Diagnosis (Also, how my mental health depends on my dog's poops)

Jun 15, 2026

We have our official Cushing's diagnosis, confirmed by the ACTH test, which was an experience in itself. Here's the story:

So, the way the ACTH test works is they do a baseline blood draw, then inject him with a synthetic hormone called ACTH, then they wait 90 minutes and do another blood draw to see how much cortisol his adrenal glands produced compared to the initial draw. This confirms the diagnosis if the cortisol production is over a certain level.

At Buster’s ACTH stimulation test, they first took him back for his baseline blood draw, then brought him back out to sit with me in the waiting room while we waited the 90 minutes before the second draw. He came back out with his tiny little bandage on his leg, and everyone in the waiting room immediately started smiling and going, “Awww!” because he looked so sweet and brave. Then they took him back again for the second blood draw, and while I was waiting, I had a clear view down the hallway. Suddenly the exam room door flew open and a vet tech burst out with her shirt pulled up over her nose. It turns out Buster farted every single time they poked him with the needle. He was on a powerful probiotic at the time, and apparently the gas was so absolutely noxious that the smell clung to their shirts and hair for the rest of the day. Even in the middle of all these scary tests, Buster still managed to be completely, unmistakably himself.

It wasn't even the next day before they called and confirmed that Buster's results were back and he was well above the cortisol levels to confirm the diagnosis. So, he started Trilostane the next day.

After a week on the Trilostane, I noticed his diarrhea just wasnt clearing up. We were using an anti-diarrheal from the vet, the diet they recommended (plain boiled chicken and rice), no treats, nothing. Which, to a dog that LOVES nothing in this life more than a pup cup and a pork chop, is basically prison on Planet Bullshit.

Two weeks of this. Every walk was just torment, wondering if he had made any progress, if there was any change, hoping for the best, knowing I was doing everything I could. But just... nothing. I just had this feeling that the Trilostane was causing it. So I stopped giving it to him yesterday. Today I picked up another anti-diarrheal (metronidazole) and 6 cans of gastro health food at the vet. And tonight we finally had a SEMI-SOLID POOP! 🎉 It is amazing how much of my mental health is tied to this dog's bowel movements at this point.

So, next steps: Get the poop situation back to normal, then begin reintroducing his medications. He will also need to have the ACTH test repeated after the first three weeks on the medicine to make sure we have the dosage correct.

So... The running total so far, just for accountability:
Initial bloodwork: $365
Ultrasound: $592.75
Initial ACTH test and adrenal blood panel: $1,080.52
Medications: $175 so far
Next ACTH test: Roughly $500-600 estimated

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