if it were my dog and my dog has the same numbers i would put on low protein and be done as there really is no need for further testing unless your dog is having symptoms so if my dog was seizing, not eating, head pressing, spaced out after eating then i would do protein c
sadly the ultrasound was a waste of money
this happened to me with pancreatitis as if someone does not know how to read it real well to find a shunt in a toy dog it is really difficult to find and wasted your money as the bile acids, protein c and scintigraphy are more accurate -- my vet wanted me to do scintigraphy with radio active dye with those numbers and i told him NO WAY she is not having any symptoms and i joined two liver groups on yahoogroups.com and after reading symptoms and what liver shunt dogs acted like i decided i was not putting my dog through this unless she was having true symptoms and she is 5 now and she is on temarilp every other day for allergies and she still has no high alt and doing fine but we treat her as a liver dog with any meds, anesthesia etc -- she just had dental and dentist said she did great under anesthesia