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This study investigated whether a single intra-articular administration (IA) of dexamethasone (DEX) in horses at therapeutic dosage could exert a systemic effect by influencing the hypothalamic-pituitary-adrenal axis activity as a consequence of (limited) absorption and systemic distribution. The results indicated that DEX was detectable in urine collected 12–48 h after IA administration and that injection was accompanied by a reduced urine excretion of cortisol, 6β-hydroxycortisol (6βOHF) and two other metabolites of cortisol lasting up to 48 h post-DEX administration. The systemic effects in horses treated with DEX by IA route are similar to those that typically occur with short-term treatment including the reduction in urinary cortisol concentration.