IACUC Approval Form Guide www.alzet.com 2008 ALZET Osmotic Pump Implantation (IACUC Approval Form Guide): A guide for filling out the Institutional Animal Care & Use Committee protocol approval form using ALZET® Osmotic Pumps. Disclaimer About the Pumps Guide Description Responsibility Literature Search Justification for Pump Use Pre-Surgical Anesthesia Induction Injectable Volatile Volatile Induction Surgical Preparation Surgical Area Subcutaneous Implantation Intraperitoneal Implantation IV IV (mice) CNS CNS (mice) Post Operative Care/Analgesics Pump Specifications Bibliography 1 IACUC Approval Form Guide www.alzet.com 2008 Disclaimer The information listed in this document is based on published research articles and consultations with experienced veterinarians. This information is intended to serve as a resource when filling out an IACUC protocol approval form for the use of ALZET Osmotic Pumps in your study. This document should be considered a supplemental resource to your own institution’s policies, guidelines, protocols, and suggestions. The information below is not “all inclusive” and may require additional information to be provided by the researcher. Title of Procedure Surgical Implantation of ALZET Osmotic Pumps in Rodents About the Pumps ALZET® Osmotic Pumps are miniature, infusion pumps for the continuous dosing of laboratory animals as small as mice and young rats. These minipumps provide researchers with a convenient and reliable method for controlled agent delivery in vivo, while avoiding the need to handle the animal during the dosing period. The ALZET pumps allow for continuous delivery from one day to six weeks with a single pump, without the need for batteries or pre-programming. Description of the procedures covered by this IACUC guide This guide should help standardize the procedure by which an osmotic pump system, capable of controlled rate delivery of compounds, drugs and or agents, may be implanted in murine models. This document is intended to serve as a resource when preparing an IACUC approval form. Information may be copied and pasted into your documents as needed. If you need help choosing a pump, see our comprehensive checklist for use here: Checklist Responsibility The user should follow manufacturer’s guidelines for pump selection appropriate to animal size and desired application. In addition, precautions for agent/vehicle compatibility with delivery device(s) must be considered and or tested. The user should adhere to aseptic principles when preparing the agent/vehicle and during filling and priming of delivery device(s). The user should follow current guidelines for veterinary anesthesia and aseptic surgical procedures, as adapted to common laboratory rodents, when performing implantations. Literature Search If references are required to help support your study, you can find over 10,000 citations available on our website under the “Research Applications” section or you can request a custom search here: Bibliography Request For citation purposes, please use the following format: ALZET® Osmotic Pumps Durect Corporation PO Box 530 Cupertino, CA 95015 2 IACUC Approval Form Guide www.alzet.com 2008 Justification for Use of ALZET Pumps ALZET pumps are commonly used as a humane alternative to dosing methods associated with higher stress levels, such as repeated injections or tethered infusion systems. Animal stress caused by these dosing methods can obscure research data and affect study reproducibility. ALZET pumps enable scientists to refine their animal treatment by eliminating the added stress of external connections and repetitive animal handling. Since ALZET pumps continuously deliver a precise dose, they ensure that all animals are properly dosed during the study period, thus allowing scientists to reduce the number of study animals needed to achieve statistical significance. In addition, the ALZET pumps can be used for in vitro studies where animals need to be replaced and controlled delivery is still required. Humane Benefits No external connections necessary for infusion Risk of infection is minimized (compared to externalized infusion systems) Minimizes animal handling and stress associated with other repetitive dosing methods (i.e., injections, gavage, tethered infusion systems) Animals are unrestrained and able to move freely Obviates need for frequent animal handling, which may interfere with animal behavior and other critical study parameters Animals may be group housed Eliminates the possibility of a missed or mistimed dose Eliminates over dosing and under dosing caused by repeated injections (reduces variability of drug levels in blood and tissues) No pre-programming, batteries, or complex software required ------------------------------------------------------------------------------------------------------------------------ Pre-surgical Considerations Healthy animals from a known source and microbiological status should be acclimatized to the laboratory environment for a minimum of 72 hours. Perform a pre-surgical assessment of: 1) Activity 