Overview
- 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 and tests.
- The cheapest place for fluids is often a local pharmacy, see Obtaining Supplies Cheaply Locally.
- 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, and MN.
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 — The American Veterinary Medical Association 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.”
Online Pharmacies
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 regular nationwide fluid shortages. A prescription is required.
The US Food and Drug Administration discusses precautions you should take when using online pharmacies. Unless indicated otherwise, I only link to sites which I or members of Tanya’s CKD Support Group have used personally.
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.
Fluids
Fluids Shortages
Unfortunately there has been regular shortages 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, and in light of Covid-19, the situation may not be too positive in the near future. Saline solution is usually the most severely affected, but lactated ringers is also sometimes 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.
The 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.
American Society of Health-System Pharmacists has details of current shortages.
PBS discusses the situation as at June 2014.
US Food and Drug Administration also has some information from October 2017.
Fluid Types
See Subcutaneous Fluids Tips for more information on the various types of fluid.
Lactated Ringers Solution (LRS)
LRS is the most commonly used fluid type for CKD cats.
All quotes below are for 1000ml (1 litre) bags of Lactated Ringers Solution, though apparently some sellers are now shipping 500ml bags x 2 instead.
Some people who are not giving sub-Qs too frequently like the idea of buying smaller fluid bags, but these tend to work out more expensive than buying 1 litre bags and discarding what you don’t use.
The US Food and Drug Administration reports on the recall of a particular batch of LRS fluids made by ICU Medical (Hospira), NDC number 0409-7953-09, lot number 07-514-FW, expiry date 1 Jul 2021.
| Supplier | Quantity | Price US$ | Shipping | Notes |
| BP Medical Supplies | 1 | 5.99 | Varies, $12-20 approx | Have only heard from one user so far. One person has been told they will only sell to vets. |
| PBS Animal Health | 1 | 7.06 | Free over $75 | Sold in bottles. Have only heard from one user so far. |
| Pet Supplies 4 Less | 1 | 9.99 | Free over $69 | |
| Heartland Vet Supply | 1 | 7.50 | Free shipping over $75 | |
| 12 | 83.40 | |||
| Entirely Pets Pharmacy | 1 | 7.55 | Free shipping over $59. | |
| Thriving Pets | 1 | 10.00 | Free shipping over $49 (after Tanya discount). | Enter tanya in promotional code box for 10% discount over US$100. |
| 12 | 96.00 (8.00 each) | |||
| KV Supply | 1 | 9.49 | US$4.99 for orders over $69 and under 20 lbs | |
| Leedstone | 1 | 7.99 | No free shipping. Costs $7.95 for certain areas. | |
| Lambert Vet Supply | 1 | 9.99 | Free shipping over $100 | |
| Valley Vet | 1 | 9.99 | Free shipping over $60 | |
| California Pet Pharmacy | 1 | 9.99 | No free shipping. Costs from $6.49 | |
| Chewy | 1 | 8.99 | Free shipping over $49. | Also offers DEHP-free LRS but it costs $11.46. |
| Med-Vet International | 1 | 12.99 | $10 for orders under $100. | Will apparently only deliver to veterinary premises. |
| UPCO | 1 | 10.95 | Free shipping over $60. | Does not ship to Virginia. 2% discount for orders over $110. |
| Vet Rx Direct | 1 | 111.88 | Free shipping over $49 | $10 off first order over $75. |
| PetMart Pharmacy | 1 | 9.49 | $7.99 flat rate | Not heard from any users as yet. |
| 12 | 104.76 | |||
| Mountainside Medical | 1 | 13.95 | Free shipping over $100 |
Normosol-R/PlasmaLyte
Normosol-R comes in two pH types, 6.6 (a very similar pH to lactated ringers solution) or 7.4. Your prescription should show which pH you need.
PlasmaLyte is essentially the same as the Normosol-R with a pH of 7.4.
