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: 2015-6069

2. Registrant Information.

Registrant Reference Number: 5461307

Registrant Name (Full Legal Name no abbreviations): Sure-Gro IP Inc.

Address: 1900 Minnesota Crt

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L5N 3C9

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. 30535      PMRA Submission No.       EPA Registration No.

Product Name: Wilson Wilsarin Rat And Mouse Killer Rodenticide Pellet Place Pack For

  • Active Ingredient(s)

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

Animal's Owner

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?

>3 days <=1 wk / >3 jours <=1 sem

10. Time between exposure and onset of symptoms

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms


  • Gastrointestinal System
    • Symptom - Loss of appetite
  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Drooling
  • General
    • Symptom - Hyperthermia
  • Gastrointestinal System
    • Symptom - Diarrhea
  • Liver
    • Symptom -
    • Specify - Hepatopathy
  • Gastrointestinal System
    • Symptom - Other
    • Specify - Cholangiohepatitis
  • Blood
    • Symptom - Hypoproteinemia
    • Symptom - Hypoalbuminemia
    • Symptom - Hyperbilirubinemia
    • Symptom - Other
    • Specify - Elevated Amylase
    • Symptom - Other
    • Specify - Elevated Lipase
  • Liver
    • Symptom - Elevated liver enzymes
    • Specify - Elevated Liver Enzymes
  • Blood
    • Symptom - Anemia

12. How long did the symptoms last?

>1 wk <=1 mo / > 1 sem < = 1 mois

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?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

The owner states that the product was first sprinkled in her neighborhood on the 19th. The dog could have had access it to it over a 6 day period. On the 25th he stopped eating and has not ate in 5 days. He was also lethargic and drooling. She took him to the vet about an hour ago and they ran some blood tests indicating that the dog has liver damage. They started him on fluids and liver protectants but they don't know why this is happening. The caller was advised that the active ingredient is cellulose from ground corn cobs. The proposed mechanism of action is volume depletion. The cellulose disrupts the rodent?s water absorption and causes dehydration and death. Generally, when dogs ingest this bait, only see mild GI upset, self-limiting. If a sufficient ingestion, there is potential for impaction or obstruction. At 10:07 PM, june 1, 2015 An E-vet called to go over case and treatment plan. Bloodwork was done at rDVM and liver enzymes are increased and now dog has a fever. Maggie has been started on fluids; and ampicillin and liver protectants. Signs not related to this exposure. Would treat the signs accordingly at this point. Maggie is scheduled for an U/S tomorrow morning. On Jun 03, 2015 at 12:58 PM CDT Owner calling back with an update. The pet is declining. She send us the report from her clinic. She would like to know if we have heard of anything like this happening before. Owner sent us an email with photos to APCC inbox. This does look like rat poison, but non of the baits effect the liver. Owner was called on to follow up on pictures, They do look like a rodenticide, but rodenticides typically do not affect the liver. Asked about mushrooms or sago palms, there are none of these in the housing complex. The authorities did come out and found more of the bait, but when they knocked on the person's door that put the bait out, he did not answer. They told (name) that there is nothing they can do unless he admits that he placed the bait. She said that other dogs have been affected, and 2 have died. The one died of what they suspect was liver cancer. The other had lethargy and died, but no necropsy was done. Maggie still has an intermittent fever and she developed diarrhea last night. She's still on fluids and has not eaten for a week. An ultrasound only showed an enlarged GB. Suggested seeing if the clinic could talk with the authorities about having the pellets and area tested, and continue with treating her. Final Outcome unknown

To be determined by Registrant

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


19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified.