By Jolan Lemmens

You might think of ketosis in cattle as a rather modern consequence of current dairy farming, but surprisingly, earliest reports of ketosis go as far back as 1849. And even though it wasn’t yet called ketosis (or hyperketonemia or acetonemia), the symptoms these early researchers described are still spot on. Understanding its symptoms, risks, and prevention strategies is critical for maintaining herd health and profitability.

What is ketosis in cattle?

Ketosis in dairy cows is a metabolic disease, mostly occurring in the first 3 weeks after calving, that is characterised by an increased concentration of ketone bodies, of which beta-hydroxybutyrate (BHB) is the most common one (70%) in ruminants. In essence, ketosis results from a negative energy balance (NEB), after which cows will mobilize fat stores in order to rebalance their big energy needs during early lactation. This will oxidize fatty acids and create ketone bodies like BHB.

Just like with milk fever and mastitis, ketosis is also commonly divided into subclinical ketosis and clinical ketosis:

• The threshold for subclinical ketosis is often described as 1.2 or 1.4 mmol/L of said ketone bodies (BHB).
• Once the concentration of ketone bodies exceeds 3.0 mmol/L, or the cow show symptoms, we speak of clinical ketosis.

What are the symptoms of ketosis in cows?

Clinical ketosis is associated with following symptoms:

1. Increase in ketone bodies in blood, urine or milk
2. Reduced rumination time
3. Loss of appetite
4. Rapid weight loss
5. Dry manure

Apart from the increase in ketone bodies, subclinical ketosis of course comes without visual symptoms which makes it all too dangerous. Many cases of subclinical ketosis in cattle will go undetected, leading to negative effects on productivity and hidden costs.

Some factors have been reported to increase the risk for (subclinical) ketosis or predict it:

1. High milk production in the previous lactation
2. Ketosis in previous lactation
3. High parity
4. High Body Condition Score before calving (BCS ≥ 3.5)
5. A low protein percentage (which is probably a consequence of NEB)
6. Low daily food intake in the previous week

Occurence of ketosis in cattle

It is widely known that ketosis is one of the most common diseases in dairy cows, but how many cows suffer from subclinical or clinical ketosis is difficult to answer. Mainly, because there is no strict threshold when measuring ketone bodies: common thresholds are 1.2 and 1.4 mmol/L, but some researchers go as low as 1.0 mmol/L or as high as 1.8 mmol/L. Obviously, this makes it difficult to compare ketosis numbers.

• The prevalence of clinical ketosis in European dairy herds ranges between 0.7% and 11.1% of the cows.
• When looking at subclinical ketosis, the numbers also vary widely. A comprehensive study of subclinical ketosis in European farms, shows a range of 11,2% (Turkey) to 36.6% (Italy) of cows suffering from subclinical ketosis. A Canadian study found that 44% of the tested Holstein cows on 4 commercial dairy farms had subclinical ketosis.

Table 1: prevalence or incidence of postpartum disease in 5,884 dairy cows of 528 heards in 10 European countries.

But, remarkably, even in grazing Holstein cows more than 1 in 10 cows are detected with subclinical ketosis between the 4^th and 19^th day in milk, showing that even these animals need to be monitored with a focus on prevention.

The real cost of ketosis in dairy cows

What is the cost of ketosis in cattle? Another question which needs a nuanced answer, as you need to check carefully which costs are taken into account. Some studies only include direct costs while indirect costs can have a big impact as well. And obviously, costs vary between countries.

Direct costs:

• Medication
• Veterinary visits
• Labor
• Cost of diagnosing

Indirect costs:

• Increased risk on secondary diseases such as metritis, lameness, displaced abomasum, retained placenta, milk fever, and mastitis.
• Lower milk production (up to a 251 kg).
• Discarded milk
• Cost of impaired fertility
• Increased risk for culling.

A Dutch study calculated an average cost of 150 euros per case of subclinical ketosis, with a range between 18 and 422 euros. Clinical ketosis costs an average of 709 euros per affected cow with a range between 64 and 1,196 euros.

The big takeaway from all this? Prevent ketosis in cattle, both for your bank account and the cow’s welfare!

Preventing ketosis starts with detecting ketosis

Many tools are available for the detection of (subclinical) ketosis in cattle these days. Hand-held meters for example are simple devices to measure the concentration of BHB. These widely available tools are important, as accurate monitoring will lead to correct diagnoses, a correct estimation of costs (mainly reducing underestimation), and the necessary prevention.

