So how is the vet identifying the “chronic cortisol” then? What makes him think the cortisol is chronically high, if ACTH tests are negative?
Or, conversely, if the tests are negative but the presumption is cortisol is still high - it makes sense to treat for Cushings even with a negative test result. Unless the theory is that it is pain related?
How are you managing the arthritis and arthritis pain? (chronic advanced arthritis (being managed since diagnoses now)
How are you preventing ulcers other than adding alfalfa?
It is possible to add an appetite stimulant if the horse is truly just disinterested in food. But I would definitely rule out pain first.
