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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-1987

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Prov / State: x

Country: x

Postal Code: X

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


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. 22968      PMRA Submission No.       EPA Registration No.

Product Name: Defend Topical Insecticide for Dogs

  • Active Ingredient(s)

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.


Units: mL

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 vet clinic recommended this product for ticks/mosquitos. I applied 1ml to my pet on Sunday May 13-2012.

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

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Shihzhu bichon X

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


  • Respiratory System
    • Symptom - Panting
  • General
    • Symptom - Vocalizing
    • Specify - yelping/screeching
  • Nervous and Muscular Systems
    • Symptom - Muscle spasm
  • Skin
    • Symptom - Irritated skin
    • Specify - scratching
  • General
    • Symptom - Polydipsia
    • Specify - drinking more water than normal
  • Gastrointestinal System
    • Symptom - Diarrhea
  • General
    • Symptom - Discomfort
    • Symptom - Fever
    • Specify - high temperature
  • Gastrointestinal System
    • Symptom - Anorexia
    • Specify - stopped eating

12. How long did the symptoms last?

Unknown / Inconnu

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

He became quite ill; symptoms include panting, constant yelping/screeching, muscle spasm, scratching, drinking more water than normal. Promptly gave the dog a bath to remove product - with no relief to the animal. Have given him 3 baths per day/each day since Sunday. He stopped eating on Wednesday, May 16th , by the afternoon of Thursday, May 17th had diarrhea for several hours, with yelping and general discomfort, high temperature since Monday. When I notified the vet clinic on Monday, May 14th at 8:30am to advise of the reaction our dog had to the product, they would only advise that the Rep for the product was in the clinic picking up the product - recall?? I could not get a refund. No advice on how to help my pet other than bathing which I had already learned from the internet. The vet clinic could not provide any solution other than to bathe the animal. This product is terrible and should not be applied to animals. Vet clinics need to be made aware of the side effects as I learned it should be used on animals under 33lbs. Purchased 12 April 2012.

To be determined by Registrant

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

Not Applicable

19. Provide supplemental information here