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Peer review Peer review information Nature Communications thanks Karen Dwyer and the other anonymous reviewer(s) for their contribution to the peer review of this work

Testosterone Replacement Therapy: Nausea or vomiting Infertility or decreased sperm count Testicular shrinkage Worsening of obstructive sleep apnea Increase in cholesterol levels Abnormal spike in blood sugar levels, which can increase the risk of developing Type 2 diabetes Yellowing of the skin or around your eyes Uncomfortable swelling or enlargement of breast tissue (gynecomastia) Redness, warmth around lower leg area Unusual increase in red blood cell count, which can result in high blood pressure, joint/muscle pain, trouble with eyesight or thrombosis (blood clotting) Frequent need to urinate Fluid retention Acne or oily skin Headaches Lumps or hardening around injection site Clomid: Headaches Nausea Bloating Mood swings Diminished sex drive Sperm counts decrease (can be reversed by changing Clomid to another type of estrogen blocker, such as tamoxifen.) Acne Chest tenderness Blurry vision Weight gain High blood pressure (hypertension) Altered taste Asthma Flushing Excess thirst Joint aches Enclomiphene Libido issues Acne A temper if levels get too high Mood swings Depression Mood irritability Anxiety Gynecomastia Headache Nausea Diarrhea Dizziness Common Cold Hot flush Joint pain NOTE: Enclomiphene is the purified isomer of Clomid (Clomiphene Citrate)

This work was supported by the IMU Research Funds [Grant Nos.: BMSc I-2025 (04) and BPC I-2024(08)]

For cats with chronic digestive issues, unfortunately, there is rarely a single magic bullet solution that resolves all of their symptoms