FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Journal of veterinary internal medicine2019; 33(5); 2257-2266; doi: 10.1111/jvim.15620

Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome.

Abstract: Plasma adrenocorticotropic hormone (ACTH) and serum cortisol concentrations increase with illness-associated stress. Dynamics of plasma ACTH and serum cortisol concentrations in adult horses with systemic illness are undocumented. Objective: To determine whether ACTH and cortisol concentrations and the ACTH/cortisol ratio vary with survival, the presence of systemic inflammatory response syndrome (SIRS), or ischemic gastrointestinal lesions at admission, or throughout hospitalization. Methods: One hundred fifty-one adult horses. Methods: Prospective study measuring serum cortisol and plasma ACTH at admission and on days 2, 4, and 6 of hospitalization. Horses were grouped by outcome (survival, SIRS status, number of SIRS criteria [SIRS score], SIRS severity group, and the presence of an ischemic lesion). Differences between groups and over time for ACTH, cortisol, and ACTH/cortisol ratio were investigated with a mixed effect model. Receiving operator characteristic curves and odds ratios were calculated for survival and ischemia. Results: In all groups, ACTH, cortisol, and ACTH/cortisol ratio significantly decreased over time (P < .0001). ACTH, cortisol, and ACTH/cortisol ratio were higher at admission in nonsurvivors, and ACTH and cortisol were higher in horses with ischemic lesions (P < .01). Horses with ACTH above reference interval at admission were 6.10 (2.73-13.68 [95% confidence interval]) times less likely to survive (P < .0001). No significant difference in ACTH, cortisol, and ACTH/cortisol ratio between horses with different SIRS status, scores, or groups were detected, although nonsurvivors had a higher SIRS score (P < .0001). Conclusions: Pituitary and adrenal responses are altered in nonsurviving horses and those with an ischemic gastrointestinal lesion.
© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Get Full Text
Publication Date: 2019-09-12 PubMed ID: 31512777PubMed Central: PMC6766528DOI: 10.1111/jvim.15620Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study investigates the levels of plasma adrenocorticotropic hormone (ACTH) and serum cortisol in horses with systemic illness, specifically systemic inflammatory response syndrome (SIRS) and ischemic gastrointestinal lesions. The study found that horses with high ACTH levels on admission were less likely to survive and the hormone concentrations were higher in non-surviving horses and those with ischemic lesions.

Objective

  • The researchers wanted to find out if ACTH and cortisol levels, and their ratio, change with survival, the presence of systemic inflammatory response syndrome (SIRS), or ischemic gastrointestinal lesions at admission, or during hospitalization.

Methods

  • The study was a prospective assessment where they measured serum cortisol and plasma ACTH of 151 adult horses at admission and on days 2, 4, and 6 of hospitalization.
  • The horses were categorized by outcome (survival, SIRS status, number of SIRS criteria [SIRS score], SIRS severity group, and the presence of an ischemic lesion).
  • A difference between groups and over time for ACTH, cortisol, and their ratio was investigated with a mixed effect model.
  • Receiving operator characteristic curves and odds ratios were also calculated for survival and ischemia.

Findings

  • For all the groups, ACTH, cortisol, and the ratio between the two significantly decreased over time.
  • On admission, ACTH, cortisol, and their ratio were higher in non-survivors, and ACTH and cortisol were higher in horses with ischemic lesions.
  • Horses with ACTH above reference interval at admission were 6.10 times less likely to survive.
  • No significant difference in ACTH, cortisol, and their ratio was found between horses with different SIRS status, scores, or groups, although nonsurvivors had a higher SIRS score.

Conclusion

  • The study shows that pituitary and adrenal responses are altered in non-surviving horses and those with an ischemic gastrointestinal lesion. The findings suggest that stress hormones could act as markers for severe illness in horses and might be useful in predicting survival rates.

