1/5 Quintus AMBG 92 (no juice)

[Steph & Quintus & L & O]

condo: http://www.felinediabetes.com/FDMB/...s-without-juice-continue-ambg-65-1-72.189076/

We seem on a roll. I have two strips left and I'm not even worried if I can't test this week-end until the next shipment arrives. I feel extremely lucky (and a bit guilty) that Quintus seems to be doing so well.

Has anybody noticed the compulsive/addictive quality there is to all this testing? It's textbook intermittent reward. When I test now I'm super tense while the glucometer is doing its thing. Will it be good? Will it be bad? An hour later I find myself wondering what his BG is and wishing I could get a number.

I know this mechanism well, having worked in the field of social media for over ten years. Just as we "train" our brains to want to check facebook or e-mail over and over again (or this forum!), I have noticed that over these last weeks my brain has been latching on to the coloured numbers game on the spreadsheet. Will I get yellow? Will I get blue? Green! Yay!!! See how it works?

This is a normal phenomenon, but it means we need to pay attention whether the amount of testing we are doing is medically necessary/useful, or whether it is simply satisfying our dopamine reward cycle.

So... maybe I'll leave it at one test today. (Unless the strips arrived, and then I'm toast )

I've added a bunch of labs to Quintus's SS.

In response to a question from @PussCatPrince I outlined my text steps for Quintus (quoting myself):

Things that remain open and I want to discuss with my vet:

- continuing antibiotic coverage, or not (convenia). I'm leaning towards "no" now because Q's BG these last days seems to go up and down around the "pretty" range, it's not steadily rising, and I think he'll say no too, but if he things it's more prudent to give another shot, I'll go with it
- whether it makes sense to micro-dose Quintus in the hope his body will "learn" that lower BG is where he needs to stay (I think the answer will be no)
- if he has any suggestions diet-wise given that the DM cans are being discontinued and that I'm sick of hand-mixing food n times a day
- if we should do a blood panel, fPLi, (or an ultrasound check?) shortly to confirm that the improvement I am noting regarding his clinical symptoms does indeed reflect that he's getting/gotten over his pancreatitis. I suspect we might do a blood panel, but not the ultrasound, though I'm sure the ultrasound vet would be super curious to go and have a look inside now! Maybe we'll wait a couple of weeks to do a fructosamine test, but if I've been taking spot checks like I'm doing now I'm not sure it will give us a lot of extra info?
- how we go forward regarding monitoring of his FD
- if Quintus's numbers start going up again: if it makes sense to move to another insulin that is more compatible with my long days away from home (PZ or why not, degludec if this is something the Zurich Tierspital is already working with).

I hope you all have a good day and wish you the best of numbers for your kitties.

 

[PussCatPrince - GA]

Has anybody noticed the compulsive/addictive quality there is to all this testing? It's textbook intermittent reward.

No.

Your suggestion is frankly insulting .

ps - I have worked in social media for much more than a decade.

 

[Steph & Quintus & L & O]

No.

Your suggestion is frankly insulting .

I'm really surprised by your reaction. I take it you haven't observed this in yourself -- great. Are you implying that the idea that an activity like testing BG should be immune to intermittent reward? (I'm assuming you know how it works.)

What is insulting about the idea that in some cases our need/desire to test might be tainted by learning/habituation mechanisms?

 

[Tuxedo Mom]

Home testing is all about the safety factor. Obviously if my kitty has high numbers it will be a concern and trying to figure out the "cause" becomes important. If my kitty has good numbers, then it is a sense of relief for myself and my kitty. There is absolutely no "bragging rights" connected with the numbers. I have not posted my own readings for a very long time time and it has no bearing on how much I test. The amount of testing is based on how the numbers are going and whether there is any reason to do multiple tests in between shots. The days the numbers are flat and of no concern I do not test further...the days the numbers are low or dropping too fast I test more.

There is no competition involved in testing. Forum members are of course happy when another member's kitty is doing well and concerned when another member's kitty is staying in high numbers. This forum is about support and caring for all forum members. When a kitty is sick and struggling or crosses the Bridge, the pain we feel for that kitty is real. I personally have cried many many times over the years for kitties I have never met. The prayers and "high fives" we send are because we can identify with the good and bad times that come from being a FD petparent.

Trust me...if I didn't have to test each day I would be a very happy person. Testing is done for the safety of my kitty not for self-gratification or a dopamine rush. I get no satisfaction from testing other than knowing that my kitty is safe.


BTW I do not post regularly on FB or any other media and this is one of the only online forums that I have ever joined or care to belong to.

 

[Steph & Quintus & L & O]

There is absolutely no "bragging rights" connected with the numbers.

There is no competition involved in testing.

This is not at all what I'm talking about. I was commenting on something I have noticed in me regarding when I feel the next test is warranted.

Intermittent rewards, or operant conditioning (for those reading who may not be familiar) is the system we use to reinforce a behaviour when training. Teach a dog to sit by giving him a treat when he does it. Then you stop treating each time and treat on an intermittent and irregular schedule. This reinforces the behaviour because something in the dog's brain goes "omg I didn't get it last time, I hope I get it this time!"

