Weird symptoms (fever, weird pee smell)-- LONG

I'm at a loss. Since Thursday, DD's urine has had a strong ammonia-type smell. She's acting fine...besides for a fever spike 1-2 times a day. The fever started on Friday (102.2), gave her Tylenol, went away. No fever until we were at the doc's office yesterday afternoon (101.7, and she got even hotter while we were there for TWO hours )...but it went away by the time we got home (NO medicine given). Her temperament is fine, she's not eating as much but besides that she's fine.

Our appt yesterday was 2 hours before they closed...as I said, we were there 2 hours...so we were the last people there. They did the bag-catch urine collection (took forever for my poor girl to pee in it ) and did a "quick swab" of it and noticed that the ketones were a little elevated, but they'd let the sample grow overnight to check for UTI, etc. That office isn't open today, but "someone was going in at 8:30am to check the cultures and would call us by 9am to let us know if there was a problem".

We weren't happy with how we were handled at the office, which has never happened there before. The doc was great, but then once she had the nurse put the bag on DD, we never saw the doc again. The nurse is the one who came back in after I told her DD peed, took the bag off, and then she is the one that came back in and told us that they'd have to grow it overnight, blah blah blah. Basically, we felt we were being rushed out b/c they were closing. She mentioned the ketones, said it could be a sign of dehydration-- but if she's drinking the same amount of liquid as always, WHY would she be dehydrated (not throwing up or no bowel problems either)? She didn't really have an answer for us, said if there was a problem someone would call today...and again, doc never came back in which really made me mad.

So, it's 9:30 and they haven't called...she said they'd call by 9am if there was a problem. Mind you, the nurse mentioned the ketones yesterday but just quickly, isn't that a "problem" that they should be calling about?

Ugh, I'm just so frustrated, feels better to get it out. HOW can a child be dehydrated if they're drinking their normal liquids and aren't sick? Is it a UTI? Bladder infection? That office isn't open today, but their other location is...should I call the answering service or the other location? I mean, something is obviously wrong....but what?? And what's with the fever spikes 1-2 times a day, then it will go away on it's own?? When I went into her room this morning, you couldn't miss the smell! That's how it's been since Thursday.

For the record, we've been through a UTI with DD before, when she turned 1. It was nothing like she is now...she was inconsolable, constant fever (105+), different-smelling urine. But obviously SOMETHING is going on (not that I'm ruling out a UTI, but still).

The nurse pretty much said to call back Monday if I'm still concerned (if nothing came up in the culture), but she started with the smelly pee on Thursday-- it's Sunday for crying out loud-- how much longer do I wait to treat my daughter if something's going on?

Thanks for reading

Message edited 11/29/2009 9:41:00 AM.

Re: Weird symptoms (fever, weird pee smell)-- LONG

Ugh! That's a tough one!!
Does the office have a service you can call to try to get in touch with the doctor? If they said they'd call by 9 and they haven't, I think you have every right to call and see what's going on. Especially since she's had a fever on and off....that's a sign that something is going on somewhere.
I would have a hard time waiting until tomorrow....

How is she feeling today?

Re: Weird symptoms (fever, weird pee smell)-- LONG

I don't have advice, but hope she is doing well.

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by Palebride

Ugh! That's a tough one!!
Does the office have a service you can call to try to get in touch with the doctor? If they said they'd call by 9 and they haven't, I think you have every right to call and see what's going on. Especially since she's had a fever on and off....that's a sign that something is going on somewhere.
I would have a hard time waiting until tomorrow....

How is she feeling today?

Message edited 11/29/2009 9:47:46 AM.

Re: Weird symptoms (fever, weird pee smell)-- LONG

SHe can still get dehydrated even though she is drinking the same from the Fever. ALso, the fact that her body is fighting something would cause her to throw higher ketones because she needs even MORE fluids than normal for her body to process what she has. Anytime you are sick or have an infection you pretty much need to DOUBLE your normal fluid intake to stay hydrated because your kidney and liver and in overdrive trying to clean and filter the blood and process everything out....

