4/27/15

KetoMonitor:  A  research  based  tool  to  

improve  on-­‐farm  Ketosis  Management  
Heather  White,  Ph.D.;  Tawny  Chandler,  BS;  Gary  Oetzel,  DVM,  MS    
Robert  Fourdraine,  Ph.D.  

§  Collabora've  research  between    

§  UW  Department  of  Dairy  Science  
• Heather  White,  Ph.D.    
• Tawny  Chandler  
§  UW  School  of  Veterinary  Medicine  
• Gary  Oetzel,  DVM,  MS  
§  AgSource  

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Transi'on  to  Lacta'on  

§  Successful  transi'oning  is  key  to  produc'on  and  health  

§  Transi'on  period  brings  increased  risk  of  metabolic  disorders  
§  40  to  60%  of  dairy  cows  develop  Ketosis  
 

Transi'on  to  Lacta'on  

calving

required

consumed

energy balance

§  Energy  and  Glucose  Demands  

of  Lacta'on  
§  Insufficient  energy  and  
glucose  intake  
Grummer, 2008.
§  Nega've  Energy  Balance  
 
 

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Transi'on  Cow  Liver  Metabolism  

Mobilized Fat

NEFA
microbial  
fatty acids + glycerol fermenta'on  

acetyl ENERGY!
CoA
ketones
lipids (ketosis)
(fatty liver)
glc   VFA  
gng  

milk  fat   lactose   §  Effects  40  to  60%  of  dairy  cows  
§  Average  case  costs  $289  
 
 

Ketosis  Management  

§  E'ology  and  Costs  of  Ketosis  

§  Cow  level  detec'on  and  treatment  
§  Herd  level  detec'on  tools  
§  KetoMonitor  
§ Development  
§ Strength  
§ Use  
§  Ketosis  Management,  a  mul'-­‐tool  approach  
 

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Ketosis  
Hyperketonemia,  blood  BHBA  >  1.2  mM  
 
Clinical  Ketosis   Sub-­‐Clinical  Ketosis  
§  Blood  BHBA  >  3.0  mM   §  Blood  BHBA  >  1.2  mM  
§  Incidence  between  10  to   §  Incidence  between  40  and  
15%  of  cows   60%  of  cows  
§  Observable  symptoms   §  “Silent  Killer”  
   
  Both  quan'fied  in  milk,  urine,  or  blood  
Can  be  primary  or  secondary  

Sub-­‐Clinical  Ketosis  

Blood  BHBA  >  1.2  mM  

§  Increase  risk  of  DA  

§  Decreased  milk  produc'on  
§  Increased  risk  of  culling  in  first  30  d  
§  Decreased  reproduc've  performance  
 

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Sub-­‐Clinical  Ketosis  
§  Cumula've  Nega've  Impacts  
§  3x  more  likely  to  develop  a  DA    
§  50x  more  likely  to  be  culled  within  30  
days   1.2  mM  
§  less  likely  to  conceive  to  first  service  
vs.  
§  produce  180  kg  less  milk  in  first  30  
days  and  whole  lacta'on  
§  Can  be  managed!  
§ Early  detec'on  and  treatment  are  
key  
2.4  mM  
McArt  et  al.,  2012  

Ketosis  
§  Incidence    
§ Total  number  of  new  cases  
§ Requires  repeat  sampling  
 
§  Prevalence  
§ How  many  cases  present  on  one  day  
§ Spot  sampling  
§ Prevalence  x  2  to  2.5  =  Incidence  
 
 
 

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Cost  of  Sub-­‐Clinical  Ketosis  

§  Each  case  of  hyperketonemia  

§ $256  for  first-­‐calf  heifers  
§ $375  for  cows  
§ Average  case  $289  
§  Cost  breakdown  
§ 41%  due  to  component  cost  of  hyperketonemia  
§ 33%  due  to  metri's  
§ 26%  due  to  DA  

McArt  and  Nydam,  2014.  The  Manager.  

