Unwell 3 year old - ketones in urine, lethargy, help?

[coves]

Not sure where to post but looking for some advice. My 3 year old has been complaining of a sore tummy over the weekend and had a bit of a temp yesterday. She woke up complaining of thirst and guzzled lots of milk and water during the night which is really unusual for her. Still in lots of tummy pain this morning so I went to GP, they gave her antibiotics for possible infection and tested her urine. She’s barely moved from the sofa all day, just drinking lots of water and smoothies but doesn’t want to eat and just crying that her tummy is sore. I noticed her breath smelled odd this morning but then I hadn’t had a chance to bathe her or brush her teeth before we rushed to the doctors so thought it was possibly that. Doctor has just phoned back to say no urine infection but there are ketones in her urine so could just be dehydrated and to push fluids and see how she goes. I phoned my mum to let her know (she’s a diabetic nurse) and now she’s worried it’s diabetes, with the increased thirst, lethargy and ketones. The GP didn’t seem concerned and I’m not sure whether to phone them back, or give it some time if it’s just a bug especially with the temperature? I’m a bit confused how she could be dehydrated when she’s been drinking soo much. Any advice welcome. :(

A&E. Diabetes in toddlers is very serious and needs to be ruled out.

Push for the diabetes test. They really need to test her blood sugar levels

My mum is on her way with some kit but I’ll phone the GP back now in case they advise A&E.

Glad you have your mum with the gear. If his BGL is abnormal and you have the data to prove it, they’ll take you more seriously and probably triage you quickly.

Ketone can show in urine if you not eating. If no sugar in urine I doubt it's diabetes but best getting checked

@Dinkiedoo thank you, that’s reassuring. She hasn’t eaten properly since yesterday afternoon so that could explain it. I guess it’s the addition of the lethargy, increased thirst and smell of her breath that’s adding to the concern. Waiting for a call back from GP.

If you can test blood sugar easily then do it. If you can’t do it in next few hours I would go to A and E. (Am absolutely shocked the GP didn’t dip urine for sugar as well as ketones - is it worth calling them to check they didn’t?)

A month ago I didn't even know what a ketone was. But 3 weeks ago my adult son was diagnosed with Type 1 diabetes. So unfortunately I now am aware of them.
My first thought when I read your post OP was diabetes and I agree with other posters that she should be tested for it ASAP. Hopefully it isn't diabetes but if it is you really need to know.

My immediate thought was T1 diabetes too.

Echoing others, A&E even if your mum can't get round with the kit. Those are classic symptoms. And after the frenzy of this bit, if you can face saying something to the GP surgery please do. There are very clear guidelines on what to do with that combination of symptoms!

GP phoned back, no sugar in urine and my mum did a finger prick test and it was fine so I feel a lot more reassured! Hopefully she perks up soon.

The GP will have tested for glucose in the urine at the same time as testing for ketones, they just didn't mention it to OP since it was negative.

Ketones are a common finding in children that haven't eaten, as is lethargy.

Yes it can also be a sign of diabetes but highly unlikely in the absence of glucosuria.

I don't think there's any need for having a word with the GP surgery here!

Not now we know the glucose in urine was negative, but with the information given prior to the OP's update, the pathways for suspected T1D weren't being followed. Kids deteriorate at speed in DKA, it's no joke.