You can read more about these fluid types here.
| Supplier | Quantity | Price US$ | Shipping | Notes |
| Thriving Pets | 12 | 119.95 | Free shipping over $49 (after Tanya discount). | Sells 6.6 pH type. Enter tanya in promotional code box for 10% discount over US$100. |
| Leedstone | 1 | 10.82 | No free shipping. Costs $7.95 for certain areas. | pH not stated but peering at the label, I think it is 6.6. |
| UPCO | 1 | 10.95 | Free shipping over $85. | Do not ship to Virginia. 2% discount for orders over $110. |
| Chewy | 1 | 9.99 | Free shipping over $49. | Save 5% with autoship |
| Heartland Vet Supply | 1 | 10.95 | Free shipping over $75 | PlasmaLyte A. Ph 7.4 |
| 14 | 143.95 | |||
| PetMart Pharmacy | 1 | 9.49 | $7.99 flat rate | Ph 6.6. Not heard from any users as yet |
| 12 | 104.76 | |||
| Lambert Vet Supply | 1 | 11.99 | Free shipping over $100 | |
| Valley Vet | 1 | 12.99 | Free shipping over $60 | pH 7.4 |
| Vet Rx Direct | 1 | 11.10 ph 7.4 | Free shipping over $49 | $10 off first order over $75. |
| 1 | 12.12 ph 6.6 |
Sodium Chloride (Saline) 0.9%
| Supplier | Quantity | Price US$ | Shipping | Notes |
| BP Medical Supplies | 1 | 8.29 | Varies, $12-20 approx | Have only heard from one user so far. One person has been told they will only sell to vets. |
| Leedstone | 1 | 8.95 | No free shipping. Costs $7.95 for certain areas. | |
| KV Supply | 1 | 8.09 | US$4.99 for orders over $69 and under 20 lbs | |
| Thriving Pets | 12 | 119.95 | Free shipping over $49 (after Tanya discount). | Enter tanya in promotional code box for 10% discount over US$100. |
| Valley Vet | 1 | 8.99 | Free shipping over $60 | |
| Chewy | 1 | 8.39 | Free shipping over $49. | Save 5% with autoship |
| PetMart Pharmacy | 1 | 10.99 | $7.99 flat rate | Not heard from any users as yet. |
| 12 | 121.32 | |||
| California Pet Pharmacy | 1 | 12.99 | No free shipping. Costs from $6.49. | |
| Vet Rx Direct | 1 | 13.27 | Free shipping over $49 | $10 off first order over $75. |
Needles
Most people use Terumo needles — you can read here why they are so popular.
If you are unable to obtain Terumo needles, you can consider Nipro ones instead. There is more information about needle choices here.
A prescription is required for needles in CT, MA, NJ, NY and RI.
According to ASD Healthcare, some Terumo needles were recalled in April 2019 because of possible sterility issues.
All the links below are for Terumo needles. Remember, you want ultra thin wall or thin wall, not regular.
| Supplier | Quantity | Price US$ | Shipping | Notes |
| Med-Vet International | 100 | 7.50 | Free shipping over $100. $10 under $100 | Needles appear to be thin wall. Cannot sell needles to NY, CT, IL, NJ, RI, NH, DE or MN. Need valid ID for residents of MA. |
| California Veterinary Supply | 100 | 10.99 | Free shipping over $49/ | Various sizes available |
| VetRxDirect | 100 | 17.00 | Free shipping over $49 | Appear to be thin wall. May require script even if your state does not require a script for needles. |
| Thriving Pets | 100 | 14.95 | Free shipping over $49 (after Tanya discount). | Ultra thin wall (imported from Canada). Other sizes are available. Enter tanya in promotional code box for 10% discount over US$100. |
| Amazon | 100 | 14.95 | Varies | Various sizes available. Prescription not always necessary. I’m giving this link in case everyone else sells out, but be careful what you buy |
Winged Infusion Sets (Butterfly Needles)
These are used when giving sub-Qs with a syringe rather than a giving set (see How to Give Subcutaneous Fluids: Syringe Method).
| Supplier | Quantity | Price US$ | Shipping | Notes |
| Thriving Pets | 1 | 1.00 | Free shipping over $49 (after Tanya discount). | Gauges 19-23. Enter tanya in promotional code box for 10% discount over US$100. |
| 50 | 31.25 | |||
| Lambert Vet Supply | 1 | 0.79 | Free shipping over $100. | Size 23 only |
| Leedstone | 1 | 1.99 | No free shipping. | Various sizes available. |
Fluid Administration Sets (Giving Sets)
These are used to connect the bag of fluid to the needle. If you are careful not to contaminate them, you can re-use them 2-3 times.
