TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 

 

   

OBTAINING SUPPLIES CHEAPLY: USA

 

ON THIS PAGE:


Discount Cards


Fluids


Needles


Winged Infusion Sets


Fluid Administration Sets


Syringes


Prescription Food


Medications & Other Supplies


 

Join

Tanya's CRF Support Group Today

 

HOME


Site Overview


What You Need to Know First


Alphabetical Index


Glossary


Research Participation Opportunities


Search This Site


 

WHAT IS CKD?


What Happens in CKD


Causes of CKD


How Bad is It?


Is There Any Hope?


Acute Kidney Injury


 

KEY ISSUES


Nausea, Vomiting, Appetite Loss and Excess Stomach Acid


Maintaining Hydration


The Importance of Phosphorus Control


All About Hypertension


All About Anaemia


All About Constipation


Potassium Imbalances


Metabolic Acidosis


Kidney Stones


 

SUPPORT


Coping with CKD


Tanya's Support Group


Success Stories


 

SYMPTOMS


Alphabetical List of Symptoms and Treatments


Fluid and Urinary  Imbalances (Dehydration, Overhydration and Urinary Issues)


Waste Product Regulation Imbalances (Vomiting, Appetite Loss, Excess Stomach Acid, Gastro-intestinal Problems, Mouth Ulcers Etc.)


Phosphorus and Calcium Imbalances


Miscellaneous Symptoms (Pain, Hiding Etc.)


 

DIAGNOSIS: WHAT DO ALL THE TEST RESULTS MEAN?


Blood Chemistry: Kidney Function, Potassium, Other Tests (ALT, Amylase, (Cholesterol, Etc.)


Calcium, Phosphorus, Parathyroid Hormone (PTH) and Secondary Hyperparathyroidism


Complete Blood Count (CBC): Red and White Blood Cells: Anaemia and Infection


Urinalysis (Urine Tests)


Other Tests: Ultrasound, Biopsy, X-rays etc.


Renomegaly (Enlarged Kidneys)


Which Tests to Have and Frequency of Testing


Factors that Affect Test Results


Normal Ranges


International and US Measuring Systems


 

TREATMENTS


Which Treatments are Essential


Fluid and Urinary Issues (Fluid Retention, Infections, Incontinence, Proteinuria)


Waste Product Regulation (Mouth Ulcers, GI Bleeding, Antioxidants, Adsorbents, Azodyl, Astro's CRF Oil)


Phosphorus, Calcium and Secondary Hyperparathyroidism (Calcitriol)


Miscellaneous Treatments: Stem Cell Transplants, ACE Inhibitors - Fortekor, Steroids, Kidney Transplants)


Antibiotics and Painkillers


Holistic Treatments (Including Slippery Elm Bark)


ESAs (Aranesp, Epogen etc.) for Severe Anaemia


General Health Issues in a CKD Cat: Fleas, Arthritis, Dementia, Vaccinations


Tips on Medicating Your Cat


Obtaining Supplies Cheaply in the UK, USA and Canada


Working with Your Vet and Recordkeeping


 

DIET & NUTRITION


Nutritional Requirements of CKD Cats


The B Vitamins (Including Methylcobalamin)


What to Feed (and What to Avoid)


Persuading Your Cat to Eat


Food Data Tables


USA Canned Food Data


USA Dry Food Data


USA Cat Food Manufacturers


UK Canned Food Data


UK Dry Food Data


UK Cat Food Manufacturers


2007 Food Recall USA


 

FLUID THERAPY


Intravenous Fluids


Subcutaneous Fluids


Tips on Giving Subcutaneous Fluids


How to Give Subcutaneous Fluids with a Giving Set


How to Give Subcutaneous Fluids with a Syringe


Subcutaneous Fluids - Winning Your Vet's Support


Dialysis


 

RELATED DISEASES


Heart Problems


Hyperthyroidism


Diabetes


Polycystic Kidney Disease (PKD)


Pancreatitis


Dental Problems


Anaesthesia


 

