A systematic review and meta-analysis of the diagnostic accuracy of point-of-care tests for the detection of hyperketonemia in dairy cows

Plasma and milk metabolomics profiles in dairy cows with subclinical and clinical ketosis

Ketosis, a commonly observed energy metabolism disorder in dairy cows during the peripartal period, is distinguished by increased concentrations of β-hydroxybutyrate (BHB) in blood. This condition has a negative impact on milk production and quality, causing financial losses. An untargeted metabolomics approach was performed on plasma samples from cows between 5 and 7 DIM diagnosed as controls (CON, BHB <1.2 mM, n = 30), subclinically ketotic (SCK, 1.2 < BHB <3.0 mM, n = 30), or clinically ketotic (CK, BHB >3.0 mM, n = 30). Cows were selected from a commercial farm of 214 Holstein cows (average 305-d yield in the previous lactation of 35.42 ± 7.23 kg/d; parity, 2.41 ± 1.12; body condition score, 3.1 ± 0.45). All plasma and milk samples (n = 90) were subjected to Liquid Chromatography-Mass Spectrometry (LC-MS)-based metabolomic analysis. Statistical analyses was performed using the Graph Pad Prism 8.0, MetaboAnalyst 4.0 and R packages (version 4.1.3). Compared with the CON group, both SCK and CK groups had greater milk fat, freezing point, and fat-to-protein ratio and lower milk protein, lactose, solids-nonfat, and milk density. Within 21 d after calving, compared with CON, the SCK group experienced a reduction of 2.65 kg/d in milk yield, while the CK group experienced a decrease of 7.7 kg/d. Untargeted metabolomics analysis facilitated the annotation of a total of 5,259 and 8,423 metabolites in plasma and milk. Differentially affected metabolites were screened in CON vs. SCK, CON vs. CK, and SCK vs. CK (unpaired t-test, False discovery rate <0.05; and absolute value of log(2)-fold change >1.5). A total of 1,544 and 1,888 differentially affected metabolites were detected in plasma and milk. In plasma, glycerophospholipid metabolism, pyrimidine metabolism, tryptophan metabolism, sphingolipid metabolism, amino sugar and nucleotide sugar metabolism, phenylalanine metabolism, steroid hormone biosynthesis were identified as significant pathways. Weighted gene co-expression network analysis (WGCNA) indicated that tryptophan metabolism is a key pathway associated with the occurrence and development of ketosis. Increases in 5-Hydroxytryptophan and decreases in kynurenine and 3-indoleacetic acid in SCK and CK were suggestive of an impact at the gut level. The decrease of most glycerophospholipids indicated that ketosis is associated with disordered lipid metabolism. For milk, pyrimidine metabolism, purine metabolism, pantothenate and CoA biosynthesis, amino sugar and nucleotide sugar metabolism, nicotinate and nicotinamide metabolism, sphingolipid metabolism, fatty acid degradation were identified as significant pathways. The WGCNA indicated that purine and pyrimidine metabolism in plasma was highly correlated with milk yield during the peripartal period. Alterations in purine and pyrimidine metabolism characterized ketosis, with lower levels of these metabolites in both milk and blood underscoring reduced efficiency in nitrogen metabolism. Our results may help to establish a foundation for future research investigating mechanisms responsible for the occurrence and development of ketosis in peripartal cows.

Milk as an indicator of dietary imbalance

BACKGROUND

Milk provides a readily available diagnostic fluid collected daily or more frequently on an individual animal or herd basis. Milk, as an aggregated sample in bulk tank milk (BTM) represents the status of a herd instead of a single animal. In this review, we examine the potential for milk to predict risks to efficient production, reproductive success, and health on the individual cow and herd level.

FINDINGS

For many conditions related to disorders of metabolism including hyperlipdaemia and ketonaemia, improved individual cow milk testing may allow a temporally useful detection of metabolic disorder that can target intervention. However, the extension of these tests to the BTM is made more difficult by the tight temporal clustering of disorder to early lactation and the consequent mixing of cows at even moderately different stages of lactation. Integrating herd recording demographic information with Fourier-transformed mid-infrared spectra (FT-MIR) can provide tests that are useful to identify cows with metabolic disorders. The interpretation of BTM urea and protein content provides useful indications of herd nutrition. These may provide indicators that encourage further investigations of nutritional influences on herd fertility but are unlikely to provide strong diagnostic value. The fat-to-protein ratio has a high specificity, but poor sensitivity for detection of fibre insufficiency and acidosis on an individual cow basis. Selenium, zinc, β-carotene, and vitamin E status of the herd can be determined using BTM.

