Diagnostic performance of the BHBCheck β-hydroxybutyrate meter for hyperketonaemia in Indian cows and buffaloes

The objective of the study was to evaluate the diagnostic performance of the electronic handheld BHBCheck meter (BHM) (PortaCheck, Inc., USA) to determine whole blood, plasma and serum β-hydroxybutyrate (BHB) against serum BHB determined using reference laboratory method of Randox D-3 Hydroxybutyrate Ranbut assay (RSM) in Indian dairy cows and buffaloes. Blood samples were collected by puncturing coccygeal vessels for determining whole blood, serum and plasma BHB using BHM and serum BHB using RSM from 217 cows (Gir breed; median 42 DIM and 3rd lactation) and 223 buffaloes (non-descript; median 39 DIM and 3rd lactation) from nearby herds. The Pearson's correlation between whole blood (0.988; 0.987), plasma (0.985; 0.983) and serum (0.985; 0.983) BHB determined using the BHM and serum BHB determined with the RSM in Indian cows and buffaloes, respectively, were significant. Bland-Altman plot demonstrated an excellent agreement between whole blood, plasma and serum BHB determined with BHM, against the serum BHB determined with RSM in Indian cows and buffaloes, respectively. For hyperketonaemia with reference serum BHB cut-off values ≥ 1.2 and 1.4 mmol/L determined with RSM, it recorded optimized BHB thresholds, sensitivity and specificity for whole blood (≥ 0.9 to 1.0 mmol/L; 91 to 95% and 88 to 98%), plasma (≥ 0.9 to 1.0 mmol/L; 91 and 100%) and serum (≥ 0.9 to 1.0 mmol/L; 92 to 100% and 85 to 94%) with BHM in cows and buffaloes, respectively. In conclusion, BHB determined with BHM demonstrated an excellent correlation, agreement and test characteristics with BHB determined with RSM and hence can accurately determine whole blood, plasma and serum BHB in cows and buffaloes.