Vets often use R to take cats sugars down in cases of emergency, like DKA for one. Their use of it might be different than we are used to it. We give it subq, which would be slower absorption. We typically start with R at AMPS and PMPS - when it makes sense to do so. There are some rules/guidelines for learning when to give/not to give. Over time and as you gather experience, you can also shoot it mid cycle. You might want to take a look at Oberon and Howie's spreadsheets as examples. Their caregivers ere giving R earlier this year, though currently not as both kitties are heading down dose scale.
Sure, we will sometimes do fast tracking if you are only seeing nadirs above 300. Your only yellow are pretty high. So up to 13 tomorrow if you don't see anything mid or lower 200's tonight. We don't fast track all the time, but for a couple cycles, then a pause at 6 cycles to let the depot catch up. However, the fast track only works if you can a second test each and every cycle. I don't see a test for last night.
Good to hear your vet is on board with Lev as an option. No problem waiting until you are close to run out of Lantus. You can get Lev from Marks Marine, or there is someone on Supply Closet who posts it regularly. We often see kitties on Lev having a bit better duration. I personally prefer doing R with Lev, cause the R action is mostly in and out by the time the Lev onset, so you don't have to worry much about the actions overlapping. With R on board, you want to limit the drop during the duration of R to no more than 100 points, or you could set yourself up for some bouncing.
I've seen papers saying that only around 35% of acrocats have clinical signs at diagnosis. Neko was part Maine Coon, but not especially large and no real other signs at diagnosis. She has some enlargement of her heart a few years in, though just on the border with normal and she was a bigger breed, that also tends to larger hearts. At the end, her liver was a bit bigger. Acrocats are ECID to signs and symptoms. It's just good to be aware of what you might see.
I'm attaching a paper that talks about a number of recent FD topics. Case #2 is an acro and talks about treatment options. Note, one of the authors is from Royal Veterinary Clinic in England, one of the very few places that does pituitary surgery. There is also a place in New York. Poke around some of the links on this post, and there are a couple more users of cabergoline there:
Cabergoline/Acro/IAA Information
Edit: still working on attaching that paper.