CONCLUSIONS

There appears to be increasing potential for the use of milk as a diagnostic fluid as more in-parlour tests become available for individual cows. However, the BTM appears to have under-utilised potential for herd monitoring.

Comparison of Two Methods for the Measurement of Blood Plasma and Capillary Blood Glucose in Tropical Highland Grassing Dairy Cows

(1) Background: There is lack of published studies validating specific cow-side glucometers such as Centrivet GK (CVGK). (2) Methods: The aims were (1) to measure and compare the blood glucose concentrations in 52 tropic highland grassing cows by using CVGK and the traditional enzymatic/photometric assay (EPA) in plasma and serum (reference method) and (2) to establish if glucose concentrations obtained via these methods could be affected by several demographic and zootechnical parameters of the dairy herd evaluated. (3) Results: Glucose concentrations were significantly (p = 0.00) affected by the method used for their measurement. The intra-assay coefficient of variation (CV) for glucose concentrations in plasma EPA and for CVGK was 14% for both methods with serum EPA, whereas the inter-assay CV for plasma EPA and CVGK was 8% and 13.7%, respectively, with serum EPA. Pearson correlation coefficient calculations between the reference method in serum and plasma presented a slightly positive significant (p = <0.000) correlation (r = 0.56), whereas there was not a significant (p = 0.413) correlation between serum EPA and CVGK (r = 0.135). The Passing and Bablok regressions were out of the ideal expected values for the slope (β = 1) and the intercept (α = 0) (11), whereas the Bland-Altman plots showed a bias of 5.29 ± 11.73 (mg/dL) for serum and plasma and 11.01 ± 15.74 (mg/dL) for serum and CVGK. The ROC curve showed no sensitivity in detecting normoglycemic cows (area = 53.7 %, e.d = 12.5 %, p = 0.759) for CVGK when compared to plasma EPA (area = 36.1 %, e.d = 14.2 %, p = 0.256). Plasma EPA exhibited a better but not significant effect in detecting hyperglycemic cows (area = 63.9%, e.d = 14.2%, p = 0.256) when compared to HHD (area = 46.3 %, e.d = 12.5 %, p = 0.759). General glucose concentrations, independently of the method used, were significantly (p = <0.001) greater in young cows when compared to adult and old cows. (4) Conclusions: Glucose concentration measurement in plasma by using EPA or in capillary blood via CVGK were not reliable methods when compared with the reference method.

Milk β-hydroxybutyrate metrics and its consequences for surveillance of hyperketonaemia on commercial dairy farms

Dairy cows that are unable to adapt to a change in their metabolic status are at risk for hyperketonaemia (HK). Reported HK herd level prevalences range a lot and we hypothesized that this is partly due to differences in used tests and monitoring protocols. Insights in milk β-hydroxybutyrate (BHB) metrics can potentially explain why the reported incidences or prevalences vary between test strategies. Automated collection and repeated analyses of individual milk samples with the DeLaval Herd Navigator™ (HN) provides real-time data on milk BHB concentrations. We aimed to use that information to gain insight in BHB metrics measured in milk from 3 to 60 days in milk (DIM). Using different cut-offs (0.08, 0.10 and 0.15 mmol/L), 5 BHB metrics were determined. Furthermore, the impact of 4 arbitrary test protocols on the detected incidence of HK was assessed. We used HN data of 3,133 cows from 35 herds. The cumulative incidence of HK between 3 and 60 DIM varied between 30.5 and 76.7% for different cut-off values. We found a higher HK incidence for higher parity cows. The first elevated BHB concentrations were roughly found between one and two weeks after calving. For higher parity cows the maximum BHB concentrations were higher, the onset of HK was earlier after calving, and the number of episodes of HK was higher. It appeared that the sensitivity of a HK test protocol can be increased by increasing the testing frequency from once to twice a week. Also extending the number of days of the test window from 4-14 to 4-21 days enhances the chance to find cows experiencing HK. In conclusion, HN data provided useful insights in milk BHB metrics. The chosen cut-off value had a large effect on the reported metrics which explains why earlier reported incidences or prevalences vary such a lot. Differences in test period and sample selection also had a large impact on the observed HK incidence. We suggest to take this in consideration while evaluating whether HK is an issue on farm level and use a uniform protocol for benchmarking of HK between farms.

Metabolic Profiling in Ruminant Diagnostics

A herd-based approach and interpretative perspective is necessary in using metabolic profile testing in contrast to individual animal disease diagnostics. Metabolic profile testing requires formulating a question to be answered, followed by the appropriate selection of animals for testing. A range of blood analytes and nutrients can be determined with newer biomarkers being developed. Sample collection and handling and herd-based reference criteria adjusted to time relative to parturition are critical for interpretation. The objective of this article is to review the concepts and practical applications of metabolic profile testing in ruminants.

