OP: Is there a reason to believe that the IMS isn't recommening the best possible route? You could get a second opinion. Chances are that with bile acids this high still after a month, diagnostics and/or surgery will be needed. If it's an intrahepatic shunt (inside the liver instead of outside - not as common in Yorkies), they won't see it when exploring.
Find a vet that you trust and help them guide you to an IMS that you trust and do what they feel is best.
If I am shelling out money for a specialist, they will be ACVIM/ACVS. It is also important to me to know how successful previous LS surgeries have been for the specialist doing it (in case they decide that's the problem). Not all surgeons are alike in their ability to correct these issues.
__________________ Crystal  , Ellie May (RIP)  , Rylee Finnegan  , and Gracie Boo🐶 |