Cost  of  Sub-­‐Clinical  Ketosis  

1,000  calvings/yr  
30%  incidence  of  ketosis  

Reduce  incidence  of  ketosis  to  15%  

$50,000/yr  savings  

$90,000/yr  
$50,000  investment  to  improve  
transi'on  cow  management  or    
comfort  that  reduces  incidence  
of  ketosis  to  15%  is  recouped  in  
McArt  and  Nydam,  2014.  The  Manager.  
1  yr  

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Reducing  Ketosis  Incidence  

§  Transi'on  cow  management  

§  Fresh  cow  monitoring  and  treatment  
§  Ketosis  monitoring!    
§  Determine  prevalence  
§  Catch  early  cases  and  treat  to  reduce  impact  

Ketosis  Tes'ng  

Cost per
Test! Sample! Ketone! Sensitivity! Specificity!
test!

Acetoacetate
Ketostix ! urine! 78%! 96%! $0.24!
(AcAc)!

KetoCheck
milk! AcAc! 41%! 99%! $0.28!
powder!

KetoTest! milk ! BHBA! 83%! 82%! $2.00!

Precision
blood! BHBA! 91%! 94%! $1.30!
Xtra Meter!
*compared  to  serum  BHBA  diagnos'cs;  Oetzel,  2004;  Townsend  and  Eastridge,  2011  

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Cowside  Detec'on  

§  Twice  weekly  fresh  cow  tes'ng    

§ 4  to  9  DIM  
§  Weekly  fresh  cow  tes'ng  
§  5  to  20  DIM  
§  Test  each  cow  twice  
§  cows  blood  BHBA  >1.0  mM  previous  week  

Herd  Level  Detec'on  

r2=0.22  

Milk  Fat:Protein    
is  sugges've  but  alone  is  not  
a  strong  predictor  

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Milk  BHBA  and  Acetone  

§ FOSS  equa'ons    
§ based  on  spectra  milk  analysis  
§ milk  BHBA  and  acetone  

Nielsen  et  al.,  2005  

Milk  BHBA  and  Acetone  

P < 0.05

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How  Do  We  Develop  a  Beler  

Herd  Prevalence  Tool?    

Research  Objec've  

§  Collected  blood  samples  on  the  day  of  milk  test  at  AgSource  
member  farms  
§ 550  cows  and  heifers  
§ 10  Holstein  farms  (2  Jersey  farms)  
§  Laboratory  BHBA  assay  “Gold  Standard”  
§  Dairy  Comp  Data  
§  Milk  Analysis  

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Analysis  
§  Sta's'cs  run  using  mul'ple  regression  models  
§  Accuracy  
§ Overall  ability  to  predict  prevalence  
§  Strength  of  the  model  
§ Sensi'vity  –  avoiding  false  nega'ves  
§ Specificity  –  avoiding  false  posi'ves  

Holstein  Cows  
7  

6  
Actual  BHBA,  mmol/L  

5  

4  

3  

2  

1  

0  
0   1   2   3   4   5   6   7  
Predicted  BHBA,  mmol/L  

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Specific  Models  Improve  Accuracy  

Animal  tested  

1st  Lact   2nd+  Lact  

5  to  11  DIM   12  to  20  DIM   5  to  11  DIM   12  to  20  DIM    

5  to  11  DIM   5  to  20  DIM   5  to  11  DIM   12  to  20  DIM  
model     model     model     model    
(R2  =  0.74)   (R2  =  0.66)   (R2  =  0.57)   (R2  =  0.67)  

Accuracy:   96%   97%   88%   83%  

How  Do  We  Use  It?    

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How  do  we  use  the  Tool?  

§  Indicator  of  herd  level  prevalence  
§  Monthly  milk  test  provide  a  management  tool  to  guide  decisions  
35  

30  

25  
SCK  prevalence,  %  

20  

15  

10  

5  

0  
Arlington   Barlass   Cottonwood   Darlington   Endres  Jerseys   Larson's  Acres   Majestic  View   Merry-­‐Water   Statz  Bros.  

Farms  

Mul'-­‐tool  Approach  

§  Economic  analysis  of  SCK  tes'ng  and  treatment  

§ If  incidence  is  <15%,  periodic  monitoring  is  recommended  
§ If  incidence  is  >15%,  it  is  most  economical  to  test  cows  2  
days/wk  from  3  to  9  DIM  
§ If  incidence  is  >50%,  it  is  most  economical  to  consider  
blanket  treatments  

What  is  the  on-­‐farm  prevalence    

month  to  month?    

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How  do  we  use  the  Tool?  

