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Luciano is an old cat, but at 16 not exactly ancient. He has, however, a panoply of interesting ailments that keep us in frequent contact with his doctors. He has three: Ralph Siegal, Fausto Finetti and Veronica, who is a brand new vet and whose last name we have not yet learned. Ralph has been waiting for Luciano’s kidneys to carry him off for three years now, but the cat keeps cashing in his extra lives and fooling all of us. Luciano’s other main diagnosis is hyper-thyroidism.

As prescribed, Kitty eats special food that is kind to kidneys – high in fiber and relatively low in protein.  It is available commercially for E 2 a tin, of which he can eat two a day.  Rather than bankrupt ourselves any sooner than absolutely necessary, we decided to make our own cat food, using an excellent recipe we found (of course!) on the internet. Here is a link to a site with cat food recipes for cats with various ailments.  We’ve been making a variant of the Hills kidney diet food.

There is no perfect cure for the thyroid problem, according to Dott. Ralph, but there is a pill that can help.  Unfortunately it is not available in Italy, but can be found in France.  So we have prevailed upon our friends who travel that way to carry back the cat’s medicine.

Which brings me around to the subject of medical care, the approach to which is much the same for animals as for people: caution! don’t over-medicate! wait and see!  Poor Luciano developed a big bump between his eyes last week.  When we took him to the vet (Dott. Veronica this time) she suggested that since the cat is pretty much blind (left that out, didn’t I) he had probably run into something and had a great big bruise.  So we left the office with instructions to ice the lump and administer cortesone pills.  Have you ever iced a cat’s nose? It’s interesting.  Actually, Luciano is quite patient with it, but I sure wouldn’t want to try it on a cat with teeth (I forgot to mention he’s toothless, didn’t I).

I believe that had we been in the US that an X-ray would have been taken on our first visit.  Instead we spent five days icing the cat’s nose and watching the lump grow.  Then we took him back and Dott. Fausto recommended an X-Ray, given the following day in a different office.  So, after three trips the cat’s lump, which proved to be an abscess, was X-rayed, opened and cleared up.  I’m not in any way saying that we don’t all receive excellent medical care here, but sometimes I think the caution is less than helpful.  The poor old cat had to make three trips to accomplish what, in the States, would have been done on the first trip. And if it had been a bruise?  There would have been one wasted X-ray.  And that’s one difference between Italy and the US.  Here waste is anathema – you don’t want a test unless it’s 99% certain to tell you something really useful, and only if other less expensive approaches have failed.  Is it dangerous?  No, because doctors and vets here are just as smart and well-trained as they are in the US, and they are careful.  Is it inconvenient?  Frequently. Is it frustrating?  Absolutely! We’ve been back for one aftercare visit, and will return again Monday for another, making a grand total of five visits.  We haven’t been billed for anything yet, but one aspect of cautious care is that it does seem to be less costly.

We’ve seen the same approach in our own medical care here.  Problems are discussed for ages and curative steps are incremental.  But then, Italian doctors don’t have to worry about the malpractice suits that threaten American doctors.  Eventually (so far!) we always get better.  And I have to add that when one of us had a very serious acute condition the initial care was immediate and excellent. Once danger was past, however, caution was again the watchword, and a condition that was treated in three days in a US hospital took twelve days for the exact same outcome in Italy.

I’m not sure what any of this proves.  Socialized medicine certainly has its pluses and minuses, and this is not an appropriate forum for that topic.  I guess if we’ve learned anything new from the last week’s experiences it’s this: it’s really hard to ice a cat’s nose.