A randomized controlled trial examining the effects of treatment with propylene glycol and injectable cyanocobalamin on naturally occurring disease, milk production, and reproductive outcomes of dairy cows diagnosed with concurrent hyperketonemia and hypoglycemia

The objective of this study was to assess the effects of treatment with propylene glycol (PG) and cyanocobalamin (B12) on health, milk production, and reproductive outcomes of cows diagnosed with hyperketonemia (HK), hypoglycemia (HG), or concurrent HKHG. Glucose and β-hydroxybutyric acid (BHBA) concentrations were assessed in whole blood using a handheld device in lactating dairy cows (n = 2,418) between 3 and 9 d postpartum. Cows categorized as HK (n = 232, BHBA ≥1.2 mmol/L), HG (n = 161, glucose ≤2.2 mmol/L), and concurrent HKHG (n = 204, BHBA ≥1.2 mmol/L, and glucose ≤2.2 mmol/L) were randomized to receive treatment or to remain untreated (control). Treatment consisted of a single dose of B12 (10 mg, intramuscularly) and 300 mL of PG orally for 5 d, starting on the day of cow-side testing. Milk production, health, and reproductive outcomes were analyzed according to groups. Statistical analysis was carried out using SAS version 9.4 (SAS/STAT, SAS Institute Inc.). Treatment in HG cows decreased clinical ketosis, increased milk production in the fifth week of lactation for multiparous cows, and tended to increase 305-d mature-equivalent milk yield (305ME) for primiparous cows compared with untreated cows with the same metabolic profile. For cows with HKHG, treatment increased 305ME in multiparous cows and tended to increase 305ME in primiparous cows. No differences were found for treatment among any of the metabolic groups regarding reproductive outcomes, nor were any treatment effects found among HK cows. Glycemic status may help identify metabolically challenged early postpartum dairy cows, which may have differential response to PG and B12 treatment.

An investigation of blood, milk, and urine test patterns for the diagnosis of ketosis in dairy cows in early lactation

Ketosis in dairy cattle is primarily diagnosed based on the concentrations of ketone bodies in the blood, milk, or urine. Cow-side tests using these fluids are available for rapid detection of elevated concentrations of ketone bodies. Although these tests have been extensively validated, the performance of different tests has not been compared over time. Our objectives were to investigate the relationship between point-of-care diagnostic tests measuring the concentrations of β-hydroxybutyrate (BHB) in blood (BT; Precision Xtra, Abbott Laboratories), BHB in milk (MT; Keto-Test, Elanco), and acetoacetate (AcAc) in urine (UT; Ketostix, Bayer Corporation) through cases of ketosis. Holstein cows (n = 148) were screened daily for hyperketonemia (HYK; blood BHB ≥1.2 mmol/L) from 3 to 16 d in milk (DIM); moreover, milk and urine samples were collected concomitantly and tested for ketones (ketosis thresholds: 100 µmol/L milk BHB and 5 mg/dL urine AcAc). Of the animals screened (n = 148), 74% were diagnosed with HYK. When diagnosed with HYK, cows were treated with propylene glycol orally once daily for 5 d. After the day of diagnosis (d 0), hyperketonemic cows were retested with BT, MT, and UT for 3 d (d 1, 2, and 3). We assessed the diagnostic test performance and time to ketosis (survival analyses and Cox proportional hazards models) of MT and UT compared with BT. Considering all paired samples (before and after diagnosis of HYK), MT had 61% sensitivity and 91% specificity, whereas the UT had 77% sensitivity and 94% specificity compared with BT. The specificity of MT and UT increased from d 0 to d 1, decreased on d 2, and increased on d 3. The median time to diagnosis of ketosis in blood was 5 DIM (95% CI 5 to 7 DIM); moreover, MT and UT had 2 d greater median time to diagnosis of ketosis compared with the BT [7 DIM (6 to 11 d); and 7 DIM (6 to 13 d), respectively]. We concluded that the UT is a more sensitive predictor of blood BHB concentration than the MT. The UT and MT tests diagnosed ketotic cows approximately 2 d later than the BT. The possible consequences of delay in detection of ketosis in milk and urine should be investigated.

Exploring the role of milk yield in the first week of lactation on the association between hyperketonemia and reproductive performance in dairy cattle

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No clear evidence was found to support an association between hyperketonemia and reproductive performance.

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Hyperketonemia was associated with lower risk of pregnancy among low-yielding cows.

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Early lactation plays a role in the association of hyperketonemia with reproduction.

