Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2013-1253
2. Registrant Information.
Registrant Reference Number: 2012BS173
Registrant Name (Full Legal Name no abbreviations): Bayer Inc
Address: 77 Belfield Rd
City: Toronto
Prov / State: ON
Country: Canada
Postal Code: M9W 1G6
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
24-OCT-12
5. Location of incident.
Country: CANADA
Prov / State: BRITISH COLUMBIA
6. Date incident was first observed.
13-OCT-12
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.
PMRA Submission No.
EPA Registration No. Unknown
Product Name: advantage
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
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).
On October 13/2012, 1 tube of feline Advantage of unknown size was applied to dorsal neck area of 14 year old, male neutered, domestic short haired cat by owner.
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 short hair
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
14
7. Weight (provide a range if necessary )
3.8
kg
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>1 wk <=1 mo / > 1 sem < = 1 mois
10. Time between exposure and onset of symptoms
>24 hrs <=3 days / >24 h <=3 jours
11. List all symptoms
System
- Skin
- Symptom - Hair loss
- Symptom - Lesion
- Specify - scaling of skin
- Renal System
- Symptom - Frequent urination
- Symptom - Anuria
- Specify - decreased urination
- Gastrointestinal System
- Symptom - Constipation
- Specify - decrease in bowel movements
12. How long did the symptoms last?
>3 days <=1 wk / >3 jours <=1 sem
13. Was medical treatment provided? Provide details in question 17.
Yes
14. a) Was the animal hospitalized?
No
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Euthanised / Euthanasie
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 October 20/2012 the cat was taken to veterinary clinic to examine skin where Advantage was applied. This cat is and in/outdoor cat and owner noticed on Oct 13/2012 the cat was not feeling well so washed the Advantage off. Throughout the week the owners noticed hair thinning and loss as well as scaling in the area of application.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
19. Provide supplemental information here
It should be noted that this cat is an in/outdoor cat. The client had noticed a decrease in urination and bowel movements. The cat had experienced drastic weight loss over the last year from 7.3kgs to 3.8kgs. On exam the veterinarian noted thinning of hair along ventrum hocks, carpi, inguinal and dorsam by the tail. On palpation of abdomen 2 irregular shaped masses were found. Veterinarian suspects possible Carcinoma or Lymphoma which most likely involves the spleen and liver. Vet discussed quality of life and owner elected to spend weekend with cat and return Oct 22/2012 to have cat Euthanized. Prednisone 5mg 1.5 tabs BID was dispensed. Cat was euthanized the evening of Oct 22/2012.