Hi Nancy, Pepper is showing some wonderful numbers for all that vetty stress. It sounds like you have a great cardio vet. It's fabulous news that the vetty thinks this can be reversed with SRT. And don't beat yourself up about getting the test done sooner. I know all too well the feeling of denial. It's great that you are now looking forward into what you can do next and that Pepper has some meds to make him feel better.
There is a difference between regular radiation therapy and true Stereotactic Radiation Therapy. For more on SRT, check out the
CSU web page on radiation therapy. The main difference is the number of beams of radiation. For SRT, the animal is placed on a table, and the beam is on a revolving gantry so that a beam of radiation is sent from 7 different angles towards the tumor. This means that a smaller amount of radiation can be sent on each beam and where the beams meet on the tumor is where it is concentrated. At CSU the first day a CT scan is done so they can plan the beams so that they have an error of no more than .1mm in coverage.
Most places that do pituitary radiation send only 3 beams of radiation, meaning that there is a higher concentration of radiation sent along each beam to get the same effective result at the tumor site. Higher concentration means more chance of tissue on the path to the tumor being damaged. However, this used to be the standard of care for acromegaly before the SRT machines came out. Those SRT machines are expensive! Cats who have had the 3 beam radiation done may need to be on prednisone for a while to combat inflammation. Looking at the picture in the Medvet brochure, it looks like one of those 3 beam machines. Poking around the Acro forum here, I think someone had that surgery done in Florida. It's worth finding out the cost of the local solution. I know of a private clinic in Canada closer to us (but still a long drive) that does the 3 beam surgery for twice the cost of CSU, which is a research facility. The total cost you look at should include travel and hotel stay if you go that route.
For me, there was a certain comfort in knowing CSU had done over 30 of these procedures before us and that they had done research studies on acromegaly there.
If you poke around the CSU website, they have a free consultation service. I did use it. You leave a brief description and they call you back for a free consult.