CLINICAL MONITORING SHEET
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Emergency Contacts
Name
Phone number(s)
Name
Phone number(s)
Office:
Mobile:
Office AND Mobile:
Chief Investigator
Other Primary contacts
Intervention Points and Humane endpoints
Define and LIST symptoms (or combination of symptoms) which require increased observations, initiation of treatment, removal of the animal from study or EUTHANASIA
Clinical symptoms
1. Intervention Points: Symptoms requiring increased observation OR
treatment OR removal from study.
Action
2. Humane Endpoints: Symptoms requiring EUTHANASIA
LIST any SAMPLES (blood /tissues) required if emergency euthanasia is performed.
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CLINICAL MONITORING SHEET
OBSERVATIONS
General Clinical Signs (abnormal)
Natural activity (mice)– nest poorly built,
isolated from cage mates
Coat – alopecia, rough/unkempt
,wounds/infection,
Breathing -rapid, shallow, abdominal,
laboured, noisy
Mobility-abnormal gait, staggering, lame,
paralysed, isolated from cage mates
Posture- hunched, trembling
Eyes- squinting, closed, matted lids
Eyes- (Rats only) 1-red tears
Alertness- disinterested, little response to
handling, unresponsive, fitting.
Movement- unable to stretch upwards,
immobile.
Urine: abnormal colour or volume
Other:
2
DATE
CLINICAL MONITORING SHEET
Project Specific Signs
Body weight: Please refer to approved protocol for permitted body weight loss from body weight at commencement of project and during project.
Body weight loss- 10-15%loss in 24hrs; >
15% loss in 24 hrs or over 3 consec. days
Dehydration – mild skin tenting, severe
tenting, eyes sunken.
Water consumption
Food consumption
Faeces/Anus – unformed, dry, watery,
blood present, rectal prolapse.
PAIN- brief hunching, belly press, prolonged
hunching, pressing, writhing.
Lameness -mild limp, shuffling, walking on
tiptoe, severe limp, non-weight bearing
Circulation -cold extremities, blue
extremities
Sores-skin abrasions, scabbing, deep ulcers,
bleeding.
Nares-sneezing, serous discharge, thick
discharge, blocked nares.
Joints- Swelling, inflamed/hot/swollen.
Surgical wound – redness, swelling,
infection/discharge, open/gaping.
Body condition score:
Other:
3
CLINICAL MONITORING SHEET
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