Cite This Article

APA
Stewart AJ, Hackett E, Bertin FR, Towns TJ. (2019). Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome. J Vet Intern Med, 33(5), 2257-2266. https://doi.org/10.1111/jvim.15620

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 33
Issue: 5
Pages: 2257-2266

Researcher Affiliations

Stewart, Allison J
  • School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
  • Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
  • Swedish University of Agricultural Sciences, Uppsala, Sweden.
Hackett, Eileen
  • College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, Colorado.
Bertin, Francois-Rene
  • School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
Towns, Taylor J
  • Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.

MeSH Terms

  • Adrenocorticotropic Hormone / blood
  • Animals
  • Female
  • Gastrointestinal Diseases / blood
  • Gastrointestinal Diseases / veterinary
  • Horse Diseases / blood
  • Horses
  • Hydrocortisone / blood
  • Ischemia / blood
  • Ischemia / veterinary
  • Male
  • Prospective Studies
  • Survival Analysis
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / veterinary

Grant Funding

  • P30 CA016672 / NCI NIH HHS
  • American College of Veterinary Emergency
  • Critical Care research award and Morris Animal Foundation
  • Veterinary Student Summer Scholarship program

Conflict of Interest Statement

Authors declare no conflict of interest.

References

This article includes 39 references
  1. Munck A, Guyre PM, Holbrook NJ. Physiological functions of glucocorticoids in stress and their relation to pharmacological actions.. Endocr Rev 1984 Winter;5(1):25-44.
    pubmed: 6368214doi: 10.1210/edrv-5-1-25google scholar: lookup
  2. Marik PE, Zaloga GP. Adrenal insufficiency in the critically ill: a new look at an old problem.. Chest 2002 Nov;122(5):1784-96.
    pubmed: 12426284doi: 10.1378/chest.122.5.1784google scholar: lookup
  3. Gold JR, Divers TJ, Barton MH, Lamb SV, Place NJ, Mohammed HO, Bain FT. Plasma adrenocorticotropin, cortisol, and adrenocorticotropin/cortisol ratios in septic and normal-term foals.. J Vet Intern Med 2007 Jul-Aug;21(4):791-6.
    pubmed: 17708401doi: 10.1892/0891-6640(2007)21[791:pacacr]2.0.co;2google scholar: lookup
  4. Hurcombe SD, Toribio RE, Slovis N, Kohn CW, Refsal K, Saville W, Mudge MC. Blood arginine vasopressin, adrenocorticotropin hormone, and cortisol concentrations at admission in septic and critically ill foals and their association with survival.. J Vet Intern Med 2008 May-Jun;22(3):639-47.
    pubmed: 18466247doi: 10.1111/j.1939-1676.2008.0090.xgoogle scholar: lookup
  5. Annane D, Pastores SM, Rochwerg B, Arlt W, Balk RA, Beishuizen A, Briegel J, Carcillo J, Christ-Crain M, Cooper MS, Marik PE, Umberto Meduri G, Olsen KM, Rodgers S, Russell JA, Van den Berghe G. Correction to: Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017.. Intensive Care Med 2018 Mar;44(3):401-402.
    pubmed: 29476199doi: 10.1007/s00134-018-5071-6google scholar: lookup
