My 16 year old at the time of diagnosis with Cushings gelding did well on Prascend for 2 years and out on grass.
He was still fat and I was worried, but vet said he would be fine.
Then he foundered practically overnight, from bucking and playing one day to standing there sad and in pain next morning, with 13% rotation.
After a few weeks, he was fine, x-rays were good, but I was not about to turn him out ever again, once was enough.
At that time we added Thyroid-L and he was stable, at good weight for him and healthy and sound for 7 more years, living in his large and a bit grassy and weedy special pen in the corner of their summer pasture.
He then crashed metabolically, he was sound still, but no energy and just standing there dejected, vet sent blood to Cornell, they said “his figures were so bad their equipment didn’t even measure that high”.
Vet retested and we decided to let him go then, as he was going to anyway in a few more days, his system finally shutting down.
It was a very hard time for all of us, not only because he was an exceptional horse all around everyone loved, horses and humans and such a loss in our lives, but you always second guess yourself what else we could have done … 
If you have a horse with metabolic issues, be aware that you can do much to help them with their quality of life, but there will be sooner or later a very sad time to come.
I still say, better not to take chances.
Horses adapt fine with our help to what they have to do to stay healthy, mentally and physically, as long as we can go there.
Maybe some can go to restricted grass, but it is always chancy.
Vets are learning more every day, stay on top of it all, that’s all that can be said.