Aging metabolic horses need more tailored nutrition plans

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Senior horses with metabolic disease need more individualized nutrition and management than standard “low sugar, low starch” advice alone, according to a new The Horse report on aging horses with insulin dysregulation, pituitary pars intermedia dysfunction (PPID), or both. The article, published March 5, 2026, highlights expert guidance from Erica Macon, PhD, and Tania Sundra, BVMS, on balancing lower nonstructural carbohydrate intake with the realities of aging, including sarcopenia, osteoarthritis, dental disease, and changing body condition. Key takeaways include keeping forage as the diet foundation, limiting nonstructural carbohydrates, monitoring insulin response at the individual level, and using higher-quality protein and low-NSC calorie sources when older horses need help maintaining weight. The report also notes that when dental disease limits chewing, older horses may need processed fiber sources such as chopped hay, hay cubes, beet pulp, or complete feeds, introduced gradually so roughage intake and gut health are maintained through dental procedures or recovery. (thehorse.com)

Why it matters: For equine veterinarians and nutrition-focused practices, the message is that “metabolic” and “senior” can’t be managed as separate categories. The Equine Endocrinology Group’s current recommendations emphasize assessing insulin dysregulation in all PPID cases and tailoring feed selection to body condition and insulin status, because some PPID horses are lean and can tolerate senior feeds and pasture, while those with insulin dysregulation need lower-NSC diets and tighter pasture control. In parallel, older horses with painful dental conditions such as EOTRH may not be able to handle long-stem forage consistently, making it important to plan chewable forage alternatives before extractions and avoid prolonged fasting. The Horse article also points to growing interest in adjunct tools such as SGLT-2 inhibitors for severe or refractory hyperinsulinemia, but frames them as additions to, not replacements for, nutrition, exercise, hoof care, and regular monitoring. (idppid.com)

What to watch: Expect more discussion around how practices monitor meal-based NSC intake, preserve muscle mass in lean PPID horses, support forage intake in horses with EOTRH or other dental compromise, and decide when off-label SGLT-2 therapy is appropriate in difficult endocrine laminitis cases. (thehorse.com)