TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 

 

LOCAL SOURCES FOR FLUID USA

 

ON THIS PAGE:


Obtaining a Prescription


Using Local Pharmacies


Discount Cards


National Drug Code (NDC) Numbers


Sources for Fluids Listed by State


 

 

 

HOME


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What You Need to Know First


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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


 

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Home > Supplies > US Local Supplies

 


Overview


  • It is usually cheaper to buy your sub-Q fluids online or from a local pharmacy.

  • Unfortunately the national fluids shortage in the USA means it can be hard to find fluids at all, let alone at reasonable prices.

  • This page has details of pharmacies where members of Tanya's CKD Support Group have been able to find fluids locally.

  • It also explains more about how to obtain these supplies more cheaply, such as by using discount cards.

  • Please see Obtaining Supplies Cheaply Online for where to buy fluids and other supplies such as needles online.

 


Obtaining a Prescription


 

A prescription is required for fluids in every state. Ask for a prescription that enables you to buy a case of fluids (12-14 bags) of fluid at one time, and that allows you to order refills.

 

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 Vetererinary 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."

 


Using Local Pharmacies


 

See Subcutaneous Fluids Tips for more information on the various types of fluid that are sold for use in cats. In practice, most people use lactated ringers solution (LRS).

 

The cheapest source for fluids is usually to find a local pharmacy in your area offering low prices. This has several advantages:

  • It saves on shipping costs, which are often expensive since fluids are heavy.

  • You will often be able to obtain the fluids more quickly.

  • 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 until 2014 chains such as Walgreen's, Costco, Target and CVS could all often obtain fluids for you quickly and cheaply, usually for under US$30 a case (a case usually refers to twelve bags of 1000 ml fluid, though occasionally it will be for fourteen bags of 1000 ml fluid). The Costco record is US$7 for a case (and that was in NYC). Using a discount card issued by the pharmacy chain itself or one of the discount cards discussed below can also result in worthwhile savings: the record for a purchase with a discount card (a locally issued card in this case) was US$5.99 for a case at a Target branch in Texas.

 

Before you get your hopes up, I have to tell you that sadly, in light of the continuing nationwide fluid shortage, obtaining fluids locally is not as easy as it used to be, and the cheapest price I've heard of in 2016 is US$32 for a case. Prices bounce all over the place these days, but the current (July 2016) going rate for most people appears to be around US$70-80 a case. Clearly not as good as US$7, but it is still cheaper than what a lot of vets charge.

 

Before you place your order, ask the pharmacist to call their supplier or check the online system to make sure the supplier has your chosen fluids in stock. Otherwise you could be disappointed a few days later when they call to tell you they can't fill your order after all. Also ask for the price before you order so you don't get any nasty shocks.

 

Do not wait until you are about to run out of fluids before trying to source them. Since fluids are usually good for at least a year, if your cat seems stable I would try to obtain a case or two as soon as you can so as not to have the potential headache of trying and failing to find any at short notice later in the year.

 


Discount Cards


 

If you are purchasing your fluids locally, it is often very worthwhile to use a discount card. Different cards are accepted by different pharmacies, so I would try obtaining all these cards and then see which one gets you the biggest discount at your local pharmacy.

 

Tanya's CKD Support Group have not received any spam as a result of using the cards, though many choose to use an inaccurate e-mail address to be on the safe side (this won't work for the GoodRx card, which e-mails you the card). See below for tips on obtaining fluids from local pharmacies.

 

Here are the cards which members have used successfully:

 

GoodRx Discount Card

This card has been used successfully by many members of my support group. In February 2014, one person was able to obtain a case of 12 bags of fluid from her local Walgreens for US$16 using the previous version of this card.

 

Pet Drug Card

Has also been used successfully by a member of the support group  to obtain discounts at Walmart.

 

Your Pharmacy Card

Has also been used successfully.

 

RX Free Card

Has been used successfully by one person I know of.

 

Simple Savings Card

Has been used successfully by one person I know of.

 

American Automobile Asssociation

If you are a member of the AAA, you are eligible for an AAA Prescription Savings Card, which some members of my support group have used successfully to obtain fluids at a discount locally.

