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Feeding the Metabolic Horse

Nutrition for Horses with Cushing’s Disease, Insulin Resistance or Equine Metabolic Syndrome

Laminitis is often related to metabolic diseases such as Cushings Disease (PPID), Insulin Resistance (IR) and Equine Metabolic Syndrome (EMS).   Dietary management is an extremely important part of treatment and management.  On average, grass hay should be fed at a rate of 1.5 – 2% of ideal body weight (i.e. 15-20 lbs /day for 1000 lb horse). This percentage will change if weight loss is required.


Grass hay should form the bulk of the diet, HOWEVER, it should be < 10-12 % non-structural carbohydrate (NSC = sugars and starches) 

Soaking grass hay for 30 minutes in hot water or 2 hours in cold water can reduce the NSC content, but a sample of soaked hay should be dried and analyzed to confirm the NSC content. Do not allow the hay to soak for a longer period of time, as the sugars will soak back into the plant.

Triple Crown Safe Starch Forage is a chopped hay product with a guaranteed low NSC level (8.8%).  This forage is easy for senior horses to eat and is less labor intensive than soaking hay.
Grass should be avoided, especially in early spring and late fall when the plant is storing the most sugars.  As a general rule, when the day length is changing, avoid allowing your horse or pony to graze on grass.  Often your horse can be turned out on a bare paddock or you may use a grazing muzzle.  Ask your veterinarian to look at the grazing at your farm if you are uncertain!


Concentrates may be fed, but must have low NSC as well.  Examples of low NSC concentrates include:

Feed Name  Non-Structural Carbohydrate (NSC %) 
Blue Seal Carb Guard 10-11
Purina WellSolve L/S 10-13
Purina WellSolve W/C 10-13
Nutrena Lite Balance 14
Nutrena Hay Extender Pellets 15
Triple Crown Low Starch 15
Triple Crown Lite 15.9 

Most metabolic horses need to LOSE weight.  However, if your horse needs to GAIN weight, consider shredded beet pulp.  Beet pulp has a very low glycemic index (does not cause spikes in blood sugar) and is relatively energy dense. Pelleted forms of beet pulp often have molasses as a binder, however it may not be included in the ingredient list. Contact the manufacturer to confirm.

  • Plain beet pulp = 4-5% NSC
  • If necessary you may substitute beet pulp at a rate of 1 lb. beet pulp per 1.5 lbs of hay.
  • Limit beet pulp if weight loss is needed
  • 1 lb beet pulp 2 oz. rice bran 3 oz. ground stabilized flax improves palatability and provides good mineral balance 

Eliminate the Following:

  • Oats, Sweet Feed, Grains containing molasses
  • Fresh grass, especially during early Spring and late Fall
  • Carrots and Apples 
  • Treats