Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2020-5554
2. Registrant Information.
Registrant Reference Number: 34477
Registrant Name (Full Legal Name no abbreviations): Bayer Inc
Address: 2920 matheson BLVD
City: Mississaugua
Prov / State: ON
Country: Canada
Postal Code: L4W 5R6
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
11-SEP-20
5. Location of incident.
Country: CANADA
Prov / State: UNKNOWN
6. Date incident was first observed.
30-AUG-20
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. 27585
PMRA Submission No.
EPA Registration No.
Product Name: advantage II small cat
- Active Ingredient(s)
- IMIDACLOPRID
- PYRIPROXYFEN
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
.4
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).
On 28-Aug-2020, a 0.75 year old, 2.1 kg, female spayed with fleas was administered one ADVANTAGE II 6 X 0.4 ML SMALL CAT, (-), by Animal owner. The product was used according to label (No- dose too high).
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
Subform III: Domestic Animal Incident Report
1. Source of Report
Medical Professional
2. Type of animal affected
Cat / Chat
3. Breed
Siamese
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
0.75
7. Weight (provide a range if necessary )
2.1
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
- Renal System
- Symptom - Painful urination
- Gastrointestinal System
- Symptom - Other
- Specify - Stopped drinking
- Renal System
- Symptom - Blood in urine
- Symptom - Other
- Specify - Bacterial Cystitis
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?
No
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Unknown/Inconnu
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 30 Aug 2020 the cat stopped drinking and began straining to urinate.
On 01 Sept 2020 the cat was seen by an emergency veterinarian and prescribed pain medication. A diagnosis of bacterial cystitis was made. Blood was noted in the urine. The cat began to improve but was still not drinking.
On 05 Sept 2020 the cat was changed to a soft food diet. The outcome is unknown.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
19. Provide supplemental information here