Managing nutrition in aging horses with metabolic disease

A new The Horse report highlights a practical challenge many equine veterinarians and nutritionists are seeing more often: older horses with metabolic disease don’t fit neatly into standard feeding plans. In “Aging Metabolic Horses—What Do They Need?”, published March 5, 2026, Stacey Oke, DVM, MSc, pulls together expert guidance on managing aging horses with insulin dysregulation, pituitary pars intermedia dysfunction (PPID), or both, with diet framed as the cornerstone of care. The piece emphasizes limiting nonstructural carbohydrates, recognizing that horses can respond differently to the same ration, and balancing metabolic control against age-related issues such as osteoarthritis, loss of topline, and changing body condition. It also notes current medication considerations, including pergolide for PPID and, in select cases, SGLT2 inhibitors as part of a broader management plan. (thehorse.com)

Why it matters: For veterinary professionals, the article is a reminder that “metabolic” and “senior” often collide in ways that complicate case management. Older horses are already at risk for PPID, which The Horse reports affects about 20% of horses age 15 and older, and the most important shared consequence of PPID and insulin dysregulation remains endocrinopathic laminitis. That means feeding plans have to do more than cut sugar and starch: they also need to preserve muscle mass, support dentition and forage intake, and account for whether a horse is an easy keeper, a hard keeper, or dealing with concurrent dental disease such as EOTRH, where pelleted or softened diets may become necessary. (thehorse.com)

What to watch: Expect continued attention on individualized ration design, medication monitoring, and how clinicians integrate endocrine, dental, and geriatric care in the same horse. (thehorse.com)