Ketosis and Fatty Liver Syndrome

What is ketosis a sign of?

Negative energy balance

What ketones are made in the body?

Beta-hydroxybutyrate

Aceto-acetate

Acetone

What is the biggest energy demand in ruminants?

Lactation bc milk has 90x as much glucose as blood

Why is losing 200lbs in the first 7 weeks of lactation normal?

Glucose demands are very high to make milk

What is glucose used for?

Nervous tissues, mammary gland, fetal growth, muscle, lactation

What is the biggest energy demand in beef cows?

Growing fetus in late gestation, especially with twins

When does ketosis occur in dairy cattle?

3-6 weeks of lactation

Ketosis occurs secondary to what diseases?

Mastitis, metritis, milk fever (anything that reduces feed intake)

Poor quality silage that is high in butyric acid and biogenic amines can cause what?

Ketosis

Where does ketosis generation occur?

Liver

What are the types of primary ketosis?

Alimentary

Hepatic

Mammary

What is alimentary ketosis?

Dietary origin of too much protein/too little carbs

What is a hepatic cause of primary ketosis?

Overwhelmed or over saturation with fat

What is a mammary cause of primary ketosis?

High lactational demands for glucose

What is secondary ketosis?

Occurs when other conditions restrict energy intake at a high demand time resulting in fat mobilization

What are the C/S of ketosis?

Decreased appetite, depression, decreased milk production, decreased rumen motility, neuro signs

How do you diagnose ketosis?

Increased ketones in blood, urine, and milk

Hypoglycemia

What is the most sensitive way to diagnose ketosis?

BHB in the blood >3mmol/L for clinical

>1.2-1.4mmol/L for subclinical disease

What are the risks of subclinical ketosis?

Decreases immune responses

Increases risk of periparturient disease (like DA, RFM)

Impairs repro performance

Decreased milk production

What is the mean cost of subclinical ketosis?

$203

T/F ruminants use ketones for energy normally?

True

What ketone is made in the highest amount?

Acetate

What is acetate used for?

It passes through the rumen wall and is made for adipose tissue

What is propionate used for?

It passes through the rumen wall and is made into glucose via the TCA cycle

What is butyrate used for?

Metabolized by the rumen wall and made into beta-hydroxybutyrate and used for extrahepatic tissues as energy

How is L-lactate used for energy?

Produced by bacteria in rumen. Absorbed and turned into pyruvate in the liver

How can you treat a negative energy balance?

Propylene glycol (must have healthy rumen flora)

What is required for propylene glycol therapy to work?

healthy rumen flora 

What 2 energy sources are common during fatty tissue breakdown?

Acetoacetate and beta-hydroxybutyrate

Lipolysis results in what as a byproduct?

Formation of triglyceride

What is the problem with triglyceride formation due to negative energy balance?

They cannot get rid of it easily leading to hepatic lipidosis

What ketones are measured in urine and milk?

Acetone and aceto-acetic acid

What ketones are measured in blood?

Beta-hydroxybutyrate

What is the problem with urine levels to diagnose ketosis?

Dilute urine can decrease results

Concentrated urine can increase results

At the herd level, when are you worried about ketosis?

15-25% with elevated BHB

What is the highest sensitivity for ketosis monitoring at the herd level?

Blood BHB post partum

When ketosis incidence is >25% what does that mean?

Any testing method and prevention strategy will have an economic benefit

When ketosis incidence is >50% what does that mean/

Blanket treat all cows with propylene glycol no earlier than 3 days post partum

Why cant we treat cows with propylene glycol until 3 days post partum?

They are hypoglycemic and can dysregulate their insulin

What diseases do not have anorexia as a C/S?

Grass tetany

Hypophosphatemia downer cow

What disease presents with depression?

Hypocalcemia, ketosis, hypokalemia

What causes fatty liver?

Build up of triglycerides in hepatocytes

What is the sequelae to fatty liver?

Decreased protein synthesis

Lower tissue responsiveness to insulin

Hepatic encephalopathy

T/F fatty liver damage is reversible?

False

How can fatty liver cause non-reversible renal damage?

Fat mobilization to the kidney

What are the C/S of fatty liver?

Anorexia, depression, weight loss, weakness, neurologic, obese to well-conditioned cows, decreased rumen motility, decreased milk production

What cows are susceptible to fatty liver?

Fat cows that are pregnant

How do you diagnose fat cow?

Ultrasound

Best is liver biopsy with lipid vacuoles

How do you treat ketosis and fatty liver?

50% dextrose IV

Propylene glycol

Dextrose fluids

Ancillary: transfaunation, vitamin B12, insulin

What is the best treatment of ketosis or fatty liver for valuable individuals?

Dextrose in crystalloid fluids

How do we prevent fatty liver?

Prevent overfeeding in far off dry period

How much do we want to feed during the far off dry period?

110-120% of energy requirements

When cows are fresh, what do you need to feed to prevent fatty liver?

High quality energy dense feed

What are non-dietary ways to prevent fatty liver?

Decrease stocking density

Increase cow comfort

Prevention/early treatment for mastitis/metritis

What is the signalment for protein energy malnutrition (PEM)

Beef cows on marginal diets in winter due to decrease in quality or quantity 

Growing pregnant heifers

What are the C/S of PEM (protein energy malnutrition)?

Weight loss, weakness, depression, inability to rise

How do you treat PEM (protein energy malnutrition)?

Propylene glycol

Force-fed alfalfa gruel

Treat concurrent illness

What is a poor prognosis for PEM?

Recumbent animals

How do you prevent PEM (protein energy malnutrition)?

Cull appropriately prior to winter (bad teeth and chronic ill thrift)

Maintain adequate BCS of 5-7 in pregnant beef cattle in last trimester

Provide good to excellent quality forage in adequate amounts