The objective of this retrospective cohort study was to investigate whether the association of hyperketonemia (HYK) with reproductive performance differs based on milk production during the first week of lactation (wk 1). Data between calving and 150 d in milk (DIM) from 2,091 Holstein dairy cows from 5 commercial dairy herds in Minnesota were collected. The concentration of β-hydroxybutyrate (BHB) was measured twice between 3 and 10 DIM in whole blood to diagnose HYK (defined as BHB ≥1.2 mmol/L). The average wk 1 milk yield was classified into 3 levels (low = lower 25th percentile; mid = 25th to 75th percentile; high = upper 75th percentile) according to parity and herd. Log-binomial regression, Cox-proportional hazard regression, and linear regression models were used to investigate the association of HYK with pregnancy to first insemination, pregnancy by 150 DIM, and calving-to-conception interval (CCI) between groups, respectively. To describe the differences in these estimates between each wk 1 milk yield level, an interaction term of HYK and stratified levels of wk 1 milk yield was added. The incidence of HYK between 3 to 10 DIM was 14.2% (4.6% in primiparous cows and 19.4% in multiparous cows). In the study population, the effect of HYK on reproduction was greater in cows with low milk yield. Among cows with low milk yield levels, HYK was associated with lower risk of pregnancy to first insemination [risk ratio = 0.62; 95% confidence interval (CI): 0.39–0.98], lower risk of pregnancy up to 150 DIM (hazard ratio = 0.70; 95% CI: 0.51–0.96), and extended days of CCI (mean difference = 13.0; 95% CI: 5.1–20.9). In contrast, among cows with mid and high wk 1 milk yield levels, hyperketonemic (HYK+) cows had a similar reproductive performance to non-HYK (HYK−) cows. Our results suggest that early-lactation milk yield plays a role in the association of hyperketonemia with reproductive performance. These results merit further investigation to determine the role that early milk yield has in the association of hyperketonemia with health and productivity outcomes.

A pilot monitoring strategy for post-partum disease in an Australian dairy herd

AIMS

To design a monitoring strategy that could be applied to regular veterinary visits to dairy farms to assess the prevalence and association between health conditions (uterine disease, hyperketonaemia and suboptimal body condition score) when diagnosed and treated at 1-7 days post-calving (DPC) and then re-examined at 28-35 DPC.

METHODS

This study evaluated data from 187 high-yielding dairy cows (21 primiparous, 166 multiparous) on one South Australian dairy farm on two occasions; Visit A which was 1-7 DPC and Visit B which was 28-35 DPC. On each visit, the nature of vaginal discharge, concentration of beta-hydroxybutyrate (BOH) in blood and BCS were recorded and assigned a clinical score. This was converted to a categorical outcome denoting the presence or absence of an abnormal health event, namely metritis or endometritis, hyperketonaemia (BOH concentration ≥1.2 mm/L) and suboptimal body condition score (>0.5 from optimum score). Cows with uterine disease or hyperketonaemia at either visit were treated. The prevalence of abnormal health events at each visit was determined and the association between the prevalence of disease at Visit A and Visit B (following appropriate treatment at Visit A) was measured using regression analysis.

RESULTS

The prevalence of abnormal vaginal discharge, hyperketonaemia and suboptimal BCS at Visits A and B were 26%, 7%, 35% and 25%,16%, 33% respectively. A higher proportion of primiparous cows (Visit A: 0.86 (95% CI = 0.70-1.00); Visit B: 0.95 (95% CI = 0.86-1.00)) were found to have suboptimal BCS at both visits compared to multiparous cows (Visit A: 0.28 (95% CI = 0.20-0.35); Visit B: 0.24 (95% CI = 0.17-0.32)). A higher prevalence of hyperketonaemia at Visit B for multiparous compared to primiparous cows (19 (95% CI = 12-25)% vs. 0 (95% CI = 0-17) respectively) was identified. An increase in clinical discharge score at Visit A increased the odds of purulent vaginal discharge at Visit B (OR = 1.77 (95% CI = 1.31-2.40)). Failing to calve at target BCS was strongly associated with cows missing target BCS at Visit B (OR = 5.77 (95% CI = 2.35-13.11)) and for every unit increase in BCS at Visit A, BCS at Visit B increased by 0.40 (95% CI = 0.26-0.53).

CONCLUSIONS AND CLINICAL RELEVANCE

This study describes a pilot monitoring strategy for clinical parameters indicative of post-partum disease at 1-7 and 28-35 DPC. Determining the herd prevalence of these conditions will enable tracking of herd disease status over time.Abbreviations: BCS: Body condition score; BOH: Beta-hydroxybutyrate; DPC: Days post-calving; NEFA: Non-esterified fatty acids; SCHK: Subclinical hyperketonaemia.

