[Ellie May]

This case has always confused me too. If the blood hemolyzed, the BAT could be redone. The longer you wait to fix a shunt, the riskier it can get. All suspected liver shunt should be looked into by an internal medicine specialist.

In the case of very high bile acids, my girl's vet insisted on a specialist. Most general vets are good at what they do, but they aren't trained to handle this. They aren't trained to assess whether or not surgery is the best option. After an IMS sees a pup and says no surgery needed or whatever, then a general vet is usually able to manage the problem knowing what they are dealing with. The bile acids are really too high for just a general vet to be involved imo.