Raised liver enzymes and bilirubin

Hi vets, looking for advice. 12 year old male cross breed (jack russell x poodle)  neutered dog. Took him to the vets to have<span style="-webkit-tap-highlight-color: rgba(0, 0, 0, 0);"> </span>a few lumps removed in feb (all benign). The pre op bloods came back showing elevated liver enzymes. Since Feb he has been on antibiotics and different liver support tablets and has had the bloods repeated- the enzymes have increased every time. I’ve had USS and X-rays done at my own vets. My vet thought he saw a possible gallbladder mucocele. Was referred to a specialist hospital where USS was repeated. Very early mucocele was seen as well as as possible enlargement ?tumour on one of the liver lobes. The vet who performed the USS advised medical management and to watch and wait. He was put back on to antibiotics and liver supps and his long term anti inflammatory pain relief was stopped incase this had effected the results. As you can see, his latest blood results are a lot worse and now his bilirubin is increased. My vet is recommending 3 options: 1. See specialist again with view to remove gallbladder and biopsy liver. May need oncologist and chemo 2. Repeat bile acid blood test and bilirubin and make sure he is fasted before hand as he wasn’t prior to the latest blood test 3. Do nothing- enjoy his time left with us and consider euthanasia when he starts showing symptoms What option would you recommend? If I choose to let him enjoy his time left with us- roughly how long am I looking at based on the bloods? Thanks Currently he shows now signs at all. He is happy, has loads of energy and is his usually bouncy self. He is eating well, if anything has increased appetite. He drinks quite a bit of water but he has done this for years. No yellowing of the gums/eyes/ear flaps Sorry they have uploaded in the wrong order. The bottom image are the pre op ones from start of feb. Middle image are from end of March. Top one (with raised bilirubin) are his latest results from 31.05.22

Hello!  You ask which is the best option.  Medically, in terms of keeping any animal alive / in the best possible health for as long as possible, the best way forward with liver cases is generally to find out what is wrong.  Your vets have made a guess but of course, liver cancer can't be definitively diagnosed by ultrasound and the only way to know for definite may be to biopsy.  I have certainly seen what I expected to be liver cancer turn out to be something else on biopsy, but I have also seen what I expected to be something else turn out to be liver cancer; ultrasound shows 'differently' textured liver extremely well, but not necessarily what the 'difference' is and this is why biopsies are taken.  I once saw an ultrasound showing liver cancer next to one showing a liver infection and I was unable to see a difference. I am not your vet and cannot legitimately advise you, which is why  I won't look at the scans until after I have pressed 'send.'  However, on a medical basis it is always good to have as much information as possible before making a decision. The main argument against this may be cost / travel / time.  Always ask for a rough estimate of these in advance.  Best of luck and do let us know what you decide and how you get on.

Ah!  They were bloods not the scans.  Sorry - you did tell me.  I would check with your vets how worried they are about the current levels - it could be that a small increase is not a concern to them after a meal.  If they are unsure, they may decide to double-check with the referral vet and take it from there.  Best of luck.