Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-1440

2. Registrant Information.

Registrant Reference Number: PROSAR 1-21996462

Registrant Name (Full Legal Name no abbreviations): The Hartz Mountain Corporation

Address: 400 Plaza Drive

City: Secaucus

Prov / State: New Jersey

Country: USA

Postal Code: 07094-3688

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

Domestic Animal

4. Date registrant was first informed of the incident.


5. Location of incident.


Prov / State: OHIO

6. Date incident was first observed.


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.


PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-151

Product Name: UltraGuard Flea/Tick Drops for Dogs/Puppies Over 60 lbs

  • Active Ingredient(s)
      • Guarantee/concentration 85.7 %

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.


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).

The product was applied to the dog on 03/18/2010 or 03/19/2010.

To be determined by Registrant

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


Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Dog / Chien

3. Breed

Labrador Retriever

4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )



8. Route(s) of exposure


9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms


  • Gastrointestinal System
    • Symptom - Diarrhea
    • Symptom - Vomiting
  • Eye
    • Symptom - Protrusion of the third eyelid
  • Gastrointestinal System
    • Symptom - Drooling
  • General
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Shaking
  • General
    • Symptom - Abnormal behaviour
    • Specify - "Circling"
  • Nervous and Muscular Systems
    • Symptom - Difficulty getting up
    • Specify - "Cannot stand"
  • Renal System
    • Symptom - Inappropriate urination
    • Specify - "Urinates when pressure is applied to the abdomen"
  • General
    • Symptom - Death
  • Gastrointestinal System
    • Symptom - Inappropriate defecation
    • Specify - defecates when pressure is applied to the abdomen"

12. How long did the symptoms last?

Persisted until death

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


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


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

1-21996462: A reporter (a veterinarian) called on 03/22/2010 to report the exposure of a dog to a flea and tick product containing the active ingredient Phenothrin. According to the reporter, the product was applied to the dog on 03/18 or 03/19/2010. On 03/20/2010, the dog developed vomiting, diarrhea, a prominent third eyelid, drooling, and lethargy. The dog was evaluated by the reporter on 03/20/2010. The dog was bathed and her symptoms improved immediately. The dog was also treated with Pepcid and subcutaneous fluids. The symptoms recurred on 03/22/2010, and the owner bathed the dog again. The signs resolved for 45 minutes following bathing, but resurfaced again. The dog presented to the reporter on 03/22/2010 with shaking, circling, lethargy, the inability to stand up, and urination and defecation secondary to applying pressure on the abdomen. The reporter was advised that the active ingredient is not one that dogs typically have a sensitivity to. The signs described are not expected following routine use of the product, nor are signs expected several days following product application. The reporter was advised that treatment is symptomatic and supportive, and that there is not an antidote. A recommendation was made to consider other causes for the dog's signs. On follow up, a veterinary clinic employee stated that the dog died on 03/22/2010. No further information was obtained.

To be determined by Registrant

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


19. Provide supplemental information here