Use of corticosteroids alone or combined with glucose to treat ketosis in dairy cows

Objective - To compare relative efficacy of dexamethasone and flumethasone alone or in combination with rapid IV infusion of glucose for treatment of ketosis in cattle. Design - Clinical trial. Animals - 127 cows with urine acetoacetate concentration ≥60 mg/dl. Procedure - Cows were treated with 500 ml of 50% glucose solution, IV, and 40 mg of dexamethasone, IM (group 1), 40 mg of dexamethasone, IM (group 2), 5 mg of flumethasone (group 3), or 500 ml of 50% glucose solution, IV, and 5 mg of flumethasone (group 4). Treatment success was defined as recovery after a single treatment without relapse during the same lactation. Uterine disease (retained placenta or metritis), parity, and pretreatment plasma glucose, serum β-hydroxybutyric acid, and urine acetoacetate concentrations were evaluated as possible confounding factors affecting recovery. Results - Only uterine disease was found to have a significant effect of recovery. Treatments 1 and 4 were significantly more efficacious than was treatment 2, but efficacy of treatment 2 was not significantly different from that of treatment 3. Regardless of treatment, cows with uterine disease were less likely to have a successful outcome than were cows without uterine disease. In all treatment groups, plasma glucose concentration increased and serum β-hydroxybutyric acid and urine acetoacetate concentrations decreased following treatment. Clinical implications - In this study, treatment of ketosis in dairy cattle with a corticosteroid alone was less efficacious than treatment with glucose and a corticosteroid.