In a controlled study of early lactation hyperketonemic cows (defined as BHB concentrations in blood of 1.2 mmol/L and greater), we compared the effects of drenching with PG alone, intravenous dextrose alone, or both in combination, to an untreated control group. Results of this study showed that the combined treatment with dextrose and PG lowered BHB concentrations to the greatest extent during the treatment period compared with dextrose or PG alone. The increase in glucose and insulin concentrations due to intravenous dextrose was short-lived, as was the decrease in NEFA concentrations. Difference in the effects of the treatments on health outcomes, intakes, and milk production could not be described due to the small sample size and short duration of the study. Follow-up studies of a larger scale are planned to compare disease and production effects for these parameters and to assess the economic cost and benefit of each treatment strategy.