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Summary Pituitary pars intermedia dysfunction (PPID) is a common endocrine disorder affecting equids. To help achieve and maintain healthy body condition, whilst reducing the risk of dietary associated laminitis, appropriate nutritional management is key. This review proposes a stepwise approach to building an individual nutritional plan for equines with PPID. Starting with considerations relating to current and desired body condition and muscle mass, it highlights the importance of providing appropriate amounts and forms of energy, carbohydrate and protein, with further practical considerations regarding the feeding of animals that are often aged and may have particular clinical sequelae to PPID. The next important step is to determine the degree of insulin dysregulation (ID), as this is a major factor associated with an increased risk of laminitis. Animals with ID should be fed low non‐structural carbohydrate (NSC) providing feeds/feedstuffs as well as fresh or preserved forage with NSC content <10‐12% on a DM basis. Finally, adjustments need to be made according to life stage and activity level.

Malabsorption syndrome results in impaired nutrient digestion/absorption. Diagnostic tests in horses are focused on reduced carbohydrate absorption demonstrated by abnormal oral glucose tolerance test. However, to determine the definitive diagnosis a biopsy should be performed. The objective was to evaluate the progress of horses believed to be suffering from malabsorption syndrome without other infectious conditions, following institution of appropriate dietary advice. Medical records of 15 horses admitted to the equine hospital of Ghent University (2014–2017) were reviewed. All horses had received corticosteroid treatment and individual dietary advice. All horse owners were contacted in 2017 for a follow-up. Most horses (86 per cent) had tolerated the recommended diets well and gained weight. Owners noticed the greatest improvements at three and six months after starting the diet. Adequate dietary formulation may therefore be a valuable adjunct to medical treatment. However, it may take several months before increases in bodyweight and condition are seen.

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