What aging metabolic horses need now
CURRENT BRIEF VERSION: Metabolic disease management gets more complicated as horses age, and a new March 5, 2026, report from The Horse pulls together current guidance on what older horses with insulin dysregulation, pituitary pars intermedia dysfunction, or both need most: tighter nutritional planning, realistic exercise programs, and more careful use of medications. The article cites input from Erica Macon of Texas A&M, Tania Sundra of Avon Ridge Equine Veterinary Services, and François-René Bertin of Purdue, emphasizing that diet remains the foundation of care, with lower nonstructural carbohydrate intake, forage-based feeding, and adjustments for body condition, sarcopenia, and laminitis risk. It also highlights that PPID is common in older horses, with estimates that about 20% of horses 15 years or older are affected. (thehorse.com)
Why it matters: For veterinary professionals, the takeaway is that “metabolic horse” protocols can’t be one-size-fits-all once these patients become geriatric. Current guidance from the Equine Endocrinology Group recommends assessing insulin dysregulation in all PPID cases and tailoring feed selection to body condition and insulin status; lean seniors may need more calories and higher-quality protein without increasing sugar and starch exposure, while obese horses still need weight loss without dropping forage below safe thresholds. The report also reinforces caution around intra-articular corticosteroids in insulin-dysregulated or laminitis-prone horses, while noting that off-label SGLT2 inhibitors work by promoting urinary glucose loss to lower blood glucose and insulin and are being reserved for severe or diet-refractory hyperinsulinemia rather than routine use. Caitrin Lowndes of Penn’s New Bolton Center, speaking in a related The Horse Q&A, described the drugs as an option veterinarians are exploring for horses at risk of metabolic laminitis when diet and exercise alone are not enough. (idppid.com)
What to watch: Expect more data on long-term SGLT2 inhibitor use, including how canagliflozin, dapagliflozin, and ertugliflozin perform in practice, along with steroid-sparing joint therapies and practical monitoring strategies for older horses with overlapping PPID, insulin dysregulation, osteoarthritis, and recurrent laminitis risk. (equineendocrinologygroup.org)