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Studies suggest that an injection of Butaphosphan and Vitamin B12 on the day of calving and one day later can decrease the prevalence of subclinical ketosis during the week after calving in mature dairy cows

The most common issues are mild injection-site reactions (redness, itching, swelling, tenderness, or bruising)

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Standardized tissue injuries were introduced, and comparative outcomes were assessed over a defined observation period

In addition, this trial design using the combination of objective and subjective endpoints offers insight into correlations with patient-reported outcomes and may provide a blueprint for superior trial design for future studies