ALso just a higher protein meal will cause Ketones

I wouldn't worry so much about the Ketones in her urine. I'd call the ped emergency line and have them call you back with that is going on.

How is she today???

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by Blissful

SHe can still get dehydrated even though she is drinking the same from the Fever. ALso, the fact that her body is fighting something would cause her to throw higher ketones because she needs even MORE fluids than normal for her body to process what she has. Anytime you are sick or have an infection you pretty much need to DOUBLE your normal fluid intake to stay hydrated because your kidney and liver and in overdrive trying to clean and filter the blood and process everything out....

ALso just a higher protein meal will cause Ketones

I wouldn't worry so much about the Ketones in her urine. I'd call the ped emergency line and have them call you back with that is going on.

How is she today???

Re: Weird symptoms (fever, weird pee smell)-- LONG

My first thought was UTI. I had one when pregnant and had no idea until the dr. told me.

Can you give her some diluted cranberry juice and yogurt in the meantime??

Maybe take her to PM pediatrics? They are open on Sunday 12-Midnight.

ETA: strong ammonia like smell in the urine is generally a sign of dehydration. Keep giving her fluids.

Message edited 11/29/2009 9:55:06 AM.

Re: Weird symptoms (fever, weird pee smell)-- LONG

I was wondering if the urine smell could be something she's eating....you know, like with asparagus?

Re: Weird symptoms (fever, weird pee smell)-- LONG

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by nbc188

Posted by Blissful

SHe can still get dehydrated even though she is drinking the same from the Fever. ALso, the fact that her body is fighting something would cause her to throw higher ketones because she needs even MORE fluids than normal for her body to process what she has. Anytime you are sick or have an infection you pretty much need to DOUBLE your normal fluid intake to stay hydrated because your kidney and liver and in overdrive trying to clean and filter the blood and process everything out....

ALso just a higher protein meal will cause Ketones

I wouldn't worry so much about the Ketones in her urine. I'd call the ped emergency line and have them call you back with that is going on.

How is she today???

Thanks. Yesterday, her fever literally lasted an hour (while she was being weighed at the doc's we noticed the fever had started, and by the time we left, it was completely, 100% gone without any meds). The day before, the fever was there after her nap, we gave her Tylenol, it was gone after that and didn't come back until yesterday. Weird, right?

I just don't get what's wrong with her, and they're really frustrating me. Something IS wrong, what's with the ammonia-smelling urine and the fever spikes?

She has been eating a lot of turkey the last few days, would that affect the ketones?

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by Blissful

Posted by nbc188

Posted by Blissful

SHe can still get dehydrated even though she is drinking the same from the Fever. ALso, the fact that her body is fighting something would cause her to throw higher ketones because she needs even MORE fluids than normal for her body to process what she has. Anytime you are sick or have an infection you pretty much need to DOUBLE your normal fluid intake to stay hydrated because your kidney and liver and in overdrive trying to clean and filter the blood and process everything out....

ALso just a higher protein meal will cause Ketones

I wouldn't worry so much about the Ketones in her urine. I'd call the ped emergency line and have them call you back with that is going on.

How is she today???

Thanks. Yesterday, her fever literally lasted an hour (while she was being weighed at the doc's we noticed the fever had started, and by the time we left, it was completely, 100% gone without any meds). The day before, the fever was there after her nap, we gave her Tylenol, it was gone after that and didn't come back until yesterday. Weird, right?

I just don't get what's wrong with her, and they're really frustrating me. Something IS wrong, what's with the ammonia-smelling urine and the fever spikes?

She has been eating a lot of turkey the last few days, would that affect the ketones?

if she's eating more protein (turkey) than normal that would ABSOLUTELY cause teh ketones....

Ketones aren't something to really worry about unless they are super high for long periods of times so don't stress about that


the urine smell can also be a result of the high ketones.