100%  
90%  
80%  
Ketosis  Prevalence  

70%  
60%  
50%  
40%  
30%  
20%  
10%  
0%  
7/15/13  

8/15/13  

9/15/13  

10/15/13  

11/15/13  

12/15/13  

1/15/14  

2/15/14  

3/15/14  

4/15/14  

5/15/14  

6/15/14  
Date  of  BHBA  Testing  

Prevalence  on  Each  Farm  is  Dynamic!  

Mul'-­‐tool  Approach  

§  Use  the  KetoMonitor  to  access  rela've  prevalence  

§ Monitor  prevalence  compared  to  the  target  
§ Monitor  the  impact  of  changes  implemented  
§ Monitor  shits  in  on-­‐farm  prevalence  
§ Monitor  shits  that  have  regional  impacts  

Provides  a  tool  to  guide    

nutri'onal  and  management    
decisions!  

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How  do  we  use  the  Tool?  

Using blood detection
protocol to reduce SCK
prevalence
Prevalence Alert Level
Detected During Milk
Low SCK prevalence Testing: Restart blood
35   justifies stopping
 detection protocol
30   blood detection
Ketosis Prevalence, %

30  
Low SCK prevalence
25   justifies stopping

25  
blood detection
20  
17  
16  
15   14  

10   10   10   10  
10   8   8  
5  
5  

0  
1   2   3   4   5   6   7   8   9   10   11   12  
Month  

Mul'-­‐tool  Approach  
=blood  test  all  fresh  cows  2x    
   $500/mth  

35  
=$6,000  
30  
30  
Ketosis Prevalence, %

25  
25  

20  
17  
16  
15   14  

10   10   10   10  
10   8   8  
5  
5  

0  
1   2   3   4   5   6   7   8   9   10   11   12  
Month  

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Mul'-­‐tool  Approach  
= milk ketone testing
$100/mth

35  

30  
30  
Ketosis Prevalence, %

25  
25  

20  
17  
16  
15   14  

10   10   10   10  
10   8   8  
5  
5  

0  
1   2   3   4   5   6   7   8   9   10   11   12  
Month  

= $1,200/yr

Mul'-­‐tool  Approach  
=$2,000    

35  

30  
30  
Ketosis Prevalence, %

25  
Total  of  mul'-­‐tool  approach=$3,200  
25  
Total  of  blood  tes'ng  every  month=$6,000  
20   total=$3,200  
17  
16  
15   Reduced  cost  to  half14  
 
10  
10  
8   Reduced  
8  
10  
.me  to  1/3     10   10  

5  
5  

0  
1   2   3   4   5   6   7   8   9   10   11   12  
Month  

= $1,200/yr

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Benfits  of  Mul'-­‐tool  Approach  

1,000  calvings/yr  
30%  incidence  of  ketosis  

•  Reduces  unnecessary  blood  tes'ng,

saving  money  and  'me  
•  Aids  farms  that  don’t  have  labor  to  
consistently  blood  test  
•  Guides  nutri'on  and  management    
decisions  
$90,000/yr   •  Flag  the  impact  of  an  implemented  
transi'on  cow  change  (inten'onal  
or  uninten'onal)  

What  Does  It  Look  Like?  

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What  Have  We  

Learned  So  Far?    

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Sta's'cs  

Fresh  Cows   Herd   Heifer   Cow  

Tested   Prevalence   Prevalence   Prevalence  
46,583   19.3%   7.2%   26.1%  

§  Highlights  higher  than  desirable  prevalence,  primarily  due  to  

high  prevalence  in  older  cows  

Sta's'cs  
KM  result   Fresh  Cows   30-­‐d  Culling  
Rate  
negative   37,465   1.2%  

positive   8,977   3.6%  

§  Analyzed  KetoMonitor  data  for  subsequent  outcomes  

§  Cows  predicted  with  ketosis  by  the  KetoMonitor  
§  Culling  was  3x  greater  

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Summary  
§  Ketosis  is  a  costly  but  manageable  disease  
§  KetoMonitor  provides  herd  level  prevalence  monitoring  
§  New  approach  to  herd  level  tes'ng  
§  Can  be  used  in  conjunc'on  with  blood  tes'ng  
§  Provides  an  economical  op'on  for  farms  that  don’t  always  need  to  do  
blood  tes'ng,  or  don’t  have  the  labor  to  do  blood  tes'ng  
§  Can  assist  in  reducing  the  nega've  outcomes  associated  with  ketosis  

Questions?  

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