I've actually found that most regular vets are not that knowledgable about liver shunt and don't even know that it could be a real possibility.
When my yorkie was a pup, he had all the signs pointing to liver shunt and we took him to the emergency vet and told her our concerns because he was doing so terribly. She literally told us that it was "not possible because he's too young"...Can you believe that?!? They're born with it...
Anyway, it's better to be safe than sorry when it comes to liver shunt. The earlier you catch it, the better off the dog will be. If it takes a long time to diagnose, the liver gets damaged with each and every day that goes by that it's not receiving liver support.
Also, keep in mind that although a dog may not have an extrahepatic liver shunt, many dogs with elevated bile acids do have MVD...
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