In most cases, your vet will charge more
for sub-Q supplies and therapeutic kidney diets than other sources. If you can
save money on the basics, you will have money available to pay your vet
for regular check ups.
Alternatively, there are good, reliable and cost effective online
suppliers, both for fluid supplies and food.
Obtaining a Prescription
A prescription is required for fluids in every state,
and in most states for
fluid administration sets and buretrols. Ask
your vet for a prescription that enables you to buy a case of fluids
(12-14 bags) of fluid plus your other supplies at one time, and that allows
you to order refills.
You also need a prescription for needles in NY, CT, IL, NJ, RI, NH, DE,
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 -
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."
If you don't live near a pharmacy which can order
fluids for you cheaply, you will probably have to use an online
pharmacy. Availability and pricing vary widely because of the nationwide fluid shortage. A prescription is required.
Since many of these suppliers charge shipping unless you reach a minimum
spend, it is often worth trying to achieve the minimum spend, e.g. by
buying needles or fluid administration sets (see below) or other
supplies such as B vitamins from the same source.
Unfortunately there has been a severe shortage of fluids in the USA since
late 2013 when
one of the major manufacturers of fluids, Hospira (now known as ICU
Medical), reduced its production capacity
while trying to improve its facilities following a series of warning
letters regarding quality control procedures from the
US Food and Drug Administration.
Another major manufacturer, Baxter, also shut down for planned
maintenance in December 2013. Since these closures coincided with the flu
season, fluid supplies for both the human and veterinary markets have been
low ever since.
Things improved for a while in 2015 but in September 2017 I heard that Braun
was closing its manufacturing facility
for two months for an upgrade. This coincided with Baxter being affected
by the hurricane in Puerto Rico, where one of Baxter's facilities is
located. As at July 2018 fluid
shortages were still common according to the
American Society of Health-System Pharmacists,
and things are unlikely to get any better in
the near future.
Saline solution is the most severely affected, but lactated ringers is
also in short supply. As a result, some of the fluid manufacturers are
only supplying companies with which they have had contracts since 2013. Even
if you are able to find fluids, you may be rationed as to how many bags
you are permitted to buy at a time.
improvements made by Hospira to their plants cost millions of dollars, and
as a result of this and the low availability of fluids generally, prices
have increased dramatically.
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.
I used to link to Santa Cruz Biotechnology, which offered good prices
for fluids. In 2015 I discovered that the US Department of Agriculture
was conducting an animal welfare investigation
into this company, so I stopped linking to them. In May 2016 the
completed investigation led to a record fine of $3.5M and the revocation
of the company's licence. I wouldn't touch this supplier with a
$10 off first order over $75.
Bulk purchase discounts available
Most people use Terumo needles
- you can read
here why they are so popular. Unfortunately it seems that the
favoured UTW (ultra thin wall) needles have been discontinued in the USA, so they are
increasingly hard to find and many of the stockists below are running
out or may have run out by the time you read this. I would recommend stocking up on
them if you can find them.
Terumo needle codes may help you if you
are trying to track down UTW needles.
Terumo (Sept 2015) indicates that
needles under the Terumo name
21-23 are still available in ultra thin wall form but only in longer
lengths and only in Canada, though they are available to US distributors,
so in principle it should be possible to find them in the USA if you shop
If you are unable to obtain Terumo needles, you can consider Nipro ones
instead. There is more information about needle choices
A prescription is required for needles in CT, MA, NJ, NY and RI.
ASD Healthcare, some Terumo needles were
recalled in April 2019 because of possible sterility issues.
All the links below are for Terumo needles. Remember, ideally you want
ultra thin wall, not thin wall.
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 therapeutic for you to try too).
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. One of
our cats 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.
TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE
tried very hard to ensure that the information provided in this website is
accurate, but I am NOT a vet, just an ordinary person who has lived
through CKD with three cats. This website is for educational purposes
only, and is not intended to be used to diagnose or treat any cat. Before
trying any of the treatments described herein, you MUST consult a
qualified veterinarian and obtain professional advice on the correct
regimen for your cat and his or her particular requirements; and you
should only use any treatments described here with the full knowledge and
approval of your vet. No responsibility can be accepted.
If your cat
appears to be in pain or distress, do not waste time on the internet,
contact your vet immediately.
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created using Microsoft software, and therefore it is best viewed in
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You may print
out one copy of each section of this site for your own information and/or
one copy to give to your vet, but this site may not otherwise be
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