OBTAINING SUPPLIES CHEAPLY


UK


USA


Canada


 

SAYING GOODBYE


The Final Hours


Other People's Losses


Coping with Your Loss


 

MISCELLANEOUS


Early Detection


Prevention


Research


Canine Kidney Disease


Other Illnesses (Cancer, Liver) and Behavioural Problems


Diese Webseite auf Deutsch


 

SITEOWNER (HELEN)


My Three CKD Cats: Tanya, Thomas and Ollie


My Multi Ailment Cat, Harpsie


Find Me on Facebook


Follow Me on Twitter


Contact Me

Home > Supplies > USA

 


Overview


  • In most cases, your vet will charge more for sub-q supplies and prescription foods than other sources. If you can save money on the basics, you will have money available to pay your vet for regular check ups.

  • The cheapest place for fluids is usually a local pharmacy, but you have to know where to go and what exactly to ask for.

  • Alternatively, there are good, reliable and cost effective online suppliers, both for fluid supplies and food.


Discount Cards                                                                                                  Back to Page Index


 

Members of Tanya's CRF Support Group have printed out the free Pet Medication Card and successfully used it to obtain discounts at some pharmacies. In December 2011, one of them was able to obtain a case of 12 bags of fluid from her local Walmart for US$16 using this card, which of course was free (whereas the Walgreens card mentioned below, whilst useful in many cases, does cost money). She has not received any spam as a result of using the card.

 

Pet Med Saver Card and the RX Free Card also offer discounts, but I don't know anybody who has used them as yet.

 


Fluids                                                                                                                     Back to Page Index


A prescription is required for fluids in every state. If your vet refuses to write a prescription, you may be able to insist that s/he does so, depending upon which state you live in - Scooter's Page has more information on this.

 

Even if you do not live in a state where the vet must give you a prescription if you ask for one, the American Veterinary Medical Association states "As a veterinarian, when you determine that a medication is needed for a patient, you can discuss with your client the benefits of having the drug dispensed directly from your clinic. If your client still wants the prescription filled elsewhere, you should comply with their wish and provide a written prescription."

 

Local Pharmacies


By far the cheapest source for fluids is to find a local pharmacy in your area offering low prices. This has two advantages. Firstly, it saves on shipping costs, which are often expensive since fluids are heavy. Secondly, your vet may be more comfortable about you using a local pharmacy and therefore more inclined to give you the prescription you need.

 

Most pharmacies do not stock fluids but can order them for you quite quickly. Walgreens, Costco, Target and CVS can all often obtain fluids for you cheaply, usually for under US$30 a case (a case usually refers to twelve bags of 1000 ml fluid). The Costco record is US$7 for a case (and that was in NYC). Other suppliers may be even cheaper, though you may need to buy a discount card from the pharmacy or use one of the discount cards discussed above. The record for a purchase with a discount card was US$5.99 for a case at a Target branch in Texas.

 

It can help if you have NDC (National Drug Code) numbers, which enable pharmacists to search their stock and supplier database quickly. NDCs consist of 11 numbers in total, i.e. the manufacturer code (five numbers), followed by the drug code (four numbers), followed by the size code (two numbers). If a number is missing, you usually just add an extra 0 at the beginning of the section with the missing number. These are the NDC codes for the most popular fluids:

  • Lactated Ringers Solution, DEHP Bags, Hospira: 0409-7953-09

  • Lactated Ringers Solution, DEHP-Free Bags, Hospira: 0409-7953-48

  • Normosol-R, DEHP Bags, Hospira: 0409-7967-09

  • Normosol-R 7.4pH, DEHP Bags, Hospira: 0409-7670-09

  • 0.9% Sodium Chloride Solution, DEHP Bags, Hospira: 0409-7983-09

Ask for the price before you order so you don't get any nasty shocks. It is usually far more cost effective to buy a case (12 bags of 1000ml fluid, though sometimes 14).

 

Walgreens


 

Many members of Tanya's CRF Support Group use Walgreens. I used to hear quite often from people who said they had not been successful buying fluids from Walgreens, but in every case they did not follow the steps below. If you follow these steps exactly, you may still need to be persistent (very few Walgreens employees seem to know what fluids are), but you should be successful.

