What to Feed a Horse with Cushing’s? | Low-NSC Diet Basics

A Cushing’s diagnosis doesn’t mean your horse can’t eat well—it means every bite needs to earn its place. Deciding what to feed a horse with Cushing’s comes down to controlling nonstructural carbohydrates (NSC), the sugars and starches that trigger insulin spikes. Kentucky Equine Research advises keeping forage under 12% NSC, and the rest of the ration should follow the same low-sugar, low-starch rule. Horses with PPID and confirmed insulin resistance need the strictest carbohydrate limits, because even small NSC excesses can trigger laminitis.

Feeding a Cushing’s Horse: The Core Rules

The foundation of a PPID diet is forage, but the exact plan depends on your horse’s body condition and insulin status. PPID horses that are normal weight and not insulin resistant can often eat much like a normal horse, as long as you monitor body condition and prevent obesity.

• Overweight: Reduce total calories and especially NSC. Restrict grazing and hay as needed, and test or soak hay to bring sugar down.
• Insulin-resistant or laminitis risk: Strictest NSC limits apply. Avoid high-sugar concentrates and sudden pasture access, and work with your vet to set the target.
• Underweight or losing muscle: Add calories with alfalfa, beet pulp, soy hulls, or a low- to moderate-NSC commercial feed.

Small, frequent meals help, too. Splitting the daily ration into two, three, or even four feedings blunts glucose and insulin spikes compared with one large meal.

What Feeds Work Best for Cushing’s Horses?

The feeds that work best are low in NSC and high in fiber or fat. Alfalfa, beet pulp, soy hulls, and fortified balancers all fit the bill. Balanced nutrition becomes harder as PPID progresses, so choosing feeds from the table keeps the daily NSC load predictable.

A vitamin-mineral balancer is essential when forage is restricted, because hay alone can’t cover all nutritional gaps. Kentucky Equine Research specifically recommends low-intake balancer pellets to supply amino acids, vitamins, and minerals without adding extra calories.

Purina notes that PPID diets should provide excellent-quality protein, adequate calories for maintenance, and balanced vitamins and minerals. If insulin dysregulation is present, lower starch and sugar even further. For older horses losing muscle, senior feeds fortified with lysine, methionine, biotin, vitamin E, copper, zinc, and selenium help close the gap. If you need extra calories, fat is your friend—vegetable oil or stabilized rice bran add concentrated energy without sugar.

For a quick look at vetted commercial options from our own testing, see our tested roundup of Cushing’s-safe feeds.

Hay and Pasture Strategies That Lower Risk

Test hay for sugar content when you can; if it runs high, change sources or soak it. Soaking guidelines vary, but a 30-to-60-minute cold-water soak (or 30 minutes in warm water) removes a meaningful portion of sugar.

Pasture is the other big variable. Lush spring grass and drought-stressed grass are highest in sugar. If your horse is insulin-dysregulated, avoid lush pasture entirely or limit turnout to short sessions with a grazing muzzle. A dry lot offers a solid alternative when grass is risky. Horses with PPID and confirmed insulin dysregulation generally need stricter NSC control than PPID horses without insulin issues.

FAQs

Can I Feed Grain to a Horse with Cushing’s?

Cereal grains (oats, corn, barley) and molasses-based feeds are too high in starch for a PPID horse. They cause a rapid insulin spike that raises laminitis risk. If you need calories, choose low-NSC commercial feeds, beet pulp, soy hulls, or alfalfa, and divide the daily ration into at least two small meals.

How Long Should I Soak Hay for a PPID Horse?

Guidelines differ.

Does a Cushing’s Horse Always Have Insulin Resistance?

No. Some PPID horses are insulin-dysregulated and some are not. Horses without insulin issues can handle a slightly higher NSC level, but keeping the whole diet on the low-sugar, moderate-starch side is still wise. Work with your vet to test insulin and set a target NSC range.