  6. Zaloga GP, Marik P. Hypothalamic-pituitary-adrenal insufficiency.. Crit Care Clin 2001 Jan;17(1):25-41.
    pubmed: 11219233doi: 10.1016/s0749-0704(05)70150-0google scholar: lookup
  7. Cooper MS, Stewart PM. Corticosteroid insufficiency in acutely ill patients.. N Engl J Med 2003 Feb 20;348(8):727-34.
    pubmed: 12594318doi: 10.1056/nejmra020529google scholar: lookup
  8. Wong DM, Vo DT, Alcott CJ, Peterson AD, Sponseller BA, Hsu WH. Baseline plasma cortisol and ACTH concentrations and response to low-dose ACTH stimulation testing in ill foals.. J Am Vet Med Assoc 2009 Jan 1;234(1):126-32.
    pubmed: 19119977doi: 10.2460/javma.234.1.126google scholar: lookup
  9. Hart KA, Slovis NM, Barton MH. Hypothalamic-pituitary-adrenal axis dysfunction in hospitalized neonatal foals.. J Vet Intern Med 2009 Jul-Aug;23(4):901-12.
    pubmed: 19496914doi: 10.1111/j.1939-1676.2009.0323.xgoogle scholar: lookup
  10. Ayala I, Martos NF, Silvan G, Gutierrez-Panizo C, Clavel JG, Illera JC. Cortisol, adrenocorticotropic hormone, serotonin, adrenaline and noradrenaline serum concentrations in relation to disease and stress in the horse.. Res Vet Sci 2012 Aug;93(1):103-7.
    pubmed: 21641009doi: 10.1016/j.rvsc.2011.05.013google scholar: lookup
  11. Mair TS, Sherlock CE, Boden LA. Serum cortisol concentrations in horses with colic.. Vet J 2014 Sep;201(3):370-7.
    pubmed: 24986316doi: 10.1016/j.tvjl.2014.06.005google scholar: lookup
  12. Dembek KA, Timko KJ, Johnson LM, Hart KA, Barr BS, David B, Burns TA, Toribio RE. Steroids, steroid precursors, and neuroactive steroids in critically ill equine neonates.. Vet J 2017 Jul;225:42-49.
    pubmed: 28720298doi: 10.1016/j.tvjl.2017.05.009google scholar: lookup
  13. Bertin FR, Ruffin-Taylor D, Stewart AJ. Insulin dysregulation in horses with systemic inflammatory response syndrome.. J Vet Intern Med 2018 Jul;32(4):1420-1427.
    pmc: PMC6060318pubmed: 29749643doi: 10.1111/jvim.15138google scholar: lookup
  14. Hoffman CJ, McKenzie HC 3rd, Furr MO, Desrochers A. Glucocorticoid receptor density and binding affinity in healthy horses and horses with systemic inflammatory response syndrome.. J Vet Intern Med 2015 Mar-Apr;29(2):626-35.
    pmc: PMC4895485pubmed: 25818217doi: 10.1111/jvim.12558google scholar: lookup
  15. Rosol TJ, Grone A. Endocrine Glands In: Grant MG, ed. Jubb, Kennedy & Palmer's Pathology of Domestic Animals. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:339‐340.
  16. Annane D, Bellissant E, Bollaert PE, Briegel J, Keh D, Kupfer Y. Corticosteroids for treating sepsis.. Cochrane Database Syst Rev 2015 Dec 3;2015(12):CD002243.
    pmc: PMC6494587pubmed: 26633262doi: 10.1002/14651858.cd002243.pub3google scholar: lookup
  17. Gibbison B, López-López JA, Higgins JP, Miller T, Angelini GD, Lightman SL, Annane D. Corticosteroids in septic shock: a systematic review and network meta-analysis.. Crit Care 2017 Mar 28;21(1):78.
    pmc: PMC5371269pubmed: 28351429doi: 10.1186/s13054-017-1659-4google scholar: lookup
