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.
Some 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 September 2012, one person was able to obtain a case of 12
bags of fluid from her local Wal-Mart for US$16 using this card, which of
course was free, whereas Walgreen's own discount card mentioned below is
not free and does not give you such a large discount on the fluids.
Group members have not received any spam as a result
of using the card, though many choose to use an inaccurate e-mail address
to be on the safe side. See below for tips on obtaining fluids from local
pharmacies.
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. Walgreen's, 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
(a locally issued card in this case) 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: 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:
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).
Walgreen's
Many members of
Tanya's CRF Support Group use
Walgreen's.
I used to hear quite often from people who said they had not been successful buying
fluids from Walgreen's, 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 Walgreen's employees seem to know what fluids are),
but you should be successful.
Please also see above
about online savings cards. In some cases, these may give you an even
lower price for your fluids. I have heard of people obtaining their
fluids for as little as US$16 with one of these cards, plus they save
you the cost of purchasing Walgreen's own discount card in step 5 below.
This is how to obtain your fluids from Walgreen's at a good
price:
You have to use this link
- just going to the Walgreens website and searching will not work.
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 September 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.
If you want Normosol, type normosol into the box
instead of lactated. The price as at September 2012 was US$43.61 for 12
bags of 1000ml each.
Print the page displaying the prices and take it to your local
Walgreen's, along with your cat's prescription.
The pharmacist will probably also need the NDC
(National Drug Code) for your fluids. For the Hospira brand of 1000ml
Lactated Ringers Solution, the NDC is 00409-7953-09. Walgreens can also obtain Braun
DEHP-free fluids for the same price, the NDC is 00264-7750-00.
Codes for others are
above.
Try to use a discount card - I would try one of those
I discuss above in the first instance. 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, or US$20 a year for an individual (i.e.
your cat).
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, especially if you have a discount card).
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 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.
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.
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).
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).
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.
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.
Sell 12 bags of fluid for
US$64.80. 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).
Normosol-R/PlasmaLyte
Normosol-R comes in two pH types, 6.6 (very similar pH to lactated
ringers solution) or 7.4. Your prescription should show which pH you
need. PlasmaLyte is essentially the same as the Normosol-R with a pH of
7.4.
You can read more about these fluid types
here.
Sell 12 bags of Normosol-R for US$65.95. They sell both pH types (6.6 or
7.4).
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).
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).
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.
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).
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).
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.
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).
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.
Sells prescription diets and a variety of other brands.
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.
