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Ketosis (also called Acetonemia) is the result of the high carbohydrate (energy) demand of multiple fetuses in late pregnancy. The kids require an increasing amount of carbohydrates the last trimester. Does bearing twins have a 180% higher energy requirement than those with just a single fetus. Does carrying triplets have a 240% greater energy requirement. When this demand exceeds the supply, fat is metabolized into glucose. The metabolic needs of the kids are met at the expense of the dam; this is what causes the ketotic condition. To complicate matters, multiple fetuses produce more waste products, which leads to the doe becoming toxic if she does not flush them from her system.

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