 

Walgreens Prescription Savings Club

This card has been used successfully by many members of my support group but it is not free. It costs US$35 a year for family membership, which includes cats, or US$20 a year for an individual (i.e. your cat).

 

Pet Med Saver Card

I haven't heard from anyone who has used this card to date.

 


National Drug Code (NDC) Numbers


 

If you are purchasing fluids locally, It can help a lot 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: 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:

 

Fluid Type DEHP Status Brand NDC Number

Lactated Ringers Solution

 

 

 

Lactated Ringers Solution

 

Hospira

0409-7953-09

Lactated Ringers Solution

DEHP-Free

Hospira

0409-7953-48

Lactated Ringers Solution

DEHP-Free

Braun

0264-7750-00

Lactated Ringers Solution

DEHP-Free

Baxter

0338-6307-04

       

Normosol

 

 

 

Normosol-R

 

Hospira

0409-7967-09

Normosol-R 7.4 pH

 

Hospira

0409-7670-09

       

Sodium Chloride

 

 

 

0.9% Sodium Chloride Solution

 

Hospira

0409-7983-09

 

 

 

 

 


Walgreen's


 

Many members of Tanya's CKD Support Group use their local Walgreen's pharmacy for their fluids. It can be a bit fiddly (you need to follow the steps below exactly) and you may still need to be persistent (very few Walgreen's employees seem to know what fluids are), and even if you are persistent, Walgreens may not be able to obtain fluids for you because of the nationwide shortage. However, if you get lucky, you should receive your fluids quickly and at a very good price.

 

Unfortunately, following a change of supplier in 2014, Walgreens no longer supplies DEHP-free fluids, so you will have to decide if this is a dealbreaker for you.

 

It also now seems to sell bags of 500ml fluids rather than 1000ml, but you can just order 24 instead of 12 to obtain the equivalent of a case of fluids. Some people who do not give sub-Qs to their cat that often actually prefer the smaller bags.

 

This is how to obtain your fluids from Walgreen's at a good price:

  1. Visit Walgreens. Be sure to use the link given, it will save you time and ensure you are in the correct place.

  1. Type lactated into the Price Your Drugs box on the left (you will need to allow cookies), then click search. You should see Lactated Ringers Injection, 500.0 ml package. Click on the link, then choose Package, 24. The price shown as at July 2016 is US$72.04 for 24 bags of 500ml of fluids (which is the equivalent of 12 1000ml bags).

  1. If you want Normosol, type normosol into the box instead of lactated. The price as at July 2016 was US$73.33 for 12 1000ml bags.

  1. Print the page displaying the prices and take it to your local Walgreen's, along with your cat's prescription. Try to speak to a pharmacist rather than a clerk if possible - apparently the pharmacist has access to the full catalogue whereas the clerks don't.

  1. The pharmacist will probably also need the NDC (National Drug Code) for your fluids, see above.

  1. Try to use a discount card. These cards are free yet in some cases may give you a lower price for your fluids. Many people print out all of these cards, then ask Walgreens to check which one gives them the biggest discount and use that.

  1. Alternatively, apply for your cat to join the Walgreen's discount scheme, the Prescription Savings Club. This costs US$35 a year for family membership, which includes cats (if you already have a family membership, you can add your cat to it for free), 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 price on the page you have printed.  Some Walgreens pharmacies will actually sell them for less, especially if you have a discount card. In May 2016, for example, one person was able to obtain a case of 12 1000ml bags for US$32 using the GoodRX card. However, other people are being asked to pay the full amount, which is probably because of the current fluids shortage and the fact that Hospira (a fluid manufacturer) greatly increased their prices.

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

It is particularly important to take the print-out with you to prove Walgreen's can obtain these supplies - many Walgreen's 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.

 


Sources for Fluids Listed by State


 

The list is ordered by state, so please click on the letter relating to your state. If there is no information, it is because I have not been advised of any suppliers as yet.

 

You will notice many people were able to obtain better prices using a variety of discount cards. You can read more about these above.

 

Please also read here about how to go about obtaining discounts at Walgreens.

