rocksbride

Where to find subcutaneous fluid supplies for Kitty?

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Got some tough news Saturday that Kitty is in stage 3 kidney failure (of 4 stages) and needs to start receiving subcutaneous fluids 2 to 3 times per week. Our vet in Dallas who did the extensive lab tests last Thursday would sell me supplies for a month at a time, but doesn't ship.  We just got back to the RGV and several vets have said I'd have to start over with their office with exams and labs before they'd talk to me about what to do next.  We're leaving the RGV in 3 weeks for more extensive travel and won't be back in Dallas or the RGV till maybe October.

Banfield w/Petsmart will recognize our vet's prescription for KD low protein food, but they don't sell the "Sub Q" supplies.

Anyone have experience with traveling with a pet in kidney failure?  with adminstering subcutaneous fluids that you had to do yourself?  Is there any kind of resource for special vet supplies that can be obtained with a prescription and shipped nationally?

Kitty doesn't look or act sick yet, but she's dropping weight and the labs show she needs the fluids to reduce toxin build-up.  Worst case I can have a friend pick up the stuff from our Dallas vet and ship it to us, but I don't want to do that if there is another way.

Thanks for your help.  Kitty's been with us 15 years and I can barely breathe when I think about losing her.

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Have you researched online to see if you can just buy the supplies? Or do you need a prescription. If you need a prescription get a pile of them from your vet and use a Canadian or US pharmacy to ship them to you. Get copies of the cat's records and carry them with you. I'll lay odds a vet in a small town will help you out...............

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Have been looking online and realized I need more specific info from the vet about what she needs.  Great idea to get multiple prescriptions from the vet.  We had the exam and test on Thursday and left town the next morning.  Didn't get result till Saturday.

This morning our vet tech thought it would be easy to get the packs at any vet and we wouldn't need a prescription... not so.

I'll call the vet directly tomorrow to get specifics and prescriptions.  Perhaps she'd be kind enough to send some through snail mail.  Looks like some places want ORIGINAL and not scanned prescriptions.  Sometimes companies will call your vet for authorization.

We carry Kitty's records and lab tests in our emergency book in the truck along with our own health info.  Been super helpful to have her history in one place to hand to vets across the country.  Thanks for bringing it up.  It was easy to verify her weight loss and how quickly it's coming off.  Lab tests over the years told us what to watch for and verified there's been a change.

Thanks for your quick reply.

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Try Petmeds, Chewy and others like that. especially if you find out you don't need a prescription. The other choice would be to transfer to PetSmart/Banfield. They are all over the country and your records would probably follow you around.

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Foster and Smith is another mail order provider of some prescription pet medications. I would also check with a local CVS or Walgreens to see if they can fill the prescription. We have gotten prescriptions for our pets filled by both of them on several occasions and you would be able to transfer the prescription to another one of their locations as you move across the country.

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Super.  Thank you!  Didn't know CVS or Walgreens did pet prescriptions.  Great idea for the nationwide network.

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Turns out Sam's Club and Costco also fill pet prescriptions.  Sam's doesn't carry what I'm looking for and Costco Pharmacy is closed right now, but here is a link to Costco's pet program.  Pets automatically go into their "uninsured" plan and it appears that the discounts are heavy.  Check out this link for popular pet meds and pricing (6/12/17).

https://www.costco.com/pharmacy/pet-medications.html

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I'm assuming you are doing the same thing we are.  That is taking a 1 liter bag of common saline solution (the same thing they give humans in the hospital through the IV) and using a IV needle, insert the needle under the skin above the cats shoulders and allow 100-150cc of the solution to flow in sub-subcutaneously. 

We have a personal relationship with our vet, who supplied us with a case of saline solution, IV tubes and enough IV needles to hold us through our travels.

I did try to get ONLY the saline solution (no needles or drip tubes) thru Sam's Club & Costco but both said they don't carry that.  I tried Petsmart (Banfield) and they said the don't do do that.  I also tried another Vet and they wanted to do an exam of our cat before selling the solution. 

The other big hurtle, I have not tried to address, is getting additional drip lines and IV needles.  We have been advised to use a new needle every time and a new drip line every 2 bags.  Twice a week comes to a lot of needles.