I would be more concerned over the fever spikes which could be totally unrelated to the urine and ketones issue.

It could be something viral... DId they check her ears and throat while she was there???

Message edited 11/29/2009 9:58:26 AM.

Re: Weird symptoms (fever, weird pee smell)-- LONG

Does she have a rash at all anywhere? There are some viruses that have triphasic fevers that end with a rash on the body.

I hope she feels better and you find an answer

Re: Weird symptoms (fever, weird pee smell)-- LONG

Can you give her some pedialyte?

Hope she feels better!

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by Stacey1403

Does she have a rash at all anywhere? There are some viruses that have triphasic fevers that end with a rash on the body.

I hope she feels better and you find an answer

Re: Weird symptoms (fever, weird pee smell)-- LONG

Re: Weird symptoms (fever, weird pee smell)-- LONG

as someone who has been prone to UTI's since i was 3 years old, it sounds like a UTI to me. I hope you find out what it is and dd gets better soon

Re: Weird symptoms (fever, weird pee smell)-- LONG

Hope C's feeling better!!!

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by steph7308

as someone who has been prone to UTI's since i was 3 years old, it sounds like a UTI to me. I hope you find out what it is and dd gets better soon

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by nbc188

Posted by steph7308

as someone who has been prone to UTI's since i was 3 years old, it sounds like a UTI to me. I hope you find out what it is and dd gets better soon

Yeah, she had one right when she turned 1...we had to have some testing done. She DOES have some kidney issues but they're not sure if they make her more prone to UTIs...that's why I'm concerned about this. Thanks!!

Message edited 11/29/2009 2:55:39 PM.

Re: Weird symptoms (fever, weird pee smell)-- LONG

Oh man, C, what a nightmare and so frustrating!

Did you ever get in touch with someone from the doc's office?

The temp spikes are really, really odd. Did the doc have any explanations for it? Is it continuing today?

I hope this gets resolved soon!!!

Re: Weird symptoms (fever, weird pee smell)-- LONG

if the culture was started later in the day chances are that nothing will grow yet... in hospitals they will typically not even look at them for 24 hours because you get very poor results prior to that


ketones in the urine can mean so many different thing.. particulary when fevers are involved... we see them alot where i work

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by chmlengr

Posted by nbc188

Posted by steph7308

as someone who has been prone to UTI's since i was 3 years old, it sounds like a UTI to me. I hope you find out what it is and dd gets better soon

Yeah, she had one right when she turned 1...we had to have some testing done. She DOES have some kidney issues but they're not sure if they make her more prone to UTIs...that's why I'm concerned about this. Thanks!!

I remember you saying she had the kidney troubles. I do as well, and the first sign that something may be acting up again is the fever and weird smellng pee for me! And for the record, even with my kidney defect, I've never once had a UTI. My kidney has a deformity and sometimes causes a blockage where it drains the urine to the ureters. They may have tested the urine for a UTI (usually a urine analysis), but make them take another sample and do a urine culture! That will tell if the problem is stemming from the kidneys.

Hope she feels better soon!

Message edited 11/29/2009 3:38:48 PM.

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by InShock

Oh man, C, what a nightmare and so frustrating!

Did you ever get in touch with someone from the doc's office?

The temp spikes are really, really odd. Did the doc have any explanations for it? Is it continuing today?

I hope this gets resolved soon!!!

Message edited 11/29/2009 3:45:22 PM.

Re: Weird symptoms (fever, weird pee smell)-- LONG

Re: Weird symptoms (fever, weird pee smell)-- LONG

Posted by nbc188

Posted by steph7308

as someone who has been prone to UTI's since i was 3 years old, it sounds like a UTI to me. I hope you find out what it is and dd gets better soon

Yeah, she had one right when she turned 1...we had to have some testing done. She DOES have some kidney issues but they're not sure if they make her more prone to UTIs...that's why I'm concerned about this. Thanks!!