8 year old FS Aussie.  Blood work has shown elevated liver values – 3/30= ALP 201, ALT 726, T bili 0.3.  4/8 ALP 234, ALT 623, T bili 0.7.  4/22=ALP 222, ALT 406, T bili 0.7, T bili unconjugated 0.4 (0-0.2), T bili conjugated 0.3 (0-0.1).  Has been on ursodiol and amoxicillin since the 8th.  Has  been on mild thistle and another liver support med for longer.  I am not able to trace the common bile duct (lots of panting and nearby gas shadowing from stomach), but not seeing any distended biliary ducts, free fluid or thickened GB wall, so leaning towards rec

8 year old FS Aussie.  Blood work has shown elevated liver values – 3/30= ALP 201, ALT 726, T bili 0.3.  4/8 ALP 234, ALT 623, T bili 0.7.  4/22=ALP 222, ALT 406, T bili 0.7, T bili unconjugated 0.4 (0-0.2), T bili conjugated 0.3 (0-0.1).  Has been on ursodiol and amoxicillin since the 8th.  Has  been on mild thistle and another liver support med for longer.  I am not able to trace the common bile duct (lots of panting and nearby gas shadowing from stomach), but not seeing any distended biliary ducts, free fluid or thickened GB wall, so leaning towards recommending continuing medical management for several months, adding in enrofloxacin.  Given the appearance, I don’t think this merits surgical consult at this time.  Thoughts?