Ketosis and Milk Fever Treatments

What are common ketosis and milk fever treatments?

By Phoebe Judge

Milk fever (parturient paresis) and ketosis are two common yet life-threatening disorders affecting cows, goats and sheep. Milk fever occurs due to low levels of calcium in the blood. The cause of ketosis is not well understood, but it occurs in animals when they rapidly mobilize fat and need high levels of glucose. Both of these disorders can occur during early lactation. A speedy remedy is often all that stands between an animal’s death and its return to a productive life. Organic producers have struggled to treat these illnesses in accordance with National Organic Program (NOP) regulations, and are always looking for new allowed treatments. In December 2018, the NOP amended the National List at §205.603 to include new tools to address these illnesses for instances when preventive practices identified at §205.238(a) are insufficient.

To treat milk fever, the NOP added calcium borogluconate (CAS #5743-34-0) (§205.603 (a)(7)) and calcium propionate (CAS #4075-81-4) (§205.603(a)(8)). These two materials are common sources of calcium in oral and intravenous milk fever treatments. Previously, some certifiers allowed the use of these calcium supplements under the §205.603(a)(11) allowance for electrolytes, due to their inclusion in a 2015 NOP Technical Report. However, these two electrolytes are now explicitly listed as treatments for milk fever only. 

The addition of propylene glycol (CAS #57-55-6) (§205.603 (a)(27)), exclusively for the treatment of ketosis in ruminants, comes as a relief to many producers and veterinarians. There are a number of widely available treatments for these disorders related to freshening, if preventive measures are inadequate. Ketosis can also be treated with other sources of high-glucose content materials, such as glucose, molasses, sugars and nonsynthetic glycerin. While low-grade cases of milk fever may be treated orally with calcium tablets or CMPK (calcium-magnesium-phosphorous-potassium) tubes, it is common to treat milk fever with a calcium solution delivered subcutaneously or intravenously. These calcium fluids (typically referred to as “Calcium Gluconate 23%”) are usually composed of calcium gluconate, with or without boric acid as a stabilizer.

Of course, there are also ways of managing milk fever and ketosis through prevention. Producers can provide consistent rations of high-quality forage, and avoid overconditioning and overfeeding animals while they are dry. However, even good management of animals will not prevent all cases of ketosis or milk fever; some estimates are that milk fever affects 5.9% of dairy cows each year, and rates of ketosis are often higher. Thus, these newly approved tools to treat ketosis and milk fever are significant additions to organic livestock production. Organic livestock producers should check with their certifier before using inputs for livestock healthcare.   

This article was originally published in the fall 2019 edition of the OMRI Materials Review newsletter, and was revised in April 2024 by Research and Education Manager Peter Bungum.