There are several clues that can help us determine when a cat may be ready to begin an OTJ trial. One would be dropping too low on the smallest dose (usually under 50, depending on the cat). Another is by being in the normal range (which is basically under 100, with some numbers in the 100-120 range being ok) pretty much 24/7 for at least 7 days. A final clue, which is less clear-cut, is when the cat displays inverted curves (curves that are frequently higher at mid-cycle than at preshot, except in cats who are usually late nadir cats), that can indicate that the cat is over dose.
I don't see those signs on Tasha's spreadsheet yet. While some cats can have a successful OTJ trial starting from numbers like these, ideally we'll wait until the preshot values come down. The reason Ronnie is mentioning +9 is that very often when a cat's spreadsheet looks like Tasha's, we are able to help bring that reading down by feeding a small meal about 3 hours prior to the reading. Why does that work? When a cat is getting ready to go off insulin, their pancreas is usually "sputtering." It is working some of the time, but not all the time. A little bit of food will usually stimulate the pancreas to turn back on, and the cat will release its own insulin and bring the number down (which is nice because the injected insulin is not very strong that late in the cycle). If you test at +9, feed a small meal, then test again at +12, if the +12 reading is lower than the +9 you can be almost positive that was the cat's pancreas that made that happen, not the Lantus.
Does that make sense?
