Abordagens terapêuticas de doenças hepáticas no período de transição de vacas leiteiras: uma revisão sistemática

Abstract

Hepatic diseases are among the main metabolic disorders affecting dairy cows during the transition period, characterized by alterations in lipid mobilization processes, hepatic triglyceride accumulation, and the development of clinical and subclinical ketosis. Given the importance of this critical period for the productive and reproductive performance of the animals, this dissertation aims to evaluate, through a systematic literature review, the therapeutic interventions applied to the treatment of hepatic alterations in dairy cows, with emphasis on the effects on metabolic biomarkers such as β-hydroxybutyrate (BHBA), non-esterified fatty acids (NEFA), serum insulin levels, hepatic triglyceride concentration, milk production, and clinical cure rates. The methodology followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, including risk of bias assessment (RoB 2.0) and the selection of randomized controlled trials published in three databases between 2015 and 2024. Seventeen primary studies with compatible experimental designs were included, encompassing various therapeutic protocols, including the use of propylene glycol, intravenous glucose, monensin, insulin, and lipotropic compounds. The results indicate that most treatments promote beneficial effects on metabolic and productive parameters, although there is high methodological heterogeneity among studies and deficiencies in randomization and blinding procedures. It is concluded that the available evidence points to the therapeutic potential of certain interventions, but highlights the need for additional studies with greater methodological rigor.