 

This is how to obtain your fluids from Walgreens at a good price:

  1. Visit Walgreens and type lactated into the box (you will need to allow cookies), then click on the first item that will pop up over to the right (Lactated Rin Inj 1000ml). You will see prices for 2000, 12000, 14000 and 36000. The 12000 means 12 bags of 1000ml each, which as at April 2012 cost US$22.96 in total, or US$1.91 per bag. The 14000 option (14 bags of 1000ml) costs US$26.12, or US$1.86 per bag.

  1. Print the page displaying the prices and take it to your local Walgreens, along with your cat's prescription.

  1. Apply for your cat to join the Walgreens discount scheme, the Prescription Savings Club. This costs US$35 a year for family membership, which includes cats, or US$20 a year for an individual (i.e. your cat).

  1. Ask the pharmacist to order the fluids for you at or near the cheap price on the page you have printed (some pharmacies will actually sell them for less). The pharmacist will probably need the NDC (National Drug Code) for your fluids. For the Hospira brand of 1000ml Lactated Ringers Solution, the NDC is 00409-7953-09. Codes for others are above.

  1. Wait for the fluids to arrive (it should only take a day or so) and go and collect them.

Nobody who has followed these instructions to the letter has failed yet. It is particularly important to take the print-out with you to prove Walgreens can obtain these supplies - many Walgreens employees do not seem to be aware that it is possible. It is also essential to explain that you wish to order the fluids - most branches do not hold them in stock, but can order them quickly.

 

Online Pharmacies


 

If you don't live near a pharmacy which can order fluids for you cheaply, you will probably want to use an online pharmacy. A case of 12 bags of 1000ml sub-Q fluid costs around US$50, including shipping. A prescription is required.

 

The US Food & Drug Administration discusses precautions you should take when using online pharmacies. I only link to sites which I or members of Tanya's CRF Support Group have used personally.

 

Many members of the support group use Thriving Pets because they can buy many of their CKD supplies there (including B vitamins, phosphorus binders and treatments for excess stomach acid and nausea) in addition to sub-Q supplies. If you enter the word "tanya" (without the ") in the promotional code box, you will receive a 10% discount on orders over US$55. Shipping is free for orders over US$55 (after the discount).

 

Lactated Ringers Solution (LRS)


 

KV Vet Supply

Sells 1000ml bags of Lactated Ringers for US$4.99 each, or US$3.99 each if you buy six or more, with free shipping over US$50 (so basically, you can buy 13 bags for US$51.87 all in).

 

Med Plus USA

Sells 12 x 1000 ringers for US$42.33 without prescription, with shipping at cost. They also sell 500ml bags.

 

Valley Vet

Sells a case of 12 x 1000ml bags for US$53.88 with free shipping. I have used Valley Vet myself for other items and have always received fast and efficient service.

 

UPCO

Sells 1 x 1000ml bag for US$4.95, but 14 x 1000ml bags cost $55.50 (equivalent to US$47.40 for 12). Handling charge is US$4-5.50 but is free with orders over US$85. The price on the website reflects the price of buying one bag of fluids only; if you enter 14, you should find the price is reduced automatically.

 

Thriving Pets

Sell 12 bags of fluid for US$52.80. If you enter the word "tanya" (without the ") in the promotional code box, you will receive a 10% discount on orders over US$55. Shipping is free for orders over US$55 (after the discount).

 

Brico Medical Supplies

Sell 12 bags of 1000ml fluid for US$29 plus shipping at cost. They also sell 24 500ml bags of lactated ringers for $49 plus shipping at cost.

 

Drs Foster & Smith

Sell Lactated Ringers for $4.99 per 1000ml bag, with free ground shipping US$49 and over, and no minimum order.

 

Normosol


 

Vet America

Sells Normosol-R with a pH of 7.4. A case of 12 bags costs US$35.99, with ground shipping costing US$5.95. They may charge more for heavy items.

