Transition period 13

TechNote 13
Monitor and mitigate milk fever
IN THIS TECHNOTE

13.1 Understand what causes milk fever

Q: “What are the symptoms of milk fever?”

13.2 Identify the factors that influence milk fever

13.3 Supplement all cows with magnesium pre-and post-calving

Q: “How much magnesium do my cows need?”

13.4 Keep dietary calcium levels low pre-calving

Q: “Should I supplement with calcium pre-calving?”

13.5 Supplement all colostrum cows with calcium

Q: “How much calcium do my cows need after calving?”

13.6 Maintain dietary phosphorus within recommended ranges

Q: “Is PKE a good feed for cows pre-calving?”

Q: “Does fodder beet require phosphorus supplementation?”

13.7 Avoid grazing effluent paddocks and supplementing with feeds high in potassium pre-calving

Q: “Can I graze effluent paddocks with my springers?”

13.8 Understand the impact of DCAD in your system

Q: “Do I need to worry about DCAD?”

13.9 Maintain recommended feeding levels pre-calving

13.10 Further reading

13.1 Understand what causes milk fever

Milk fever, or hypocalcaemia, arises when the dairy cow has lowered levels
of blood calcium. Milk fever generally occurs within the first 24 hours Q: What are the signs of milk
post-calving but can still occur 2 to 3 days post-calving. It can be clinical or fever?
sub-clinical:
A: Cows will be restless and
• clinical milk fever (includes both ‘downer’ and ‘non downer’ cows): cows disorientated. They may be
with less than 1.4 mM blood calcium staggering or be weak in the hind
legs. In severe cases, the cows will
• sub-clinical milk fever: cows with less than 2.0 mM but more than 1.4
be unable to stand (downer cow),
mM blood calcium.
have a low body temperature and
be unresponsive.

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Milk fever increases the risk of other metabolic diseases and infections such as ketosis and metritis, and approximately
5% of downer cows do not recover. In 2000, a study indicated 33% of cows in NZ had sub-clinical milk fever (e.g.
blood calcium levels below 2 mM) with an additional 7% showing signs of clinical milk fever (e.g. downer cows and/or
blood calcium levels below 1.4 mM). Cows suffering from clinical milk fever produced 14%, less milk, while cows with
sub-clinical milk fever produced 7% less milk. The impact of this disorder on the average NZ farm was estimated to be
$8,000 per 100 cows.

The dairy cow obtains calcium from her diet or from stores in her bones. Although there are substantial amounts
of calcium available from these sources, the absorption from the intestines or resorption from bone is under tight
hormonal control and is affected by other minerals (e.g. phosphorus and magnesium) and vitamins (e.g. vitamin D).

With the onset of lactation, and production of colostrum, the cow’s requirement for calcium increases substantially
(400% increase in a day). To meet these calcium requirements, the cow must increase both the absorption and
resorption processes. Any factors that interfere with these processes mean the cow cannot meet the increased demand
for calcium and this results in lowered blood calcium concentration and milk fever.

13.2 Identify the factors that influence milk fever

Milk fever is a multifactorial disorder. Thus there are several factors that influence milk fever (Table 1). Some of these
factors are controlled by strategic management decisions (e.g. breed, age and BCS of the cow), while others are under
tactical control (e.g. mineral/feed management decisions and milking frequency). Other factors that influence milk
fever, such as the weather, are not within farmer control.

Table 1. Factors which influence milk fever (adapted from Roche, 2012)

Influence

Several nutritional factors affect the risk of milk fever, including pre-calving feeding level
(see TechNote 12: Feed the transition cow appropriately) and minerals (pre-and post-calving).
Important minerals are listed below and explained in more detail in the check list and
following sections:
Nutrition
More important 1. magnesium
2. calcium
3. potassium
4. phosphorus
Less important 5. dietary cation anion difference (DCAD)

Holstein-Friesians with North American genetics are more at risk of milk fever than those of
Genetic strain
New Zealand origin.

Age Older cows (6 years and more) have a greater occurrence of milk fever.

Breed Jersey cows are 2.5 – 5 times more likely to get milk fever than Holstein-Friesian cows.

Milking cows once a day during the colostrum period reduces the demand for calcium and
Milking frequency
can potentially reduce the risk of milk fever.

Cows that are above BCS targets at calving (BCS > 5.5) or well below (BCS < 4.0) are at
BCS
increased risk of milk fever.

