Feeding Horses with Cushing’s Disease

Caring for a horse with Cushing’s disease often requires owners to think more carefully about nutrition, weight management, and overall metabolic health.

Many horses with Cushing’s disease, also known as PPID, continue living active and comfortable lives with thoughtful management. Forage selection frequently becomes one of the most important components of that long-term care.

Because every horse responds differently, individualized feeding programs are essential.

Understanding Cushing’s Disease

Pituitary Pars Intermedia Dysfunction, commonly abbreviated PPID, is a hormonal condition most commonly seen in older horses.

Affected horses may experience:

• changes in metabolism,

• altered body condition,

• muscle loss,

• abnormal hair coats,

• increased drinking and urination,

• and increased laminitis risk.

Not every horse shows identical symptoms.

Some horses primarily struggle with weight management, while others remain relatively stable for years with careful monitoring.

Why Forage Matters

Hay represents the largest portion of most horses’ diets.

For horses with PPID, forage quality can influence:

• calorie intake,

• digestive health,

• metabolic stability,

• and body condition management.

Many owners focus on selecting:

• consistent forage,

• moderate calorie density,

• clean hay,

• and appropriate sugar levels.

Because some horses with PPID are more metabolically sensitive, NSC management may become important.

Understanding NSC

NSC stands for non-structural carbohydrates, which primarily include sugars and starches.

Some horses with PPID also experience insulin dysregulation, making them more sensitive to elevated sugar intake.

This is why owners often seek forage with moderate or lower NSC levels.

However, nutritional needs still vary significantly between horses.

Some horses maintain weight easily and require calorie control.

Others struggle to hold body condition and may require more digestible forage.

Weight Management Challenges

PPID horses can sometimes become difficult to manage nutritionally because they may experience either:

• unwanted weight gain,

• or gradual muscle and condition loss.

This makes individualized feeding especially important.

Owners often benefit from monitoring:

• body condition,

• topline changes,

• appetite,

• and seasonal fluctuations.

Regular evaluation allows feeding programs to adjust gradually rather than react after significant condition changes occur.

Digestibility Matters for Older Horses

Many horses with PPID are seniors.

As horses age, chewing efficiency and digestive function may gradually decline.

Softer, more digestible forage may become helpful for:

• horses with dental wear,

• reduced appetite,

• or difficulty maintaining weight.

At the same time, excessively rich forage may complicate metabolic management in easy keepers.

Balance becomes extremely important.

Consistency Supports Stability

Frequent forage changes can make metabolic management more difficult.

Consistent hay quality allows owners to:

• monitor weight trends more accurately,

• maintain stable feeding routines,

• and reduce digestive disruption.

Gradual transitions are generally preferred whenever forage changes become necessary.

Many horses with PPID benefit from predictable feeding schedules and steady nutritional programs.

Clean Forage Is Important

Respiratory sensitivity and immune challenges may increase as horses age.

Dusty or moldy hay may contribute to:

• coughing,

• respiratory irritation,

• or reduced forage intake.

Clean, properly stored forage supports both palatability and overall health.

Feeding the Individual Horse

No single hay works perfectly for every horse with PPID.

Factors influencing forage selection include:

• insulin sensitivity,

• age,

• body condition,

• dental health,

• workload,

• and digestive function.

Thoughtful forage management helps owners create more stable, sustainable feeding programs over time.

The best feeding plans are rarely the most extreme.

They are usually the most consistent and individualized.

FAQ

What is PPID in horses?

PPID, commonly called Cushing’s disease, is a hormonal disorder most often affecting older horses.

Should horses with PPID eat low-sugar hay?

Some horses with PPID benefit from careful NSC management, especially if insulin dysregulation is present.

Why do older horses need softer hay?

Dental wear and reduced chewing efficiency may make softer forage easier to consume.

Does forage consistency matter for PPID horses?

Yes. Stable feeding programs often make body condition and digestive management easier.

Common Feeding Mistakes with Laminitic Horses

Managing a horse with laminitis can feel overwhelming, especially for owners trying to balance nutrition, weight control, digestive health, and overall comfort at the same time.

Many owners work incredibly hard to help their horses recover, yet small feeding mistakes can sometimes make long-term management much more difficult.

Fortunately, most forage-related mistakes are correctable once owners better understand how nutrition influences metabolic stability.

