This is my first post here. I joined because I am looking for help to help my sick maltese. He is ten years old. He started acting very odd a short while ago. I took him straight to the vet. The vet told me his symptoms sounded like it could be his liver, thyroid or kidneys. They ran a complete blood count, including full thyroid panel and urine test. It all came back normal except the alkaline phosphate. The vet told me eventhough the alk phos is high its not that high. He told me sometimes alk phos being high can be cushings, but since my dog's is not that high and he doesnt have symptoms of cushings its not that. He told me to monitor him, which I have been doing. He said it could be a behavioral issue. I am sure its not and that there is something wrong with him causing him to act odd. He will be fine and then all of the sudden he will walk back and forth and back and forth. He does this over and over. I get down and talk to him. I'm pretty sure he hears me. Sometimes I will offer him a treat. He most of the time will eat the treat and then he starts the pacing again. He sometimes goes to places in the house he never has gone before and looks very confused. Then all of the sudden he will act normal again. He will be his old self for a long time, then start acting weird again. I know eventhough his tests look good something is not right. Yesterday, I took him to a different vet. She asked me if he was ever tested for a liver shunt. He hasnt been. I dont know much about that. She said his tests dont look like its that, but sometimes bloodwork can fool. She said that considering his breed he should be tested for mvd/liver shunt. She told me its called a bile acid test. She told me to come back and make sure he has fasted for 12 hours before the test. I came home and read about liver shunts. It all looks confusing to me. From what I read on the forum it looks like the bile acid test is used to confirm liver shunts in puppies? What about old dogs? Is that the right test? Also, can a ten year old dog all of the sudden have a liver shunt? He doesnt have diarhea or vomiting. He loves to eat. So far all of his syptoms seem nuerological. Also, I read that most of the time the alt in the blood work is high. My dog's is normal. Please forgive me for asking so many questions. We are just looking for answers so we can get our baby the right tests to get him the help he needs. I also want to add he seems very noise sensitive. Any advice would be appreciated.