Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-0001

2. Registrant Information.

Registrant Reference Number: 140139563

Registrant Name (Full Legal Name no abbreviations): Wellmark International

Address: 100 Stone Road West, Suite 111

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G5L3

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

Domestic Animal

4. Date registrant was first informed of the incident.

02-NOV-14

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

02-NOV-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. 28382      PMRA Submission No.       EPA Registration No.

Product Name: Zodiac Dual Action Flea and Tick Spray for Cats and Kittens

• Active Ingredient(s)
  • (S)-METHOPRENE
  • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
  • PIPERONYL BUTOXIDE
  • PYRETHRINS

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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).

On November 2, 2014 the owner sprayed the kitten pretty heavily with the product, was not soaked, but definitely damp.

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

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.33

7. Weight (provide a range if necessary )

3.0

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

<=30 min / <=30 min

11. List all symptoms

System

• Nervous and Muscular Systems
  • Symptom - Ataxia
  • Symptom - Disorientation

• General
  • Symptom - Vocalizing

12. How long did the symptoms last?

>24 hrs <=3 days / >24 h <=3 jours

13. Was medical treatment provided? Provide details in question 17.

No

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Fully Recovered / Complètement rétabli

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 November 2, 2014 the cat became symptomatic. A little later the owner rinsed the cat's coat/skin with water and then shortly after contacted the Animal Product Safety Service (APSS). The APSS veterinarian stated the risk is for mild, self-limiting gastrointestinal (GI) upset and for mild-moderate, self-limiting, dermal hypersensitivity/paresthesia ("pins and needles" feeling). The APSS assistant recommended bathing the cat (liquid dish washing detergent (LDWD)), providing thermoregulation (wrap in warm towel until dry), offering food (give something to eat after bath), monitoring the cat at home (if signs are not improving call back or take to a veterinarian), calling back with questions.

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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

On November 3, 2014 the owner called the APSS and stated the cat did not improve after the bath and the cat has not eaten anything. The APSS veterinarian recommended taking the cat to the veterinarian and having the veterinarian call for information. On November 8, 2014 the APSS assistant contacted the owner to follow-up on the case. The owner stated she was not able to take the pet into the vet due to finances and she continued to treat the cat at home and gave the pet another bath. The owner stated the pet fully recovered between November 4 and 5, 2014.