Clinical Findings:

Digestive/Wasting Form:

• Most common form of ketosis; about 90% of cases
• Reduced feed intake
• Drop in milk production
• Sweetish smell of breath, milk and urine
• Emaciation/woody appearance due to rapid loss of body weight.

Nervous Form:

• Less common form
• Aimless wandering
• Head pressing
• Vigorous licking of skin and inanimate object
• Staggering of gait, crossing of legs
• Circling movement, chewing movement
• Profuse salivation
• Hyperesthesia; tremor, convulsion, may occur in short episodes at an interval of about 8-12 hours.

Diagnosis:

• Based on history
• Based on clinical findings
• Based on clinical pathology:
  • Ketone bodies; increased upto 20-100 mg/dL
  • Blood glucose level: decreased to 20-40 mg/dL

Treatment and Control:

• Administration of 500 ml of 50% dextrose solution is common therapy. It should be given IV
• dexamethasone or isoflupredone acetate @ 5-20 mg/dose IM
• Propylene glycol @ 250-400 g; PO, BID
• Long-acting insulin preparation administered intramuscular @ 150-200 IU/day
• Glucose orally 500 g drench with 30 g sodium bicarbonate solution.
• Niacin @ 8gm orally for 5-6 days
• Vitamin B₁₂ @ 1-2 mg/kg IM or IV
• Ferroliv with B complex @ 5-10 ml IM on alternate days.