Toddler not peed in 30hrs

[Fingerscrossed22]

Hi all,

My toddler hasn't peed in 30hrs.

Currently in childrens hospital, been checked but the Dr seems unconcerned.

She has drank and eaten v.little in this time- stats are normal as are all other checks.

Toddler was lathargic all yesterday but perked up by tea time but I still came in as no urine passed at that point -22 hrs.

Has anyone else had this?

Currently waiting an hr extra, on advice of Dr, to see if ' anything changes' before being sent home

as someone else said, not urinating can be a sign of sepsis. Have they checked for infection markers?

If the rest of her obs are fine then the not peeing is more likely dehydration from the not drinking I’d have thought.

Obviously if she gets worse symptom wise then take her straight back to A&E. I’d definitely want her checked for a UTI tomorrow. Although you will need a urine sample for that so…

Im back at A&E.
Peads didn't give me open access.
Dd hasn't peed since this 9.30am, hasnt eaten barr rice crispies at 7.30am.
Since 9.45am she has had approx 200 mls. I've tried everything to get her to drink.
She has cried on and off since leaving Peada this am and is very lathargic.
She was sick at 10pm- all fluid.
Ive told peads "Im not leaving till further investigations are done'

Not at all.
She had simple obs done and a heel pric test for bloods yesterday, thats it.

@DinoLil - That must've been very frightening.
Glad DC is ok now.x

They said viral and I get that , the Dr did say they were unsure why no wet nappies.
I did ask why they were discharging her if they couldn't work out why she hadn't peed in 36 hrs.
The response was ' Because she has peed now' 🤦‍♀️

Thanks all for replies- will be re asking about sepsis but wont be leaving until she has further investigations.
I just know that there is an infection somewhere.

It most certainly CAN be a red flag

A red flag for sepsis

Just because it wasnt for your child, you posting something like this is so dangerous and could stop a parent going to the hospital

Trust your gut! Always listen to the mum

@Fingerscrossed22 The info I have copied and pasted below is from a hospital in a different country, but it might help. I hope you get answers soon, you must be so worried. Hope your little one gets better soon. 💖

Acute urinary retention is considered an emergency, so you should seek immediate care if your child hasn’t been able to urinate or fully empty their bladder for 12 hours or more. In addition to taking a medical history and performing a physical exam, the physician may recommend other tests, such as:

• Urinalysis to check for UTI or abnormal kidney function
• Renal bladder ultrasound: This imaging examination is used to determine the size and shape of your child's kidney and bladder, and to detect a mass, stone, cyst, or other obstruction or abnormalities.

https://www.childrenshospital.org/conditions/urinary-retention-and-straining

@CucumberCool you can request a second opinion. You can’t just ring the critical care out reach team. A district general hospital won’t have a paediatric one anyway. We have an out reach team and they will not see children without a serious concern.

Are you getting anywhere @Fingerscrossed22 ? It's absolutely exhausting having to fight every step of the way in addition to the stress and worry of having a very ill child x

I never said it isn’t a red flag. Re-read my post.

Plenty of posters have said it could be sepsis so me explaining that it doesn’t necessarily mean something is seriously wrong to try and bring comfort to OP during a stressful time is not “so dangerous”. Jeez.

I don't think it will let me post a link but worth looking it up.

it's rolling out nationally and the trail has been extended for another year.

Worth reading up about and knowing it is an option if you are not being listened to, weather you are the patient or family of one.

You'll need to look on the hospital website (should be advertised too around the ward) and make sure you concerns have been communicated with the ward manager first.

Its for clinical deterioration - not complaints about the food or parking though!

@CucumberCool I’m a paediatric nurse, in a children’s hospital. I don’t think it’s in use yet. I have not really heard of it. Children with a PEWS of over five already automatically alert to the pccot team. They will ring and see if we are concerned. But don’t automatically review. Not sure how they will have the capacity to see children that doesn’t actually need them.

Oh blimey, what a worry for you and your poor little one. I do hope you get some answers soon.

i guess blood tests are not easy, particularly in a toddler
i hope things improve

I’m pretty sure it’s still in pilot and hasn’t been rolled out everywhere. It requires the hospital to have set up a dedicated line though so if the hospital the OP is in hasn’t rolled it out I don’t see how staff/patients/parents can use the rule.

