NAVLE Prep Ketosis 2011

11/16/2011
Ketosis
Ketosis
Jim Brett, D.V.M. Assistant Clinical Professor College of Veterinary Medicine Mississippi State University http://128.118.11.160/dairynutrition/ documents/duffieldtrtketosisppt.pdf
Clinical ketosis is a metabolic disorder in highproducing dairy cattle that occurs typically in the first 2 months after calving with a prevalence of around 5-8% Subclinical ketosis is defined as blood serum BHBA above a threshold (~1/2 mmol/L) and has a prevalence of around 15 to 30% and up to 50% on some farms
Ketosis
Caused by a severe negative energy balance, because of high milk production and insufficient energy intake, and excessive body fat mobilization. Reasons for insufficient energy intake may be poor ration quality (forage), insufficient dry matter intake, or other diseases (e.g., hypocalcemia). Ruminants are more prone due to their heavy dependence on gluconeogenesis
Response to Negative Energy Balance (NEB)

Adaptive: Spare glucose, shift to fat as fuel Problem:
Prepartum (fetal demand for glucose near parturition) Postpartum (udder need for glucose to make lactose)
Ketosis
When fatty acids are mobilized from adipose tissue, there is an increase pool of ketone bodies: BHBA, acetoacetate, & acetone. BHBA increases in fasting / limited DMI cases & acetoacetate (oxidized form of BHBA) increases in pathological ketosis (hepatic lipidosisi) unstable and decomposes to acetone and CO2 (toxic).
Ketosis
Ketosis is associated with a loss in milk production and a greater incidence of leftdisplaced abomasum, metritis, cystic ovaries, resumption of postpartum luteal function, and mastitis Clinical signs may be minimal: decreased DMI, mild lethargy/depression, slight decreased milk production, doughy rumen/feces or dry feces, hypomotility of the rumen, sweet smell to breath
11/16/2011
Nervous Ketosis
Seen in ~ 10% of primary ketosis cases Signs: head pressing, stuporous attitude, apparent blindness, excessive licking and chewing, isolated muscle twitches, acting crazy or like they have rabies With concurrent subclinical hypocalcemia: stiff gait or saw-horse stance
Secondary Ketosis
As a result of any disease that causes a in appetite during early lactation (LDA, Metritis, Mastitis).
Diagnosing ketosis
Ketosis
Subclinical ketosis is a metabolic disorder in high producing dairy cattle that can be detected by ketone bodies in urine, milk & blood: acetone (Ac), acetoacetate (AcAc), and -hydroxybutyrate (BHBA).
Herd MonitorsPre-Partum Testing: serum NEFAs

Currently, 0.40 meq/L is the line of demarcation for SCK. Herd goals less than 15% of cows 2 weeks or less from calving have NEFA values over 0.4 meq/L. On farm testing not available sent to a referral lab. Not accurate to predict DAs on individual cows, but useful as herd monitoring tool.
BHBA
Monitoring blood BHBA is superior to monitoring urine acetoacetate using urine test strips. Precision Xtra: Measures either whole blood BHBA or whole blood glucose. No other human glucometer can also function as a ketometer (i.e., able to measure blood BHBA). Accurate for measuring whole blood BHBA in cows.
11/16/2011
BHBA
A test result on the meter of 1.2 mmol/L equals 12.2 mg/dL. Cows that are 1.2 mmol/L or higher are considered positive for ketosis. Used only for individual cow treatment decisions and not as a herd-based monitoring test. Glucose is not useful as a herd-level test because it is a highly regulated metabolite that is unlikely to change in response to overall herd management or nutrition.
Herd MonitorsProtein to Butterfat Ratio on 1st Test Day

A protein : butterfat ratio of 0.75 is indicative of SCK Low sensitivity 58% and specificity 69% make this a poor individual cow test If more than 40% of the herd has a protein to butterfat ratio 0.75 at 1st test, this is a reliable indicator of SCK.
What can we do to lighten the cows load?
Monensin (Rumensin Elanco)

Monensin is a compound which can increase the amount of glucose derived from feedstuffs and has the potential to help prevent ketosis. The rumen digests CHOs into VFA (primary source of energy for cattle). Proprionic acid provides more energy than the other 2 forms of VFAs (acetic acid & butyric acid)
Monensin (Rumensin Elanco)

Rumensin improves the efficiency of rumen fermentation. (promotes growth of naturally occurring, more efficient rumen bacteria) AND increases the % of propionic acid in VFA production (33% to 38%) = more energy. Secondary effect is the decrease in energy used to produce methane & CO2 (waste energy)
Treatment
11/16/2011
Treatment
200-500 ml 50% Dextrose IV repeat in 24 hours if needed Propylene glycol 12-16 oz once daily or 8 oz twice for 4-5 days OR use as follow-up to IV dextrose Corticosteroids 10ml (20mg) dexamethazone IM Supportive care oral fluids + yeast/probiocin, electrolytes *Dietary choline and niacin
Incidence of reoccurrence
Cows with a history of ketosis are 1.5- 2.0 times greater to have clinical ketosis on their next lactation as cows with no history of ketosis
Questions?

NAVLE Prep Ketosis 2011

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What causes ketosis in dairy cattle?

How is ketosis diagnosed?

11/16/2011

Response to Negative Energy Balance (NEB)

Herd MonitorsPre-Partum Testing: serum NEFAs

Herd MonitorsProtein to Butterfat Ratio on 1st Test Day

What can we do to lighten the cows load?

Monensin (Rumensin Elanco)

Monensin (Rumensin Elanco)

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