BSE Surveillance Candidate Questionnaire

Was the bovine born in Canada?

Yes

Don't know

Is the bovine 30 months of age or older?

Yes

Is this the only bovine in the herd or lot presenting with the specific health issue?

Yes

Select all the signs that represent an abnormal change in behaviour in the observed animal:

unexpected excitability and/or nervousness

over-reactivity to stimuli

excessive vocalisation

excessive salivation and/or difficulty swallowing

excessive teeth grinding

excessive licking of the muzzle

asymmetrical ear and eye movements

uncoordinated gait

difficulty avoiding obstacles

abnormal pacing in circles

low carriage of the head and/or head shyness

tremors (involuntary quivering muscle movements)

dullness combined with compulsive behaviors, such as pacing in circles or increased chewing and licking

any other neurological sign(s)

None of the above

Select the signs that seem out of the ordinary for the specific bovine you are observing. Compare them with what is typical for other bovines in the same group, considering their sex, age and the current environment or situation.

For example, it is typical for bulls of certain breeds to vocalize a lot when they are in a new environment. Because this is typical behavior for them, it wouldn’t be considered excessive, unexpected or abnormal.

Select the situation that applies to the bovine. The bovine was…

Able to stand and move without help when last observed with clinical signs

Unable to stand and move without help after being observed with clinical signs

Found dead after being observed with clinical signs

Not observed with clinical signs before being unable to stand or move, or before being found dead

This is a BSE surveillance candidate

Provide additional details to generate a unique identifier (UID).

Include this UID in all documentation related to the carcass or sample.

Make sure to enter the UID in any invoices you send to the Canadian Food Inspection Agency (CFIA) for claimed services.

If you need to change your answers on the previous page, start the questionnaire again. Do not use your browser’s back button.

You are a:
NOTE: If you are a cattle producer planning to dispose of the BSE surveillance candidate on your farm, you must involve a veterinarian to complete the questionnaire and collect the sample.

Veterinarian who evaluated and sampled the bovine on farm

Veterinarian referring the bovine for necropsy at a pathology laboratory

Cattle producer arranging for the bovine to be picked up by a deadstock collector

Cattle producer sending the bovine for necropsy at a pathology laboratory without a veterinarian’s referral

Person at a necropsy room with a bovine not pre-identified as a BSE surveillance candidate before arrival

Person at an abattoir observing a BSE surveillance candidate

What's the location of the BSE surveillance candidate? Which of the following will you provide?:

Premises identification (PID) number *Preferred

Complete address

Geographical coordinates (latitude and longitude, in decimal degrees)

PID

The PID number contains 9 alphanumeric characters, and starts with 2 letters.

Complete address. Include the street name and number, city or town, province or territory, postal code, and any additional details for rural or remote areas

Latitude and longitude, in decimal degrees, where the bovine is located:

Example: 52.1342, -106.6299

In Canada, when expressed in decimal degrees, all latitudes are positive, and all longitudes are negative.

You can find these coordinates using Google Maps:

locate your place on the map,
right-click on the location on a computer, or tap and hold on a mobile device, and
view the info card that appears or select ‘What’s here?’

Latitude

Longitude

Select the diagnostic pathology laboratory where you found the BSE surveillance candidate that was not previously identified as one

Name of the diagnostic pathology laboratory and the supporting institution

You are at a

federal abattoir with this SFCR Food Licence Number:

federal abattoir with this Establishment Number:

provincial abattoir with this Establishment Number:

SFCR Food Licence Number

The SFCR is a combination of 9 letters and numbers

Establishment number

The age of the bovine either in years or in months. You can use a decimal if needed.

In years

In months

Number of years

Number of months

The sex of the bovine

female

male

The production type of the bovine

beef

dairy

mixed

The province or territory where the bovine was or will be sampled

Does the bovine have a Canadian Cattle Identification Agency (CCIA), ATTESTRA or DairyTrace indicator number?

Yes, the bovine has one of those national approved indicator numbers:

No, the bovine dies on birth farm without a national approved indicator number

Enter the last 9 digits of the national approved indicator number. Do not use spaces or hyphens. Do not enter the start “124 000”

124 000

Select and write all other indicators and markings that apply:

Coat colour

Breed

Brand and its location

Tattoos and their locations

Brisket tag

Any additional tags/indicators

Coat colour

Breed

Brand and its location

Tattoos and their locations

Brisket tag

Any additional tags/indicators

You've entered all the information needed for the BSE surveillance candidate

Once you click on the Submit button below, you will see a unique identifier (UID) for this submitted form.

You will need to include this UID in all documentaiton related to the carcass or sample, and in any invoices you send to CFIA for claimed services.

Email to receive the UID

First name

Last name

I hearby declare that I have read and accept the Privacy Notice Statement applicable to this survey.

I hereby declare that the information provided in this form is true, accurate, and complete to the best of my knowledge and belief.

Serial ID

Submission Date

For assistance with this questionnaire or to report a problem, email BSE-ESB@inspection.gc.ca