Capel M B, Bach K D, Mann S, McArt J A A
Perry Veterinary Clinic, Perry, NY 14530.
Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
J Dairy Sci. 2021 Feb;104(2):2185-2194. doi: 10.3168/jds.2020-19111. Epub 2020 Dec 11.
Our objective was to investigate the effect of i.v. dextrose as an adjunct therapy to oral propylene glycol on the resolution of hyperketonemia (HYK; blood β-hydroxybutyrate ≥1.2 mmol/L), disease incidence, and early lactation milk yield. Cows (n = 1,249) between 3 and 16 d in milk (DIM) from 4 New York dairy farms were screened once weekly for HYK for 2 wk. Those with HYK and no previous history of retained placenta, metritis, or HYK were randomly assigned to 1 of 3 treatment groups: 300 mL of oral 100% propylene glycol for 3 d (PG3); 300 mL of oral 100% propylene glycol for 3 d plus 500 mL i.v. 50% dextrose on d 1 (PG3D1); or 300 mL of oral 100% propylene glycol for 3 d plus 500 mL i.v. 50% dextrose on all 3 d (PG3D3). Cows with a blood β-hydroxybutyrate <1.2 mmol/L at initial screening were re-screened the following week and randomly assigned to the above treatment groups if blood β-hydroxybutyrate was ≥1.2 mmol/L. Cows were assessed for post-treatment HYK resolution 1 and 2 wk after initial HYK diagnosis. We collected farm-diagnosed occurrence of adverse events (sold, died, metritis, displaced abomasum, or ketosis) during the first 60 DIM and milk yield data from the first 10 wk of lactation from herd management software. We used mixed-effects multivariable Poisson regression models to assess the risk of post-treatment HYK resolution at 1 and 2 wk following initial HYK diagnosis and adverse event occurrence among treated cows. We used repeated-measures ANOVA to assess differences in average daily milk yield between treatments. The overall HYK incidence was 30.1% (n = 373). Sixty-four percent of cows (n = 237) were assigned to a treatment group in the first week (3 to 9 DIM), and 36% (n = 136) assigned the second week (10 to 16 DIM). The incidence of 1 or more adverse events during the first 60 DIM was 9.4% (n = 35). We found no effect of treatment on risk of post-treatment HYK resolution at wk 1 (PG3 56.9%, PG3D1 45.0%, PG3D3 50.0%) or wk 2 (PG3 60.0%, PG3D1 52.1%, PG3D3 59.5%) following initial diagnosis, or for risk of adverse event occurrence (PG3 7.4%, PG3D1 8.0%, PG3D3 12.6%). Average daily milk yield (mean ± SE) was similar between treatment groups (PG3: 42.7 ± 0.6 kg/d, PG3D1: 42.4 ± 0.6 kg/d, PG3D3: 42.6 ± 0.6 kg/d). The addition of dextrose for 1 or 3 d provided no improvement in resolution of ketosis assessed once weekly, reduction in adverse events during the first 60 d of lactation, or a difference in average daily milk yield during the first 10 wk of lactation.
我们的目标是研究静脉输注葡萄糖作为口服丙二醇的辅助治疗手段，对高酮血症（HYK；血液β-羟基丁酸≥1.2 mmol/L）的缓解情况、疾病发生率以及早期泌乳量的影响。对来自4个纽约奶牛场、处于产奶3至16天（DIM）的奶牛（n = 1249头），每周筛查一次高酮血症，持续2周。那些患有高酮血症且无胎盘滞留、子宫炎或高酮血症既往史的奶牛被随机分配到3个治疗组中的1组：口服300 mL 100%丙二醇，持续3天（PG3）；口服300 mL 100%丙二醇，持续3天，加第1天静脉输注500 mL 50%葡萄糖（PG3D1）；或口服300 mL 100%丙二醇，持续3天，加3天均静脉输注500 mL 50%葡萄糖（PG3D3）。初次筛查时血液β-羟基丁酸<1.2 mmol/L的奶牛在接下来一周重新筛查，如果血液β-羟基丁酸≥1.2 mmol/L，则随机分配到上述治疗组。在初次诊断高酮血症后1周和2周评估奶牛治疗后高酮血症的缓解情况。我们收集了农场诊断的前60天产奶期内不良事件（出售、死亡、子宫炎、真胃移位或酮病）的发生情况，以及来自牛群管理软件的泌乳前10周的产奶量数据。我们使用混合效应多变量泊松回归模型来评估初次诊断高酮血症后1周和2周治疗后高酮血症缓解的风险以及治疗奶牛中不良事件发生的风险。我们使用重复测量方差分析来评估各治疗组之间平均每日产奶量的差异。总体高酮血症发生率为30.1%（n = 373）。64%的奶牛（n = 237）在第一周（3至9 DIM）被分配到治疗组，36%（n = 136）在第二周（10至16 DIM）被分配。前60天产奶期内发生1种或更多不良事件的发生率为9.4%（n = 35）。我们发现，在初次诊断后第1周（PG3为56.9%，PG3D1为45.0%，PG3D3为50.0%）或第2周（PG3为60.0%，PG3D1为52.1%，PG3D3为59.5%），治疗对治疗后高酮血症缓解的风险没有影响，对不良事件发生的风险也没有影响（PG3为7.4%，PG3D1为8.0%，PG3D3为12.6%）。各治疗组之间平均每日产奶量（均值±标准误）相似（PG3：42.7±0.6 kg/天，PG3D1：42.4±0.6 kg/天，PG3D3：42.6±0.6 kg/天）。添加1天或3天葡萄糖，在每周评估一次的酮病缓解情况、泌乳前60天不良事件减少情况或泌乳前10周平均每日产奶量差异方面均未带来改善。
