[107barney]

Just wanted to chime in again and give you some prices that I've paid for these things in the Northeast.

Superchemistry (blood profile) with urine: $160
Bile Acids study $80
Internal Medicine consult $185
Ultrasound $165 plus $35 radiologist consult fee at a specialty hospital, (single organ ultrasound at regular vet without radiologist $95)

Perhaps the price you were quoted was for a ultrasound guided wedge biopsy ?? I don't know but I'd think $500-700 would get you blood, urine, BATs, ultrasound and that is in the northeast where everything is overpriced.

As for doing to a hospital w/o xrays or a ultrasound, you are wasting money you could use to get answers, in my view. Your money is better spent at an internal medicine consult. My dog also has liver disease and we started with a internal med consult and from there did blood testing and an ultrasound.

It should also be noted that an experienced ultrasound reader (i.e. a board certified radiologist) is the most likely person to pick up a shunt on an ultrasound as it is often not detected even when present.

As for AAI and it's differentials, my understanding from Teddy's neurologist is that a starting point is an oblique lateral xray of the neck, followed by MRI and spinal tap.