[Ellie May]

The BAT itself isn't too bad but the high ALT would make me nervous.

While I might be talked into an ultrasound in this case, I don't think it is the best way to go. Why don't they do scintography or are they looking for bladder stones? If a scintography shows no shunt and the vet thinks it's MVD, there is really no good reason to open her up for a biopsy that I know of. It would probably be a good idea to do one when she is spayed though...