Gordon J L, Duffield T F, Herdt T H, Kelton D F, Neuder L, LeBlanc S J
Department of Population Medicine, University of Guelph, Guelph, ON, N1G 2W1, Canada.
Department of Population Medicine, University of Guelph, Guelph, ON, N1G 2W1, Canada.
J Dairy Sci. 2017 Apr;100(4):2954-2966. doi: 10.3168/jds.2016-11925. Epub 2017 Feb 16.
The objective of this study was to determine the effects of butaphosphan-cyanocobalamin (B+C), glargine insulin, and propylene glycol on resolution of ketosis and average daily milk yield after treatment. Cows from 16 herds in Ontario, Canada, and 1 herd in Michigan were tested at weekly intervals between 3 and 16 DIM. Ketosis was defined as blood β-hydroxybutyrate (BHB) ≥1.2 mmol/L. All ketotic cows were given a baseline treatment of 3 d of 300 g of propylene glycol orally. Animals were then randomly assigned to treatment with 3 doses of either 25 mL of B+C or 25 mL of saline placebo and 1 dose of either 2 mL (200 IU) of glargine insulin or 2 mL of saline placebo in a 2 × 2 factorial arrangement. Outcomes of interest on all farms were ketosis cure (blood BHB <1.2 mmol/L 1 wk postenrollment), maintenance of ketosis cure (blood BHB <1.2 mmol/L 1 and 2 wk postenrollment), and blood BHB concentrations at 1 and 2 wk postenrollment. Milk weights were collected daily in 1 large freestall herd. Repeated measures ANOVA was used to evaluate blood BHB concentrations 2 wk after treatment and milk production for 30 d after treatment. Poisson regression was used to examine the effect of treatment on cure and maintenance of cure. Due to a regulatory delay causing temporary unavailability of B+C in Canada, data were analyzed in 2 sets of models: one for insulin and the corresponding placebo (n = 620) and one for the full trial (n = 380). Animals with blood glucose concentrations ≤2.2 mmol/L at the time of ketosis diagnosis were 2.1 times more likely (95% CI = 1.2 to 3.7) to be cured if treated with B+C. Animals in lactation 3 or higher that had blood glucose concentrations <2.2 mmol/L at enrollment produced 4.2 kg/d (95% CI = 1.4 to 7.1) more milk if treated with insulin versus placebo and 2.8 kg/d (95% CI = 0.9 to 4.7) more milk if treated with B+C versus placebo. Animals in lactation 3 or higher with blood glucose ≥2.2 mmol/L that were treated with insulin produced 2.3 kg/d (95% CI = 0.3 to 4.4) less milk than untreated controls. No interaction was observed between treatments. This evidence suggests that B+C and insulin may be beneficial for ketosis treatment in animals with blood glucose <2.2 mmol/L at ketosis diagnosis. It also suggests that blood glucose concentration may be an important predictor of success of ketosis treatment.
本研究的目的是确定布他磷 - 氰钴胺（B + C）、甘精胰岛素和丙二醇对治疗后酮病消退及平均每日产奶量的影响。来自加拿大安大略省16个牛群和密歇根州1个牛群的奶牛在产后3至16天每周进行一次检测。酮病定义为血液β - 羟基丁酸（BHB）≥1.2 mmol/L。所有患酮病的奶牛均接受为期3天、每天口服300 g丙二醇的基础治疗。然后，动物被随机分配接受治疗，采用2×2析因设计，分别给予3剂25 mL的B + C或25 mL的生理盐水安慰剂，以及1剂2 mL（200 IU）的甘精胰岛素或2 mL的生理盐水安慰剂。所有农场关注的结果包括酮病治愈（入组后1周血液BHB <1.2 mmol/L）、酮病治愈的维持（入组后1周和2周血液BHB <1.2 mmol/L）以及入组后1周和2周的血液BHB浓度。在1个大型散栏牛群中每天收集牛奶重量。重复测量方差分析用于评估治疗后2周的血液BHB浓度以及治疗后30天的产奶量。泊松回归用于检验治疗对治愈和治愈维持的影响。由于监管延迟导致加拿大暂时无法获得B + C，数据在2组模型中进行分析：一组用于胰岛素和相应的安慰剂（n = 620），另一组用于完整试验（n = 380）。在酮病诊断时血糖浓度≤2.2 mmol/L的动物，如果用B + C治疗，治愈的可能性高2.1倍（95% CI = 1.2至3.7）。入组时处于第3胎或更高胎次且血糖浓度<2.2 mmol/L的泌乳动物，与安慰剂相比，用胰岛素治疗产奶量多4.2 kg/d（95% CI = 1.4至7.1），与安慰剂相比，用B + C治疗产奶量多2.8 kg/d（95% CI = 0.9至4.7）。入组时处于第3胎或更高胎次且血糖≥2.2 mmol/L并用胰岛素治疗的动物，产奶量比未治疗的对照组少2.3 kg/d（95% CI = 0.3至4.4）。未观察到治疗之间的相互作用。该证据表明，B + C和胰岛素可能对酮病诊断时血糖<2.2 mmol/L的动物的酮病治疗有益。这也表明血糖浓度可能是酮病治疗成功的重要预测指标。
