Our findings in four herds suggest that intravenous dextrose for one or three days in addition to oral PG for treatment of early postpartum ketosis did not improve recovery, reduce the risk of adverse health events, or improve average daily milk yield over treatment with PG alone. Ketosis risk, treatment preferences, and occurrence of negative health events vary between herds. Therefore, we suggest that producers discuss the results of this and other studies with their veterinarian to determine the optimal ketosis treatment plan for each individual herd.