 

Drs Foster & Smith

Sell Normosol for US$5.99 a bag if you buy four, with free shipping.

 


Needles                                                                                                                    Back to Page Index


 

A prescription is required for needles in CT, IL, MA, NJ, NY and RI. Most people use Terumo needles - you can read here why they are so popular.

 

Med-Vet International

Sells a box of 100 needles for US$5.95. Shipping is US$10 for orders under US$100.

 

Thriving Pets

Sells Terumo needles for US$6.45 per 100, plus shipping. If you enter the word "tanya" (without the ") in the promotional code box, you will receive a 10% discount on orders over US$55. Shipping is free for orders over US$55 (after the discount).

 

Brico Medical Supplies

Charges US$6.90 per 100 needles, plus shipping.

 

Amazon

Sells a variety of Terumo needles at differing prices, which do not always need a prescription. Since Amazon is not a specialist seller, make sure you're purchasing the correct item.

 


Winged Infusion Sets (Butterfly Needles)                                                     Back to Page Index


 

These are used when giving sub-Qs with a syringe rather than a giving set (see How to Give Sub-Cutaneous Fluids: Syringe Method).

 

Thriving Pets

Sells these for US$23.95 for 50 Terumos in size 19 or 21, or US$24.95 for size 23. If you enter the word "tanya" (without the ") in the promotional code box, you will receive a 10% discount on orders over US$55. Shipping is free for orders over US$55 (after the discount).

 

Brico Medical Supplies

Sell these at US$24.50 for 50 Terumos, in sizes from 18 to 21 gauge.

 


Fluid Administration Sets (Giving Sets)                                                        Back to Page Index


 

These are used to connect the bag of fluid to the needle. If you are careful not to contaminate them, you can re-use them 2-3 times.

 

Med-Vet International

Sells these for US$1.10 each. Shipping is US$10 for orders under US$100.

 

Brico Medical Supplies

Sell giving sets for US$2.50 each plus shipping.

 

KV Vet Supply

Sells giving sets for US$2.85.

 

Thriving Pets

Sells 72 inch long DEHP-free sets for US$2.50 each or US$27 for 12. If you enter the word "tanya" (without the ") in the promotional code box, you will receive a 10% discount on orders over US$55. Shipping is free for orders over US$55 (after the discount).

 


Syringes                                                                                                                 Back to Page Index


 

Lambert Vet Supply

Sells syringes (without needles) in a number of different sizes.

 

Please see the Persuading Your Cat to Eat page for information on obtaining smaller syringes for assist feeding purposes.

 


Prescription Diets                                                                                                Back to Page Index


 

Pet Food Direct

Sells Hi-Tor Neo, a low protein, low phosphorus food which does not require a prescription. Shipping can be expensive, but there are regular 20% off sales which can help offset the cost.

 

WagginTails

Sells Hi-Tor Neo without prescription.

 

Southern Agriculture

Sells prescription diets from Purina, Royal Canin IVD, Waltham Royal Canin, Eukanuba and Hill's. They will also sell individual tins, which can be helpful if you want to try different foods (though sometimes your vet can get a variety of prescription foods for you to try too).

 

RX Petfood

Sells prescription diets from Purina, Royal Canin IVD, Waltham Royal Canin, Eukanuba and Hill's. They need a prescription or contact details for your vet. I do not know of anybody who has used them as yet.

 

Alternatively, you could ask about buying in bulk from your vet. Our cat, Harpsie, needed a prescription food which cost US$2 per 5.5 oz can. However, when we bought a case, the price fell to US$1.40 a can.

 


Medications and Other Supplies                                                                   Back to Page Index


 

Walmart and Target both sell a number of generic medications, such as lactulose or benazepril, for US$4 for a month's supply.

 

Please also see the following pages:

  • Medicating Your Cat - for items to help make pilling less stressful for you both, such as Pill Pockets and gelcaps.

 

 

 

Back to Page Index

This page last updated: 27 April 2012

Links on this page last checked: 27 April 2012