What's going on with DS1? Excessive urination. (UPDATE in #35, 49, 53)

[essnce629]

DS1 is 11 years old and has always been a super deep sleeper and bed wetter. I got him a bed wetting hypnosis cd a few years ago and he was dry at night for over a year. When he would have a random accident at night I attributed it to constipation and after a few days of prunes he'd be fine. No issues during the day back then.

But now, over the past year he's been going to the bathroom during the day more frequently. Every time we go to a store or out to eat he goes to the bathroom (so like every hour). For instance, we eat at Ikea every Wednesday after his fencing class and he always goes the bathroom before we leave fencing, as soon as we get to Ikea (it's just 1 mile away), and as soon as we finish eating (45 minutes later). A year ago at his 10 year check-up I brought up the fact that he seemed to go pee a lot so the doctor did a urine culture and it came back negative. We weren't having any other issues so it didn't really worry me. He's never had any pain with urination, fever, cloudy urine, back pain, etc.

Fast forward to about a month ago and we're now having major issues. DS is still going pee frequently during the day, but now he is waking up multiple times a night (about every 30 minutes the first few hours that he goes to bed) and is peeing a TON each time. It's like he's drinking a gallon of water every 30 minutes or something. After about two hours of getting up multiple times (it's only 10pm right now and he's gotten up to pee 6 times already) he finally falls into a deep sleep and sleeps through the night. I go to bed around midnight or 1am every night and always check on him and most of the time he's wet the bed. And not just a little, a TON. Like someone poured a gallon of water all over the bed. I've thrown away two waterproof pads in the past week because he just peed right through them. During the day he says it just feels like he has to go to the bathroom really bad and the same thing for at night. So now we're having frequent urination during the day, waking up multiple times during the night to pee, and nightly accidents. He still has no pain with urination, fever, or back pain. His pee is clear and came back negative for infection with the uti test strips I did on him two days ago. He's on a 10 day course of antibiotics (Keflex) right now because his eczema has been out of control as well and the allergist was worried about it being infected with staph. We're on day 3 of 10 and there's been no change in his urination issues so I'm assuming it's not related to a uti or bladder infection as the antibiotics would have treated that as well.

My first thoughts are type 1 diabetes or diabetes insipidus, but he does not have excessive thirst, fatigue, or weight loss. In fact, he's actually gained 12 pounds over the past several months. He swims 5 days a week on a competitive swim team and is like a little brick of muscle. He takes a 20oz water bottle to school every day and drinks the whole thing, but usually doesn't refill it. At home I see him drink a glass of water at breakfast and dinner and then he takes another bottle of water to swim practice. That doesn't seem excessive to me.

I got him into the doctor today (decided not to wait till his 11 year checkup next week) She did a finger prick blood test on him that came back at 120, but he had eaten a snack of salami and an apple exactly 2 hours beforehand so this number seemed within the normal range. She had him give a urine sample as well that she sent off to have cultured. She's having me bring him back first thing tomorrow morning for a fasting blood draw and a more thorough urine test.

I'm at a loss for what's going on. Since typing this out he's woken up two more times to go pee. DH is worried too. All I can find online is type 1 diabetes, diabetes insipidus, uti/bladder infection, and overactive bladder. And with the overactive bladder thing I don't think he'd be peeing a gallon of urine every 30 minutes right? It would be more like you have the sudden urge to go but only a little comes out and so you have to go more frequently. That's definitely not him.

He did start middle school in the fall and I thought it could be stress related, but he swears he's not stressed or anything. His school is k-8, but the middle school is on a separate campus down the street from the elementary school. It's super small though (2 classrooms per grade, 32 kids each class) and half of the kids came over from the elementary school so he didn't need to make new friends or anything. The teachers are all great and he seems really happy at school. And I don't think stress can make you pee excessive amounts of urine can it? Affecting the urge or frequency seems more likely, but not actually increasing ones urine output.

Anyone have any ideas? Or more specific questions I should ask tomorrow? The plan is go do all the blood work and if that comes out normal then we'll head to a pediatric urologist.

ETA: There is no history of diabetes on either my side or DH's side of the family. DH's side does seem to have auto immune issues though-- his dad has celiac's disease and his aunt (his mom's sister) has multiple sclerosis.

[lalasmama]

Top thoughts would be points you've already hit on--diabetes (type 1 or 2), a UTI, constipation, encopresis, excessive water intake. Sounds like you've ruled those out, or are on the way to ruling them out.

Good luck tomorrow!

[alexsmommy]

Probably like most who will read this, my mind went to diabetes. I'd wait for the fasting blood sugar results and if it's not ordered with the fasting, an A1C. I wonder if the fact that he is so fit and so muscular could be masking a weight loss? I think you also eat fairly low carb so that could be masking/treating early diabetes symptoms? Not a physician but couldn't not offer support. I hope you get answers soon, it's so scary when our "babies" have something going on that we can't get a handle on.

[wendibird22]

Diabetes popped into my head too. And I would agree with you that having to go and going a considerable amount every time doesn't sound like overactive bladder (which I categorize more has having a frequent urge but not necessarily having to actually go each time). Sounds like you are doing the right testing to rule some of the basics out. I'd keep on pushing for more investigation or referral to a specialist if initial bloodworm comes back normal because it definitely sounds outside what I'd consider a normal/typical pattern.

[TwinFoxes]

Diabetes popped into my head too. And I would agree with you that having to go and going a considerable amount every time doesn't sound like overactive bladder (which I categorize more has having a frequent urge but not necessarily having to actually go each time). Sounds like you are doing the right testing to rule some of the basics out.

Diabetes is really the only thing I can think of as well, since I think he'd know if he had a UTI.

Sorry you're having to deal with this. It's been a rough few weeks for you.

[Melaine]

I would go ahead and make an appointment with the ped. Urologist just bc that can take some time. The blood work may turn something up in which case you can cancel. Hope you guys get some answers soon.

[Mikey0709]

GOOGLE - "pollakiuria" in children. My son had this - - we were in the bathroom up to 20 times AN HOUR at one point!!!!!! Had every test run, all came back negative.... THEN SUDDENLY IT STOPPED! It did go on for MONTHS though.

Peak ages for this are 5-8 i think.... but also has shown in kids 3-13. Put "pollakiuria" in our search engine here and you'll also read some feedback of others who went through it on our BBB pages.

My pediatrician said they at once it was suspected it could be from a strep virus - but never proven..... and no idea what causes it.

We just dealt with it - but it was very frustrating! We would just get in the car - and he would have to go. he would go every 15 minutes in school. I felt like i LIVED in the bathroom with him!!!

[Indianamom2]

Like others, I immediately thought diabetes and I still think it's a valid guess. I would ask the doctor to do an A1C test to check his blood sugar over time. It's a lot more accurate than a single blood sugar test. As someone else pointed out, at his age, it could be hard to tell a true weight loss.

[egoldber]

When they do blood work, make sure they do an HbA1c as well as standard blood glucose measurements. That will tell you what his blood glucose levels have been on average over time. A standard blood glucose measurement just tells you what his current blood glucose range is, which can be affected by a lot of things. A postprandial (2 hour) blood glucose level of 120 after a low carb meal like salami and apple would concern me.

ETA: Cross posted with Indianamom.

[essnce629]

Thanks everyone for your support. I'm going to wake him up now and take him in. I will ask for the A1C test as well. Any info is still appreciated. Thanks!

Bumping for Bisous as well since her son has type 1 diabetes.