Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2024-1598
2. Registrant Information.
Registrant Reference Number: 2023-CA-000069
Registrant Name (Full Legal Name no abbreviations): Ceva Animal Health Inc.
Address: 150 Research Lane, Suite 225
City: Guelph
Prov / State: ON
Country: Canada
Postal Code: N1G 4T2
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
28-JUL-23
5. Location of incident.
Country: CANADA
Prov / State: MANITOBA
6. Date incident was first observed.
10-JUL-23
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. 33421
PMRA Submission No.
EPA Registration No.
Product Name: VECTRA 3D DOGS & PUPPIES OVER 7 WEEKS WEIGHING 4.6 KG TO 9.0 KG
- Active Ingredient(s)
- DINOTEFURAN
- PERMETHRIN
- PYRIPROXYFEN
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
1.6
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 July 10, the dog owner applied 1 pipette topically.
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
Medical Professional
2. Type of animal affected
Dog / Chien
3. Breed
Shih Tzu
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
5
7. Weight (provide a range if necessary )
5
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
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Skin
- Symptom - Itchy skin
- Symptom - Irritated skin
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
Between July 10 and 12, the dog experienced itching and skin irritation, and these lasted for 48 hours. The dog owner discontinued the use of VECTRA 3D, and no further treatment was required.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here