The association of prepartum urine pH, plasma total calcium concentration at calving and postpartum diseases in Holstein dairy cattle

The use of anionic salts to prevent milk fever in dairy cattle has been an effective nutritional strategy; however, the degree of acidification that determines the most acceptable productive responses and well-being of the cow is still a controversial topic. The objective of this study was to assess urine pH in prepartum Holstein cows fed anionic diets and determine its association with plasma total Ca, Mg, P, β-hydroxyl-butyrate (BHB) concentrations at parturition and the occurrence of peripartum disorders. This investigation consisted of 2 studies. Study 1 was conducted on a grazing dairy. Between February and May 2019, 60 prepartum multiparous cows were tested for urine pH and plasma metabolite concentration at parturition. Total Ca, P, Mg and BHB at day 1 in milk (DIM) were assessed and statistically analyzed by ANOVA (models for polynomial regression). Study 2 was conducted on a drylot dairy farm. Between July 2018 and January 2019, 203 cows were evaluated for urine pH and followed-up for 30 DIM to obtain the incidence of dystocia, stillbirths, milk fever, retained fetal membranes, metritis, clinical mastitis and ketosis. Cows were categorized based on their last urine pH as group 1: pH > 7.0 (n = 135); group 2: pH between 6.0 and 7.0 (n = 46) and group 3: pH < 6.0 (n = 22). A logistic regression model for each health event was conducted considering urine pH group as the main effect. Urine sample was collected at 2.71 ± 2.84 days before parturition. In study 1, there was a quadratic effect of urine pH on total Ca. Total Ca concentration was higher between urine pH 6.0 and 7.0, while decreasing below pH 6.0 and above pH 7.0. There was a trend (P = 0.11) for a quadratic effect of urine pH on the concentration of plasma BHB at parturition. β-Hydroxyl-butyrate was lower approximately between urine pH 6.5 and 7.5. In study 2, the odds for a stillborn in cows with urine pH < 6.0 was 2.39 (95% CI = 1.06-5.40) times the odds for a stillborn in cows with urine pH ≥ 7.0. There was no association between urine pH and the other diseases. In conclusion, cows with prepartum urine pH < 6.0 and >7.0 had lower concentration of plasma total Ca and tended to have a higher concentration of BHB. Cows with urine pH < 6.0 had a higher incidence of stillbirths than cows with urine pH > 7.0.

Diagnostic accuracy of a bovine specific electronic beta-hydroxybutyrate handheld meter in fresh blood and stored serum samples

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The nova vet handheld beta-hydroxybutyrate meter showed high accuracy and precision.

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Anticoagulants caused minimal interference in measurements.

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The best calibration factor on cattle was obtained with the default slope setting.

This study aims to evaluate the diagnostic accuracy of the bovine specific beta-hydroxybutyrate (BHB) meter Nova Vet (NVET). We evaluated the accuracy and agreement of the NVET in fresh blood and thawed serum with the reference laboratory assay; and the repeatability, the interference by anticoagulants, and the optimum slope calibration factor. Individual blood samples were collected from 200 Holstein and crossbred cows between 3 and 14 days post-calving from 13 dairy herds in Minnesota. Using a laboratory assay with a cut point of 1.2 BHB mmol/L hyperketonemia prevalence was 10.6% (95% CI: 6.7, 15.8). The sensitivity of NVET in blood and serum was 100.0% while the specificity was 98.3 and 97.7% respectively. The agreement between NVET and the laboratory assay was the highest using blood samples (concordance correlation coefficient –CCC = 96.2, 95% CI: 95.0, 97.1. The coefficient of variation including within day (intra-meter), between- days, and -batches was 13.4% when testing blood samples. Minimal interference was observed with the use of anticoagulants (K-EDTA and Li-Heparin, CCC 0.90 and 0.93 respectively) in reference to whole blood without anticoagulant. The best calibration slope factor in serum was 1.0 (Youden's index: 0.98). Results suggest that the NVET device maintained a high accuracy and precision to quantified BHB concentration when applied in fresh blood and thawed serum under field conditions using the default calibration slope (1.0), and with minimal anticoagulant interference when used in whole blood samples.

Ketosis an Old Story Under a New Approach

Ketosis, characterized by high concentrations of ketone bodies in the blood, urine, and milk, affects a considerable number of cows immediately after calving. Although much is known about ketosis, dairy cows continue to be affected in every herd world-wide. Cows affected by ketosis are treated with palliative treatments after the disease is diagnosed. This is a very expensive approach and costs the dairy industry extra expenses, contributing to lower profitability of dairy herds. In this review article, we summarize the mainstream view on ketosis, classification of ketosis into three types, current diagnostic approaches to ketosis, and the economic impact of ketosis on dairy farms. Additionally, we discuss the most recent applications of the new ‘omics’ science of metabolomics in studying the etiopathology of ketosis as well as its contribution in identification of novel screening or diagnostic biomarkers of ketosis.