  18. Roy MF, Kwong GP, Lambert J, Massie S, Lockhart S. Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome.. J Vet Intern Med 2017 Mar;31(2):582-592.
    pmc: PMC5354005pubmed: 28207163doi: 10.1111/jvim.14670google scholar: lookup
  19. Golland LC, Evans DL, Stone GM, Tyler-McGowan CM, Hodgson DR, Rose RJ. Plasma cortisol and beta-endorphin concentrations in trained and over-trained standardbred racehorses.. Pflugers Arch 1999 Dec;439(1-2):11-7.
    pubmed: 10650995doi: 10.1007/s004249900111google scholar: lookup
  20. Funk RA, Stewart AJ, Wooldridge AA, Kwessi E, Kemppainen RJ, Behrend EN, Zhong Q, Johnson AK. Seasonal changes in plasma adrenocorticotropic hormone and α-melanocyte-stimulating hormone in response to thyrotropin-releasing hormone in normal, aged horses.. J Vet Intern Med 2011 May-Jun;25(3):579-85.
    pubmed: 21457320doi: 10.1111/j.1939-1676.2011.0712.xgoogle scholar: lookup
  21. Schreiber CM, Stewart AJ, Kwessi E, Behrend EN, Wright JC, Kemppainen RJ, Busch KA. Seasonal variation in results of diagnostic tests for pituitary pars intermedia dysfunction in older, clinically normal geldings.. J Am Vet Med Assoc 2012 Jul 15;241(2):241-8.
    pubmed: 22765372doi: 10.2460/javma.241.2.241google scholar: lookup
  22. Dembek KA, Hurcombe SD, Frazer ML, Morresey PR, Toribio RE. Development of a likelihood of survival scoring system for hospitalized equine neonates using generalized boosted regression modeling.. PLoS One 2014;9(10):e109212.
    pmc: PMC4189956pubmed: 25295600doi: 10.1371/journal.pone.0109212google scholar: lookup
  23. Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG, Olsen E, Burns T, Slovis NM, Wilkins PA. Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates.. J Vet Intern Med 2018 May;32(3):1185-1193.
    pmc: PMC5980351pubmed: 29582480doi: 10.1111/jvim.15087google scholar: lookup
  24. McConachie E, Giguère S, Barton MH. Scoring System for Multiple Organ Dysfunction in Adult Horses with Acute Surgical Gastrointestinal Disease.. J Vet Intern Med 2016 Jul;30(4):1276-83.
    pmc: PMC5094519pubmed: 27296454doi: 10.1111/jvim.14321google scholar: lookup
  25. Furr MO, Lessard P, White NA 2nd. Development of a colic severity score for predicting the outcome of equine colic.. Vet Surg 1995 Mar-Apr;24(2):97-101.
    pubmed: 7778263doi: 10.1111/j.1532-950x.1995.tb01302.xgoogle scholar: lookup
  26. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system.. Crit Care Med 1985 Oct;13(10):818-29.
    pubmed: 3928249
  27. Jarek MJ, Legare EJ, McDermott MT, Merenich JA, Kollef MH. Endocrine profiles for outcome prediction from the intensive care unit.. Crit Care Med 1993 Apr;21(4):543-50.
    pubmed: 8472574doi: 10.1097/00003246-199304000-00015google scholar: lookup
  28. Rothwell PM, Lawler PG. Prediction of outcome in intensive care patients using endocrine parameters.. Crit Care Med 1995 Jan;23(1):78-83.
    pubmed: 8001391doi: 10.1097/00003246-199501000-00015google scholar: lookup
