My advice is to schedule an appointment with an ACVIM diplomat in internal medicine to have your dog properly assessed for a liver issue. I would do this before I did any other testing, including Bile Acids Testing so that the internist can interpret the results An ultrasound can pick up a shunt in some cases but IMO should only be done by a Board Certified radiologist with experience. This would be my course of action if this were my dog.
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