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1. DIAGNOSIS OF KETOSIS
AND ITS TREATMENT
DR. MUHAMMAD ATIF RAZA
DVM, RVMP (PAKISTAN)
M.PHIL PATHOLOGY

2. LIST OF CONTENT
What is Ketosis?
Classification
Etiology
Symptoms
Diagnosis
Treatment
Control

3. WHAT IS KETOSIS?
It is a metabolic disease of high yielding animals characterized by
hypoglycaemia, ketonaemia and ketonuria.
Most common in Bovines,Ovines and Caprines.
Common in Housed or Stall Fed animals.
Also called as Acetonaemia.

4. CLASSIFICATION OF KETOSIS
Ketosis is basically classified into two classes:
Primary Ketosis Secondary Ketosis
 Starvation
 Under Feeding
 Uncomplicated Ketosis
 As a result of various
systemic or infectious
diseases like mastitis,
metritis, pneumonia etc.
 Animal do not take sufficient
feed due to loss of appetite.

5. ETIOLOGY
Undernutrition/Starvation or Feeding of Low Carbohydrate Diet.
Feeding of Excess Amount of Protein Rich Diet.
Excess Feeding of Silage.
High Milk Yield.
Deficiency of Cobalt and Phosphorus.
Lack of Exercise.
Hepatic Insufficiency.
Loss of Appetite due Various Diseases.

6. PATHOGENESIS

7. SYMPTOMS
Two major clinical forms of bovine ketosis. These are as follow:
1. The Wasting Form
2. The Nervous Form

8. THE WASTING FORM OF BOVINE KETOSIS
Most common form of Bovine Ketosis.
Gradual and Moderate decrease in Appetite and Milk Yield over 2-4
days.
Pattern of Appetite loss is specific (First cow refuses grains and
then silage. But eats hay).
Body weight lost rapidly.
Cow has woody appearance because of low cutaneous elasticity.
Feces are firm and dry, but no severe constipation.
SYMPTOMS

9. THE WASTING FORM OF BOVINE KETOSIS
Cow mildly depressed and quieter.
Disinclination to move and to eat (mild abdominal pain).
TPR Normal.
Ruminal movements are decreased in
amplitude and number.
Characteristic sweet odor of ketones on
breath and in milk.
SYMPTOMS

10. THE NERVOUS FORM OF BOVINE KETOSIS
Walking in circles.
Crossing of the legs.
Head pushing or leaning into the stanchion.
Apparent blindness.
Aimless movements and wandering.
Vigorous licking of the skin and inanimate objects.
Depraved appetite.
Chewing movements with salivation.
SYMPTOMS

11. SERUM OR PLASMA BIOCHEMISTRY
Glucose: Plasma glucose concentrations are reduced to 20-40
mg/dL.
Normal Value: 50 to 65 mg/dL.
Ketones: Plasma ketones concentration is increased to 1.1-1.4
mmol/L and 2.5-10.0 mmol/L in sub-clinical and clinical ketosis
respectively.
Normal Value: 1.0 mmol/L.
Free Fatty Acids: Free fatty acids are highly increased upto
29mg/100ml in case of ketosis.
Normal Value: 09mg/100ml.

12. SERUM OR PLASMA BIOCHEMISTRY
Parameters Normal Values In Ketosis
Glucose (mg/dL) 50-65 20-40
Ketones (mmol/L) 1.0 1.1-1.4 (Sub Clinical)
2.5-10.0 (Clinical)
Free Fatty Acids
(mg/100ml)
9 29
β Hydroxy Butyric Acid
(mg/100ml)
8 30

13. DIAGNOSIS
History: Recent calving, Under Feeding, High Milk Yield etc.
Symptoms: Refusal of Concentrates, Marked Drop in Milk
Production, Rapid Emaciation.
Blood Chemistry
Urine Analysis: Rothera’s Test

14. ROTHERA’S TEST
This test is used for the detection of presence of ketone bodied in
the urine.
Apparatus: Test Tube, Test Tube Stand, Test Tube Holder, Measuring
Cylinder, Beaker.
Reagents: 2% Sodium nitroprusside, Ammonium Sulphate Crystals,
Liquor ammonia.
Sample: Urine
Principle: Acetoacetate and acetone in the urine react with sodium
nitroprusside in the presence of alkaline medium and produces a
purple color complex.

15. Procedure:
1. Take 3ml of urine in a test tube.
2. Add ammonium sulphate until saturation.
3. Add two drops of ammonium nitroprusside and shake well.
4. Add 1ml ammonium solution by the side of test tube.
Observations:
Purple ring formation at the junction of two solutions.
It indicates positive Rothera’s Test for the presence of ketone bodies.
ROTHERA’S TEST

16. ROTHERA’S TEST

17. TREATMENT
Specific Treatment:
1. Glucose Therapy Alone: Glucose 20% @ 0.5 g/Kg IV daily for 2-3
days.
2. Glucose + Insulin Therapy: Glucose 20% @ 0.5 g/Kg IV plus insulin
(Short Acting) @ 0.5 IU/Kg IM only once is highly effective.
Supportive Treatment:
1. Inj. Liver Extract with B Complex @ 5-10 ml IM on alternate day.
2. Provision of mineral mixture comprising of phosphorous and
cobalt.

18. CONTROL
1. Cows and Buffalos should neither be starved nor overfed at the
time of calving.
2. Give extra allowance of concentrate during advance pregnancy.
3. After calving concentrate ration should be offered according to
milk production 1kg concentrate for 3 kg milk production.
4. Provide ample good quality hay and limited silage.
5. Give adequate exercise to lactating animals.

19. REFERENCES
1. Veterinary Medicine 11th Edition by Peter D. Constable, Kenneth
W. Hinchcliff, Stanlay H. Done and Walter Grunberg.
2. Handbook of Veterinary Clinicians by Dr. A.U. Bhikane and Dr. S. B.
Kawitkar.

20. THANKYOU