Restricting Forage Too Aggressively

One of the most common mistakes owners make is drastically reducing hay intake in an attempt to control weight.

While calorie management matters, horses still require consistent fiber intake for:

• digestive health,

• hindgut stability,

• chewing behavior,

• and emotional well-being.

Severe forage restriction may increase:

• stress,

• ulcer risk,

• boredom,

• and undesirable feeding behaviors.

The goal is usually not eliminating forage.

The goal is selecting more appropriate forage and managing intake carefully.

Assuming All Grass Hay Is Safe

Many owners assume any grass hay automatically qualifies as “safe” for metabolic horses.

In reality, forage sugars can vary tremendously depending on:

• harvest timing,

• sunlight exposure,

• plant maturity,

• weather,

• and growing conditions.

Two grass hays may appear similar while containing very different nutritional profiles.

For horses with significant metabolic sensitivity, forage testing often provides much more reliable information than visual evaluation alone.

Changing Hay Too Frequently

Frequent forage changes can create digestive instability and make weight management more difficult.

Some owners purchase hay opportunistically from multiple sources without realizing how dramatically nutritional characteristics may vary.

Consistency helps owners:

• monitor body condition more accurately,

• maintain stable feeding routines,

• and reduce digestive stress.

When forage changes are necessary, gradual transitions are generally preferred.

Overlooking Portion Size

Even appropriate hay can contribute to weight gain if portions are excessive.

Easy keepers often require fewer calories than expected.

Estimating flakes visually may lead to unintentional overfeeding because bale density varies significantly.

Many owners benefit from weighing forage rather than relying on appearance alone.

This creates more consistent intake and allows for gradual, controlled adjustments.

Ignoring Body Condition Changes

Weight gain often occurs slowly over time.

Owners who see their horses daily may not immediately notice subtle changes in:

• fat deposits,

• neck crest development,

• or overall body condition.

Regular monitoring helps owners respond earlier before metabolic problems become more severe.

Helpful practices include:

• body condition scoring,

• periodic photographs,

• and consistent weight tracking when possible.

Feeding Too Many Extras

Treats, supplements, and concentrates can add up quickly.

Owners sometimes focus heavily on hay while overlooking calories coming from:

• commercial treats,

• sweet feeds,

• multiple supplements,

• or excessive grain.

For many metabolic horses, simplifying the feeding program can improve consistency and reduce unnecessary calorie intake.

Forgetting About Digestive Health

Laminitic horses still require healthy digestive function.

Overly coarse or poor-quality forage may create additional problems for:

• senior horses,

• ulcer-prone horses,

• or animals with dental issues.

The best forage programs balance:

• appropriate calorie management,

• digestibility,

• chewing comfort,

• and consistency.

Lower-calorie forage should still support healthy fiber intake.

Neglecting Exercise and Overall Management

Nutrition is only one piece of metabolic management.

Whenever medically appropriate and veterinarian-approved, movement and exercise may help support:

• weight control,

• insulin sensitivity,

• and overall health.

Sleep, stress, pasture access, medications, and overall management also influence metabolic stability.

Individual Horses Require Individual Plans

Perhaps the biggest mistake of all is assuming one feeding program works for every horse.

Some horses require stricter NSC control.

Others struggle more with portion management or obesity.

Thoughtful forage selection, consistency, and individualized management often provide the best long-term results.

Managing laminitis is rarely about finding one perfect solution.

It is usually about combining many small, consistent management decisions over time.

FAQ

Should laminitic horses have constant access to hay?

Many horses benefit from consistent forage access, though calorie intake still requires management.

Why should hay be weighed?

Flake size varies significantly, making visual estimates unreliable.

Is all grass hay safe for founder-prone horses?

No. Sugar levels vary widely depending on growing and harvest conditions.

Can rapid hay changes affect digestion?

Yes. Sudden forage changes may contribute to digestive stress in sensitive horses.

What Low-NSC Hay Really Means

The term “low-NSC hay” has become increasingly common in horse nutrition conversations, especially among owners managing metabolic conditions such as laminitis, Equine Metabolic Syndrome, or Cushing’s disease.

However, many owners are still unsure what NSC actually means and why it matters.

Understanding forage sugars does not require a nutrition degree, but it does require looking beyond general labels like “horse hay” or “premium hay.” Nutritional differences between forage lots can be significant, and those differences may affect certain horses more than others.