Wet or frosty weather can increase the risk of milk fever, most probably due to lower dry matter
Weather intakes (less energy and dietary magnesium and calcium), increased stress, and less efficient
magnesium supplementation (less water drunk and magnesium oxide washed off pasture).

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Much research has focused on the effects of feed and mineral management during the transition period on the risk of
milk fever and a check list is provided below to quickly step through key recommendations. Each recommendation is
expanded on in TechNotes 12 and 13.

Check list to mitigate milk fever

Ensure cows are at target BCS 2-3 weeks prior to calving 12

Separate at-risk cows prior to calving and feed appropriately 12

Supplement all cows with magnesium pre-and post-calving 13.3

Keep dietary calcium levels low pre-calving 13.4

Supplement all colostrum cows with calcium 13.5

Avoid feeds high in phosphorus (e.g. PKE) and supplement with phosphorus 13.6
if diets are low in phosphorus (e.g. fodder beet)

Avoid grazing effluent paddocks 13.7

Understand the impact of DCAD in your system 13.8

Research on the effect of milking once a day during the colostrum period on milk fever is limited. What is known is
that milking cows once a day for the first 4 - 8 days of lactation reduces milk production by approximately 20% (while
the cows are being milked once a day), has only a small impact on dry matter intake (DMI), and thus improves energy
status during this period. The reduced milk production has a potential benefit as there is reduced demand for calcium
in these cows and this may help maintain blood calcium levels and reduce risk of milk fever. However, this requires
confirmation.

Prevention is better than treatment. If milk fever occurs, downer cows need to be treated immediately. Every farm
needs to have a treatment protocol. A vet should be involved in setting up an appropriate treatment plan, and all the
farm team need to be equipped with the necessary skills and resources to ensure cows are treated correctly.

13.3 Supplement all cows with magnesium (Mg) pre and

post-calving
As a rule of thumb, dry cows require 0.4% magnesium in the diet
for two - three weeks pre-calving while lactating cows require 0.3%
magnesium for four months post-calving.
Requirement for Mg in dry cow diet
Magnesium plays a vital role in the prevention of milk fever. It is essential = 0.4% DM
for the efficient absorption and resorption of calcium. Supplementation with
500 kg cow eating 10 kg DM
magnesium has the largest effect on decreasing the incidence of milk fever
requires = 40 g Mg
and cows should receive supplemental magnesium for 2 – 3 weeks pre-
calving until 4 months post-calving. As a rule of thumb, magnesium should Winter grass supplies ~ 0.2% DM
be 0.4% DM for a dry cow and 0.3% for a cow in early lactation. This is Mg = 20 g Mg
equivalent to adding approximately 20 g supplementary magnesium to the
Additional dietary requirement from
diet; however, this amount varies depending on current diet, and cow intake
supplement = 20 g Mg
(Table 2).

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Three main sources of supplementary magnesium are used and these contain different amounts of magnesium. The amount
of magnesium in each source and the amount of each product required to supply 20 g magnesium is detailed in Table 3.

Table 2. Different magnesium sources and amounts required to provide 20 g magnesium.

Product required
Source % Mg Example of product
(g/cow/d)

Magnesium oxide
55% CausMag 36
(MgO)

Magnesium chloride
12% Mag chloride 170
(MgCl2)

Magnesium sulphate
10% Epsom salts 200
(MgSO4)

These amounts are down the throat and the amount of magnesium supplement that needs to be offered will depend
on the administration method.

If you are:

• dusting with MgO the amount offered should be doubled and in wet weather, tripled,

• adding minerals to feed, typical wastage for the feeding method needs to be accounted for (e.g. 5 - 10% wastage
for automated in-shed feeding, 10% for feed pads, 15% for trailers and 40 – 60% for silage fed in the paddock).

• adding to water, follow the supplier’s instructions. It must be noted that it is difficult to supply enough magnesium
using magnesium chloride or sulphate through drinking water, and high doses can reduce the palatability of water
causing cows to stop drinking.

A combination of magnesium supplements can be used. For example: Adding 60 g magnesium chloride or magnesium
sulphate to the water trough AND dusting pastures with 50 - 70 g magnesium oxide daily will provide a grazing cow
with the recommended level of magnesium.

The pros and cons of different magnesium supplementation methods are outlined in Table 4.

Be sure to:

• Check the magnesium content of a product before administration.

