Okay, back from researching... I think your dog has multiple issues. Polycystic Kidney Disease is congenital and at his age may be getting worse. Also, is he being treated for Valley Fever (fungal disease)? Is he on a prescription Kidney diet?
I think your vet is looking for liver problems, but the kidneys can also cause a high ALKP. The fact that the ALKP rises when he's off the Fluconazole may point to the fungal disease being very active and possibly affecting the kidneys. Also HBP can be a result of kidney problems.
Beyond this little bit of info, IDK. I would get him to a Nephrologist and an Infectious Disease Specialist ASAP, preferably at a vet school.
IMHO, I don't think this at all has anything to do with the liver, or shunting, etc... I think the main concern is the kidneys and the fungal infection, and that these, in turn, may be affecting the liver.
I highly recommend getting him to a vet school ASAP, as all the specialists are there in one place and they will get to the root of the problem quicker than you running from vet to vet. |