Transition cow diseases are a multifactorial complex. Veterinaries need reliable indicators to identify risk animals, take treatment decisions or monitor the metabolic state of the herd. The identification and development of prognostic markers, accompanied by sound metaphylactic treatment protocols are needed. For the trial 80 German Holstein dairy cows (<$Esymbol У~2 sup nd> lactation, clinically healthy and pregnant) were selected from the herd. The study included an intense analysis of each animal from 14 days ante-partum until 49 days post-partum: daily milk yield, monthly milk content analysis, clinical state throughout the trial, ultrasonography of the liver and back-fat tissue measurement, liver biopsies, blood and urine sampling, rumination and locomotion behaviour. To evaluate a metaphylactic treatment protocol with Butaphosphan and Cyanocobalamin two groups received a treatment with Catosal at either a low or high dosage (5 ml and 10 ml/100 kg body weight, 10 % Butaphosphan and 0,005 % Cyanocobalamin) and two placebo-groups were formed (5 ml and 10 mL NaCl 0,9 %/100 kg body weight). We identified "high risk" animals based on their metabolite profiles and that these metabolic alterations were already present prepartum. The cows in the spring-calving group exhibited higher clinical scores (e.g. concerning the genital tract, the gastro-intestinal tract and treatment frequency), fat accumulation in the liver and higher serum fatty acid concentrations, indicative for a more pronounced energy deficit in this group. By the analysis of each group separately at the separate time points the effect of the treatment with Butaphosphan and Cyanocobalamin emerged. In the "high-risk" group a long-lasting effect (day 28 postpartum, 3 weeks after treatment) was observed. Further analysis is needed to identify the metabolites involved in the alterations observed across the transition period, as well as describing "high-risk" animals and treatment effect with Butaphosphan and Cyanocobalamin and bringing the observed metabolic alterations on a production level.