2) Skin/coat characteristics/integrity especially at implantation site 3) Occulo-nasal-oral areas moist with clear fluid, yet free of mucopurulent or other discharge, swelling or injury 4) Respiratory rate and effort barely discernable 5) Individual or group body weights Withhold dry food, but not water for 4-12 hours before surgery. This reduces weight of ingesta in oropharynx and GI tract such that respiratory efforts and venous return to the heart are not impaired when animals are placed in recumbency under anesthesia. May give moist or gel diets or enriched water (make sure animals accept additives to water 48 hours prior to removing food)5 3 IACUC Approval Form Guide www.alzet.com 2008 Anesthesia Induction (General) Animals and occupied animal cages (including induction chambers) should be placed on preheated circulating water heating pads set to 90-100F. This is to prevent hypothermia, slowed metabolism, prolonged induction, and recovery times. A “Balanced Anesthetic Regiment” is recommended, which includes pre-emptive analgesia1 administration with Buprenorphine or Butorphanol delivered SQ 15-60 minutes before induction. This can easily be administered to the entire group of animals by drawing up enough to dose all with a single syringe, based on heaviest body weight (it is recommended to dilute with sterile saline so that the injection volume for each animal is between 0.1 and 0.2 ml). Attach a butterfly extension with small gauge needle (22-25 x 5/8 inch) so that the animals can be dosed SQ into tented scapular skin with minimal restraint in their home or transport cages. Change butterfly between cages/groups or as needed. The long duration of action (4-12 hours) of these agents allows them to: 1) act as a pre-anesthetic, to facilitate further handing and decrease anxiety/stress, 2) decrease the amount of anesthetic agent(s) to maintain surgical plane 3) alleviate any potential pain during the immediate post operative period. You may also want to look into NSAID’s 1 (nonsteroidal anti-inflammatory drugs) as they are gaining popularity due to their long acting effects. Parenteral administration of (100 F or 40 C) sterile isotonic fluids, such as physiological saline or LRS, should be given at a rate of 1-3% of body weight (SQ or IP), depending on the intended site of pump placement. These should be administered upon anesthetic induction so they can be absorbed to offset hypotonic effects of general anesthetics. Injectable Anesthetics1 Induce surgical plane with an IP injection of Ketamine and Xylazine or some other alpha-adrenergic agonist such as “Domitor.” Do not inject IM even if planning to implant IP as most of the agent will track back out of the needle path and end up SQ, which results in delayed induction and failure to reach a surgical plane. If desired, the alpha-adrenergic component can be reversed with an antagonist. The effects of the Ketamine may be diminished, but not reversed with the respiratory stimulant doxapram. Recommended drawing of anesthetic is as follows: Per individual body weight or based on lowest body weight in-group X 2. Thus, have twice as much as is needed. Administer half in a single IP bolus using good head-down restraint into lower lateral abdominal quadrant to reduce risk of intraluminal injection into GI. Place animal in clean paper towel lined cage so particulate bedding will not obscure airways or damage corneas while going under the influence. Once the animal has lost its righting reflex proceed with surgical preparation of implantation site(s). If animal does not loose it’s righting reflex within 5-10 minutes, either remove from study (as anesthetic may have been injected intraluminally into GI tract), or give an additional dose. Volatile Anesthetics1 Most common is isoflurane, but halothane is acceptable, though poses more of a health risk to personnel. The most common carrier gas is 100% medical grade oxygen, but an oxygen enriched atmospheric mixture or one containing nitrous oxide may also be used. Preemptive analgesia (as described above) is also recommended, as it will decrease the amount of volatile anesthetic required. 4 IACUC Approval Form Guide www.alzet.com 2008 Induce in a suitable chamber, which is transparent, air/water tight, and free of sharp/rough surfaces. The chamber should be large enough to accommodate several animals without crowding and easily enable retrieval of anesthetized animals, but not so large as to be wasteful of oxygen and anesthetic agent. Ideally the chamber should be in a fume or externally vented hood/area, but can also be attached to an active or passive scavenging system through a charcoal canister. The canister should be changed regularly. The chamber should be attached via air and watertight tubing to a calibrated precision vaporizer. Many commercial units are available or can be adapted from surplus human or larger animal units. Alternatively, separate systems can be used for induction and maintenance during prep and surgery. Always leak check systems with carrier gas before each procedure-day. In