I apologize for asking this if it's been answered (but I searched the archives and didn't find a definitive answer)---

There is a little draft cross horse at the farm I now board at who came from a hack stable in the mountains, apparently was very very fat when they got him, was on (I was told) a high fat sweet feed (??? never heard of that! I wish somebody had had the sense to ask WHY he was on a high fat diet then--but they didn't) so they switched him to Nutrena Senior. He is very ribby now, has a big crest still but that dip in front of his withers that says metabolic syndrome to me, and a slightly swayed back with no topline muscle at all. About a month ago they switched his feed again to Nutrena Safe Choice, and he has really taken a turn for the worse. They also started giving him beet pulp--but it had added molasses, to try to put weight back on him. I have convinced his owner and the barn manager to get him off sugar as much as possible, so they are going to start feeding him alfalfa cube mashes like Tink gets, start adding a little oil, and put him back on the Senior or Lite feed. And the vet will be called for him--I just don't know how soon that will happen--to me it's urgent--so I'd like to push the diet issue immediately, rather than wait. (Not to mention the one vet they call sometimes is an incompetent boob, but that's another story!)

Everybody agrees there is no downside to taking him off sugar, but these myths about alfalfa and oil persist, so I have questions. People STILL insist alfalfa will founder a horse--that is false, right? Carbohydrate overload founders them, not protein, right? I know if he has EPSM the alfalfa and oil is good for him, but if he does have metabolic syndrome, will the fat and protein hurt him? Will an EPSM oil quantity harm a metabolic syndrome horse? Can a horse have both EPSM and Cushings--I'm guessing yes? Is unmolassessed beet pulp better than the alfalfa mash to get him plumped back up, or is it just a matter of what he prefers? I certainly don't want to suggest anything that will hurt the poor little guy.

I know you're going to say it's important to get the vet out and I couldn't agree more, but this situation made me very curious, and now people are asking me diet questions, and I'd love to have authoritative answers!

Tina, you are quite correct that when it comes to dietary factors and laminitis it is carbohydrate, not alfalfa, that is the problem. And in the carbohydrates it is specifically the non-structural carbohydrates (NSC). Either alfalfa or beet pulp with added oil would be fine. As you say, whatever he prefers to eat. As to the added fat and insulin resistance/metabolic syndrome and Cushing's horses. When they are in need of weight added fat is actually the recommended feed. When is it a draft cross or any other horse with potential for EPSM muscle issues the fat is essential - the horse can't exercise properly to help the insulin resistance problems if they don't have the fat in their diet to fuel their muscles. I've worked with many horses with both EPSM and either insulin resistance or full blown Cushings disease. Just make all changes to the diet slowly to help avoid changes in the gastrointestinal environment. I hope this helps to answer your questions and those of others working to help this horse. Please let us know how things go!

Thanks, Dr. Beth! The good vet was out yesterday, thinks the little guy is much older than his owner was told, and thinks he does indeed have Cushings, so he recommended all the right things--low starch and sugar diet, start to add some fat, and Pergolide. Fortunately the horse isn't laminitic or anything that should prevent a full recovery in short order, and the owner and barn manager are 100% on board with the treatment. He's such a great little horse, I'm so relieved. Thanks for your reply!

Tina, thanks for this update - here's hoping this guy gets back on track quickly!

I'm happy to report the little old guy is showing a marked improvement in his attitude and energy level already. Hopefully he'll be fat and sassy and ready to hit the trails again when spring comes!