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Ketosis may occur in high milk yielding cows at the beginning of lactation due to negative energy imbalance. All cows have a metabolic activity that creates ketones by mobilizing their fats in order to adapt to the negative energy balance in early lactation periods. Therefore, there is some ketone in the bloodstream of cows and this adaptation provides high milk yield and a good peak.

However, excessive increases in the level of ketone bodies, primarily beta hydroxybutyrate or BHB, lead to conditions that threaten animal health and productivity, such as decreased feed intake, abomasum displacement and metritis.

Ketosis is a disease that can be overlooked because animals do not initially show obvious symptoms. When the BHB value in the blood exceeds 1.2 millimoles per liter, this is associated with a 2-4 times higher risk of abomasum displacement, metritis, endometritis, and a 50% increase in the risk of cows not showing a cycle for approximately 60 days after parturition.

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