addition, check carrier gas pressure and anesthetic reservoir level since changing/filling during procedure increases potential operator exposure. Always keep at least one syringe of injectable anesthetic for emergency use if volatile system fails during procedure. Volatile Induction1 Place animal(s) into chamber, secure lid, and fill with anesthetic gas at 2-4% with a flow of 1-2 L/min. If animals are immature or in a disease state, you may want to preoxygenate them for a few minutes before adding the anesthetic. Once animals begin to show signs of staggering you can reduce the flow rate, but not the percent of anesthetic. Observe animals constantly until loss of righting reflex, and then place them on a snuggly fitting nose cone. Make sure the cone fits securely over muzzle, but does not abrade corneas. Keep animals positioned such that the neck is extended to avoid tracheal narrowing. Remember not to prolong or put undue pressure on the thorax, especially when animal is in ventral or lateral recumbencey, as it can inhibit respiration and lead to hypoxia and or death. If attempting to intubate or perform a quick surgical preparation without anesthetic maintenance, (not recommended unless animals are already devoid of hair) leave in chamber several minutes longer until significant change in rate and depth of respiratory movements are noticed. Then perform intubation with appropriate diameter and length tube. Intratracheal intubation in rodents is possible but requires precision and practice, hence will not be covered here. Methods can be found in published in literature1. Surgical Preparation Place animal on pre-warmed circulating water heating pad, covered with absorbent material to reduce hypothermia and decrease metabolic rate. 1. Immediately apply ocular lubricant since antiseptic solutions and loose hair can abrade corneas. Administer fluids as described above to counter act hypotension, caused by anesthetic agents. This will also help with vessel dilation if cannulating for IV delivery. 2. Shave hair with clean, well-lubricated fine blade clippers. Be sure to periodically check the clippers as the heat generated can cause thermal burns thus delaying the healing process. If many animals are being shaved, it is recommended to have multiple clippers so each unit can rest, clean, and lubricate, while using the other. Clip at least a 1-2 cm border around implantation site(s). For SQ implantation, clip both the insertion and seating areas so you can assess healing and pump implantation site(s). It is ideal to have the pump seated 5 IACUC Approval Form Guide www.alzet.com 2008 away from insertion site so there is no pressure on the healing incision. Placing a gentle two-way traction on skin facilitates clipping. It is best to clip in a designated area slightly aside from where you will prep skin, so loose hair is contained. Remove loose hair with dry or just damp cloth or with vacuum suction or compressed air or hair dryer on low or no heat. 3. Shaved skin should be cleaned of any visible contamination with a dilute antiseptic soap or solution. Avoid excessive water or alcohol as evaporation facilitates hypothermia. In rodents that are not visibly soiled it is recommend to simply wipe with antiseptic solution 23 times using freshly opened gauze, wipes, or cotton tipped applicators. It is important to assure at least 3-5 minutes of contact time with skin before surgical incision is made and to wipe in a single pass outward motion from incision site towards hair. It is suggested to avoid detergents as they tend to irritate skin and may lead to scratching during the healing process. Avoid iodine-based products especially in nude rodents as they can cause irritation and discolor skin, such that postoperative observation is more difficult. Assess anesthetic depth by pinching interdigital skin, ear tip, or lip margin with fine rat toothed forceps. This mimics the full thickness penetration caused by a surgical incision, in a smalldefined, highly innervated site. If an animal shows a withdrawal reflex (twitches in the pinched area) more anesthetic is needed; wait at least 5 minutes before proceeding. Move animal to surgical area. Surgical Area Animal should be placed on a clean, dry, absorbent, pad, covering a circulating water heating pad set at approximately 90 – 100F. Two or three sets of autoclaved instruments and trays should be prepared. The trays should contain the following: A tray of high-level disinfectant and a tray of sterile physiological saline. Optional drying tray. This way one set can be immersed in the high level disinfectant while the other is being used and then rinsed and dried before using again. This allows sufficient contact time with the high level disinfectant between uses. A glass bead sterilizer can also be used, but you must be cautious to avoid overheating the instruments (have a dipping container of sterile saline or water and use another cold instrument to transfer from glass beads to cooling rinse). Draping rodents can be problematic especially when planning to perform two