Incidence and effects of subacute ruminal acidosis and subclinical ketosis with respect to postpartum anestrus in grazing dairy cows

Subclinical Ruminal Acidosis (SARA) and Subclinical Ketosis (SCK) are two of the most prevalent metabolic diseases of dairy cows, with impacts on reproductive performance. There is scarce literature about these diseases in dairy regions in Colombia. In 29 randomly selected herds in Pasto, Colombia, 249 dairy cows were followed weekly for two months postpartum to determine: 1) incidence risk of SARA and SCK; and 2) effects of SARA and SCK on the occurrence of postpartum anestrus (PA) at two months. Samples from ruminal liquor and blood were obtained one time per cow during the first week postpartum to determine presence of SARA (pH < 5.6) and SCK (1.0-2.9 mmol/L of blood Beta-Hydroxy-Butyrate), respectively. PA diagnosis was determined with ultrasound. Pregnancy risks at 30 and 60 days post-breeding (and assumed embryo losses between these days) were determined. Risk factors associated with PA were estimated through a mixed multi-level multivariable logistic regression model, adjusting for clustering of cows within herds. The incidence risks of SARA and SCK were 23.3% and 46.2%, respectively. Simultaneous occurrence of SCK and SARA (SCASCK) was present in 5.2% of the cows. In the final multivariable model, the occurrence of SARA (Odds Ratio: OR = 39.4), SCK (OR = 47.4) and SCASCK (OR = 68.5) was associated with increased odds of PA. Feeding a transition period diet was associated with reduced odds of PA (OR = 0.15). Second parity cows had significantly lower odds of PA than first parity cows (OR = 0.21). In conclusion, inadequate pre-partum and postpartum nutritional management of the herds increased the occurrence of SARA and SCK, which had adverse effects on reproductive performance.

Farmer and Veterinary Practices and Opinions Related to the Diagnosis of Mastitis and Metabolic Disease in UK Dairy Cows

Production diseases are highly prevalent in modern dairy herds, resulting in lost productivity and reduced animal welfare. Two important production diseases are mastitis and metabolic disorders. The availability of robust diagnostic tools that can detect animals at early stages of disease is crucial to prevent the high costs associated with lost productivity and the treatment of clinically and/or chronically diseased animals. Despite a variety of diagnostic methods being available to farmers and veterinarians, the incidence of these diseases in UK dairy herds has not changed over the last decade, underscoring the need for improved approaches for early disease detection. To this end, we administered a questionnaire to farmers and veterinarians to understand current diagnostic practices in the UK dairy cow sector, and to gather opinions on the suitability of currently available diagnostic tests in order to identify specific areas where improvement in diagnostic technologies and/or practices are needed. Data from a total of 34 farmers and 42 veterinarians were analyzed. Results indicated that most farmers surveyed used a combination of methods to diagnose mastitis and metabolic disorders, the most popular of which were visual inspection and milk recording somatic cell count data for mastitis, and body condition score and milk ketone testing for metabolic disorders. These preferences were not always in line with veterinarian recommendations of different diagnostic tools. Moreover, veterinarians indicated they were not satisfied with currently available diagnostic tools or how these were implemented by farmers. Both farmers and veterinarians recognized there was substantial room for improvement of current diagnostic tools, particularly in regard to the need to detect disease early. A majority of respondents preferred new diagnostic tests to be suitable for use with milk rather than blood or urine samples, and to yield results within 24 h. Finally, both groups surveyed identified economic cost as the most important barrier for the future uptake of new diagnostic technologies. The information obtained should guide the future development of diagnostic approaches that meet both the expectations of farmers and veterinarians, and help bring about a reduction in the incidence of production diseases in UK dairy herds.

Development, diagnosis and therapy of ketosis in non-gravid and non-lactating Guinea pigs

Background

Ketosis is a metabolic disorder often triggered by anorexia in animals fed on high energy diets. Although mostly described in pregnant female guinea pigs, under the name of pregnancy toxicosis; there is limited information on ketosis in males and non-pregnant females, often presented to clinics with anorexia or inappetence. The objective of this study was to observe progression of ketosis in guinea pigs, document the changes and evaluate diagnostic methods and a therapeutic approach.

