![]() ![]() Our visiting nurse notified her GI last week, who only recommended that she up her daily 15ml of Lactulose to 30ml daily if she is having less than 2 bowel movements per day (she was constipated when she had the bouts of confusion). She was prescribed 15ml daily of Lactulose in April after blood tests showed ammonia levels were high (though we hadn’t noticed confusion, just extreme fatigue), but it looks like that is a low dose. She seemed to realize a minute later that we don’t have another dog. Since the consultation (literally 2 weeks ago), she has had a few episodes of confusion, once she asked me where our other dog was. She was confused briefly after she got out of the hospital, but she hadn’t said anything strange to me that made me suspect HE (though she is tired all of the time and seems “different”-she doesn’t seem like she enjoys things and seems depressed, but she has been in a wheelchair since May after the sepsis, even though we have been getting PT), so I explained to the doctor and he did not think a few days of confusion after a hospital stay was a big deal. He also asked if she had any episodes of confusion. He also explained the risks (strain to heart, increased risk of HE, etc.). We had a consultation for a TIPs procedure recently and the doctor explained that she wouldn’t be a candidate for a liver transplant due to her age, and that she is not an ideal candidate for TIPS with a MELD of 17 (unfortunately, they also found a blood clot in her liver in June, though the IR doctor who gave the TIPS consultation thinks they may still be able to do the procedure), but that it may help get rid of or reduce the fluid and help her process nutrients more effectively. We never got a MELD score when she was diagnosed or during her May hospital stay, in June when she was admitted to the hospital they said her MELD was 22 upon admit, when she was released it was 17. She did have major edema in her legs before her June hospital stay, which seems to have gone away). After that hospital stay, they switched her diuretic, set her up with biweekly paracentesis procedures (the most she has gotten was 7 liters out in May and June, last week it was 4 liters so I’m not sure if the different diuretic makes a minor difference, though that's still a lot. ![]() She had a week-long hospital stay for the ascites and sepsis (related to the wound in her foot) in May, and another week long stay in June due to ascites and acute kidney injury (the hospital stay happened right after her GI doctor had upped her Lasix, I had wondered at the time if that was too much for her and affected her kidney numbers). Her primary symptoms seem to be extreme fatigue and weakness, also she does have ascites and did get sepsis from a minor fall that resulted in a wound in May. Hello, my 72 mother was recently diagnosed with cirrhosis in March. ![]()
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