 

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C


 

 

Location

Pharmacy

Address

Purchase

(1000ml bags)

Price US$

Discount Card

Date

CALIFORNIA

 

 

 

 

 

 

Northern LA Walgreens   12 LRS 30.00 AAA Card 2016 05

Northern LA

Walgreens

 

12 LRS

22.50

AAA card

2015 02

Southern California

Sav-on Drugs, Albertsons

 

14 LRS

33.00

Albertson's own card

2015 02

 

Walgreens

 

12 LRS DEHP-free

33.26

GoodRX

2016 03

Pacifica

Walgreens

 

12 LRS

32.00

GoodRX

2016 05

Berkeley

Costco

 

14 LRS

56.29

 

2015 06

Santa Monica

Rite Aid

 

1 LRS

11.00

 

2015 01

Northridge

Costco

 

12 LRS

43.00

 

2016 07

 

 


D


 

Location

Pharmacy

Address

Purchase

Price US$

Discount Card

Date

DELAWARE

 

 

 

 

 

 

 

Walgreens

 

12 LRS

33.60

Your Pharmacy

2016 07

 


F


 

Location

Pharmacy

Address

Purchase

Price US$

Discount Card

Date

FLORIDA

 

 

 

 

 

 

Cooper City

Walgreens

NW corner of Pine Island and Stirling

12 LRS DEHP-free

34.90

AAA card

2014 10

Central Florida

Walgreens

 

12 LRS

23.00

 

2015 08

Miami

Walgreens

NW corner of Sunset Drive and SW 157th Ave

12 LRS

72.00

Prescription Savings Club

2016 05

Miami

Walgreens

NW corner of Sunset Drive and SW 157th Ave

12

Nornosol-R

72.00

Prescription Savings Club

2016 05

 


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H


 

 


I


 

Location

Pharmacy

Address

Purchase

Price US$

Discount Card

Date

ILLINOIS

 

 

 

 

 

 

Aurora

Walgreens

 

12 LRS

37.68

Prescriptions Saving Club

2014 12

Chicago

Costco

 

12 LRS DEHP-free

44.00

 

2015 07

 

 


K


 


L


 


M


 

Location

Pharmacy

Address

Purchase

Price US$

Discount Card

Date

MAINE

 

 

 

 

 

 

Portland

Walgreens

 

12 LRS

33.60

GoodRX

2016 06

 

 

 

 

 

 

 

MARYLAND

 

 

 

 

 

 

Baltimore

Costco

 

12 LRS

88.00

Costco Member

2016 07

 

 

 

 

 

 

 

MASSACHUSETTS

 

 

 

 

 

 

 

Walmart

 

12 LRS

46.00

Pet Medication

2015 01

Deadham

Costco

 

12 LRS

39.00

 

2016 05

 


N


 

Location

Pharmacy

Address

Purchase

Price US$

Discount Card

Date   

NEW JERSEY

 

 

 

 

 

 

Wayne

Wayne Pharmacy

1055 Hamburg Turnpike, Wayne

NJ 07470

973-696-6667

12 LRS

44.95

 

2016 05

 

 

 

 

 

 

 

NEW YORK

 

 

 

 

 

 

Brooklyn

Costco

Redhook

4 LRS

26.00

 

2015 03

Poughkeepsie

Walgreens

 

12 LRS

15.00

 

2015 02

 

Walgreens

 

12 LRS DEHP-free

34.00

 

2016 03

 

 

 

 

 

 

 

NORTH CAROLINA

 

 

 

 

 

 

 

Walgreens

 

12 LRS DEHP-free

30.60

Simple Savings

2016 03

 


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P


 


R


 


S


 

 

 


T


 


U


 


V


 

Location

Pharmacy

Address

Item

Price US$

Discount Card

Date

VIRGINIA

 

 

 

 

 

 

 

Walgreens

 

14 LRS

46.20

Can't remember

2015 09

 


W


 

Location

Pharmacy

Address

Purchase

Price US$

Discount Card

Date

WASHINGTON STATE

 

 

 

 

 

 

Seattle

Walgreens

 

9 LRS

34.70

Your Pharmacy

2015 06

 

 

 

     

 

 

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This page last updated: 19 July 2016

Links on this page last checked: 16 July 2106