This mechanism comes into play online (this is where I initially discovered it) with e-mail, for example. The "urge" to check mail to "see if there's something" -- that is the result of intermittent rewards (here, reward = an e-mail, or a nice e-mail, or a stimulating e-mail). You find it all over social media of course, now. You find it when a disaster is unfolding on TV and one can't stop checking the news to see how things are going. You find it when the stock marking is crashing and people check every 30 minutes to see what is happening.

Different people are more or less susceptible to this kind of reinforcement. It has nothing to do with "competing" with others. It's about what "pushes" us from inside.

I am not implying that testing regularly is useless, or that we are not caring for our cats. I am wondering if other people than me have noticed that there might be other things in play when it comes to deciding how much to test, how often, and when.

What brings me to wonder about this and ask if other people have made the same observations as me is that despite the fact Quintus seems to be doing "fine" these last days, I keep wondering what his numbers are. I tested this morning, but I feel a mild urge to test him again later today. Objectively, this is frankly not necessary. So there is something lingering on, a habit or anxiety I've developed, and the lack of data is making me want to get some.

Again: nothing to do with competing.

 

[Tuxedo Mom]

You have been most fortunate to have a kitty that is responding so well early in the FD treatment plan. Perhaps it is common with people whose kitties are hitting good numbers so quickly to be more "curious" about where the readings are, with the hopes that they remain good. Quintus looks like he may very well be on his way to remission.

However, for people who have more complex situations or longer term FD kitties, testing becomes just a routine part of the day.I have been doing the FD dance for over 3 years with two kitties. I lost one of my kitties over 7 months ago and my other one is almost 2 years into the dance. I hold no false hopes of attaining remission and have doubts whether Maxie will ever be well regulated. In the beginning, especially with Maxie, who had no other health issues, I was always hopeful that her numbers would stabilize and she would be one of the lucky ones to go into remission. So each time I tested there was a "holding the breath" feeling waiting for the number to show. I also tested more frequently in the start with her since I had seen how much glucose levels can vary with her brother and more data is always valuable. Now my testing is based on all the data I have gained and knowing how she responds to the type of insulin I use. The timing of the testing coincides with her usual responses and only changes if the numbers are very high or very low.

The only reward I get from testing is seeing that her numbers are under renal threshold and I can breathe easier for the time being. Certainly if she is running at good numbers I am happy, because there is less damage being done to her body and if she is running high then I am concerned about what I need to do as far as dosing and the such. The meter is merely a tool and readings are merely a necessity...not a conditioned response.

 

[Steph & Quintus & L & O]

I am very much aware of how lucky I seem to be (and grateful). You make a very good point that as a short-timer, I have a different experience with testing from people who have been doing it for years. Very good point. ETA: particularly with rapidly changing numbers.

The only reward I get from testing is seeing that her numbers are under renal threshold and I can breathe easier for the time being.

As far as the "intermittent reward" stuff goes, this is precisely the kind of "reward" that reinforces behaviour (relief is a reward -- "reward" in this context is not necessarily something that makes us feel great), which is why I've been wondering what I've been wondering.

 

[Tuxedo Mom]

As far as the "intermittent reward" stuff goes, this is precisely the kind of "reward" that reinforces behaviour (relief is a reward -- "reward" in this context is not necessarily something that makes us feel great), which is why I've been wondering what I've been wondering.

Rather than calling home testing a "reinforced behaviour" I would call it a necessary tool. The only reinforcement I personally find on doing testing is to know that I won't have any surprises out of the blue. The only "reward" I get is knowing that I am doing as much as I am able to keep my kitty safe and I am able to make informed decisions based on the testing.

Human diabetics are taught to test their levels much in the same way that petparents do..before each shot and periodically during the day to make sure levels are not going too low or too high. This is for safety reasons rather than any sort of reward system. Although I do know a few human diabetics that will test their levels and see if they are able to cheat a little with their foods.

 

[Steph & Quintus & L & O]

Rather than calling home testing a "reinforced behaviour" I would call it a necessary tool.

Wait, where did you see I was questioning the necessity and usefulness of home-testing? Of course home-testing is useful, necessary, and the way to go. Nowhere did I put that in doubt.

(And compare the rather modest number of tests you do and how many I have been doing with Quintus... I personally wouldn't single you out as a CG for which compulsion could be suspected as an factor in how often you test.)

 

[Tuxedo Mom]

Wait, where did you see I was questioning the necessity and usefulness of home-testing? Of course home-testing is useful, necessary, and the way to go. Nowhere did I put that in doubt.

(And compare the rather modest number of tests you do and how many I have been doing with Quintus... I personally wouldn't single you out as a CG for which compulsion could be suspected as an factor in how often you test.)

Since I have merely stated my take on the subject, rather than have this turn confrontational I will make one last comment. I was merely stating what the "rewards" of testing were for me not saying that you suggested that home testing was not useful or necessary.