  29. Rohrbach BW, Buchanan BR, Drake JM, Andrews FM, Bain FT, Byars DT, Bernard WV, Furr MO, Paradis MR, Lawler J, Giguère S, Dunkel B. Use of a multivariable model to estimate the probability of discharge in hospitalized foals that are 7 days of age or less.. J Am Vet Med Assoc 2006 Jun 1;228(11):1748-56.
    pubmed: 16740076doi: 10.2460/javma.228.11.1748google scholar: lookup
  30. Dembek KA, Toribio RE. Hypothalamic‐pituitary‐adrenal axis, steroids, and neuroactive steroids In: Reed SM, Bayly WM, Sellon DC, eds. Equine Internal Medicine. St Louis, MO: Elsevier; 2018:1069‐1079.
  31. Senior JM, Proudman CJ, Leuwer M, Carter SD. Plasma endotoxin in horses presented to an equine referral hospital: correlation to selected clinical parameters and outcomes.. Equine Vet J 2011 Sep;43(5):585-91.
    pubmed: 21496089doi: 10.1111/j.2042-3306.2010.00328.xgoogle scholar: lookup
  32. Epstein A, Nir E, Eyngor M. Dynamics of cytokine gene transcription (TNF‐alpha, IL‐1 beta, IL‐6, IL‐8) in surgically treated colic horses by use of real‐time PCR (RT‐PCR). Isr J Vet Med 2016;71:24‐30.
  33. Stewart AJ, Wright JC, Behrend EN, Martin LG, Kemppainen RJ, Busch KA. Validation of a low-dose adrenocorticotropic hormone stimulation test in healthy neonatal foals.. J Am Vet Med Assoc 2013 Aug 1;243(3):399-405.
    pubmed: 23865883doi: 10.2460/javma.243.3.399google scholar: lookup
  34. Stewart AJ, Behrend EN, Wright JC, Martin LG, Kemppainen RJ, Busch KA, Hanson RR. Validation of a low-dose ACTH stimulation test in healthy adult horses.. J Am Vet Med Assoc 2011 Sep 15;239(6):834-41.
    pubmed: 21916767doi: 10.2460/javma.239.6.834google scholar: lookup
  35. Hinchcliff KW, Rush BR, Farris JW. Evaluation of plasma catecholamine and serum cortisol concentrations in horses with colic.. J Am Vet Med Assoc 2005 Jul 15;227(2):276-80.
    pubmed: 16047666doi: 10.2460/javma.2005.227.276google scholar: lookup
  36. Bone RC, Fisher CJ Jr, Clemmer TP, Slotman GJ, Metz CA, Balk RA. A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock.. N Engl J Med 1987 Sep 10;317(11):653-8.
    pubmed: 3306374doi: 10.1056/nejm198709103171101google scholar: lookup
  37. Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE. APACHE-acute physiology and chronic health evaluation: a physiologically based classification system.. Crit Care Med 1981 Aug;9(8):591-7.
    pubmed: 7261642doi: 10.1097/00003246-198108000-00008google scholar: lookup
  38. Stewart AJ. Endocrine Response to Illness in Sick Horses: Presence of Critically‐Illness‐Related Corticosteroid Insufficiency or Pancreatic Insufficiency in Horses Is Related to Poor Survival. Vol 138 Uppsala: Swedish University of Agricultural Sciences; 2018.
  39. Hart KA, Barton MH, Ferguson DC, Berghaus R, Slovis NM, Heusner GL, Hurley DJ. Serum free cortisol fraction in healthy and septic neonatal foals.. J Vet Intern Med 2011 Mar-Apr;25(2):345-55.
    pubmed: 21281351doi: 10.1111/j.1939-1676.2010.0667.xgoogle scholar: lookup