incisions at different sites such as with an intraperitoneal catheter connected to a SQ pump. Commercially prepackaged disposable drapes are available, which can be cut down to size such that one can serve a few animals in a single session. A traditional 4-corner drape is impractical for rodents and with a little practice the right dimension can be cut for each procedure. A version of the 4-corner drape can be done with unfolded sterile gauze pads placed over 1-4 sides of the site. Another option, especially when planning two distinct incisions, is to use commercially available adhesive drape or a sterile stockinet. A commonly used option is to drape one area at a time and perform an abbreviated prep with antiseptic on the second site with spray bottle or cotton tipped applicator swab. ------------------------------------------------------------------------------------------------------------------------ 1. Subcutaneous Implantation Procedure The usual site for subcutaneous implantation of ALZET pumps in mice and rats is on the back, slightly posterior to the scapulae. Other regions may be used, provided that the pump does not put pressure on vital organs or impede respiration. If the pump is implanted subcutaneously without a 6 IACUC Approval Form Guide www.alzet.com 2008 catheter attachment, the contents of the pump will be delivered into the local subcutaneous space. Absorption of the compound by local capillaries results in systemic administration. For subcutaneous pump implantation, perform the following steps: 1. Once the animal is anesthetized, shave and wash the skin over the implantation site. 2. Make a suitable incision adjacent to the site chosen for pump placement. If the back of the animal is the site of choice, make a mid-scapular incision. 3. Insert a hemostat into the incision, and, by opening and closing the jaws of the hemostat, spread the subcutaneous tissue to create a pocket for the pump. The pocket should be large enough to allow some free movement of the pump (e.g., 1 cm longer than the pump). Avoid making the pocket too large, as this will allow the pump to turn around or slip down on the flank of the animal. The pump should not rest immediately beneath the incision, which could interfere with the healing of the incision. 4. Insert a filled pump into the pocket, delivery portal first. This minimizes interaction between the compound delivered and the healing of the incision. 5. Close the wound with wound clips or sutures. Two clips will normally suffice. The clips or sutures can be removed 7-10 days post procedure. 6. An analgesic1 should be given post-operatively as needed. ------------------------------------------------------------------------------------------------------------------------ 2. Intraperitoneal Implantation Procedure ALZET pumps can be implanted intraperitoneally in animals with sufficiently large peritoneal cavities. Depending on the size of the animal relative to the pump, intraperitoneal implantation can disrupt normal feeding and weight gain for a day or two thereafter. Allow 24 to 48 hours for the animal to recover after intraperitoneal implantation. With any substance administered intraperitoneally, whether by injection or by infusion, a majority of the dose may be absorbed via the hepatic portal circulation rather than by the capillaries. For substances that are extensively metabolized by the liver (i.e., have a high “first pass effect”), the intraperitoneal route of administration may produce highly variable concentrations of agent in plasma and consequently highly variable effects. Therefore, the intraperitoneal route should probably be avoided with agents that have a significant first-pass effect. For intraperitoneal implantation, perform the following steps: 1. Once the animal is anesthetized, shave and wash the skin over the implantation site. 2. Make a midline skin incision, 1 cm long, in the lower abdomen under the rib cage. 3. Carefully tent up the musculoperitoneal layer to avoid damage to the bowel. Incise the peritoneal wall directly beneath the cutaneous incision. 4. Insert a filled pump, delivery portal first, into the peritoneal cavity. 5. Close the musculoperitoneal layer with 4.0 absorbable sutures in an interrupted or continuous pattern, taking care to avoid perforation of the underlying bowel. 6. Close the skin incision with 2 or 3 wound clips or interrupted sutures. The clips or sutures can be removed 7-10 days post procedure. 7. An analgesic1 should be given post-operatively as needed. 7 IACUC Approval Form Guide www.alzet.com 2008 ------------------------------------------------------------------------------------------------------------------------ 3. Intravenous Infusion (via the External Jugular Vein) in Rats The following procedure details placement of a catheter in the external jugular vein. In many cases, this site is preferable because of its size and ease of access. Other sites may also be used. Note: This procedure requires attachment of a catheter to the pump (more info) Prepare the pump and catheter (more info). