Tips For Feeding Horses with Cushing’s Syndrome

As the number of horses known to have Cushing’s Syndrome increases, questions on how to feed horses with this condition also increase.  As a starting management practice, your veterinarian may recommend pergolide as an added medication for your horse.  This is available from a number of pharmaceutical sources by prescription. When it comes to feeding them, though, here are a few tips that may help make life a little easier:

Consider Joint Support for Horses with Joint Problems

If your Cushing’s horse has some joint problems, you may want to also consider using one of the chondroitin sulfate + glucosamine products that are available in supplement form.

Opt for Low Non-Structural Carbohydrate (NSC) Forage

Cushing’s syndrome horses require a hay or pasture source that is low in non-structural carbohydrates (NSC), so you might want to have your forage tested.

Choose Fortified Senior Feeds For Horses With Cushing’s Syndrome

They do well on senior feeds that are fortified with lysine, methionine, biotin, vitamin E and organic trace minerals (copper, zinc, manganese and selenium) to help maintain muscle mass, support hoof growth and support immune response.

Follow Feeding Directions for Senior Feed

Feeding directions need to be followed to make certain enough senior feed is being fed as these older horses may not be able to utilize forage very efficiently.

Address Weight Maintenance

If your horse is not maintaining weight, you may need to increase the feeding rate of the senior feed or add a low starch, rice bran based high fat supplement.

Consider Medication and Cost For Horse’s With Cushing’s Syndrome

Most senior horses with Cushing’s Syndrome do very well on a senior feed and appropriate medication.  Cost of pergolide can vary greatly and your veterinarian may be able to direct you to the best source.  Good luck, and please let us know if we can help!

Ready to ensure your horse is getting the optimum nutrition at feeding time, every time? Find the perfect feed formulated specifically for horse’s needs with our Feed Selector Tool.Feed Selector tool

17 Replies to “Tips For Feeding Horses with Cushing’s Syndrome”

  1. What about LiteBalance for Cushing’s horses given pergolide? Also, I thought glucosamine was a “no no” for Cushing’s horses.

  2. hello—this article does not mention your safe choice feed–is that not recommended?
    have had my horse on cool balance produced by flint river mill for over a year and a half—got a couple of bad batches and tried your safe choice—my horses that are on a low starch or combination feed actually preferred your feed but since my feed for my other horses is blended at a local mill that also carries frm products i went back to the cool balance for convenience sake, want to be safe as i have just had a horse founder (she has cushings,thyroid disease as well as IR and has been on pergolide and thyroid meds for many years) her blood tests showed sky high so while i THOUGHT we were doing things right i have to totally amend her life now–have been told by a cushings/IR group that i do not want more than a 10% type of feed–cb has 14% so does your safe choice but i know the regular senior feeds are at least that or more–any suggestions as i was seriously considering switching to safe choice

  3. Cheryl & Lorene – Thanks for both of the excellent questions.

    There are a number of options for feeding horses with Cushing’s Syndrome. The focus of many groups and individuals has been on % NSC in the feed. This can be a little bit incomplete information at times because what is really important for the horse is the actual intake of starch and sugar per meal to help control blood glucose level. As more information becomes available, we hope to move to a measurement of intake, expressed perhaps as grams or ounces of starch and sugar per kg or per lb of bodyweight, that will provide more accurate comparisons of different products.

    SafeChoice has been used successfully for horses with Cushing’s Syndrome when fed with appropriate forage and fed as directed with moderate meal size. Key to forage selection is avoiding cool season grasses that are high in NSC content.

    We also use Life Design Senior with a great deal of success.

    Another option if the horse is maintaining body condition and does not require much additional Calorie intake is our LiteBalance product.

    At this time, I am unaware of any contraindications for glucosamine for Cushing’s Syndrome horses. It is best to check with your veterinarian on that topic.

    Best wishes, Roy J.

  4. What is the NSC content of Nutrena products? My horse has metabolic and I need a very low NSC. Nutrena products are great but I’m having trouble finding answers re ingredients and NSC content for Safe Choice, which my barn uses for IR horses. Would love to have mine on Nutrena but need more information.