Results

Twenty eight adult guinea pigs (Cavia porcellus), castrated males and intact females of obese and slim body condition were fasted for 3 days and refed afterwards. The slim animals served as control group for body condition. Either slim and fat animals were divided into two treatment groups: half of them received fluid replacements with glucose subcutaneously, the other half did not receive any injection and served as treatment control. Serum beta-hydroxybutyrate, and urine acetoacetate and acetone were measured during and after fasting. Serum ALT, bile acids and liver histology were also analyzed after 7 days of refeeding (and therapy). Females and obese guinea pigs showed a significantly higher increase in ketone bodies in serum and urine. Obese, female, or animals not receiving therapy needed more time to regulate ketone bodies to normal levels than slim animals, males or animals receiving therapy. Liver histology revealed increased hepatocyte degeneration and higher glycogen content in obese animals and animals receiving therapy, and additionally more glycogen content in males. Only minor hepatic fat accumulation was documented. Bile acids showed good correlation to histological liver changes whereas ALT did not.

Conclusions

Female and obese animals react more intensively to fasting. As preventive management, animals should be kept in adequate body condition, fasting should be avoided, and anorexia should be treated immediately. In such a case, urinary dip sticks to detect ketone bodies are a useful diagnostic tool. Glucose therapy leads to faster cessation of ketogenesis and should be recommended in cases of ketosis. However, it needs to be adjusted to avoid hepatocyte glycogen overload and degeneration. Measuring bile acids presents a valuable indicator of liver damage.

Association between blood β-hydroxybutyrate at 7 days postpartum and milk yield, disease occurrence and fertility in grazing dairy cattle with seasonal calving: a case study

Context Ketosis in grazing cattle has been sparsely studied. A large commercial grazing dairy in southern Chile, representative of a significant proportion of the systems in the country, was used in this case study. Aims The study had three objectives: (i) to establish a cut-off for β-hydroxybutyrate (BHB) concentration for subclinical ketosis (SCK), and use this to measure the proportion of cows with SCK at 7 days postpartum in spring- and autumn-calving cows; (ii) to describe the relationship of SCK and other periparturient diseases and fertility; and (iii) to compare milk yield of healthy cows and those affected by SCK in a dairy herd with autumn and spring parturitions under grazing conditions in southern Chile. Methods During 2016, 234 cows with autumn parturitions and 632 cows with spring parturitions (n = 866) were assessed for blood BHB at 7 days postpartum. A receiver operating characteristic analysis for a BHB cut-off value was completed. Models were developed for disease occurrence, culling risk, conception risk and pregnancy rate, considering SCK as the main explanatory variable. Key results In total, 810 cows were used for the final analysis. The frequency of cows with SCK, based on the cut-off value obtained (BHB ≥1.1 mmol/L), was 22.2% at 7 days postpartum. The risk of SCK was higher (P &lt; 0.0001) in cows calving in spring (27.0%) than in autumn (10.3%), and in multiparous (24.6%) than primiparous cows (15.1%). The seasonal difference in proportion of cows with SCK was parity-dependent, because the frequency of SCK in multiparous cows was higher (P &lt; 0.0005) in spring (32.0%) than autumn (10.1%), whereas SCK in primiparous cows showed no significant (P = 0.41) difference between spring (15.4%) and autumn (12.5%). Milk production up to 100 days-in-milk was greater (P = 0.002) in cows with SCK (3394 kg) than without SCK (3015 kg). Disease occurrence was higher (P &lt; 0.0001) in cows with SCK and in multiparous cows (P &lt; 0.0001). There was no difference in conception risk at first service (P = 0.62) or in overall pregnancy rate (P = 0.90) between cows with and without SCK. Conclusions Multiparous cows calving in spring had the highest risk of SCK (BHB ≥1.1 mmol/L). SCK was associated with higher milk yield and greater occurrence of other diseases, but not with reproductive performance. Implications Grazing herds have challenges with SCK that may require different management strategies depending on the calving season and the parity of the animals.

Short communication: Validation of a test-day milk test for β-hydroxybutyrate for identifying cows with hyperketonemia

