[Ellie May]

I would do what my general DVM wanted me to do... If she gave me options, (with a post of 22), I would choose between them. If Gizmo does have MVD, that is important to know because anesthesia and analgesia protocols would be tailored to meet his needs. However, even if you go to a specialist, if the liver looks fine on U/S with a post of 22, they almost certainly won't do the biopsy to confirm anyway (well, maybe they will - but I don't think that's a great idea in most cases).

Anyway, I'd be interested to see what the liver enzymes are doing in a few days. Depending on how high they are elevated, you'll need to know if they went back down. Young dogs shouldn't have high liver enzymes. There is usually a reason. It could have been just the liver getting irritated from intestinal issues, but you need to make sure they go down. I know the first r/o around here lately in young dogs with unexplainable liver enzymes is lepto. Doubt he has it, but it's the major thought here now... It's coming up quite a bit.

Do what your vet thinks. If I were in this case, no way would I pay for a U/S at a specialty hospital, but my vet would probably agree with that choice. Also if this is where I think it is, they are a very, very, very good specialty hospital and I loved E's IMS, but I didn't feel like they are great with the liver or anything and I didn't really like some things there. If I had to do the diagnostics over again, I'd probably just head to MSU personally. Maybe I should word this another way.. I felt like a good job was done on the U/S, but the conclusion that was reached I could have reached myself. Just wouldn't be excited to take another liver compromised dog there.