this looks like progress! Go Meadow!
I would start trying to get a few spot checks here and there, especially earlier in the cycle. When Meadow DOES start to move, you don't want to miss it.
Also, a couple of us were talking about her dosing. In this dose range, there is an option of doing dose increases by 1 unit at a time, instead of 0.5 units, until she starts to show some movement. If you do that, you would need to slow down the increases to every 6 cycles instead of every 4 cycles. You would also definitely want to increase the number of spot checks and always get some mid-cycle spot checks before deciding to do the next dose increase.
If you think about it, increasing by 1 unit when she's at 11 units is about equivalent to a cat that's on 1 unit increasing by 0.1, so it's not as drastic as it sounds.
It's up to you, either continue with 0.5 increases every 4 cycles, or try 1 unit increases every 6 cycles (or until there is movement, then you'll need to slow down). I just wanted to put the options out there for you.
((((Amber)))) I know this must be frustrating for you, but others have been through this long climb so you're not alone.