Vet Times published a clinical review titled "Bovine metabolic disorders: screening and management," walking practitioners through the diagnostic and therapeutic decisions that dominate early-lactation dairy work. The piece sits inside the magazine's cattle section and addresses ketosis, hypocalcemia, displaced abomasum and related conditions clustered around calving.

The transition period - the three weeks before and after calving - remains the highest-risk window. Dry matter intake drops by roughly 10-20% as calving approaches, while energy output rises sharply with the start of lactation. That gap drives most cases of clinical ketosis, subclinical ketosis and hepatic lipidosis.

What does the article cover on screening?

Screening tests for ketosis center on beta-hydroxybutyrate (BHB) in blood. Thresholds of 1.2 mmol/L mark subclinical ketosis and 3.0 mmol/L mark clinical disease. Urine ketone strips and milk ketone tests offer cowside alternatives at lower cost, trading sensitivity for convenience. Non-esterified fatty acids (NEFA) measured prepartum flag cows likely to develop disease postpartum. Herd-level screening uses pooled BHB or strategic sampling of fresh cows between days 3 and 14 of lactation.

How does management respond to a positive screen?

Treatment of clinical ketosis typically combines oral propylene glycol at 300-500 mL per cow per day for three to five days with intravenous dextrose in acute cases. Propylene glycol supplies glucose precursors without the rebound hypoglycemia seen with bolus dextrose alone. Cobalt supplementation supports rumen propionate production. Monensin in lactating-cow rations shifts volatile fatty acid profiles toward more propionate.

Hypocalcemia sits alongside ketosis as the second pillar of transition cow disease. Prepartum dietary cation-anion difference (DCAD) feeding, targeting urine pH of 6.0-6.5 in Holsteins, mobilizes calcium reserves before calving and reduces clinical milk fever incidence. Calcium borate boluses administered orally at calving address subclinical hypocalcemia in older cows and in herds without DCAD programs.

What production impact should practitioners expect?

Subclinical ketosis carries an estimated cost of $200-300 per case in lost milk yield, treatment and reproductive penalty. Herd-level prevalence often runs 20-40% in fresh cows during the first two weeks of lactation. Clinical milk fever cases carry mortality risk, particularly when complicated by recumbency, and predispose cows to displaced abomasum.

How does the review frame the herd-level decision?

The piece emphasizes that individual cow decisions feed herd protocols: screening determines which cows receive treatment, monitoring determines whether protocols need adjustment, and economics determine whether the intervention pays. Decision rules must accommodate herd size, labor availability and the financial position of the operation.

What's next on the metabolic-disease frontier?

The Vet Times review arrives alongside ongoing work on automated monitoring tools. In-line milk BHB sensors, reticulorumen boluses tracking rumination, and activity collars flagging reduced feeding behavior all expand the screening universe beyond pen-side tests. These tools shift cost structures rather than replace veterinary judgment. More herds should adopt continuous monitoring within the next three to five years, with milk-component and rumination data feeding back into transition-cow protocols.