Hypothalamic-pituitary-adrenal Axis Dysfunction in Critically Ill Foals and Horses.

Critical illness-related corticosteroid insufficiency is a transient dysfunction of the hypothalamic-pituitary-adrenal axis, leading to inadequate cortisol responses during severe stress from endotoxemia and sepsis in horses and foals. This condition is associated with poor outcomes, and its diagnosis is complicated by interindividual variability in cortisol response. Recent advances in dynamic testing and point-of-care hormone tests offer promise for better assessment and treatment, enabling more precise steroid replacement therapy in affected equine patients.