Citations

This article has been cited 16 times.
  1. Moss A, Leise B, Hackett E. Stress response as a contributing factor in horses with laminitis. J Vet Sci 2023 Mar;24(2):e33.
    doi: 10.4142/jvs.22039pubmed: 37012040google scholar: lookup
  2. Martín-Cuervo M, Gracia-Calvo LA, Macías-García B, Ezquerra LJ, Barrera R. Evaluation of Eosinopenia as a SIRS Biomarker in Critically Ill Horses. Animals (Basel) 2022 Dec 15;12(24).
    doi: 10.3390/ani12243547pubmed: 36552467google scholar: lookup
  3. Drozdzewska K, Gehlen H. Markers for internal neoplasia in the horse. Vet Med Sci 2023 Jan;9(1):132-143.
    doi: 10.1002/vms3.1042pubmed: 36495211google scholar: lookup
  4. Kirkwood NC, Hughes KJ, Stewart AJ. Prospective Case Series of Clinical Signs and Adrenocorticotrophin (ACTH) Concentrations in Seven Horses Transitioning to Pituitary Pars Intermedia Dysfunction (PPID). Vet Sci 2022 Oct 17;9(10).
    doi: 10.3390/vetsci9100572pubmed: 36288186google scholar: lookup
  5. Kirkwood NC, Hughes KJ, Stewart AJ. Pituitary Pars Intermedia Dysfunction (PPID) in Horses. Vet Sci 2022 Oct 10;9(10).
    doi: 10.3390/vetsci9100556pubmed: 36288169google scholar: lookup
  6. Theuerkauf K, Obach-Schröck C, Staszyk C, Moritz A, Roscher KA. Activated platelets and platelet-leukocyte aggregates in the equine systemic inflammatory response syndrome. J Vet Diagn Invest 2022 May;34(3):448-457.
    doi: 10.1177/10406387221077969pubmed: 35168432google scholar: lookup
  7. Hinrichsen SL, Yuen KY, Dryburgh EL, Bertin FR, Stewart AJ. Short-Term Effects of Temperature and Thyrotropin-Releasing Hormone Stimulation on Adrenocorticotropin Stability in Horses. Animals (Basel) 2022 Jan 28;12(3).
    doi: 10.3390/ani12030324pubmed: 35158648google scholar: lookup
  8. Kam YN, McKenzie K, Coyle M, Bertin FR. Repeatability of a thyrotropin-releasing hormone stimulation test for diagnosis of pituitary pars intermedia dysfunction in mature horses. J Vet Intern Med 2021 Nov;35(6):2885-2890.
    doi: 10.1111/jvim.16281pubmed: 34642962google scholar: lookup
  9. Hicks GR, Fraser NS, Bertin FR. Changes Associated with the Peri-Ovulatory Period, Age and Pregnancy in ACTH, Cortisol, Glucose and Insulin Concentrations in Mares. Animals (Basel) 2021 Mar 20;11(3).
    doi: 10.3390/ani11030891pubmed: 33804751google scholar: lookup
  10. Tatum RC, McGowan CM, Dean RS, Ireland JL. Equine pituitary pars intermedia dysfunction: Identifying research priorities for diagnosis, treatment and prognosis through a priority setting partnership. PLoS One 2021;16(1):e0244784.
    doi: 10.1371/journal.pone.0244784pubmed: 33395695google scholar: lookup
  11. Horn R, Stewart AJ, Jackson KV, Dryburgh EL, Medina-Torres CE, Bertin FR. Clinical implications of using adrenocorticotropic hormone diagnostic cutoffs or reference intervals to diagnose pituitary pars intermedia dysfunction in mature horses. J Vet Intern Med 2021 Jan;35(1):560-570.
    doi: 10.1111/jvim.16017pubmed: 33368633google scholar: lookup
  12. Anderson MJ, Ibrahim AS, Cooper BR, Woolcock AD, Moore GE, Taylor SD. Effects of administration of ascorbic acid and low-dose hydrocortisone after infusion of sublethal doses of lipopolysaccharide to horses. J Vet Intern Med 2020 Nov;34(6):2710-2718.
    doi: 10.1111/jvim.15896pubmed: 33026127google scholar: lookup
  13. Goodrich EL, Llanos-Soto SG, Ivanek R, Pinn-Woodcock T, Frye E, Wells A, Purdy SR, Berryhill E, Place NJ. Both Season and Equid Type Affect Endogenous Adrenocorticotropic Hormone Concentrations in Healthy Donkeys, Mules and Hinnies in the United States. Animals (Basel) 2026 Jan 16;16(2).
    doi: 10.3390/ani16020290pubmed: 41594480google scholar: lookup
  14. Menzies-Gow NJ. Equine Pituitary Pars Intermedia Dysfunction. Vet Sci 2025 Aug 20;12(8).
    doi: 10.3390/vetsci12080780pubmed: 40872730google scholar: lookup
  15. Villalba-Orero M, Contreras-Aguilar MD, Cerón JJ, Fuentes-Romero B, Valero-González M, Martín-Cuervo M. Association between Eosinophil Count and Cortisol Concentrations in Equids Admitted in the Emergency Unit with Abdominal Pain. Animals (Basel) 2024 Jan 4;14(1).
    doi: 10.3390/ani14010164pubmed: 38200895google scholar: lookup
  16. Massányi M, Halo M, Mlyneková E, Kováčiková E, Tokárová K, Greń A, Massányi P, Halo M. The effect of training load stress on salivary cortisol concentrations, health parameters and hematological parameters in horses. Heliyon 2023 Aug;9(8):e19037.
    doi: 10.1016/j.heliyon.2023.e19037pubmed: 37636408google scholar: lookup
Subscribe to our newsletter
Join 99,727 horse owners like you who receive our email updates on horse health and nutrition.