Shpigel NY, Chen R, Avidar Y & Bogin E
Use of corticosteroids alone or combined with glucose to treat ketosis in dairy cows.

J Am Vet Med Assoc, 208(10): 1702-1704, 1996
ISSN: 0003-1488 Journal of the American Veterinary Medical Association (PubMed)

Abstract
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 > or = 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 beta-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 on 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 beta-hydroxybutyric acid and urine acetoacetate concentrations decreased following treatment. CLINICAL IMPLICATIONS - In this study, treatment of ketosis in dairy cattle with a corticosteriod alone was less efficacious than treatment with glucose and a corticosteroid.