A Protein C test will help determine if it's MVD or liver shunt. MVD is tiny shunts throughout and is inoperable. If the ultrasound clearly saw an extrahepatic shunt, then the surgery should be done.
The Protein C test is relatively inexpensive though and will help decipher between MVD and liver shunt. This would be the next step before surgery.
OR a scintigraphy, but it's more costly.
BAT results under 100 are more indicative of MVD whereas numbers above 100 are more indicative of a liver shunt.
That being said, it's important to note that these are only guidelines.
I have seen cases where a dog with numbers under 100 have had an extrahepatic liver shunt, and I know of dogs with numbers above 100 who have had MVD.
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