After they do the bile acid test, make sure that they do at least a doppler ultrasound, not a regular ultrasound...Regular ultrasounds are generally inconclusive in pointing out liver shunts...Generally a scintigraphy or portography are the tests that they do to check for liver shunt.
Also, if Bogey does not have a liver shunt, he could have HMD/MVD which is managed through special diet, lactulose, and supplements...
If it is an extrahepatic liver shunt, it requires surgery...They do this surgery at the University of Tennessee for around $1600 which includes pre-op testing(ie.scintigraphy and bloodwork), the actual surgery, and post-op care...The vets there are some of the best liver shunt vets in the nation.
I am praying for your sister's yorkie, and please continue to keep us updated!!
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