Ideally you need them to be either 10 drop/ml or 15 drop/ml and at least 72 inches long. Click here to learn more about what features you need.
| Supplier | Quantity | Price US$ | Shipping | Notes |
| BP Medical Supplies | 1 | 0.89 | Varies, depends on weight | 10 drop/ml, 72 inch |
| Mountainside Medical | 1 | 1.19 | Free over $100 | 15 drop/ml, 78 inch |
| Mountainside Medical | 1.99 | 10 drop/ml, 78 inch | ||
| Net32 (Carolina Dental Supply) (search for IV set if the link does not work) | 50 | 45.90 | Standard shipping costs $9.95 | 15 drop/ml, 78 inch |
| Med-Vet International | 1 | .1.25 | Free shipping over $100. $10 under $100 | 10 drop/ml |
| Thriving Pets | 1 | 2.50 up | Free shipping over $49 (after Tanya discount). | Various sizes available. Enter tanya in promotional code box for 10% discount over US$100. |
| 12 | 27.00 (2.25 each) | |||
Syringes
| Supplier | Quantity | Price US$ | Shipping | Notes |
| Pet Supplies 4 Less | 1 | 1.29 | Free shipping over $69. $5.99 below $69 | Price is for 20cc size. |
| Thriving Pets | 1 | 1.00 | Free shipping over $49 (after Tanya discount). | Price is for 20cc size. Other sizes available.Enter tanya in promotional code box for 10% discount over US$100. |
Please see the Persuading Your Cat to Eat page for information on obtaining smaller syringes for assist feeding purposes.
Buretrols
Some people use buretrols to measure how much fluid they are giving. You can read more about them and which features to consider here.
| Supplier | Quantity | Price US$ | Shipping | Notes |
| Med-Vet International | 1 | 3.27 | Free shipping over $100. $10 under $100 | Has attached IV set, so much slower drip |
| Health Products Express | 1 | 21.96 | Price depends on weight of order | |
| Mountainside Medical | 1 | 16.99 | Free over $100 | Pressure infusor bag |
| Boundtree Medical | 1 | 14.79 | Unstated, presumably based on weight | |
Veterinary Diets
Please see Which Foods to Feed for information on your veterinary kidney food choices, including trial packs. Some brands of Petsmart sell individual cans of therapeutic kidney diets.
The following sell cat food in bulk.
Sells therapeutic kidney diets and a variety of other brands. I have never heard anything but praise for this company. Pet
Sells various brands of therapeutic kidney diets. Prescription required. 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).
Sells therapeutic diets from Purina, 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.
Does not sell veterinary diets but has good prices for some other brands.
Medications and Other Supplies
Wal-Mart sells a number of generic medications, such as lactulose or benazepril, for US$4 for a month’s supply.
Many of the companies listed above also sell other supplies. Please also see the following pages:
- Phosphorus Binders — for phosphorus binders.
- Holistic Treatments — for holistic supplies such as slippery elm bark.
- Erythropoiesis Stimulating Agents — for Aranesp, Eprex or NeoRecormon.
- Appetite Loss, Nausea and Vomiting — for treatments for vomiting and nausea, such as ondansetron or famotidine.
- Medicating Your Cat — for items to help make pilling less stressful for you both, such as Pill Pockets and gelcaps.
- Obtaining Supplies at Reasonable Prices: USA Local — for purchasing sub-Q fluids locally.
This page last updated: 22 June 2021
Links on this page last checked: 06 September 2020