Q: Your German Shepherd may have a hard time pumping blood throughout his body if his aorta is deformed. The aorta is the main artery leaving the heart. If the valve into the aorta is narrowed, as in AS, a backpressure is created in the heart making your dog work harder to circulate blood. Medication is the most common treatment for AS, which treats the irregular heart rhythm and may include antibiotics to prevent infection. Surgery is not recommended. Your German Shepherd may have a heart deformity that's causing a heart murmur or another health condition (like problems eating or with blood circulation). These deformities may include:  Patent ductus arteriosus (PDA): This is a temporary blood vessel in a fetal puppy that should close shortly after he's born. If it stays open, blood may bypass your dog's lungs. Vascular ring anomaly (also known as persistent right aortic arch): This is another blood vessel that should close before your dog is born. If it stays open after birth, the vessel traps your dog's esophagus which makes it hard for him to swallow food down into his stomach.  Mitral or tricuspid valve disease: These valves separate the heart's atria from the ventricles. If they don't fit perfectly together, then blood can leak in the wrong direction, causing a heart murmur. If your dog has abnormalities in the heart muscle itself, he may have dilated or hypertrophic cardiomyopathy. With Dilated cardiomyopathy (DCM), the heart muscle tires and becomes baggy. With hypertrophic cardiomyopathy, the heart muscle thickens, causing the chambers to get smaller and hold less blood. Treatment usually focuses on improving your dog's diet and exercise habits. Most vets don't recommend surgery unless your German Shepherd develops congestive heart failure. Older German Shepherds are prone to a vascular tumor (hemangiosarcoma) that attacks the vessels lining the heart. This tumor is the most common type in dogs and usually isn't noticed until it gets big enough to cause complications. Your dog may have abdominal swelling, irregular heartbeat, and anemia. Treatment for hemangiosarcoma is difficult. Veterinarians usually recommend chemotherapy and possibly draining the site of the tumor. Because the tumor is on the heart, treatment may only be able to add a few months to your dog's life.
A: Consider if your German Shepherd has aortic stenosis (AS). Think about whether or not your dog has heart defects. Think about if your dog has cardiomyopathy. Consider if your dog has a tumor.

Article: Avoid using strong soap, cream, douches, powders and sprays.  These products may increase the chances of contracting a UTI during pregnancy.  Take a shower rather than a bath. If you must bathe, avoid taking more than two baths per day or bathing for more than half an hour at a time.  Avoid bubble bath or bath beads, which can inflame the urethral opening. Make sure the tub is cleaned and rinsed well before taking a bath. Holding your urine keeps bacteria in your bladder longer and gives it a greater chance of developing into an infection.  Take care to completely empty your bladder during each trip.  Remember that the pressure of your growing uterus may complicate this practice; you'll need to carefully consider whether you're actually done urinating.  Blot dry with toilet paper and do not rub your genital area. Wipe from front to back every time.  Treat constipation properly as soon as possible. Wash your genital area with warm water before sex to eliminate bacteria.  You may use a water-based lubricant during sex. You should not have sex if you are being treated for a urinary tract infection.
Question: What is a summary of what this article is about?
Keep your genital area clean. Go to the bathroom as soon as you feel the urge. Go to the bathroom before and after sexual intercourse.

Q: Sometimes we just need a little reassurance and a friendly voice to help us relax. If calming yourself does not work, try to call a friend (if a friend is available). Hopefully, the soothing voice on the other end of the phone will help put you at ease and help you get to sleep.  Make sure to call someone who is already familiar with your anxiety problems so you won’t need to explain your situation. Try talking to a friend who will only listen and not add more to the conversation. Talking to someone who will make you worry more will not help you. Always make sure to call your friend the next day after you’ve settled down and thank them for their time. One way to get to sleep when anxious is to take melatonin supplements. Melatonin is a chemical that naturally occurs in our bodies and helps us go to sleep. If you’re lucky, a little melatonin will go a long way and put you to sleep in a jiffy.  Melatonin is sold over the counter in 1, 2, 3, and 5 milligram tablets. Talk to your doctor or pharmacist about using melatonin before you take it. Do not take melatonin with alcohol or other controlled substances. If your anxiety is consistently undermining your ability to get to sleep, you should talk to a medical professional. Your doctor should be able to refer you to a specialist or diagnose your problem.  If anxiety undermines your ability to sleep consistently over a short amount of time, make an appointment with your doctor as soon as possible. Be truthful and honest with your doctor about what is causing your anxiety. If appropriate, seek help from a psychologist or psychiatrist. A doctor might put you on anxiety medicines or prescription sleep aids. One way to deal with persistent anxiety that interferes with your sleep is to get professional mental health counseling. A mental health counselor (whether a counselor, a psychiatrist, or a psychologist) will talk to you and help you identify the source of your anxiety.  Psychiatrists might choose to treat you with medication. Many counselors or psychologists will allow you to talk about your problems and work through them in a structured environment. Some counselors might choose cognitive behavioral therapy, a technique widely used to treat anxiety. If you’ve got a pet in your household, you may want to consider recruiting them and stationing them nearby to make you feel relaxed and loved. Who knows, your dog’s snoring might relax you and help put you to sleep.  Lure your dog nearby with a treat or a bone. If it’s okay with you, invite them to sleep in the bed with you. Try to get your family cat to snuggle with you. It is possible that your cat’s purring might soothe you and put you to sleep. Relocate yourself to the vicinity of your gerbil or ferret’s habitat. Just being near a cute little animal might help to relax you and relieve your anxiety.
A:
Call a friend. Try melatonin supplements. Talk to your doctor. Seek mental health counseling. Recruit the family pet.