Ketosis is the excessive accumulation of ketone bodies in the bloodstream in response to a negative energy balance. In Ethiopia, there is limited data on subclinical ketosis. The study aimed to estimate the prevalence and identify factors associated with subclinical ketosis (SCK), as well as measure the economic losses among lactating dairy cows. Cross-sectional and longitudinal study designs were employed. Samples used to assess SCK were blood and milk. A total of 198 cows from 78 dairy farms were included as samples. The level of ketone bodies was estimated from the fat-to-protein ratio (FPR). Data were collected by face-to-face interviews. The milk yield of 32 cows was measured over eight days to estimate the reduction in milk production. Logistic regression models were used to identify factors associated with the prevalence of SCK. The prevalence of SCK was 57 %. Cows with concentrate feeding, with mastitis, and with >50 % Holstein Friesian blood level had higher odds of SCK. Poor body condition was associated with reduced odds of SCK , whereas increased parity increased the odds of SCK. SCK resulted in a daily milk loss of 0.8 liters per cow, which resulted in average annual losses of 5182 Ethiopian Birr (ETB) per farm (1 ETB = 0.023 US Dollars) and 2445 Birr per cow. SCK is a problem in crossbred dairy cows that contributes to significant economic losses, with a negative impact on the income of smallholder dairy farmers. It emphasizes the need for improved awareness, dairy extension services, and better health management practices to mitigate the impact of SCK on smallholder dairy farms.
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