KETOTOP bolus: four lines of defense against ketosis in cattle

In its essence ketosis is a complicated case of energy deficiency. To solve this case Resco developed it’s ketosis bolus Ketotop. This bolus will supply energy in four different ways. We will describe these four lines of defence and its main ingredients.

1 Clean up the liver

Ketotop protects and cleans up the liver thanks to betaine, choline, and methionine, among other ingredients like riboflavin and cobalamin. Improving the liver function will help the liver with metabolizing glucose and thus providing energy.

Betaine

1. Betaine is found to limit fat from accumulating in the liver as it restricts the development of fatty acids.
2. Furthermore, it helps with turning the ‘old’ fatty acids into energy and any fat that does form is excreted faster (for example through milk or blood).
3. Betaine will also convert the harmful substance homocysteine into methionine, which is a helpful substance to combat ketosis.
4. Lastly, betaine helps containing inflammatory responses, which prevents additional stress on the liver. A liver that is already very busy.

Choline

1. Just like betaine, choline also processes fatty acids from the liver.
2. But more importantly, choline is a precursor to betaine and all it’s benefits to liver health.

Crucial to know is that choline has a very low bioavailability as the rumen will degrade it rapidly. Therefore, two things are important: choline should be rumen-protected, and the liver will make choline from methionine. As methionine is also crucial for protein- and milk production, cows with ketosis can be supplemented with choline and/or methionine.

2 Hepatoprotective herbal extracts

Plant extracts and essential oils are becoming increasingly popular in cattle feed and Ketotop contains a mixture of different extracts as well, like fennel, milk thistle and artichoke, among others.

Fennel

1. Fennel has antioxidant and hypolipidemic properties: it helps in lowering the amount of fat in the bloodstream so the risk of high blood-fat problems like ketosis drops.
2. But more importantly, it stimulates appetite: dry matter intake increases after cows and calves have been supplemented with fennel seed powder. And more feed intake equals more energy, which lowers the chance to develop ketosis.

Milk thistle

Milk thistle is a great hepatoprotector as well: it helps with rapid cell renewal in the liver, which helps the damaged liver in functioning properly. A crucial action on moments when the liver is in full force!

Artichoke

1. Another impressive hepatoprotector is artichoke extract, having both protective and regenerative properties on liver cells.
2. Furthermore, artichoke stimulates bile production which helps with digestion of fat.

3 Rumen stimulation

Ketotop stimulates the ruminal fermentation using niacin, cobalt, and yeast.

Niacin

1. Niacin increases the number of protozoa and bacteria in the rumen which will improve fermentation and digestion of the feed.
2. It will also increase the levels of propionate (propionic acid) which can be metabolized into energy.
3. Additionally, niacin reduces beta-hydroxybutyrate, the main ketone bodies. And less ketone bodies also means a lower risk for ketosis.

Cobalt

1. Cobalt is the same as niacin as it will also promote bacterial growth.
2. However its main function is that of “vitamin-B12 factory”. The rumen flora can only make vitamin B12 (cobalamin) given it has enough cobalt. The vitamin B12 itself is vital for the transformation of propionate into energy.

Yeast

Lastly, yeast is an additive which is widely used to improve feed efficiency as it competes with less useful bacteria. The more efficient feed is converted into energy, the lower the risk on acidosis and ketosis.

4 Energy boost

Ketotop contains calcium propionate. This propionate will be converted to glucose in the liver (gluconeogenese) and becomes a fast and easily available energy source, which will help in restoring the energy balance. Important in the conversion of propionate to glucose is vitamin B12 (or cobalt, which is used by bacteria to make vitamin B12). Without enough vitamin B12 the “glucose factory” shuts down.

Additional measures to prevent ketosis in cattle

1. Energy: mix a total ration that contains enough energy so the high-yielding cow does not need to use her body fat.
2. Roughage: ensure that the ration contains sufficient roughage with a good structure.
3. Feed: avoid sudden feed shortages.
4. Feed changes: make sure that there are no rapid changes in the feed that result in disturbances in the fermentation of the feed taken in.
5. Exercise: ensure that the animals get sufficient exercise.

Source list

[1] Shaw, J. C. (1955). Ketosis in dairy cattle: a review.

