Sounds like you made a good decision. With a number like 43 and no plan to spay, then the answer is pretty easy. Too invasive. But if they already have the abdomen open, I lean toward doing it. There is extra risk, but there are more answers too.
My dog's post BAT was just 4 points higher and we did do a biopsy at time of spay. I don't regret it at all. My only regret is that only one sample was taken instead of several. Her liver may be a bit pale, so that tells me perhaps something is going on not just locally. The biopsy did NOT show MVD (and Dr. Powers at CSU interpreted it - I've heard if it's there, she will find it..). So unless Ellie has localized MVD, then she has high bile acids (gone up to 106 since) for another reason. I think in the case of hepaticlipidosis (not common in dogs), they can present with high bile acids but the management for it and MVD aren't the exact same. So jmho, if a vet is in there anyway and wants to biopsy, I let them.
Hopefully it will come back with just a mild case of MVD and she will be able to be medically managed for life.
