Managing metabolic diseases in aging horses, such as insulin dysregulation (ID) and pituitary pars intermedia dysfunction (PPID), poses unique challenges. Approximately 20% of horses aged 15 and older are affected by PPID, while the prevalence of ID remains less clear. A significant concern for these horses is laminitis, particularly endocrinopathic laminitis, which leads to severe pain and diminished quality of life.

Effective management of these conditions hinges on tailored diet and exercise plans. Diet is crucial for controlling postprandial hyperinsulinemia, with recommendations emphasizing the limitation of nonstructural carbohydrates (NSC) in the diet. While guidelines suggest a maximum of 12% NSC in hay and concentrates, individual horses may respond differently due to genetic and microbiome factors, necessitating careful monitoring and adjustments based on insulin levels.

In addition to dietary considerations, the article highlights the importance of exercise and medication in managing aging horses with metabolic disorders. Special attention is also given to addressing osteoarthritis and planning for end-of-life care, ensuring a comprehensive approach to the well-being of these horses.