Q: How much magnesium do
my cows need?
• If mixing magnesium supplements with feed, take into account wastage in
the feeding method.
A: Cows generally need an
extra 20 g supplementary
• If dusting on pasture, use two to three times the required amount to allow magnesium daily (down the
for losses, especially if it is wet. throat) for 2 – 3 weeks pre-
calving until 4 months after
calving.

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Table 3. Pros and cons of magnesium supplementation methods.

System Pros Cons

In diet all the time

Decreased intake in wet conditions
In-line Water Dispenser Easy to monitor
Eliminate alternative water sources
Centralised

Need to pre-charge trough

Works with non-centralised water
Trough Dispensers Variable accuracy
supply
Decreased intake in wet conditions

Weather affected
Easily calculated Time consuming
Dusting – Paddock or Hay
Simple task High wastage
Variable accuracy

Mixed through feed Variable mixing

Application to Silage
Easily measured Wastage (when paddock feeding)
Simple task Variable intake of individuals

Variable individual intake

Relatively easy
As a sole method may be difficult to
Automated/in-shed Feeding System Measurable supply adequate mineral
Can be formulated into feed Period of Mg demand may result in
unprofitable use of supplements

Accurate and efficient Labour intensive

Drenching Low capital Skill required
Not suitable in all sheds

Unlikely to provide sufficient minerals

Mineral Blocks / Licks Easy to use
Expensive

13.4 Keep dietary calcium (Ca) levels low pre-calving

Recommendations are to keep dietary calcium levels low (< 0.5% DM) prior to calving.

Cows maintain blood calcium levels at 2.2 to 2.5 mmol/L by regulating their dietary calcium absorption (from their
intestines), and if necessary resorption (from bones). The ability of the cow to alter the proportion of calcium absorbed
from the diet or resorbed from bone takes time. This is an important consideration for the calving cow as her demand
for calcium increases rapidly after calving by approximately 400%.

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The recommendation to keep dietary calcium levels very low (< 0.5% DM)
prior to calving is to stimulate an increase in the proportion of calcium that is Q: Should I supplement with
absorbed from the diet at this time. calcium pre-calving?

For example, if a transition cow requires 15 g of calcium pre-calving but is

A: No, general

being fed 100 g, (approximately 1% DM) she will only be absorbing 15% of recommendations are to keep
the dietary calcium. If instead she was only being fed 20 g calcium (0.2% dietary calcium levels low
DM) pre-calving, she would be absorbing 75% of the dietary calcium. In this pre-calving (<0.5% DM) to
later scenario, when lactation commences and the calcium requirements for stimulate absorption of a higher
colostrum and milk production markedly increase, the cow will be able to proportion of dietary calcium.
absorb a greater proportion of the extra dietary calcium supplied. Then, after calving, when a
high-calcium diet is fed, calcium
This management strategy is commonly used and is effective on many pasture- absorption can increase quickly
based farms. However, when the level of calcium in pastures is over 0.5% and reduce the risk of milk
DM, it is sometimes difficult to keep calcium levels low enough to stimulate fever.
adequate calcium absorption post-calving.

In addition to recommending low levels of dietary calcium pre-calving, the risk of milk fever can also be
reduced by feeding very high levels of calcium (> 2% DM) prior to calving. In pasture-based systems,
these high calcium levels are difficult to achieve; however, if feeding a high level of supplement through
this period, it may be possible to increase calcium intake to these levels pre-calving.

Calcium binders can be used to reduce calcium absorption pre-calving

An alternative strategy that has been tested is the use of calcium binders pre-calving to mimic the effect of a low-
calcium diet. Administration of short-term calcium binders, such as zeolite, reduces calcium availability pre-calving, and
increases blood calcium post-calving. However, limited has been research conducted in pasture-based systems, and
the impact on absorption of other important minerals, such as phosphorus and magnesium, needs to be considered.
Research indicates grazing cows treated with zeolite had higher blood calcium levels for a week post-calving; however
they had lower than recommended phosphorus levels prior to calving, and lower magnesium levels pre-and post-
calving. These results indicate using zeolite would not be a good strategy in diets already low in phosphorus or
magnesium (e.g. fodder beet) and more research is required to determine the cost/benefit of using zeolite in pasture-
based systems.

13.5 Supplement all colostrum cows with calcium

All cows should receive at least 100 g lime flour each day during the colostrum period, with this increasing
to 300 g lime flour for cows with an increased risk of milk fever.

