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There are links between diets high in fat, such as the keto diet, and BV, suggesting that a high fat diet may increase the likelihood of developing the infection. The keto diet advocates high fat and low carbohydrate consumption and began in the 1920s as a treatment for epilepsy. However, many people who do not have epilepsy follow the diet to lose weight.

Producers may follow up with drenches of propylene glycol or calcium propionate gels as necessary. While prevention is far preferable, getting affected cows back on feed as quickly as possible is the key to successful treatment. Feed intake, or lack thereof, is a critical component in the onset of ketosis. In all cows, dry matter intake begins to decline approximately one month prior to calving, although many people will not notice this decline until several days prior to calving.

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