From Cow
Ketosis, a common cause of downer cow syndrome in cattle

Ketosis (Acetonemia, Ketonemia) is a common multifactorial disease resulting in downer cow syndrome in adult cattle worldwide[1].

Causes which predisposed to ketosis include:

Ketosis is a common disease of dairy cows in early lactation caused by a negative energy balance that results in high concentrations of circulating nonesterified fatty acids (NEFAs) (acetone, acetoacetate, and β-hydroxybutyrate (BHB)). This disease is usually associated with fatty liver.

Clinical signs

Clinically affected cattle shows signs of anorexia, reduced milk yield and may present as downer cows. Neurological signs of restlessness and ataxia may sometimes be noted. A sweet breath may be observed by an observant farmer or veterinarian.


Diagnosis is based on presenting clinical signs supported by laboratory tests such as urinalysis and milk detection of ketones. During the first month of lactation, ratios of glycerophosphocholine:phosphocholine less than 2.5 in the milk indicate a high risk for developing ketosis[2].

Blood tests showing elevated NEFAs can assist diagnosis in more valuable cattle[3].


Bolus IV administration of 500 mL of 50% dextrose solution is a common therapy[4].

Glucocorticoids including dexamethasone or isoflupredone acetate at 5–20 mg/dose, IM, generally results in a more sustained response.

Oral propylene glycol (250–400 g) may be effective as ketosis therapy[5].


  1. Wang X et al (2012) Correlation between composition of the bacterial community and concentration of volatile fatty acids in the rumen during the transition period and ketosis in dairy cows. Appl Environ Microbiol 78(7):2386-2392
  2. Klein MS et al (2012) NMR metabolomic analysis of dairy cows reveals milk glycerophosphocholine to phosphocholine ratio as prognostic biomarker for risk of ketosis. J Proteome Res 11(2):1373-1381
  3. Borchardt S & Staufenbiel R (2012) Evaluation of the use of nonesterified fatty acids and β-hydroxybutyrate concentrations in pooled serum samples for herd-based detection of subclinical ketosis in dairy cows during the first week after parturition. J Am Vet Med Assoc 240(8):1003-1011
  4. [ Merck Vet Manual]
  5. McArt JA et al (2011) A field trial on the effect of propylene glycol on milk yield and resolution of ketosis in fresh cows diagnosed with subclinical ketosis. J Dairy Sci 94(12):6011-6020