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Hi there, you are through to Dr Linda, a UK based vet.
I'm sorry to hear of your cat's recent diagnosis and appreciate that it can be a lot to take in.
I am a big fan of the transdermal gel and find cats tolerate it a lot better than tablets. In my experience it works very well. We should not usually notice lethargy as a side effect so I would want to rule out another issue. For example, it may be that the dose is too high and the thyroid glands are being over suppressed. It could also be that treating the thyroid disease has unmasked underlying kidney disease (a known risk). Typically, after 2-3 weeks of the treatment starting we should check the thyroid hormone level as well as run a general panel assessing liver and kidney function as well as a red blood cell count. This way we can see how well Kenny is responding to the medicine and if the protocol needs adjusting.
It is certainly reassuring that he is now putting on weight.
My opinion on the iodine therapy is that it is fantastic. It can work brilliantly and offer a solution to daily medication and frequent reviews. The downsides are that it is very expensive and it means the cat has to stay in the clinic for some time after. The patient needs to be amenable to nursing and some cats are too nervous/naughty to make good patients.