Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2017-0144

2. Registrant Information.

Registrant Reference Number: 160141821

Registrant Name (Full Legal Name no abbreviations): Wellmark International

Address: 100 Stone Road West, Suite 111

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G5L3

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

22-SEP-16

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

19-SEP-16

Product Description

7. a) Provide the active ingredient and, if available, the registration number and product name (include all tank mixes). If the product is not registered provide a submission number.

Active(s)

---

PMRA Registration No. 23120      PMRA Submission No.       EPA Registration No.

Product Name: Vet Kem Ovicollar for Cats

• Active Ingredient(s)
  • (S)-METHOPRENE

---

7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

1

Other Units: collar

10. Site pesticide was applied to (select all that apply).

Site: Animal / Usage sur un animal domestique

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Between May 8, 2016 and May 22, 2016 the owner put the collar onto the cat.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

13.0

7. Weight (provide a range if necessary )

4.58

kg

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• Skin
  • Symptom - Dermatitis
  • Specify - Moist Dermatitis

• Eye
  • Symptom - Other
  • Specify - Chemosis

12. How long did the symptoms last?

Unknown / Inconnu

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

16. How was the animal exposed?

Treatment / Traitement

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

On September 19, 2016 the cat developed moist dermatitis (seemed mostly confined to white area around the neck, very rapid progression, several inches across when veterinarian (DVM) saw the cat, same day as owner noted) and chemosis (overall healthy cat, had been suspected to have chlamydia ocular signs in past). Later that evening, the cat was given symptomatic care (corticosteroid ophthalmic product), cefovecin sodium, tobramycin ophthalmic ointment, and control pain. On September 22, 2016 the attending veterinarian called the Animal Product Safety Service (APSS). The APSS veterinarian stated it is possible to develop contact sensitivity to almost anything. The APSS veterinarian also stated since the cat is outdoors mostly, possible that cat got wet and then moisture under the collar could promote dermatitis; self trauma could accelerate as well. The APSS veterinarian finally stated that she believes it less likely that the ocular changes are related. The APSS veterinarian recommended a referral to the manufacturer (attending veterinarian wanted to discuss with customer service, as well.

---

To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Moderate

19. Provide supplemental information here

Pet under DVM care and improving.