    1. Hi Nancy, Great question. The NSC (starch + sugar) for SafeChoice is 21%, with starch being 17% and sugar at 4%. SafeChoice can successfully be fed to horses with metabolic problems, if managed properly. These horses truly need low NSC intakes PER MEAL, because it’s about how much they can take in & process at one time. So, more smaller meals can be very beneficial. Typically we do have two recommended products, though, for these types of horses – one for horses who are easier keepers, and one for those horses who may have a little harder time keeping weight on or who are still exercised regularly. For the easy keepers, Empower Balance works very well – it is our lowest NSC feed, at 14% total NSC (8% starch and 6% sugar). It has all the amino acid, vitamin, and mineral content they need to stay feeling their best, while keeping that NSC low and the calorie level low. For horses that need a few more calories, our SafeChoice Senior horse feed is a great option. Also has all the nutrition they need, but more calories from fat. It is our second lowest NSC, at 20% (14% starch and 6% sugar).
      I hope that helps you out, and if you have any more questions, please feel free to let us know! ~ Gina T.

  5. I use well solve low sugar low starch grain since my cushings mare gets too vertical on senior feed, I also feed her beet pulp and pelleted rice bran with her orchard alfalfa mix hay. She is 24 going on 25 still sound for use as a trail horse. There is no grass in her paddock area that is 35 feet by 75 feet so she can self exercise and keep from getting too stiff. she has a run in shelter and she uses it religiously when it rains or snows.

  6. My retired 31 year old Arab has Cushings and Insulin Resistance so my vet recommended the Empower Balance. He gets the max amount suggested plus beet pulp and hay. Unfortunately he has lost weight. What do you suggest that would help him gain weight. Other than being a little under weight he is doing great.

    1. Hi Mary, Thanks for checking in with us. Knowing his weight, his body score and how much and what type of hay he is getting would help to make a better recommendation, but there are some basics we can cover.

      I will assume your horse is much like my 24 year old Arabian and about 800 pounds. At that weight 1.6- 2 pounds of the Empower Balance a day would be adequate for maintenance level feeding. To properly balance the diet, I would need to know what type and amount of hay he is consuming per day, as well as how much beet pulp he receives.

      I do recommend the utilization of high fat and fiber rations to minimize the effects of the blood glucose response and assist in the nutritional management of the disorders. Triple Crown makes a Rice Bran oil which is rich in Omega 3/6. I would recommend adding this to his feed as it will provide safe calories, to help increase his weight gain. I would also ask your veterinarian if you could supplement, as he knows your horses medical history better.

      Hope that helps, please do let us know if you have more questions!
      Thanks ~ Gayle R.

  7. I am confused about the starch/sugar ratio. You claim SafeChoice to be low, but I found Purina’s Well Serve L/S to be much lower in starch. Only 7% compared to your 17%. Kent Feeds also offers a similiar feed with 11% overall percentage. At 21%, I find SafeChoice still on the high side. Is there a reason?

    1. Hi Margaret,

      Thank you for your excellent question regarding the starch and sugar levels in SafeChoice and other products. This is an area of great interest to many people in the industry and is also an area of a certain amount of confusion and difference in interpretation of research results.

      SafeChoice will be about 17% starch and about 4% sugar for a total Non-structural carbohydrate (NSC) level of 21%. I say “about” only because there is a certain amount of analytical variation in laboratory techniques and terminology. Using the same laboratory techniques, good quality oats would be about 42-44% starch and 2-4% sugar for an NSC value of 44-48% for comparison. Other grain, such as corn, may be substantially higher

      What is most essential to the horse is the actual intake per meal or per day, depending on the condition. Research which established some of the current recommendations of 10-13% NSC in the diet for Cushing’s Syndrome or Equine Metabolic Syndrome horses is based on total diet intake. When we designed SafeChoice, we calculated the contributions from both forage and our product in arriving at appropriate levels. If you are feeding say 1/3 SafeChoice and 2/3 appropriate forage, the total diet intake of NSC will be appropriate for the animal. We also use a combination of ingredients to make certain that the starch and sugar are digested and absorbed in the optimum portions of the digestive tract to control glycemic response while minimizing risk of undigested starch getting to the hind gut.

      We also looked at animal performance in terms of body condition and physical activity and realized that going too low on starch and sugar may have a negative impact on the ability of the animal to maintain condition and perform even limited physical activity that requires the use of glycogen as an energy source. Starch and sugar are effectively converted to glycogen by the animal. We want the animals to be able to maintain productive lives as much as possible so that the owner can continue to enjoy riding or using their horse. At a certain point, if less is good, a lot less may not be better. The horses fed our SafeChoice with forage or our Life Design Senior with limited forage have experienced very good quality of life on these diets.