Post-calving, cows require more dietary calcium, and all cows should receive
supplementary calcium (lime flour; calcium carbonate) daily during the Q: How much calcium do my
colostrum period. For some cows, supplementation with 100 g lime flour is cows need after calving?
enough to prevent milk fever; however, for cows at risk of milk fever (e.g. older
cows, Jerseys, those greater than BCS 5.5 at calving or with previous history of A: All cows should receive
milk fever) a higher daily dose of 300 g lime flour is required. at least 100 g lime flour daily
during the colostrum period,
Lower levels of lime flour can be mixed in with feeds, while the higher levels while those at increased risk of
(200 – 300 g) need to be dusted on pasture or mixed in with molasses as a lick. milk fever (older cows, Jerseys
After the colostrum period there is no known benefit of supplementing cows or those greater than BCS 5.5
with calcium (lime flour) unless milk fever is occurring in the milking herd or at calving) should receive 300 g
cows are consuming large amounts of low calcium feeds e.g. maize silage or lime flour.
cereal grains.

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13.6 Maintain dietary phosphorus (P) within
recommended ranges.
The recommended range for phosphorus pre-calving is between 0.25 and 0.45% DM.

Generally, due to the use of phosphorus fertilisers in pasture-based systems,

phosphorus levels in pasture fall within this range. If levels are greater than this
Q: Is PKE a good feed for cows
the excess phosphorus can interfere with production of vitamin D. As vitamin
pre-calving?
D is required for calcium absorption from the diet this increases the risk of milk
fever. Therefore, feeds that are high in phosphorus e.g. palm kernel extract A: No, if there is a risk of
(PKE), distillers grains, or maize gluten, should be limited to less than 30% of milk fever, do not feed PKE to
the diet in the two to three weeks pre-calving, and removed completely from springing cows. PKE is relatively
the diet in cows prone to milk fever. high in phosphorus and this can
increase the occurrence of milk
A phosphorus deficiency close to calving can also contribute to milk fever. fever.
Some feeds contain very low levels of phosphorus. For example, whole
fodder beet contains on average 0.2% DM as P, with bulbs in some regions
containing less than 0.05% DM. Therefore, if cows are fed fodder beet pre-
calving, a phosphorus deficiency can occur. Recommendations are to supply Q: Does fodder beet require
supplementary phosphorus to these cows. Examples of the different types phosphorus supplementation?
of phosphorus supplements, amount of phosphorus contained in these and
administration methods are outlined in Table 5.
A: Yes, fodder beet is
low in phosphorus and it
Current recommendations for cows grazing fodder beet are to supplement is recommended that cows
daily with di-calcium phosphate (DCP) as a slurry on the supplement (e.g. grazing fodder beet are
straw/silage). An alternative is to add soluble phosphorus (e.g. soluphos) to supplemented with phosphorus.
drinking water. However, there can be substantial wastage when mixing
and applying a slurry and individual animals will eat varying amounts of the
supplement. Additionally, water intake from troughs during late winter/early spring can be very low due to the high
water content of the crop and alternative water sources (e.g. puddles). Other options for phosphorus supplementation
to cows grazing fodder beet include mineral licks; however, the effectiveness of mineral uptake from these licks is low.

Table 4. Different phoshorus sources and recommended dose rates.

Phosphorus Other minerals Dose*

Supplement Administration method
(% DM) (% DM) (g/cow/d)

Mixed into a slurry and applied to

Di-calcium Phosphate supplement (e.g. silage or hay)
18% P 21% Ca 50 g
(DCP)
Dusted on pasture

Mixed into a slurry and applied to

Mono-calcium supplement (e.g. silage or hay)
21.5% P 16% Ca 30 g
Phosphate (MCP)
Dusted on pasture

Mixed into a slurry and applied to

Magnesium phosphate supplement (e.g. silage or hay)
14% P 26% Mg 42 g
(MagPhos)
Dusted on pasture

Mono-sodium Water soluble so can be dosed

phosphate (e.g. 26% P 31% Na 20 g through in-line dispenser
soluphos) Mixed in with water or feed

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13.7 Avoid grazing effluent paddocks and supplementing
with feeds high in potassium (K) pre-calving
The recommended range for potassium pre-calving is between 1.0 and 4.5% DM.

Potassium interferes with the absorption of magnesium in the rumen, and as magnesium is important for calcium
absorption, high levels of dietary potassium can contribute to milk fever. Therefore, it is recommended to avoid feeding
a diet high in potassium pre-calving.

