical signs such as anxiety, insomnia, vivid dreaming, irritability or hysteria. In traditional Chinese veterinary Medicine (TCVM) a Shen disturbance is often due to a Heart Deficiency and Deficient Heart Blood is often part of the pattern. If the Shen imbalance is due to agitation from the presence of pathogens like Heat, Phlegm or Stagnant Blood, removal of the pathogens is often enough to re-balance the Shen. Common TCVM patterns causing Shen disturbances in dogs and cats include: Heart Blood and Yin Deficiency, Heart and Spleen Qi and Blood Deficiency, Global Qi and Blood Deficiency (Dual Vacuity Pattern), Phlegm-Fire Disturbing Heart, Phlegm Obstructing Heart, Heart and Kidney Fail to Link and Kidney Jing Deficiency (Essence Insufficiency). The typical historical and TCVM examination findings for each pattern are reviewed and suggested acupoints, Chinese herbal medicine, Tui-na therapy and Food Therapy are outlined.