Ewes carrying twins require 1.9 times the dry matter intake as ewes with singles. The symptoms of pregnancy toxemia are vague and can be similar to other diseases, especially hypocalcemia or milk fever. Milk fever can be differentiated from pregnancy toxemia by the affected ewe's response to calcium therapy. Ewes in early stages of pregnancy toxemia will go off feed and appear lethargic. Their heads droop and they lag behind the rest of the flock and walk aimlessly.
Teeth grinding and twitching is common.
Eventually, affected ewes become depressed, weak and have poor muscle control. In latter stages, they lie down and are unable to rise. If left untreated, coma and death result. The most common treatment is to drench ewes with 2 to 3 ounces of propylene glycol 2 to 3 times daily. Yogurt mixed with water will also provide energy and bacteria to stimulate the rumen.