What's new in ketosis in dairy cows?

Over the last twenty years, much has been learned about ketosis as a disease of dairy cattle. Its aetiology has been found to be more complex than it was previously thought to be, with new factors coming to light–such as the discovery that the disease actually begins in the weeks before calving – and the exploration of the risk factors and genetics of insulin resistance. The importance of abnormalities other than hyperketonaemia has been demonstrated, and a better understanding of its treatment and prevention has been gained, including the use of non-steroidal anti-inflammatories and the most suitable gluconeogenic precursors, and the selection of replacement heifers with a lower genetic predisposition to ketosis.