Ketosis in cows: Causes, Symptoms, Treatment and Prevention

Ketosis in cows: Causes, Symptoms, Treatment and Prevention

Ketosis in cattle is the most common metabolic disorder in modern dairy farms. Due to its frequent occurrence, it is better described as a condition of modern productive cows than a disease. Ketosis, especially its subclinical form, occurs as a consequence of a negative energy balance during heavy milk production after calving.

Lack of energy

Ketosis occurs when a cow experiences a negative energy balance—meaning she is using more energy than she is consuming. This often happens after calving when energy demands spike due to milk production, but feed intake may not yet have increased to match those demands. To compensate, the cow's body mobilizes fat reserves for energy. These fats are broken down into non-esterified fatty acids (NEFAs), which the liver converts into ketone bodies (like beta-hydroxybutyrate, or BHBA). When ketone levels become too high, they accumulate in the blood, leading to ketosis

Stage of lactation

Most cattle suffer from ketosis during the first third of lactation, while the disease occurs less often in the late stage of lactation or during lactation. During the first 10 days of lactation, milk yield increases significantly, and feed intake and absorption increase slowly, so the negative energy balance is at its highest on days 7 – 14 after calving. In the first weeks after calving (usually 4-8 weeks), a negative energy balance is inevitable, but this does not mean that the animal will necessarily become seriously ill.

Obesity

Cows with high productivity and high body condition score fall into the high-risk group. A very large drop in weight and milk yield after calving reflects the negative energy balance characteristic of ketosis. The more obese a cow is at calving, the more likely it is to lose weight after calving.

The industry evaluates the development of muscle and fat tissue by the “BCS” scores (body condition score). A very lean cow is evaluated by 1 point (almost no fat and poorly developed muscles), a very fat cow is evaluated by 5 points (abundant adipose tissue and well-developed muscles).

Improper feeding

Ketosis is often also called the “starvation” disease – it is a disorder of protein, fat and carbohydrate metabolism, when ketones increase in the body. Improperly balanced feed (lack of carbohydrates), poor feed quality (e.g. poor-quality corn silage) are some of the factors leading to ketosis.

Just before calving, dry matter intake typically declines by 5% per week during the last 2–3 weeks and can drop by up to 30% in the final 3–5 days 1. A typical Holstein cow may consume 22–26 lbs. of dry matter per day during the close-up period, but this can fall to 14–18 lbs./day right at calving.

Post-calving, cows are in negative energy balance—they need more energy for milk production than they can consume. DMI (dry matter intake) usually doesn’t peak until 8–12 weeks into lactation, while milk production peaks earlier, around 6–10 weeks.

Preventing ketosis in dairy cattle involves a combination of nutritional management, monitoring, and environmental support, especially during the transition period around calving. Ensuring cows receive a balanced diet rich in energy, particularly in the last trimester and early lactation is crucial. Supplements like propylene glycol, glycerol, and niacin can help boost energy availability and support metabolism. Maintaining an optimal body condition score (BCS) of 3.0 to 3.25 at calving helps reduce the risk, as over-conditioned cows are more prone to ketosis due to reduced feed intake and increased fat mobilization. During the transition period, cows should be grouped separately to minimize stress and encourage feed intake and diet changes should be introduced gradually to allow rumen adaptation. Regular testing of blood, milk, or urine for ketone levels is essential to catch early signs of ketosis, with routine screening recommended in the two weeks before and after calving. Additionally, providing clean, dry housing and access to high-quality water supports overall health and helps prevent ketosis.

Genetics

Genetics has a measurable impact on the risk of ketosis in dairy cattle. While environmental factors like diet and management play major roles, genetic predisposition also influences how susceptible a cow is to developing ketosis. Studies have shown that certain genes involved in lipid metabolism, immune response, and energy regulation are linked to ketosis. Specific genetic markers—such as SNPs on chromosomes BTA14, BTA15, and BTA16—have been associated with increased risk. Additionally, cows with genetic variants affecting insulin secretion, glucose metabolism, and cellular repair may be more vulnerable during the transition period. Understanding these genetic factors allows for selective breeding strategies aimed at improving metabolic resilience and reducing the incidence of ketosis in herds.