What Does NSC Stand For?

NSC stands for non-structural carbohydrates.

In simple terms, NSC refers primarily to sugars and starches contained within forage.

Plants naturally produce sugars through photosynthesis. These sugars help fuel plant growth and energy storage. Horses then consume those sugars when eating hay or pasture.

Many healthy horses tolerate moderate sugar levels without problems. However, metabolically sensitive horses may have difficulty processing elevated sugar intake efficiently.

For some horses, excessive sugar intake may contribute to:

• weight gain,

• insulin dysregulation,

• hoof soreness,

• or increased laminitis risk.

This is why owners often seek hay with lower NSC values.

Why Visual Appearance Is Not Enough

One of the biggest misconceptions in hay selection is assuming appearance tells the entire nutritional story.

A soft, green, leafy bale may look excellent while still testing relatively high in sugars.

Conversely, a slightly more mature hay may contain lower sugar levels while still providing adequate fiber and digestibility.

Weather conditions, cutting timing, sunlight exposure, and plant maturity all influence forage sugar levels.

Without laboratory testing, estimating NSC accurately can be difficult.

This is why hay testing has become increasingly important for owners managing metabolic horses.

What Is Considered “Low” NSC?

There is no universal definition that applies perfectly to every horse.

However, many veterinarians and nutritionists commonly look for hay below certain NSC thresholds when managing metabolic conditions.

Appropriate levels often depend on:

• the horse’s medical history,

• insulin sensitivity,

• body condition,

• workload,

• and overall feeding program.

Some horses require stricter sugar control than others.

Because individual needs vary, forage selection should ideally be part of a broader nutritional management plan.

hay type Matters

Different forage species naturally vary in nutritional characteristics.

Grass hays are often favored for easy keepers because they may provide:

• moderate calorie levels,

• good fiber content,

• and lower energy density than richer feeds.

Common options may include:

• orchardgrass,

• timothy,

• bermudagrass,

• or mixed grass hay.

However, species alone does not guarantee sugar content.

An orchardgrass hay harvested under certain conditions could test higher in NSC than another grass harvested differently.

This reinforces the importance of consistency and testing.

Why Digestive Health Still Matters

Owners sometimes become so focused on reducing sugar that they accidentally select forage that is too coarse, stemmy, or poorly digestible.

Fiber quality still matters tremendously.

Horses require adequate chewing activity and healthy digestive function. Extremely poor-quality forage may create additional issues, especially for:

• senior horses,

• horses with dental problems,

• or hard keepers.

The goal is not simply finding the lowest sugar number possible.

The goal is finding balanced forage appropriate for the individual horse.

Feeding Management Is Also Important

Even excellent hay can become problematic if feeding management is inconsistent.

Helpful practices often include:

• gradual forage transitions,

• consistent feeding schedules,

• controlled portion sizes,

• regular body condition monitoring,

• and appropriate exercise when possible.

Many owners also find slow feeders useful because they help extend forage consumption time while reducing boredom and rapid eating.

Hay Testing Provides Clarity

For owners managing medically sensitive horses, forage testing often provides valuable peace of mind.

Laboratory analysis can reveal:

• NSC levels,

• protein,

• fiber,

• digestibility,

• moisture,

• and mineral information.

This allows owners to make decisions based on measurable nutritional information rather than assumptions.

For horses with previous laminitis episodes, that information can be especially valuable.

Individualized Feeding Matters

No single hay works perfectly for every horse.

Some horses maintain excellent condition on moderate-calorie grass hay, while others may require additional calories or softer forage.

The best feeding programs typically focus on:

• consistency,

• forage quality,

• appropriate calorie balance,

• digestive health,

• and the individual animal’s needs.

Careful forage selection is not about chasing trends.

It is about supporting long-term animal health through thoughtful nutritional management.

FAQ

What is NSC in horse hay?

NSC refers to the sugars and starches contained within forage.

Why do metabolic horses need lower NSC hay?

Some metabolically sensitive horses may struggle to regulate elevated sugar intake effectively.

Can you tell sugar levels by looking at hay?

Not reliably. Laboratory forage testing is the most accurate method.

Is all grass hay low in sugar?

No. Sugar levels vary significantly depending on growing and harvesting conditions.