Abstract
Background:
Ketosis is one of the most important metabolic disorders occurring in dairy cows after calving, which is caused by a negative energy balance during the peripartum period or around parturition.

Aim:
The current study focused on the diagnostic significance of the clinical scoring system, with serum lipid profiles, mainly lecithin cholesterol acyltransferase (LCAT) and apolipoprotein B-100 (ApoB-100), as recovery indicators in ketotic dairy cattle using the hormonal-steroids-carbohydrate therapeutic protocol. The study also discussed the correlation coefficient between serum apo-B100 and serum non-esterified fatty acids (NEFAs) in pretreated and posttreated ketotic cattle.

Methods:
In this study, 50 ketotic cattle from various dairy farms. The ketotic cows were subjected to a hormonalsteroids-carbohydrate therapeutic regimen extended for a continuous 5 days, including mainly insulin, dexamethasone, and carbohydrate replacement therapy (Glucose solution 50% alternative with dextrose solution 50%) with drenching of propylene glycol. and vitamin B12 injection. Insulin was administered simultaneously with both of glucose and glucocorticoid (Dexamethasone) and alternatively with a 50% dextrose solution. All animals were undergoing thorough clinical and biochemical investigations including mainly clinical scoring system, serum lipid profiles, and serum enzyme activities (Aspartate aminotransferase; AST) in days 0, 7, 14, 21, and 30.

Results:
The ketotic dairy cattle needed a maximum 30-day follow-up period post-therapy to restore their physiological status for clinical scoring data (7 days needed) and most serum lipid indices [14 days needed, i.e., apoB-100, β-hydroxy butyric acid, NEFA, glucose, cholesterol, and AST]. A 30-day post-therapy as a follow-up period was urgently required to restore their reference values of serum LCAT. The results of this study indicated that serum LCAT activity and ApoB-100 were the most sensitive indicators of the efficacy of therapy and the restoration of the physiological status. The study revealed a significant negative correlation between serum NEFA and apoB-100 in ketotic cattle. The results of this study indicated that serum LCAT activity and ApoB-100 were the most sensitive indicators of the efficacy of therapy and the restoration of the physiological status. This could
be seen by an obvious improvement in serum lipid profiles, mainly LCAT and apoB-100, and clinical findings as well as clinical coring data. The study identified a significant negative correlation between NEFA and apoB-100 in ketotic cattle.

Conclusion:
Exposure of diseased ketotic dairy cattle to this specific therapeutic strategy had a great impact on their recovery from ketosis and improved their health and productivity status. The current study concluded the diagnostic significance of the clinical scoring system (Appetite score, rumen filling score, manure digestion score, and manure condition score), and serum lipid profiles, mainly LCAT and apoB-100, as recovery indicators in ketotic dairy cattle using hormonal-steroids-carbohydrates therapeutic protocol.

Key words: Apolipoprotein B-100, Clinical scoring data, Hormonal-steroids-carbohydrate therapeutic regimen, Ketotic dairy cattle, Lecithin cholesterol acyltransferase