A vet recommended nutritional approach for your horse or pony with PPID 

Before you make a feeding plan, it is important to have a clear picture of your horse’s condition. A thorough evaluation prevents problems from unintentionally worsening after changes. 

Pay attention to the following points before adjusting the ration: 

• Current diet: knowing the current amount of energy, sugar, and protein intake helps you or your vet to see where adjustments might be needed. 
• Available resources and housing: does your horse get access to a pasture? What type or quality of hay and pasture are available? Is your horse kept alone or in a group? 
• Medical history: a new feeding schedule should support past and current issues. 
• Existing additional conditions: Do you have an older horse? You might need to check for dental problems or arthritis, as your feeding plan can accommodate for these issues. 

In PPID, the brain loses its natural brake on hormone production, resulting in excess adrenocorticotropic hormone (ACTH). ACTH stimulates the adrenal glands to produce cortisol. In PPID horses, this happens too much and too often. The result is a continuously elevated cortisol level in the body.  

Due to this hormonal imbalance, horses with PPID use energy and nutrients less efficiently, leading to abnormal fat storage and faster muscle breakdown. Without the brake on ACTH production, more sugars enter the bloodstream after meals. The horse’s body assumes more energy is needed, producing more insulin to move the sugar into the cells. If the sugar is not used by the cells, they become insensitive to insulin over time. This is known as insulin dysregulation and often accompanies PPID. 

A standard ration is therefore often no longer sufficient. 

Creating a customized feeding plan based on body condition and the presence of insulin dysregulation helps support hormone balance and maintain stable weight. 

1. Nutrition for overweight horses with PPID 

A Body Condition Score (BCS) above 6 is considered overweight. The principles for weight loss are the same for horses with or without PPID. In both cases, energy intake must be lower than energy expenditure. 

The following points are important when creating a feeding plan for overweight horses: 

1. Reduce energy intake and increase exercise 
2. Avoid feeds high in sugar and starch (grains, young grass). Sugars and starch raise insulin levels, promoting fat storage and reducing fat burning 
3. Consider levothyroxine sodium under veterinary supervision in cases of weight loss resistance. Horses that retain fat reserves or have a slow metabolism may benefit from this medication. 

💡 Practical example: A pony weighing 250 kg may lose a maximum of 1% of body weight per week, equal to 2.5 kg in the first week. After that, 0.5% per week is a safe goal. 

Feeding strategy: Use hay nets with small holes or a grazing muzzle to prolong eating time and prevent hunger spikes. Optionally add straw to hay to lower energy density. Your horse will spend more time chewing and stay satiated longer. Older horses with arthritis sometimes struggle to eat from hay nets. They may prefer hay at ground level to avoid neck strain. 

Supplements: A vitamin and mineral balancer such as ESTE Balancer replenishes deficiencies that occur when your horse mainly eats roughage, ensuring a complete and balanced ration. Steady&Stable from Curafyt contains Berberis vulgaris and helps maintain weight and regulate sugar metabolism. 

Muscle maintenance: Use alfalfa or Body&Build from Curafyt for extra protein and help promote muscle mass and growth. Proteins, especially the amino acid tyrosine, are important because they help maintain muscle mass and support dopamine production, which is often deficient in PPID. Combine this with light, regular exercise to limit muscle breakdown and keep metabolism active. 

2. Nutrition for underweight horses with PPID 

Determining the BCS is an important part of clinical evaluation, especially since underweight in horses with PPID can sometimes be harder to detect. Hormonal changes affect fat distribution and muscle development. 

Your horse’s diet should be adjusted according to the underlying causes of weight loss: 

• Dental problems: check the teeth and correct chewing issues such as quidding (dropping food). 
• Parasites: horses with PPID can be more sensitive to parasites, so reduce parasite load by deworming strategically every 3-4 months. 
• Social hierarchy: consider hierarchy during feeding. Lower-ranked horses often receive less feed or eat too fast due to stress. 
• Muscle breakdown: activation of the ubiquitin-proteasome system stimulates protein degradation. It works as a type of “recycling mechanism”: it identifies damaged or old proteins and breaks them down so the body can reuse them. In PPID, this system is overactive due to cortisol overproduction. 

3. Nutrition for PPID with insulin dysregulation 

In addition to dietary management for PPID in overweight or underweight horses, extra attention is needed when horses and ponies also suffer from insulin dysregulation. This combination increases the risk of laminitis (due to high insulin levels) and requires stricter control of sugar content in the diet. 

Key points for horses with PPID and ID: 

• Have an oral sugar test or insulin tolerance test performed by your veterinarian every 4–6 months. 
• Limit sugar and starch to <10–12% non-structural carbohydrates (NSC). 
• Analyze roughage (e.g. hay) to determine sugar content and nutritional value. 
• Soak hay for 6 hours in cold water or 1–3 hours in warm water to reduce sugars. 
• Exercise improves insulin sensitivity. For laminitic horses, exercise should only be done in consultation with your veterinarian. 
• Oil is a good energy source without sugar or starch and is therefore safe for horses with insulin issues. EPA and DHA from oil have anti-inflammatory properties. PPID and insulin resistance are linked to inflammation in fat tissue, which worsens insulin sensitivity. Supplementing with EPA and DHA from high-quality microalgae oil, such as in Grow & Glow from Curafyt, is a useful dietary addition. 

4. Nutrition based on age and teeth 

Your horse’s age plays an important role in nutritional needs. Older animals often face specific challenges such as dental problems or reduced mobility, affecting how they consume and process feed. 

Here are some nutrition tips for older horses: 

• Without dental problems: long-stem roughage 
• With severe dental problems: soaked pulp or hay pellets 
• Feed at least 1.5% of body weight in dry matter per day 
• Feed several small meals per day (rule of thumb: never longer than 6 hours without hay) 
• Choose low-sugar feed to prevent gastric ulcers 
• Alfalfa pellets are a good protein source (without molasses) 

💡 Practical example: How much hay is this for a 500 kg horse? This equals 7.5 kg of dry matter for a 500 kg horse. Hay contains about 85% dry matter. Taking this into account, a 500 kg horse may receive about 8.8 kg of hay per day. 

In addition to these general guidelines, there are some nutrients that deserve extra attention in PPID. Proteins, vitamins, minerals, and electrolytes can directly influence muscle maintenance, hormonal balance, and the immune system. 

• Proteins: Dopamine is made from amino acids such as tyrosine and threonine. Dopamine is needed to maintain hormonal balance, which is disturbed in PPID. Extra lysine and threonine (15–20 g/day) are important for muscle development and help limit muscle loss. 
• Vitamins and minerals: There are no specific guidelines for vitamins and mineral supplementation for PPID. Adjust according to age and activity in consultation with your veterinarian. 
• Electrolytes: Horses with PPID can suffer from polyuria/polydipsia (frequent urination/drinking). Always provide a salt block to replenish losses through urine and sweat. 
• Immune support: Vitamin C can improve immune function and lung health.