[2] ZhiGang, Z., GuoWen, L., HongBin, W., XiaoBing, L., & Zhe, W. (2012). Detection of subclinical ketosis in dairy cows. Pakistan Veterinary Journal, 32(2), 156–160.

[3] Garro, C. J., Mian, L., & Roldán, M. C. (2013). Subclinical ketosis in dairy cows: prevalence and risk factors in grazing production system. Journal Of Animal Physiology And Animal Nutrition, 98(5), 838–844.

[4] Raboisson, D., Mounié, M., & Maigné, E. (2014). Diseases, reproductive performance, and changes in milk production associated with subclinical ketosis: A meta-analysis and review. American Dairy Science Association, 97, 7547–7563.

[5] Steeneveld, W., Amuta, P., Van Soest, F., Jorritsma, R., & Hogeveen, H. (2020). Estimating the combined cost of clinical an subclinical ketosis in dairy cows. Plos One, 15(4).

[6] Suthar, V., Canelas-Raposo, J., Deniz, A., & Heuwieser, W. (2013b). Prevalence of subclinical ketosis and relationships with postpartum diseases in European dairy cows. Journal Of Dairy Science, 96(5), 2925–2938.

[7] Kaufman, E., LeBlanc, S., McBride, B., Duffield, T., & DeVries, T. (2016). Association of rumination time with subclinical ketosis in transition dairy cows. Journal Of Dairy Science, 99(7), 5604–5618.

[8] Jessica, G., LeBlanc, S., & Duffield, T. (2013). Ketosis treatment in lactating dairy cattle. Vet Clinic Food Anim, 29.

[9] Rasmussent, L. K., Nielsen, B. L., Pryce, J. E., Mottram, T. T., & Veerkamp, R. F. (1999). Risk factors associated with the incidence of ketosis in dairy cows. Animal Science, 68(3), 379–386.

[10] Cainzos, J., Andreu-Vazquez, C., Guadagnini, M., Rijpert-Duvivier, A., & Duffield, T. (2022). A systematic review of the cost of ketosis in dairy cattle. American Dairy Science Association, 105, 6175–6195.

[11] Zhang, L., Qi, Y., ALuo, Z., Liu, S., Zhang, Z., & Zhou, L. (2018). Betaine increases mitochondrial content and improves hepatic lipid metabolism. Food & Function, 10(1), 216–223.

[12] Arumugam, M.K.; Paal, M.C.; Donohue, T.M., Jr.; Ganesan, M.; Osna, N.A.; Kharbanda, K.K. Beneficial Effects of Betaine: A Comprehensive Review. Biology, 2021, 10, 456

[13] Shahsavari A, D'Occhio MJ, Al Jassim R. The role of rumen-protected choline in hepatic function and performance of transition dairy cows. Br J Nutr. 2016 Jul;116(1):35-44.

[14] Chen J, Yang Z, Dong G. Niacin nutrition and rumen-protected niacin supplementation in dairy cows: an updated review. British Journal of Nutrition.

[15] González-Montaña JR, Escalera-Valente F, Alonso AJ, Lomillos JM, Robles R, Alonso ME. Relationship between Vitamin B12 and Cobalt Metabolism in Domestic Ruminant: An Update. Animals (Basel). 2020 Oct 12;10(10):1855.

[16] Moosavi-Zadeh E, Rahimi A, Rafiee H, Saberipour H and Bahadoran R (2023) Effects of fennel (Foeniculum vulgare) seed powder addition during early lactation on performance, milk fatty acid profile, and rumen fermentation parameters of Holstein cows. Front. Anim. Sci. 4:1097071.

[17] Tedesco, D., Tava, A., Galletti, S., Tameni, M., Varisco, G., Costa, A., & Steidler, S. (2004). Effects of Silymarin, a Natural Hepatoprotector, in Periparturient Dairy Cows. Journal Of Dairy Science, 87(7), 2239–2247.

[18] Florek, E.; Szukalska, M.; Markiewicz, K.; Miechowicz, I.; Gornowicz-Porowska, J.; Jeli ´ nska, A.; Kasprzyk-Pochopie´ n, J.; Nawrot, J.; Sobczak, A.; Horoszkiewicz, M.; et al. Evaluation of the Protective and Regenerative Properties of Commercially Available Artichoke Leaf Powder Extract on Plasma and Liver Oxidative Stress Parameters. Antioxidants 2023, 12, 1846.

[19] Elliot, J. M. (z.d.). Propionate metabolism and vitamin B12.