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I think the reason any new vet wants to do an exam is that by law I believe they are required to have a "relationship" with the pet/patient to write any prescriptions

Our dog requires prescription meds and I order online indicating who the vet is.  The pharmacy then contacts the vet for the prescription .  I have previously ordered from all of them mentioned.  One of the current meds she has for her eyes is a compounded medication.  There is 1 pharmacy that does this out of Phoenix AZ area.   The name is Roadrunner Pharmacy.  I don't know if they would have anything like that or could mix it for you, but they commonly ship medications.  Your vet has to call them with a prescription.  You then call and they require a credit card.  They will then fill your prescription, charge your card, and ship it to the address you give them.  The shipping is free.   This has worked out very well with us traveling.  After you have ordered the first time, you can set up an online account to order whenever you need it until your prescription expires.

I

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I think Walmart does pet prescriptions also.

Make a quick trip to Mexico and stock up on what you need.

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I'm going to mention an alternate route that may or may not piss you (or someone else) off.  Euthanize kitty before your trip.  Yes, I know it sucks, BTDT several times.  

How much stress do you want to put on kitty...and yourself?  

Our first kitty went into kidney failure.  She was a sweet little girl.  Our last kitty that died had thyroid issues and was diabetic.  We kept her going a long time with meds and such.  She eventually had a neurologic episode while we were on a trip and we put her down about 4 days later after spending a lot at an emergency vet.  

I know it is hard.  But, how much stress do you want to live with.  When kitty doesn't make it to the littler box, kitty will be upset and so will you.  Not kitty's fault and you know it, but you'll still be a little miffed, especially the 4th or 5th time it happens.

Whatever you do, give kitty lots of love and remember the good times.

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Remoandiris, Kitty isn't at that stage yet.  She still seems normal, just losing weight.  The vet said we are quite a ways before we have to make hard decisions... Two of my kitties have lived nearly 20 years.  I know about the issues.  Our new fiver has minimal carpet and if Kitty throws up it's an easy clean up.

 

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Al F, thanks for sharing your experience.  Will let you know what I find.

LFDR3116, thanks for the resource.

 

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21 hours ago, Al F said:

I'm assuming you are doing the same thing we are.  That is taking a 1 liter bag of common saline solution (the same thing they give humans in the hospital through the IV) and using a IV needle, insert the needle under the skin above the cats shoulders and allow 100-150cc of the solution to flow in sub-subcutaneously. 

We have a personal relationship with our vet, who supplied us with a case of saline solution, IV tubes and enough IV needles to hold us through our travels.

I did try to get ONLY the saline solution (no needles or drip tubes) thru Sam's Club & Costco but both said they don't carry that.  I tried Petsmart (Banfield) and they said the don't do do that.  I also tried another Vet and they wanted to do an exam of our cat before selling the solution. 

The other big hurtle, I have not tried to address, is getting additional drip lines and IV needles.  We have been advised to use a new needle every time and a new drip line every 2 bags.  Twice a week comes to a lot of needles.

Al F., after an extensive talk with the vet in Dallas, the answer is yes - pretty much the same thing you are doing - 100-200ml of one of 3 choices, which are the same supplies people use:

  1. NORM-R or
  2. LRS (lactated ringer solution) or
  3. Plasmalyte

We need tubing and yes, new needles each time (2 times per week).  She said it was optional to get an extention set for the tubing in case it is contaminated with blood, so only the short extention had to be tossed.

She also recommended 18 gauge needles which hurt more going in, but drip faster and hurt less overall.

She confirmed LFDR3116's comment re other vets needing to examine the cat but that they should respect our lab results.  That's not going to work as we move often.

If I can find a pharmacy online or wherever that will sell me the supplies, they can call my vet and she'll fax the prescription for the supplies.

With some of the recommendations here in the thread and a local pharmacy Costco recommended for IV supplies, I ought to be in the cat doctoring business in a week or so.  I wonder if the kit comes with some kind of calming solution for the cat mom.  Egad, I hope I don't faint or throw up.

If I find a good resource for supplies, I'll post.  If you have any other tips re the procedure and your mental health, please PM me.

THANKS EVERYONE FOR YOUR INPUT.  IT HELPED ME PUSH THROUGH THE SHOCK AND START WORKING TO SOLVE THE PROBLEM.  BLESS YOU, FORUM FRIENDS!

I think Kitty is going to have to get a job to afford prescription food.  That's a whole nother convo.

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For the  food check the online sites. We had a diabetic cat and found the food online. Varied which site was least expensive so each time we needed food we researched all the sites. 

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Went through the same thing with my cat .... subcutaneous injections of fluid from an IV bag.  Think it was the ringers solution.  Drs Foster and Smith sells it online.  

It was a bit traumatic doing it at first (I really hate needles).  But you'll quickly get the hang of it.  I never had any blood come back up the tube, or a insert point start to bleed.  The procedure is to slip it between the skin and the tissue, so there is never any bleeding.  My cat had quite loose skin as she had lost weight.  Just put in the required amount and then it kind of flowed underneath her skin and made little pockets of liquid in her belly.  Quite a strange thing.  And it made her feel much better for her last few months.  Best of luck to you.