      Best wishes,

  8. I have an oder horse that presents as cushings syndrome. The first summer he did not shed his coat i tried to keep him cooled down. The last two years i shave off what he will put up with. This year has been exetremely dry and hay sources were less than half. I have been supplimenting hay with a product our feed store makes up called custom roughage. I was told it was peleted hay. They recommend grain in the morning with a flake of hay and the roughage in the evening. It has been doing well but over the last few days i have noticed my horse staying to the back of the barn where it is softer. He moves slowly and stiffly. I was afraid to keep him up because i thought that it may make it worse. Once he moved a little he walked better and was able to walk up to the pasture to be with the other horses. I need to find out what the roughage is made up of. This could be due to a change in the hay, as i have round bales from several sources, the feed, or a progression of the syndrome. I have just logged on to get info today.

    1. Hi Mary, Thanks for checking in with us. My concern on your older horse that that he may have insulin resistance as well as Cushing’s. Have you had his blood work tested by your veterinarian? Also, the fact that your horse wants to stay on the softer footing, suggests he may have had a laminitic episode. Again, please check with your veterinarian for an evaluation.

      If indeed he has metabolic or insulin issues, he should be on a diet low in starch and sugar. I am curious what the NSC (starch and sugar level) is in the forage replacer you are purchasing. Horses with metabolic issues or insulin resistance need an overall diet of less than 10% NSC. Unfortunately last year was a trying year for hay production, and much of the hay was stressed from drought, which could result in higher starch and sugar levels. Soaking the hay will help lower the NSC in the forage, but again every cutting of hay is different. You are on the right track that the symptoms can be a combination of all factors, but I would work with my veterinarian to get a medical diagnosis first, and then we can further establish the diet.

      Good luck ~ Gayle R.

  9. By 23 year old Arabian gelding was diagnosed a year ago with cushions he has always been an easy Keep most his life. He has been on the prascend 1 mg a day for about a year. He has been losing weight to the point I’m starting to get a little worried. I have been feeding him Orchard Grass tested between 7 to 8 NSC. I have been also been feeding him the safe choice with beet pulp three times a day and on pasture for half hour with muzzle. He is on vitamins and supplements to fill in the holes but still no gaining just losing. I bought a bag of the Empower boost today to try to see if we can get some more weight on him wondering what the starch and sugar level if any are in the Empower knowing most of it is fat any help with this diet would be highly appreciated.

    1. The combined non-structural carbohydrate (starch + sugar) maximum nutrient guarantee in Empower Boost is 26%.
      Please keep in mind that NSC intake from the total diet at every meal is what really matters to the horse’s health, so its great that you know the NSC content of your hay, SafeChoice Original, and Empower Boost.

      If you were feeding Empower Boost at the maximum recommendation of 3 lbs per day, the NSC intake would equate to approximately 378 grams. For an average 1100 lb horse, that works out to be less than 1 gram per kg bodyweight, and would be less with a smaller daily intake of Boost, and even less if your horses gets his ration divided up into multiple meals a day. The total dietary NSC intake depends on how many lbs per day of hay + SafeChoice + Beet pulp + Empower Boost + pasture your horse gets. We are happy to help you calculate the total dietary NSC intake if you provide us with the lbs per day of feed and supplements your horse gets.

      Although there is nothing wrong with combining SafeChoice Original with beet pulp and Boost, if you find you are feeding SafeChoice Original at or below the minimum recommended intake level or simplifying your feeding program is of interest to you, we would recommend Nutrena SafeChoice Senior or ProForce Senior. Both are controlled NSC, contain beet pulp and highly digestible sources of added fat via an extruded rice bran nugget (like Boost), flax, organic trace minerals, NutriBloom technology to help your horse get more nutrients out of every bite, and Topline Balance to help support muscling. Both products also soak quite well if dental issues ever become a challenge, or if extra water intake is desired. When feeding at the recommended rate, along with appropriate forage intake, these products are safe and work very well for older horses faced with challenges like Cushings.

      Please let us know if you or your vet have any additional questions or concerns. We are happy to help!


  10. Wondering about special care feed for my cushing horse. He is losing top line. Feed aged grass hay.

    1. Hi Kimberly,
      Thanks for reaching out. I would highly recommend you visiting this website: You can get a customized feeding recommendation for your horse’s specific needs.

      Best of luck!
      Robyn A.

Comments are closed.

Privacy Policy | Terms