Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-4291

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-38254795

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.

26-AUG-14

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

23-JUN-14

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)

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PMRA Registration No. 26491      PMRA Submission No.       EPA Registration No.

Product Name: Ultraguard One Spot Treatment for Cats/ Kittens

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

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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).

To be determined by Registrant

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

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

3

7. Weight (provide a range if necessary )

7

lbs

8. Route(s) of exposure

Skin

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

System

• Gastrointestinal System
  • Symptom - Salivating excessively

• Nervous and Muscular Systems
  • Symptom - Trembling
  • Symptom - Seizure

• General
  • Symptom - Abnormal behaviour
  • Specify - Jumpy and noise sensitive

• Nervous and Muscular Systems
  • Symptom - Shaking

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?

Yes

14. b) How long was the animal hospitalized?

Unknown

15. Outcome of the incident

Recvrd resid.effects/Rétabli séquelles

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

1-38254795 - The reporter, a pet owner, indicated that her cat was exposed to an insecticidal spot-on product containing the active ingredient methoprene. At the time of the initial call the reporter no longer had product packaging and could not provide the full name of the product, the bar code number or registration number for the product but the reporter was certain that it was a cat spot-on product that was used. The reporters husband applied the spot-on product to their 3 year old, 7 pound, male cat two months prior to initial contact with the registrant. That same night the reporter heard a loud noise and found her cat shaking, seizing and drooling. The cat was brought to the emergency veterinary clinic where it was bathed, given intravenous fluids, valium and methocarbamol. The cat stayed for a few days (caller did not specify how long the cat was hospitalized) and then released. The reporter states that the cat still seems a little more noise sensitive which the reporter interprets as damaged nerves. The reporter was advised that the cat spot-on products contain an insect growth regulator which has little to no toxicity in mammals and the described symptoms are not consistent with exposure to the product. The reporter was further advised that the described symptoms may be consistent with exposure to a pyrethroid insecticide but since the exposure occurred two months ago testing for pyrethroid exposure was no longer an option. No further information is available.

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To be determined by Registrant

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

Moderate

19. Provide supplemental information here