That doesn’t mean they can’t ask staff why they don’t think it’s sepsis looking at the entire clinical picture or asking for a second opinion as you could before.

Not convinced it would get a different answer in this case unless the child is deteriorating since being discharged. It’s not really feasible to sepsis 6 the hell out of every patient who has a single sepsis symptom anyway.

How is she doing now, OP?

I was thinking the same. Sepsis doesn't always follow the easy to spot rules.

Whilst not peeing is one of the signs of Sepsis, it is not the only one. You were absolutely raise the issue as a precaution, but there would have been other signs too. Did they take her blood pressure? That's one way to rule it in or out. It's not something that I would be worrying about right now. However, if there is any deterioration, then I would raise it again because it can develop quite rapidly.

Btw, my husband nearly died of Sepsis and ended up on life support in intensive care. It can be hard to spot in the early stages. However, I have helped train people up on it and done a fair share of media work to increase awareness. If you have raised it and staff are happy, then take some reassurance from that. However, as I have said, always seek further assistance if things change or ask for a second opinion if worried.

I had something similar with my daughter a year ago when she was 3. She'd had a temp of 40° for 5 days though before she refused any fluids.

They admitted her and ended up putting her on IV fluids overnight. it had been close to 24hrs of no urine at that point. She was also very lethargic with it and syringes of juice, water anything we're a struggle. They even tried putting a nasal feeding tube in but she just yanked it out. They discharged us after she passed what I'd consider a very small concentrated amount of urine.

It all came down to her throat (viral) in the end, it wasnt swollen at all, but mustve been a bit sore. So, the only way to get her to take anything was to use numbing spray every couple of hours, and slowly as and steadily she managed to take fluids again. There was a really dodgy 48hours though after the hospital discharged us (after 2 days there) where I was just on edge the whole time as she was still struggling to drink or eat anything and I lived about the same amount of time as you from the hospital.

I feel your pain, I hope they manage to help get the fluids in her and perk her up a bit.

Try and get anything sweet into her, lollipops, ice lollies, fruit juice, fizzy lemonade.

Hope she's better soon x

Absolutely this. Sepsis would be reflected in the child’s pews score. And deteriorating clinical picture. Just because a child has an infection, it doesn’t mean they have sepsis. Sepsis is an overwhelming infection.

Hope you’re getting the investigations you need, and getting answers.

We’ve been there. I almost guarantee she has a UTI. Our daughter didn’t wee for 24 hours but dipstick when she finally did was fine. Sample sent off showed infection. Make sure they send a sample and don’t just work off the dipstick results (they should know this anyway…)

Hi all,
Thanks so much for everyone's replies, I really appreciate it!

We got on to Peads ward for assessments at 2.30am.
I expressed my concerns and the team last night seemed much better than the night before.
At this point, she hadn't peed again 19 hrs.
DD blood sugars were down from 4.4 on Monday to 3.7 this Am.
Fluid challenge was done immediately this time ,rather than waiting 7hrs after arrival, like Monday.
Dd was checked over and it was discovered that this time, her throat now shown infection. Throat spray given straight away.
Dd seemed to take drink better and was able to pee (on the potty for the first time!! We haven't started potty training yet!) So her pee was tested- this showed no obvious infection but ofcourse was obvious dehydration.
She continued to drink after this.

The consultant arrived at 6am and apologised for treatment the night before and that she shouldnt have been sent home following 38.5hrs of no pee (until 45 mins before discharge ,after starting the fluid challenge where she did pee!)

The consultant explained that a combination of throat infection and likely stomach viral infection ( Lack of eating/fluids but sick twice) was the course.

He felt IV was not needed at this point nor bloods taken ,but gave us 48hrs open access and reassured if we came back in ,then she would have bloods and IV fluids.

Since coming home at 7am , Dd slept all day till 1.30pm ( she did drink 130mls after her pee in hospital) she then ate lunch- her first meal in 5x days!! She has drank too, not as much as I would like but also ate dinner and has enjoyed a few snacks too!!

What a relief!!!

Again, thank you all so much for replies!