Subclinical ketosis is a common metabolic disorder affecting dairy cattle that results in a greater risk for the development of subsequent metabolic and infectious disease. Canwest Dairy Herd Improvement (DHI; Guelph, ON, Canada) has begun to use an infrared test (MilkoScan FT600, Foss Analytical A/S, Hillerød, Denmark) applied to metered composite milk samples to detect β-hydroxybutyrate (BHB) levels as a herd surveillance test for hyperketonemia. However, the test has not been compared with the gold standard, serum BHB as determined in a reference diagnostic laboratory. The objective of this cross-sectional diagnostic accuracy study was to validate the DHI milk BHB test to identify cows with hyperketonemia as determined by quantification of BHB in serum. A total of 316 cows from 17 dairy herds in southwestern Ontario had a milk and blood sample taken. Milk was collected at a routine DHI test, and blood from the same cow was sampled within 24 h of the milk test. The BHB concentration in milk was determined using the DHI milk BHB test, and serum was sent to the Animal Health Laboratory at the University of Guelph (Guelph, ON, Canada). A nonparametric receiver operating characteristic curve was generated to compare DHI milk BHB concentrations with serum BHB concentrations. Overall, a total of 34 cows (11%) had a level of serum BHB ≥1.2 mmol/L. The concentration of DHI milk BHB was moderately correlated with the concentration of serum BHB, yielding a coefficient of determination value of 0.61. The optimal cut point for determining hyperketonemia (≥1.2 mmol/L) on the DHI milk BHB test was ≥0.14 mmol/L, yielding a sensitivity of 81% and specificity of 92%. The performance of the DHI milk BHB test varied depending on the days in milk (DIM) of the cows tested, with a higher specificity being found in cows that were ≤25 DIM compared with cows tested >25 DIM. If the herd-level prevalence of hyperketonemia was ≥14%, the DHI milk BHB test had an improved sensitivity when compared with a herd-level prevalence of <14%. This study demonstrates that the DHI milk BHB test is a reliable measure for evaluating hyperketonemia using routine DHI milk samples and could be used as a herd-level monitoring tool for ketosis when evaluating nutritional management or preventative medicine strategies.

Neck circumference may be a valuable tool for screening individuals with obesity: findings from a young Chinese population and a meta-analysis

BACKGROUND

Central obesity and overweight/obesity can result in various chronic non-communicable diseases, such as cardiovascular disease, metabolic syndrome, and diabetes mellitus. Waist circumference (WC) and body mass index (BMI) are widely used to measure obesity despite their limitations. For example, WC and BMI cannot be measured in pregnant women and subjects with abdominal ascites or masses. Therefore, this study aims to determine the efficacy of neck circumference (NC) as a tool for screening central obesity and overweight/obesity.

METHODS

A total of 1169 undergraduates aged 18-25 years were studied by a cross-sectional survey in China, 2016. Questionnaires and physical examinations were used to collect data. Receiver operator characteristic (ROC) curve was performed to determine the best threshold of NC for screening central obesity and overweight/obesity. Meanwhile, a meta-analysis was conducted to estimate the efficacy of NC for screening central obesity and overweight/obesity synthetically.

RESULTS

NC was moderately correlated with WC and BMI. The ROC analysis showed that 37.1 cm for male and 32.6 cm for female were the best thresholds for central obesity, and 37.4 cm and 32.2 cm for overweight/obesity, respectively. The sensitivity, specificity, area under receiver operating curve (AUC) of central obesity and overweight/obesity were higher. In the meta-analysis, the pooled sensitivity, specificity, AUC and their 95%CI of NC for screening central obesity were 0.72 (0.68~ 0.75), 0.87 (0.74~ 0.94), 0.77 (0.73~ 0.80) for male and 0.73 (0.65~ 0.80), 0.80 (0.71~ 0.86), 0.82 (0.79~ 0.86) for female. For overweight/obesity, the pooled sensitivity, specificity, AUC and corresponding 95%CI were 0.83 (0.70~ 0.91), 0.77 (0.66~ 0.85), 0.86 (0.83~ 0.89) for male and 0.82 (0.71~ 0.90), 0.84 (0.61~ 0.95), 0.89 (0.86~ 0.92) for female.

CONCLUSION

NC may not be a good tool for screening individuals with central obesity. But it may be a simple and valuable tool for screening individuals with overweight/obesity, especially in females.

Effects of Boron Supplementation on Peripartum Dairy Cows' Health

Although many different dietary studies on the prevention of negative energy balance related diseases are often encountered, this is the first study investigating the effects of boron supplementation on peripartum dairy cows' health in the light of an omics approach. Twenty-eight healthy cows (1 control and 3 experimental groups) were enrolled from 2 months before predicted calving until 2 months after calving. Experimental groups were assigned to receive boron at increasing doses as an oral bolus. Production parameters, biochemical profile, Nuclear Magnetic Resonance based metabolomics profile, and mRNA abundance of gluconeogenic enzymes and lipid oxidation genes were determined. Pivotal knowledge was obtained on boron distribution in the body. Production parameters and mRNA abundance of the genes were not affected by the treatments. Postpartum nonesterified fatty acids, β-hydroxybutyrate, and triglyceride concentrations were significantly decreased in experimentals. The primary differences among groups were in lipid-soluble metabolites. There were significant differences in metabolites including postpartum valine, β-hydroxybutyrate, polyunsaturated fatty acid and citrate, propionate, isobutyrate, choline metabolites (betaine, phosphatidylcholine, and sphingomyelin), and some types of fatty acids and cholesterol in experimentals. Boron appears to be effective in minimizing negative energy balance and improving health of postpartum dairy cows.