Cushing’s or Adrenal Stress?

Holistic Horsekeeping Newsletter, June 2022, Volume 27, Number 6 Dr. Madalyn Ward – How to have a healthy happy horse

I don’t believe every horse that tests with a high ACTH has classical Cushing’s. My mare that I lost in 2018 helped teach me this. Cerise was losing strength but showing no other signs of Cushing’s. She tested high for ACTH and I started her on Pergolide. I was able to get all of Cerise’s blood work back within normal range but she continued to fail in her overall strength.

Madalyn with horse

 In hindsight I learned a lot from losing Cerise. I don’t feel she was a classic Cushing’s case. I believe her true issue was adrenal insufficiency. The adrenal gland produces cortisol to help the body manage stress and inflammation. I believe Cerise’s high ACTH levels were the result of her body trying to make more cortisol.

I am now adding a resting cortisol test to the metabolic screen including ACTH, Glucose and insulin. Normally a resting cortisol is not useful because cortisol goes up and down in a rhythm so one test is not accurate. In this case an elevated ACTH should also result in an elevated cortisol but in adrenal insufficiency cases it does not. I am finding this scenario in some horse diagnosed with Cushing’s but not responding to medication as they should. These are often horses that start showing Cushing’s symptoms early in life. I am so grateful for yet another lesson from Cerise. 

I wish Phyto Adrenal had been available for Cerise. I used several adrenal support products but none seemed to help much. I have had amazing results with Phyto Adrenal for myself and multiple horses. Phyto Adrenal nourishes the adrenal glands without stimulating them. I take it every day and take extra if I notice any mid back pain. Please consider testing any horse that is acting like Cushing’s or has been diagnosed with Cushing’s but in not responding to medication. 

I prefer Cornell lab for metabolic testing in horses. It is important that the serum be separated from the blood within a few hours of it being collected so you will need to haul your horse to the clinic or have your vet come to you on his way back to the clinic. Remember to ask for ACTH, insulin, glucose and baseline cortisol. 

Here is the link to the discount shipping label portion of Cornell’s website:

Your vet needs to set up an account with Cornell in order to send the samples to them directly. Special handling is needed for accurate testing.  (1)EDTAplasmainLTT(separated and placed in plastic tube or plain RTT) and frozen within 4 hours of obtaining sample; AND (2)serum (separated promptly). SHIP CHILLED/FROZEN. 1)Lavender top tube AND 1)Redtop(1)Separate and Freeze

Online Class For Horse Temperament Typing

The self-paced online course is open to anyone interested in learning more about the Horse Temperament Types. It was created to share information about the eleven Horse Temperament Types as explained by Madalyn Ward, DVM.

Dr. Ward has been a pioneering voice in the field of holistic horse care for over two decades and she breaks new ground with the Horse Temperament Typing system. Her cutting edge casework now extends to helping horse lovers find their perfect equine match or better understand their current equine partner. If you want to learn more about determining the temperament type of your horses, this course is the one for you. You can sign up and find more information at

Dr. Ward also has a mentoring program to work one-on-one with you learning homeopathy and nutrition.

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