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TRACKING BACK TO CLOSE THE LOOP:

Sorted through http://www.drsfostersmith.com and http://www.vetrxdirect.com

There were differences in pricing and products, but in the end the total package needed (fluid, drip line, needles) came down to just a few dollars difference with Free Shipping & a 10% off coupon.  I went with VetRXDirect because they sell a brand of thin-walled needles that had strong reviews compared to the brand sold at Dr. Foster's.  The net was the needles were sharper, quicker, and easier on the patient.  I could also buy them for 11 cents each, so 40 needles were only $4.40.  A pharmacy in town wanted nearly $4 PER NEEDLE for the same gauge (different brand).

If you find yourself having to deal with this, here are the reviews for Terumo needles that helped me make the choice: http://www.vetrxdirect.com/product/view/terumo-needle-rx/variation-11843#   Some reviewers actually contrast and compare  their experience using both the thin-walled Terumo and the Monoject sold by Dr. Foster.

Like others in this thread, my mother also has high regard for Dr. Fosters and uses them exclusively.  They have a lower threshold for free shipping and low prices.  VetRXDirect had a 10% OFF code on their site, and immediately sent me an e-newsletter with 10% off the next order, too.  I was glad to find my vet's partner already registered by another customer at VetRXDirect.  This order met the free shipping threshold and we should be set for the next few months.

So... once we get going if there is anymore feedback worth sharing I'll let you know.

Beerboy, thank you for sharing your experience about what to expect, and that it was worth your discomfort to help your kitty feel better in her last days.  I'm so sorry for your loss. 

Al F., I'm sorry you are going through it too, but so appreciate you sharing.  "I did try to get ONLY the saline solution" - I saw both sites had 0.9% Sodium Chloride: Fosters was cheaper by the 1000 ml unit and more so in a 4-pack.

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SWharton, thanks for the tip to keep price-checking online sites for prescription foods. 

Kitty ate only one can of KD chicken and wouldn't touch any other of the prescription flavors.  With a receipt PetSmart will take back unopened cans and open Kibble, which is a great way to test new food.  After she's had a few days on the fluids maybe her interest will change, but if not, that return alone will pay for the IV order I just made.

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5 hours ago, rocksbride said:

SWharton, thanks for the tip to keep price-checking online sites for prescription foods. 

Kitty ate only one can of KD chicken and wouldn't touch any other of the prescription flavors.  With a receipt PetSmart will take back unopened cans and open Kibble, which is a great way to test new food.  After she's had a few days on the fluids maybe her interest will change, but if not, that return alone will pay for the IV order I just made.

Our cat will not eat the KD dry or canned food.  We have another cat who is on ID (Intestinal Disorder) food, and she likes that.  Also the other cat will not eat the KD food either.  We know the ID food is not the best for her, but having her eat is much better than her not eating.  Keep her comfortable and happy is what we care about for the time she has left. Months or years we don't know.  We are hydrating her every 3 days with 100cc each time.  

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"Comfortable and happy"... I'm with you on that choice.

She won't eat the kd - kibble or canned - even with tuna juice poured over it or her favorite treats used as croutons.  She IS still eating dehydrated chicken from The Honest Kitchen.  It comes powdered and I grind it finer and add water to adjust the consistency of the rehydrated chicken, from "soup" to very thick "gravy."  The biggest thing with that is that once mixed with water, it will go bad if you leave it out so I make small servings and make sure it gets back in the fridge if she doesn't finish her meal.  She likes it on the soupy side so hopefully that brings down the protein percentage.

I'm praying she gets her appetite back once we start the fluid therapy. 

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Sorry about your kitty and good luck with all your efforts.  On the diet side and her reluctance to eat the prescription KD food, have you googled for ideas on home-cooked meals for kitties with kidney disease?  I have done so for my dog and settled on a recipe for ground beef (with high fat content), white rice, sweet potatoes, and green beans.  She loves it and is doing quite well on it.  I mix in lots of water at serving time to help with her fluids (I flunked the sub-cue procedure and am unable to do it).  It will possibly be different for a kitty, but just as an example from the dog side, beef was recommended over chicken because of lower protein and lower phosphorus content.  Best of luck to you and your sweet pet.

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Thank you, Carolaow.  Hadn't thought of that yet.

Since Kitty enjoys "soup," I may try mixing the open can of KD stew with water and giving it a whirl with an immersion blender.

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