So I started the Acro dance with Tubby a little over a year ago, after adopting him from an elderly owner who couldn't properly care for him. Our original post is here: http://www.felinediabetes.com/FDMB/threads/any-acro-folks-around.140825/ Since then, his ear and skin infections have cleared and he's relatively healthy and happy. He still battles constipation (it has sent him to the ER and has also required surgery to remove blockages) and is a high-dose kitty at 12u Prozinc + 3.5u R BID. He has the classic clinical signs of acro and his IGF-1 is 218. A year ago, we did a full workup at the university to determine whether he was a candidate for SRT. Bloodwork looked good, X-rays and ultrasound showed enlarged organs, his heart showed mild thickening of the interventricular septum, but there were no show stoppers. My vet conferred with CSU and they recommended a CT scan before making the trip there -- they said the pituitary tumors must be visualized in order to target them with SRT, but in a very small percentage of cats (2% or so) they're not visible, and so it would be a wasted trip if that was the case. Even though CSU said they'd have to redo the CT scan there, it's a long trip so we went forward with the CT locally just to be sure. And of course Tubby was in the 2 percent. With no tumors visible, I was told to wait a year and reevaluate. MRI was never mentioned. So here we are a year later. We just re-did all of the same tests and everything is pretty much status quo, although the pituitary gland is a bit larger. The university vet has been trying to reach someone at CSU to consult with but hasn't had any luck yet. I also put in a request for a consultation. I have a lot of questions and was hoping some of you might have some insight. 1) Have any other acro cats had tumors that couldn't be seen on CT scans? What did you do? 2) Did any of your cats also need dental work? How was that prioritized vs the SRT? (Tubby has a few cracked and erupting teeth and is scheduled for a dental in late October, but the vet said some forms of radiation can impact healing so we need to ask q's). 3) Have any of your acro cats shown thickening of the intestines on abdominal ultrasound or have an actual diagnosis of IBD or intestinal lymphoma? Did you go forward with SRT? Do further diagnositcs? (Tubby shows thickening of the 3rd layer of the intestines, though shows none of the typical signs of IBD or lymphoma--unless constipation counts, that is). 4) When switching from Prozinc + R to Lev, is there a general guideline for where to start on dosage? I hadn't been able to shoot an exact 12-hr schedule the past year so stuck with Prozinc. I just picked up the Lev prescription, though, so am thinking about moving in that direction. Thanks everyone!