It is
usually cheaper to buy your sub-Q fluids online or from a local
pharmacy.
Unfortunately there have been fluids shortages in the USA in recent
years, which means it can sometimes 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.
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 —
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."
Using Local Pharmacies
See
Subcutaneous Fluids Tips for more information on the various types of
fluid that are sold for use in cats. 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 or Costco 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
regular nationwide
fluid shortages,
obtaining fluids locally is not always as easy as it used to be. CVS and
Target no longer seem willing to order fluids. Prices bounce
all over the place these days, and the current going rate
for most people appears to be around US$35-120 a case. This is still
cheaper than what many vets charge.
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.
Approaching Local Pharmacies
Because
of the regular fluids shortages in the USA, it is not as easy as it was to find
fluids locally, but here is a strategy that might help. If you get
lucky, you should receive your fluids quickly and at a reasonable price.
Visit or call your local pharmacy (if you visit, take
your cat's prescription with you). Try to speak to a pharmacist rather
than a clerk if possible — apparently the pharmacist has access to the
full catalogue whereas the clerks often do not.
It is particularly important to explain that you wish to order the
fluids — most branches do not hold them in stock, but can order them
quickly, though not every employee realises this.
It greatly increases your chances of success if you
can provide the pharmacist with the NDC (National Drug Code) for your
fluids, see
below.
Try to use a discount card (seebelow).
Most of these cards are free yet may sometimes entitle you to a lower price for
your fluids. Many people print out all of these
cards, then ask the pharmacist to check which one gives them the biggest
discount and use that one.
If you decide to source your fluids from Walgreens,
you can consider having your cat join the Walgreen's discount scheme,
the
Prescription Savings Club(though sometimes the free discount cards actually
give you a better price, so check before you sign up). 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). You can sign up
online or in the store. Unfortunately this is
not available if you live in Washington State.
If you live in Florida, there is a new programme
called
Walgreens Plus,
available at 17 stores. According to page 47 of the
price list dated November 2018
(still valid as at July 2020),
under this scheme you can buy 30 days worth of LRS (the odd amount of
8762ml) for US$53.94, so presumably a case of 12 would cost US$73.87.
One thing to note about Walgreens is that,
following a change of supplier in 2014, it no longer supplies
DEHP-free fluids, so you will have to decide whether this is a dealbreaker for you.
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 double check the price before you order so you
don't get any nasty shocks.
Ask the pharmacist to order the fluids for you if you
are happy with the price quoted. Wait for the fluids to arrive (it
should only take a day or so) and go and collect them.
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.
You usually print them out and then take them with you to your local
pharmacy and see which one gets you the biggest discount.
Tanya's CKD Support Group
members 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:
This card has been used successfully by many members
of my support group.
I have been told that Wal-Mart no longer accepts this card for pet
medications, though some people have used it successfully. You can obtain
a general discount card, but you may have more success if you go to the
GoodRx website, state your location and choose a local pharmacy, then
print a coupon for the item you require, to be used at that particular
branch.
Has been used successfully by a member of the support group to obtain a
discount for ESAs. The
website quotes prices from US$30.84 for a case of 12 1000ml LRS, though
prices vary depending upon your location. You choose the local pharmacy
you wish to use from a list provided and then print out a coupon to take
with you when you order.
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.
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).
has a discount card available.
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:
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.
Links on this page last checked: 06 September 2020
*****
TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE
EXTREMELY DANGEROUS.
I have
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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