Avoid high-NSC diets for horses with metabolic problems such as EMS or PPID. | Adobe StockQ:I have a 20-year-old former easy keeper that has just been diagnosed withpituitary pars intermedia dysfunction(PPID,once calledequine Cushings disease). My vetadvisedI switch him to a low-nonstructural-carbohydrate(NSC)feed to helpmanage the condition,butmy horsehas started going off his grain and is beginning to lose weight. How do I balance his need for a low-NSC dietwhilekeeping him eating and at a healthybody condition score (BCS)?A:This is an increasingly common scenario faced by owners of horses that have historically been diagnosed with equine metabolic syndrome (EMS),a condition in which easy keepers often become less responsive toinsulin,that then go on to age into PPID. Your vet has given you some good advice about minimizing the NSC content of your horses diet.Thatsa foundational part of managingequine insulin dysregulation (ID),meaning the horse produces or responds to insulin abnormally.Insulin dysregulationis certainly associated with an easy keeper phenotype(physical traits)but can also be associated with PPID.Becauseolder horses (with or without PPID) mightexperienceloss of body condition and muscle wastingandcouldbenefit from supplemental calories,concurrent ID might make some commercially available calorie-dense diets less safe forhorses who need to gainweight (andpotentially risk causing or exacerbating laminitis).Generally,youshould avoidhigh-NSC diets(over20%NSCon adrymatter basis) for horses with ID, especiallywhenfeeding themin quantities meant to encourage weight gain. Someadditionaltesting for ID (such asan oral sugar test and insulin tolerance test) might be helpfultodeterminethe degree ofyour horses ID.Safer caloriesources for horses with ID that need to gain weightincludefat and fiber, so consider one or more of the following strategies to encourage a normal body condition in a horseon the thin side:1.Ensure PPID is well-managedwithappropriatemedicationsprescribed by your veterinarian.2.Gradually increase the amount of fermentable fiber inyour horsesdiet.Ifhisdentition is stillreasonably normal,givehimad libitum access to low-NSC grass hay (and potentially judicious access to pasture if the horseisntseverely ID). Consider gradually adding legume forage (alfalfaandclover), cubes, or pellets to the diet as well. Alfalfa often gets a bit of a bad rap for horses with metabolicproblems, but it canhavea lower NSC content than many grass hays. Horses often find it highly palatable,so it mighthelp with yourhorsesfeed refusal issues. You can alsoconsider gradually adding meals ofnonmolassedbeet pulp. Ifhesnotable to chew properlydue to the condition of histeeth, adding meals ofsoaked andmashedalfalfacubes or pellets or aforage-basedcomplete pelleted dietmight be helpful.3.Add supplemental fat to the diet,along with a little extra vitamin E. Adult horses can tolerate a surprising amount of fat(up to 20% or more on a dry matter basis),which you canuseto encourage weight gain inindividualswith ID. Gradually adda fat supplement, such as corn oil, vegetable oil, flaxseed oil,stabilized ground flaxseed, or a commercially available combination product,to increase the caloric density ofyour horsesdiet. Some fat supplements,such asricebran, can have arelatively highNSC content as well (20-30%), so carefully consider if this isappropriate beforeaddingitto yourhorsesdiet.As always, fostering a good working relationship with yourprimary care veterinarianhelpsensureyoureceiveaccurate, practical guidanceformanagingyour metabolic horsesdiet and supporting his health over the long term. Claim your promo code to receive 20% off any product in Equithrive's Easy Keeper collection: MetaCare, Metabarol, Vitamin E or Hoof. Name(Required) First Last Email(Required) By clicking submit I consent to Equine NetworksPrivacy Policy and Terms of Serviceand I represent that I am over 16 years old.