I would never buy another maltese (or yorkie for that matter) without having the results of bile acid tests. I personally think that a breeder who demands that their dogs are healthy and therefore don't need this test is being closed minded. While that may very well be the case, what would be the harm in having the extra piece of mind. The bile acid test is the best indicator of possible liver shunt/MVD without having to opt for an invasive option, such as a biopsy. And, a blood panel would not be enough for me as we have seen other dogs with normal blood levels (ALT) and they still have high bile acids. There are several great breeders out there, I would say to keep looking until you find one that is willing to work with your needs. After all, YOU are the one that has the responsibility of dealing with this once the puppy leaves the breeders hands. And once you get attached to a maltese, there is no giving them up should they become sick one day, or "trading" them for a healthy pup. I would say most everyone just deals with the heartache and takes care of their baby.