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Institutional Care and Use Committee
Application for Breeding of Non-Genetically Modified Animals
FOR IACUC ADMINISTRATIVE USE ONLY
IACUC Number:
Date Reviewed:
Reviewers:
Date Approved:
Date Closed:
Disapproved
This protocol is for the breeding colony of Non-Genetically Modified Animals. Once approved by the IACUC, you will
need to transfer animals from this protocol to the approved experimental protocol
SECTION 1 - PROTOCOL INFORMATION
Protocol Title:
Funding Agency:
SECTION 2 - PRINCIPAL INVESTIGATOR
Principal Investigator’s Name (last, first):
Department:
Position Title:
Office Phone:
Emergency Phone:
E-Mail:
SECTION 3 - PERSONNEL
List PI and all personnel who will be directly involved with animals.
Prior to approval, anyone working with animals must have completed the IACUC animal certification.
All personnel who will be working with animals must participate in the Research Occupational Program.
Last name, First name
1Mark
Role in Project
Phone Number
Experienced1
with an “X” to indicate that the person is experienced with the species mentioned in this protocol. If the person
is not leave the box blank and indicate below by whom and when they will be trained.
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SECTION 4 - PROTOCOL INFORMATION
New
Three Years Renewal
Please provide previous Protocol Number :
Estimated Starting Date:
Estimated Ending Date:
If Three Years Renewal, please provide a brief summary describing work accomplished during the last approval
period and how the work proposed in this renewal extend the previous studies.
SECTION 4 – ANIMAL REQUEST BY SPECIES, PAIN CLASSIFICATION AND SOURCE
Total Number of Animals to be Breed over 3 Years Period
Species
Strain
Pain
Class
Number
Purchased
In-House
Transferred
Produced by
On-Site
Breeding
Other Sources
Specify
Total
Total Animals Requested
Class C Classification; please provide a scientific justification as to why you cannot use sedatives or analgesics.
Animal Pain Classifications
Class A
Animals are not experiencing anything more than momentary or slight pain and distress and no pain relieving measures
are being used. For instance, animals that are euthanized (according to guidelines) and their tissues harvested for study
could be considered Class A animals. Animals that are receiving minor injections or non-invasive behavioral tests could
be considered Class A animals also.
Class B
Animals are undergoing procedures with the potential to cause pain and distress but appropriate pain relieving
medications, including analgesics, anesthetics or tranquilizers, are being used. Any animal that undergoes a surgical
procedure, even a non- survival surgery, would be considered Class B.
Class C
Animals are undergoing pain and distress which is not relieved by appropriate anesthetics, analgesics, tranquilizers or
other treatments. For instance, some pain studies require that animals not receive pain medication. If relief of pain or
distress will interfere with the objectives of the experiment, the scientific justification for this must be clearly demonstrated.
Other methods for minimizing discomfort that will not interfere with experimental objectives or early end points should also
be considered.
Animals to be Transferred
Report the IACUC Protocol Number from which the animals will be transferred. If this is a three years renewal of an expiring
protocol, report the number of animals alive on the vivarium that need to be transferred.
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SECTION 6 - ANIMAL INFORMATION
A.
Housing
Richard Freeman
Coolidge West
Overnight Housing
If “Overnight Housing” please provide location, justification and procedures to be performed.
B.
Special Requirements :
Caging
Housing
Yes
Medication
No
Physical Restrain
Diet
Other
If “YES”, please explain.
SECTION 7 - PROTOCOL SUMMARY
Answer must be in language understood by a person unfamiliar with your area of research. Define all acronyms
A.
Summarize the Specific Aims in the space below.
B.
Non Technical Summary.
SECTION 8 – TECHNICAL SUMMARY AND JUSTIFICATION FOR THE USE OF ANIMALS
A.
Please explain the need for breeding on this protocol
B.
From where are you getting the founders? Provide the name of the vendor or the institution.
C.
How many founders do you need to order? – Include this number in the table.
D.
List the species and strains of animals to be produced in this breeding protocol.
E.
List the anticipated total number of offspring that will be produced.
You are required to keep accurate records of the number of animals produced and their final disposition.
F.
Provide rational and scientific justification for the number you have provided in question 8E.
You should be able to give an estimate of the number of animals you intend to breed and the reasoning behind that
estimate.
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G. What will be done with those animals that are breed in excess of your needs or those that do not meet your
needs?
H.
1.
Transfer to other IACUC approved protocols.
2.
Euthanized and dispose.
3.
Use waste tissue from euthanized animal for other purposes – Please describe planned use of
tissue.
If you will be performing any surgical procedure (e.g. - vasectomies or cesarean sections) please describe,
including aseptic techniques.
SECTION 7 - EUTHANASIA METHODS
Pentobarbital 100 mg/kg
IM
Thoracotomy
CO2 OD Bottled
IV
Decapitation
Isoflurane 5% for 10 minutes
IP
Exsanguination
Other
IC
Cervical Dislocation
Inhalation
Other
If “Other” explain.
As Principal Investigator, I will comply with the procedures and methods outlined in The Guide for the Care and Use
of Laboratory Animals, as well as the Public Service Policy on Humane Care and Use of Laboratory Animals, the
Animal Welfare Act, and the applicable OCF policies. The activities described herein do not unnecessarily duplicate
any previous experiments. I certify that the individuals listed in Section 13 are authorized to conduct procedures
involving animals under this protocol, and have received the necessary training in the handling and care of laboratory
animals. I also acknowledge that OCF is not a Good Laboratory Practice (GLP) facility for FDA purposes.
Signature
Date