Pregnancy toxemia, ketosis, or twin lamb disease is a nutritional stress syndrome of pregnant sheep during the last 2-4 weeks of gestation. Occasionally, this problem can also occur during lactation. This problem happens when a ewe's system has a shortage of glucose (blood sugar). The animal's body demands more glucose than can be readily supplied by carbohydrate intake and stores of glycogen in the liver. The body then turns to the formation and release of ketones.
The disease is associated with ewes carrying a large single fetus, twins, or triplets where a high energy demand is placed on the mother. Anything that causes the ewe to decrease her feed consumption (change in weather, severe heat or cold, stress from transport, or other disease conditions, etc.) will cause a drop in glucose and an increase in ketone production. An animal that is excessively fat will also lack sufficient room in the abdomen for adequate feed intake.
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