Potassium levels in pasture range from approximately 1.0 – 4.5% DM and sometimes pasture contains too much
potassium for the transition cow. However, research trials determined that feeding pastures with potassium levels
ranging from 3.3 to 4.2% DM did not alter blood calcium levels or increase the risk of milk fever.

Although the incidence of milk fever in pasture-based cows is generally low,

the potassium levels (up to approximately 4.2% DM) that were tested are Q: Can I graze effluent
within the natural range for pasture. It is recommended to avoid adding paddocks with my springers?
fertiliser to, or grazing pastures with higher than usual potassium levels (e.g.
effluent paddocks) in the weeks prior to calving. A: No, it is wise to limit access
to pastures high in potassium,
If pasture use is minimal and supplements make up a large proportion of the such as effluent paddocks, in
diet, recommendations are to reduce feeds that are high in potassium, e.g. the weeks prior to calving.
high potassium forages and by-products.

13.8 Understand the impact of DCAD

in your system.
The dietary cation anion difference (DCAD) is the difference between the
DCAD (mEq/kg DM)
cations (positively charged minerals) and the anions (negatively changed
minerals) in the diet. =

((% Na x 434) + (% K x 256))

The main cations in the diet of the dairy cow are potassium (K) and sodium
(Na), and the primary anions are chlorine (Cl) and sulphur (S). The proportion –
of these minerals in the diet influences blood pH (blood acidity), which in turn
((%Cl x 282) + (%S x 624))
affects calcium absorption and subsequently alters the risk of milk fever.

Collective research indicates that when the DCAD is negative, less than 0
mEq/kg DM, blood pH drops and calcium absorption from the small intestine
increases, thereby reducing the risk of milk fever. Q: Do I need to worry about
DCAD?
Urinary pH levels at different DCAD values are highlighted in Figure 1. Urinary
pH is an indicator of blood pH, and blood pH is negatively associated with A: No, not in pasture-based
calcium absorption from the small intestine. Thus a low blood pH increases systems as it is virtually
dietary calcium absorption and reduces the risk of milk fever. impossible to achieve a
negative DCAD; however,
The profile highlighted in Figure 1 indicates that the effect of lowering DCAD if feeding low DCAD
on urinary pH is not linear; it is not until DCAD values are negative, (below supplements, then DCAD can
0) that there is any significant drop in urinary pH. This means that it is not be lowered sufficiently to
until DCAD is negative that there is a significant drop in blood pH, increase in reduce the risk of milk fever.
calcium absorption and reduced risk of milk fever.

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Figure 1. Relationship between urinary pH and DCAD (adapted from Charbonneau et al., 2006).

9.0

Adjusted urinary pH
8.0

7.0

6.0

5.0

-600 -400 -200 0 200 400 600

DCAD (mEq/kg DM)

When DCAD levels are negative (below 0) there is a noticeable drop in the incidence of milk fever (Figure 2); however
when DCAD levels are above 0, there is very little correlation between DCAD and incidence of milk fever.

Figure 2. Relationship between incidences of milk fever in the herd and DCAD levels (adapted from Charbonneau et al., 2006).

70

60
Milk fever, % of herd

50

30

20

10

0
-200 0 200 400 600

DCAD (mEq/kg DM)

In pasture-based systems, or where a high proportion of other green forages are fed, achieving a negative
DCAD is generally not possible. Therefore, strategies to reduce DCAD in a pasture-based system are not
likely to be of benefit. A negative DCAD can only be achieved by replacing pasture with low DCAD feeds
(e.g. maize silage, brewers grains, PKE), and adding ionic salts to the diet (e.g. magnesium sulphate and
magnesium chloride).

If milk fever is an issue in a pasture based system, and factors such as cow BCS, feeding levels and
mineral management (e.g. magnesium, calcium, phosphorus, and potassium) do not reduce the
occurrence, lowering the DCAD to a negative value (ideally -100 mEq/kg DM)) is an option. However,
this will require increased use of supplementary feeds, alter feed management decisions and potentially
increase costs. An example of a simple low DCAD diet is provided in Table 6.

In systems where there are a high proportion of supplementary feeds, in particular low DCAD feeds such
as maize silage, molasses, PKE or brewers grain, a negative DCAD is more easily achievable. Therefore,
adding ionic salts e.g. magnesium sulphate or magnesium chloride, or removing high potassium forages
from the diet will lower the DCAD further (ideally - 100 mEq/kg DM), improve calcium absorption, and
reduce the risk of milk fever.

