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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-1265

2. Registrant Information.

Registrant Reference Number: 110020894

Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.

Address: 301 W. Osborn Road

City: Phoenix

Prov / State: Arizona

Country: USA

Postal Code: 85013

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

Domestic Animal

4. Date registrant was first informed of the incident.


5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

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. 25358      PMRA Submission No.       EPA Registration No.

Product Name: Farnam Blue Streak Fly Bait

  • Active Ingredient(s)
    • (Z)-9-TRICOSENE

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.

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

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

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

Golden 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

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms


  • Nervous and Muscular Systems
    • Symptom - Muscle tremors
    • Specify - Hind Limb Tremors
    • Symptom - Depression
  • Gastrointestinal System
    • Symptom - Drooling
  • Cardiovascular System
    • Symptom - Tachycardia
  • General
    • Symptom - Hyperactivity
  • Nervous and Muscular Systems
    • Symptom - Anxiety
  • Gastrointestinal System
    • Symptom - Vomiting

12. How long did the symptoms last?

>8 hrs <=24 hrs / > 8 h < = 24 h

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

Fully Recovered / Complètement rétabli

16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

On February 18, 2011, the dog's emergency veterinarian noticed the dog had hind limb tremors and depression, so he induced emesis, gave activated charcoal, and then the dog vomited once. The hind limb tremors ended after the dog vomited. The emergency veterinarian also ordered a chemistry profile, provided fluid therapy, and provided a dose of Atropine. Later that day, the emergency veterinarian contacted the Animal Product Safety Service (APSS) to obtain help. The APSS veterinarian stated that methomyl is a carbamate insecticide with a narrow margin of safety and that she would expect to see a rapid onset of signs that would be either muscarinic SLUDDE (salivation, lacrimation, urination, defecation, and emesis; dyspnea; and bradycardia) signs, nicotinic (tremors, weakness, and paresis progressing to paralysis) signs, central nervous system (CNS) signs (seizure or tremor), or a combination of these signs. The APSS veterinarian recommended providing supportive care, symptomatic care, fluid therapy, Diazepam, and Methocarbamol; monitoring at a veterinary facility; monitoring for central nervous system signs; monitoring cardiovascular function, electrolytes, and acid base status; providing an ethylene glycol test and urinalysis; and obtaining additional information. Later that evening, another emergency veterinarian at another location contacted the APSS to obtain help. She noticed the dog was drooling, tachycardic with a heart rate of 200 beats per minute, hyperactive, and anxious. The dog had not vomited anymore. She stated she had given the dog another dose of Atropine and was continuing to provide fluid therapy. The APSS veterinarian recommended the same patient cares that were described to the previous emergency veterinarian, as well as giving the dog a low dose of Acepromazine if the dog's blood pressure was OK or high.

To be determined by Registrant

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


19. Provide supplemental information here

The APSS veterinarian stated that the substance was considered to have a medium likelihood of causing the clinical situation. On February 25, 2011, an APSS technician called the emergency veterinary clinic to update the case and left a message to call back. On February 28, 2011, the emergency veterinarian called the APSS back to say that the dog was given supportive care, symptomatic care, fluid therapy, and Diazepam, its cardiovascular function was monitored, and obtaining additional information was not needed. She also stated that all of the dogs's signs ended on February 19, 2011 and that the dog had fully recovered.