As far as testing amounts go...I test when it is necessary and do more tests if needed. On Dec. 21 I tested 18 times through the day because of low numbers. I cannot afford to test obsessively each day so I test as required to keep my kitty safe. If a petparent chooses to do more tests than are necessary that is their choice.

 

[Steph & Quintus & L & O]

I was merely stating what the "rewards" of testing were for me not saying that you suggested that home testing was not useful or necessary.

My apologies for jumping the gun. It seemed to me that you were opposing "testing is just reinforced behaviour" to "testing is necessary". I obviously misunderstood -- I'm not trying to be confrontational.

 

[Alicia & Maggie (GA)]

Nice to see Q still in the greens.

 

[Sandy and Black Kitty]

How is Quintus today? All 5 Ps in place?
(Purring, Playing, Peeing, Pooping and Preening)

There are a few self described "Testaholics" among the population here
However make no mistake it is driven by the desire to keep our kitties safe.

It can feel quite hopeless when the test after test after test is pink or red or black.
It was 6 months before we saw green - it lasted a couple hours and did not return for 6 weeks or so.

It was for safety sake I had to do a whole lot of testing during our very wild journey.
After 21 months, when it was time to start the OTJ trial, it felt very strange indeed to only take 2 tests per 24 hours (the AMBG and the PMBG). Even stranger was the first day I did not test at all.

 

[Steph & Quintus & L & O]

Nice to see Q still in the greens.

It is!

 

[Steph & Quintus & L & O]

How is Quintus today? All 5 Ps in place?
(Purring, Playing, Peeing, Pooping and Preening)

The day is still young but things look good! He’s not quite a daily pooper so we’ll have to see if he gives me a stinky present today.
We had a good trip outside mid-morning, just added the videos to his album: https://photos.app.goo.gl/7vCSM7NcMALUEYom2 (scroll to the bottom for the latest ones).

Seeing the vet on Wednesday to see what we do (or don’t do!) next.

Thanks for your « testing testimonial”!

 

[MyTitan (GA)]

Well that's an interesting post! Here's to paws crossed the test strips show up soon ! Go Quintus Go!

 

[Kris & Teasel]

The day is still young but things look good! He’s not quite a daily pooper so we’ll have to see if he gives me a stinky present today.
We had a good trip outside mid-morning, just added the videos to his album: https://photos.app.goo.gl/7vCSM7NcMALUEYom2 (scroll to the bottom for the latest ones).

Seeing the vet on Wednesday to see what we do (or don’t do!) next.

Thanks for your « testing testimonial”!

Looks like he enjoyed his walkabout!

 

[Steph & Quintus & L & O]

He just chewed in my heel. That counts as playing (getting up to fetch his toy).

 

[Phoebes (GA)]

Raises hand. Hello my name is Angela, it's been a year and I am a testaholic.

 

[Gill & George]

Raises hand. Hello my name is Angela, it's been a year and I am a testaholic.

Thought I recognised you from a meeting.

 

[Gill & George]

Sounds like Q is feeling good.
That's what we like to hear.

 

[Sandy and Black Kitty]

We had a good trip outside mid-morning,

does he have any vision at all?

 

[Marje and Gracie]

I’m late to the morning’s “discussion”. I only have to say that not only was I a testaholic (because Gracie was unpredictable even when I knew her patterns well) but I hated every single poke. Gracie was my baby girl and the soul I love most in this universe other than my husband. Although she was amazingly sweet and accepting of every single poke from the first to the last, I detested that I had to do it to her. My absolute, one consolation when she crossed was that I would never, ever have to poke my baby again. For me, it was torture to have to poke this wonderful, amazing, soul because I love her so very much and couldn’t bear that our closeness and bond had to include that.

But I did it to keep her safe. And I’d do it again if I had to.... and still hate it.

 

[Steph & Quintus & L & O]

does he have any vision at all?

So that's a tricky one to answer. In 2016 when we realised he was (going?) blind, he clearly did have some vision left. He would step over the ledge to get in the carrier. More revealing, they dug something up on the path just outside the building and filled it in with new black tar. It made a dark strip that Quintus would try and jump over -- clearly it looked like a hole for him.

One of his eyes still reacts to light and dark, so we suppose he has perception of light and dark. But does it mean he still sees shapes? It's really hard to try and make deductions with an animal whose primary senses are not vision, and quite alien to us.

I try to take him outside when there is the most light -- it seems to me he does better. I watch him like a hawk to make sure he doesn't approach the little ledge where he might fall down. When we come back inside I have to pay attention he aims for the "up" stairs and not the "down" ones. He uses the sound of my feet (I'll drag them on the ground to make more noise) and other sounds to guide him. I talk to him, call him, (try to) snap my fingers, jiggle my keys, etc. I'm his white cane. I'll tap on the first stair so he hears where to go.

General news:

One strip left. Today's yielded a pretty 68.

I started incorporating some m/d kibble to his food (less carbs than NF, and he seems to like it more). Pretty poop this morning, so he seems to tolerate it. Today I'm going to try switching out the NF for the m/d. Fingers crossed for the next poop.