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13.9 Maintain recommended feeding levels pre-calving
Cows that are at, or above, target BCS should be fed at 90% of metabolisable energy requirements.

Increasing pasture intake prior to calving to more than 90% of requirements in cows that are at, or above, BCS targets
lowers calcium concentration post-calving and increases the risk of milk fever. Although the exact reason for this is not
clear, it is probably due to one or more of the following:

• increased dietary calcium intake pre-calving and consequently reduced calcium absorption post-calving,

• increased dietary potassium pre-calving,

• reduced dry matter and calcium intake post-calving.

Table 5. Example of a low DCAD diet.

  DMI Na K Cl S Mg Ca P DCAD DCAD

Variable
kg %DM mEq/kg DM eaten/day,mEq
Pasture 2 0.3 3.6 1.3 0.3 0.25 0.5 0.4 500 1000
Maize silage 6 0.01 1.1 0.4 0.1 0.1 0.2 0.1 110 660
PKE 1 0.01 0.8 0.25 0.24 0.34 0.6 0.7 -10 -10
MgSO4 0.15 0 0 0 13 10 0 0 -8112 -1217
MgCl2 0.10 0 0 35 0 12 0 0 -9870 -987

TOTAL 9.25 0.07 1.50 0.88 0.35 0.44 0.33 0.27 -554

DCAD eaten, mEq -554

Diet DCAD, mEq/kg -60

DM*

* this figure should be less than zero and ideally closer to -100/mEq/kg DM

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13.10 Further reading
Charbonneau, E., D. Pellerin, and G. R. Oetzel. 2006. Impact of lowering dietary cation-anion difference in nonlactating
dairy cows: A meta-analysis. Journal of Dairy Science. 89: 537 – 548.

Grace, N., S. Knowles, A. Sykes. 2010. Managing mineral deficiencies in grazing livestock. Occasional Publication 10 –
New Zealand Society of Animal Production: Palmerston North, New Zealand.

Kay, J. K., J. J. Loor, A. Heiser, J. McGowan, and J. R. Roche. 2015. Managing the grazing dairy cow through the
transition period: a review. Animal Production Science. 55: 936 – 942.

Loiselle, M. C., C. Ster, B.G. Talbot, X. Zhao, G. F. Wagner, Y.R. Boisclair, and P. Lacasse. 2009. Impact of postpartum
milking frequency on the immune system and the blood metabolite concentration of dairy cows. Journal of Dairy
Science. 92: 1900 – 1912.

NRC. 2001. Nutrient requirements of dairy cattle (7th rev. ed). Washington, United States of America: National
Academy Press.

Phyn, C. V. C., J. K. Kay, A. G. Rius, S. R. Morgan, C. G. Roach, T. M. Grala, and J. R. Roche. 2014. Temporary
alterations to postpartum milking frequency affect whole-lactation milk production and the energy status of pasture-
grazed dairy cows. Journal of Dairy Science. 97: 6850 – 6868.

Roche, J. R. 2012. Avoiding metabolic diseases around calving. DairyNZ Technical series. June 2012. 2012: 13 - 18.

Roche, J. R., A. W. Bell, T. R. Overton and J. J. Loor. 2013. Nutritional management of the transition cow in the 21st
century – a paradigm shift in thinking. Animal Production Science. 53: 1000 – 1023.

Roche, J. R., and D. P. Berry. 2006. Periparturient climatic, animal and management factors influencing the incidence of
milk fever in grazing systems. Journal of Dairy Science. 89: 2775 – 2783.

Roche, J. R., D. Dalley, P. Moate, C. Grainger, M. Rath, and F. O’Mara. 2003. Dietary cation-anion difference and the
health and production of pasture-fed dairy cows 2. Nonlactating periparturient cows. Journal of Dairy Science. 86: 979
– 987.

Roche, J. R., D. Dalley, and F. P. O’Mara. 2007. Effect of a metabolically created systemic acidosis on calcium
homeostasis and the diurnal variation in urine pH in the non-lactating pregnant dairy cow. Journal of Dairy Research
74: 34 – 39.

Schultz, L. H. 1971. Milk fever and ketosis. Digestive Physiology and the Nutrition of Ruminants. D. C. Church, ed.
Illinois, United States of America: Waveland Press, Inc.

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