[Ellie May]

My dog had near normal enzymes when we realized she had a liver problem. Her bile acids (post) were high. She had no symptoms on a daily bases. Looked healthy.

Medical management was approved as appropriate for her by her IMS. She felt that Ellie was in no danger and that we should watch what drugs are given very carefully, give Denosyl if we felt like it, etc. Her regular vet agreed that she did not appear to be in danger. Her preprandial bile acids were only slightly elevated once. She had a liver biopsy. So while, yes, her bile acids were up and she appeared to be totally healthy, her IMS felt that she was okay. That can't be said for Lucy, unfortunately.

So if the bile acids go down in 6 weeks, are you supposed to assume that they are going to stay down or do you keep retesting? By the time put all that money into continuously testing bile acids, you could have a diagnosis... If they do come down some and it's decided to retest in 6 months, what happens if they went back up and were elevated all that time (all the while the IMS thinks more needs to be done).

L/D and Denamarin are not wrong, but they are probably wrong for Lucy if the IMS has recommended otherwise. They don't recommend invasive procedures for no reason. I'm confused why this protocol wasn't started last month. It also doesn't seem that the specialist has done anything more than a regular vet could have so far, so why dish out the money for a specialist and not do what they suggest?