Ketosis Treatment and Welfare in Dairy Cows

Ketosis is one of the most common metabolic diseases in early-lactation dairy cows, causing significant welfare impairment that is highly amenable to prevention and treatment.

Key Facts

Clinical ketosis affects 2-15% of early lactation cows in most herds; subclinical ketosis (blood BHB 1.2-2.9 mmol/L) affects 20-50%
Signs include reduced appetite, reduced milk yield, sweet-smelling breath, and in some cows, neurological signs (nervous ketosis)
Treatment with propylene glycol drenches, glucocorticoids and IV glucose is effective when initiated promptly
Cows with subclinical ketosis have 3-4x higher risk of developing displaced abomasum, metritis and other transition diseases

Welfare Considerations

Ketosis welfare impacts range from subclinical impairment (reduced appetite, fatigue, immune suppression) to acute neurological crisis in nervous ketosis. The insidious nature of subclinical ketosis — causing significant welfare impairment without triggering obvious farmer concern — makes metabolic monitoring with cow-side BHB testing a critical welfare intervention. Fresh cow protocols that include routine BHB monitoring in the first 7 days of lactation identify subclinical ketosis for treatment before clinical disease develops.

What You Can Do

Implement fresh cow BHB monitoring in the first 3-7 days after calving using cow-side ketone meters
Treat cows with BHB above 3.0 mmol/L and clinical signs with propylene glycol and veterinary assessment
Evaluate nutrition, body condition score and transition management when herd ketosis prevalence exceeds 15%
Provide propylene glycol prophylactically to high-risk cows (over-conditioned, high parity) in the first week of lactation