Radiation in Veterinary Practice: Paradigm Shift Toward Precision and Curative Approaches.

Ionizing radiation therapy has undergone a clear paradigm shift in veterinary oncology and inflammatory disease management, moving from mainly palliative use toward structured, curative treatment programs. This review synthesizes current evidence on key modalities used in veterinary practice, including external beam radiotherapy, brachytherapy, systemic targeted radionuclide therapy, stereotactic radiosurgery, stereotactic body radiotherapy, radiosynoviorthesis, and low-dose radiotherapy. Each modality is discussed in relation to its physical and biological basis, major isotopes or beam types, routes of delivery, target species such as dogs, cats, and horses, clinical indications, and global availability. Comparative analysis highlights differences in clinical acceptance, evidence strength, access, and cost. External beam radiotherapy and stereotactic techniques support curative tumor management, whereas radiosynoviorthesis and low-dose radiotherapy are effective for inflammatory and degenerative disorders. Despite ongoing progress, challenges remain in access, dosimetry standardization, and prospective evidence. Companion animals are also emphasized as valuable translational models, guiding future innovation and collaboration internationally.