Hello! I apologize if this post ends up being a little all over the place. The last few weeks have been difficult and I'm a bit at my wit's end with figuring out what the best options are. Let me start out by saying that my kitty, Boo, is 15 years old (16 in April) and was diagnosed with diabetes when she was 8 years old. She has been on Novolin N (NPH) ever since her diagnosis, except for one short stint of trying Lantus which resulted in her being too low and we put her back on the Novolin N. She has ranged from 1-2.5 units of Novolin N 2 times a day, and is currently at 1 unit twice a day. For a long time I thought she was well regulated. I bought an Accu-Chek Nano for her and tested her blood sugar occasionally, but generally only when she was acting "off" or hadn't eaten. The vets always said that I did a good job with her and every time she went in for a visit they would tell me how well I was doing. However, whenever she would get the blood glucose test that measures her average for 2 weeks (I'm sorry, I forget what it is called) it would always read high (above 300mg/dL). Fast forward to last fall (2020)- Boo's teeth started to get quite bad. She had previously been in the vet's office to get them removed in 2018, but they decided not to remove them at that time and just cleaned them instead. This time, she had an infection in her teeth and they absolutely had to be removed. She had her two top canines removed as well as a bottom incisor in early November of 2020. Her recovery from the anesthesia seemed slow, much slower than in previous years (I thought, she's 15, so that makes sense right?). She started being very picky about her food (I had been feeding her Fancy Feast Classic diligently up to this point) and I started giving her half Fancy Feast Gourmet Naturals and half Fancy Feast Gravy Lovers. The reason I started giving her the Gourmet Naturals was because I was unable to find the Classic online during the midst of the pandemic last September and didn't think much of them being a different type of food, and I bought the Gravy Lovers by accident during this time. Predictably, once I started feeding her some of the Gravy Lovers foods, she stopped wanting any pate of any type! I'm certain that this didn't help her predicament coming up. She had her first serious hypoglycemic episode about a month after her dental extraction. I am convinced she was on the brink - she tested in the low 20's. We were able to get her back up after this but she seemed sluggish for several days after, understandably recovering from a very stressful and dangerous situation. I can provide more details on these episodes if it is helpful but I don't want to stress anyone out with descriptions of what was happening during them - it was pretty bad. We brought her back to the vet (this is early December), who tested her blood sugar and saw she was still peaking very high. They gave her subcutaneous fluids and also prescribed us a week of subcutaneous fluids (which she took like a champ), gave her a B-12 shot, and noted that she seemed to be losing weight. On December 22nd the vet recommended that we start giving her 2 units twice a day of her insulin because her levels were still high. The vet recommended that on days that she seemed "off" that we give her subcutaneous fluids, especially on days that she didn't eat well. On January 11th, Boo had a second hypoglycemic episode, just as bad as the one she had in December. I thought for sure we had lost her during this one - she went completely limp and nonresponsive, amongst other things. Somehow after hours of coaxing her to eat food and giving her quite a bit of Karo syrup, she pulled through. We had already had an appointment with her vet for the next day because she had been coughing and that was concerning us, so she went in for another exam. The vet recommended at that point that we take her off insulin completely for 10 days and then test her blood sugar after that to see where we should be. She mentioned during this time that Boo's liver was enlarged, but she noted that it could be because of her blood sugar episodes. Notably, I had been creating a curve the day that Boo had her low blood sugar episode, and she was reaching as high as 600+, and as low as mid-30's (during hypoglycemia). The doctors gave her another shot of B-12, subcutaneous fluids, and sent her home. For a couple of days she seemed to feel better. The vet was due to call me on Friday day to check on Boo, and during the call she mentioned the possibility of lymphoma being the cause of the enlarged liver. Almost like clockwork, that night she started to cough again and even seemed to have congestion that lasted the night and into the next day had some wheezy breathing. She still coughs occasionally. The vet said this may be because her throat could have been irritated by vomiting the week before. Between Friday and yesterday, Boo has seemed to decline - she is incredibly tired, sleeping or laying down most of the day. She is weak and very thin - I can easily feel her ribs. She still eats and drinks regularly, and her bowel movements are regular and she urinates fine, but she just seems to continue to lose weight and stays weak and tired. We called the Vet again yesterday after testing her blood sugar (this is before the 10-day mark, but we were growing desperate for advice), and twice in one day she tested at 463mg/dL (once before a meal, and once about 3 hours after). She advised that we give her 1 unit a day again and are now giving her weekly B-12 injections starting today. When we asked about the possible lymphoma diagnosis, she said that it is "tricky, because of the diabetes". We are sad, and stressed, and just want our kitty to be comfortable. It is not clear if we are talking about end-stages of life, though I certainly worry it is heading in that direction. The vet has not discussed that or brought it up, so my hope is that we can still somehow get her to pull through (if she does not actually have lymphoma). I realize that some of this discussion is probably above this forum's paygrade, and I appreciate that - I am looking for any advice or suggestions, any words of support. This has been the longest couple of weeks I've experienced in a long, long time. My boyfriend and I are heartbroken and haven't been sleeping well. I love my cat and I want to do anything that I can for her. This morning I was able to dig up some Classic Pate for her and she ate most of a can. I worry that the food we have been feeding her has been part of the problem. We gave her 1 unit of insulin and her B-12 shot. I am hoping for the best, but if anyone has any suggestions or words of advice I would truly appreciate it. I apologize if this is a super rambling thread, and please if I need to clarify anything let me know - I'm more than happy to give details where needed! Thank you.