The numbers could've been thrown off by something.
Could you not do any meds or vaccines and then retest a couple weeks later?
Biopsy is not the right way to go for some dogs, especially if the vet isn't in there for another surgery.
Ultrasounds are only 60-80% accurate, so you may not want to go that way.
I would have a hard time dishing out all that money for more testing if the bile acids could be up do to something else.
Then again, I don't want to say to wait and it be the wrong thing.
What is the ALT?
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