In infants with fever and vomiting we always like to check for a urine infection. Now catching a urine to test it is probably the most annoying thing I ask parents to do on a daily basis. It’s not fun sitting there watching your baby, with their nappy off, urine pot handy, waiting for a wee. Of course babies tend to time it so perfectly that they do it during the only split second the parents aren’t watching. Or they just hold off. Usually if we’re worried about how unwell the child is and want an answer straight away, or it’s a very young baby, we try a more accurate and quick way to get the urine. Either we go for a tiny catheter (tube) into the bladder through the urethra (up the “pee hole” in girls or “willy” in boys) or a tiny needle through the skin of the lower abdomen straight in to the bladder. This second method sounds terrible to explain but it’s such a quick and accurate way to get urine, I’d prefer this on my child any day. It’s not just me.. the vet a few weeks ago was a bit taken aback when I said yes straight away to try this method on my kitten after he refused to pee for her. I had to explain that I’m a Paediatric Doctor and do this to babies all the time so I completely agreed with her decision. She looked relieved. I could relate to how hard it is to tell a worried parent you’re about to stick a needle in their child’s abdomen. We had a moment bonding over supra-pubic aspirates.
So I had this 3 month old girl in Emergency. Parents had tried for a while to get a urine sample. She was still having fevers and I wanted to know what I was dealing with sooner rather than later. It was the middle of the night, parents falling asleep standing, urine pot in hand. Finally they agreed to give the catheter a go. I had a resident working with me, she was keen to do it. We prepped everything, all set to go. She was leaning over concentrating so hard to try and find the right place to insert the catheter and suddenly, like someone had lifted the flood gates to a dam a forceful fountain of pee came gushing out. Now baby boys can wee in all sorts of directions depending on where their willy is facing (I’m a Paeds doctor I’m allowed to talk about this. Besides, it’s baby pee. So innocent) I’ve seen baby boys pee on doctors, pee on their parents faces, pee on their own faces. But this little girl; she gave all those silly boys a run for their money. First it came straight out and missed the concentrating nervous resident by about a centimetre. The resident squealed, we all jumped back, mum nearly fell off her chair. The baby took a deep breath in and then let out a God almighty fountain of pee that literally shot straight up to the ceiling. I’ve never seen anything like it before. It was like something from one of those spoof movies.
Somehow in the midst of it all I grabbed the urine pot and caught some of the valuable wee on the way down. Thank goodness for that.
She didn’t have a urine infection, but she had some sort of super powers
Dr. Nelu x
(Photo credit: http://www.cluig.info/elephant-fountain/elephant-fountain-baby-elephant-fountain-photograph/)