Integrated Herd Health Approaches for Ketosis Prevention and Control: A Review

Ketosis is a common metabolic disorder of dairy cattle during the transition period, when the energy demands of late gestation and early lactation often exceed energy intake. This imbalance produces negative energy balance, stimulates adipose tissue mobilisation and increases hepatic ketone-body production, particularly β-hydroxybutyrate. Increased ketone concentrations may appear as clinical or subclinical ketosis and are associated with reduced milk yield, impaired reproductive performance, higher susceptibility to metabolic and infectious disorders, increased culling risk and economic loss. Because ketosis develops through interacting nutritional, physiological, environmental and management-related factors, its prevention and control require an integrated herd health approach rather than reliance on therapeutic intervention alone. This review summarises herd-level approaches for limiting ketosis through transition cow nutrition, dry-period feeding, body condition score management, energy balance optimisation and strategic use of glucogenic and metabolic supplements, including propylene glycol, monensin, niacin and rumen-protected choline. It also considers the roles of housing design, cow comfort, stocking density, heat-stress control, calving management and welfare-based practices in supporting metabolic adaptation. Diagnostic and monitoring strategies, including blood β-hydroxybutyrate, non-esterified fatty acids, milk and urine ketone testing, metabolic profiling and routine herd surveillance, are discussed as tools for early identification of at-risk animals. The review further outlines the contribution of precision livestock farming, automated monitoring, artificial intelligence, machine learning and predictive analytics to proactive decision-making. Integrated nutritional, managerial, therapeutic and technological measures can reduce ketosis prevalence, support animal welfare and improve productive, reproductive and economic outcomes in dairy herds under practical farm conditions in modern dairy production systems.