Question from Albany, New York, USA:

I recently tested my four year old daughter’s urine. I had some ketone test sticks at my house. I was surprised to see the strip turn purple. According to the bottle, the color represented ketones in the urine in the moderate or high range. Out of concern, I called her pediatrician. They had me come in. They tested her urine in the office (a clean catch) and it showed ketones again. This was mid-day.

Lately, for the past week or two, my daughter has been complaining about her tummy hurting a lot. She eats about the same as she has been, not eating any less or more than usual. She always says she is hungry. She always wants a drink and goes to the bathroom a lot. They didn’t see any sugar in her urine. They also pricked her finger and got a reading of 122 mg/dl [6.8 mmol/L]. The doctor said she had microscopic blood in her urine but it was not a big deal. Nothing else was found. As a precautionary measure, she is getting her fasting sugar done and another urine specimen for culture. Why is she having ketones? She isn’t sick, no cold, no vomiting, no loose stools, no asthma, nothing to indicate an illness to me. She is not on any medications either.