Q. My 28-year-old gelding has PPID (formerly called equine Cushing’s disease), but he refuses to eat wet hay and only eats dry alfalfa well. Is alfalfa okay for him to eat? Is there a way to get him used to eating wet hay, or can he safely continue to eat dry hay?

A. Senior horses, especially those diagnosed with PPID, need carefully curated nutrition plans that are customized to their needs. For these cases it is crucial to maintain a ration that is low in non-structural carbohydrates (NSC), which is calculated by adding starch and water-soluble carbohydrates (WSC), while still ensuring that he is maintaining a healthy body condition and does not have any underlying nutrient deficiencies. With older horses that might be picky eaters, we sometimes must get creative to keep them in an optimal body condition. However, your horse might not need soaked hay, and dry alfalfa could be a good option for him.

When managing a horse with PPID, the first step is to ensure you are working closely with your veterinarian for medical management. When there are issues with consuming long-stem fiber for horses, especially those within this age demographic, having their dentition evaluated by your veterinarian is important.

Most of the reason alfalfa gets a bad reputation for metabolic cases is due to the higher caloric content; therefore, if your horse is overweight, adding alfalfa is not recommended. Despite this, the NSC content of legumes such as alfalfa can be lower than cool-season grasses such as timothy, and many owners are unaware of this. Additionally, horses with PPID can often have difficulty maintaining their topline. Therefore, if he is on a low-NSC diet made up of soaked hay, he might need an additional protein source, and the alfalfa could fit in well.

Any forage you’re giving your horse should be tested for its NSC content. If your hay is below 12% NSC on a dry matter basis, you may not need to soak it, especially if all the other components of his ration are not high in NSCs. If the alfalfa is what he is keen to eat, and he is not overweight, then I would strongly recommend having that forage tested to ensure it is safe for him to consume. The only way to ensure the alfalfa is safe for him is to have it tested and confirm NSC levels are below 12%. If you are soaking his current hay for a significant amount of time, this can negatively impact the palatability and appeal of the forage. Soaking for 30-60 minutes instead of many hours can improve palatability depending on the current soaking protocol.

In these more complicated situations, I recommend having an equine nutritionist formulate your horse’s ration because they will be able to consider the nutritional content of the entire ration to ensure there are no nutrient deficiencies and nothing is being greatly oversupplied.