Karen, I know it's *really* hard because Grace isn't your cat and she is so far away. Honestly, I think Grace does need insulin. Not a lot of it. The numbers she is getting on 0.1 and skinny 0.1 are fine - there is nothing wrong with going to high 40s on such a low dose. Grace is a bouncer, definitely, and it's harder to deal with bouncers. She needs the insulin to help her overcome the high numbers. Hypo isn't much of a concern at a dose of 0.1. Jojo used to say that a symptomatic hypo on 0.1 of Lantus/Lev was impossible. I don't like the word impossible, but I would say it is very unlikely. The lower numbers can be controlled by food. Usually it doesn't take much food at all to bring a cat up when they are getting such a teeny drop of insulin. Do you know how much of a bump Grace gets in 1/2 hour from low carb food?
My suggestion for people who get to a tiny dose like this and still see 40s and 50s is to try this experiment: the next time Hollis sees a number like that 59 (which was definitely a fast drop), feed 2 tsp of LOW carb food and test in 30 minutes. See how much response she gets to that low carb food and write it down. Because she is only waiting 30 minutes to retest, there is still PLENTY of time to intervene with a higher carb food if necessary. However, if the low carb works to slow/stop the drop, hooray! Then you know that the numbers, while lower than you are used to, are actually very controllable and safe. It means that Grace can feed her own curve with her regular food to keep herself safe. Once I discovered that Lucy was able to bump herself enough with low carb food, I suddenly felt a lot better about letting her surf low. It turns out that Lucy LOVED surfing the 50s. Seeing a 50 early in the cycle (once she was on a small dose) didn't mean that she was dropping to the basement, it just meant that she was in a hurry to get to the 50s so she could surf there for the rest of the day. Once I realized that 50s were fine and safe and comfortable for Lucy, we both were able to relax a lot.
The next experiment, especially if low carb isn't working well to bring up numbers, is to then feed to prevent the low numbers. When Grace starts the day in pink, most of the time she is going to plummet in the first few hours of the cycle. If Hollis gets a +1 or +2 that is already lower than the pink PS, go ahead and feed something higher carb to try to prevent the number from dropping lower. For example, yesterday she would feed normally at AMPS, test at +1 and feed either LC or MC depending on the number. At +2 there was already a big drop (onset is just starting, so +2 is usually about the same as PS, a number 140 points lower than PS at +2 means "pay attention."). At that point she can feed high carb food and test at +3. Experiment and see what works, but the idea in that case is to prevent Grace from getting to the 40s. Understandably, that is not a schedule that can be maintained long term, but doing it for a little while might give Grace's body a little more healing time on insulin so she can quit bouncing.
The important thing at this point is to write down what/when Grace eats and write down the response on the retests. That way the next time she is dropping, you can look back and say "hey, on Tuesday she did this and the low carb bumped her back to 60 and everything was fine, let's try low carb again." Do you know what she fed between +4.5 and +5 yesterday? She got a 40 point bump, so whatever she fed was probably more (or higher carb) than needed. Bumping her up to 60 would probably have been plenty.
Don't forget, also, that the lower you shoot on Lantus or Lev, the flatter the curve. Just because she drops so far from the 300s doesn't mean she will try to drop as far from the 100s. Lucy was a bouncer too (less so than Grace), and I was usually more afraid to give her a shot and leave for the day when she was pink than when she was in blue. She could easily drop to the 30s from 300, but if I shot blue she usually stayed blue or higher green. I know Grace DOES drop low from blue sometimes, but try not to let your mind go too much to the idea that she dropped xxx points in xx hours. Usually that is something as simple as the fact that a bounce just happened to clear out at the same time the insulin was kicking in, so there was some extra oomph in that cycle. It doesn't necessarily mean that she is getting too much insulin. The darn Lev shed is tricky, even at tiny doses. You have to look at the spreadsheet several cycles at a time rather than one cycle at a time.
Usually what we see when a cat is ready to go OTJ is that the bouncing stops. Then Mr. P is on the job and doing what he is supposed to do. Most cats really are not ready for OTJ until then. I'm sure there are exceptions.
Good luck! She is close, and hopefully once the thyroid is controlled Grace will be able to go OTJ again.
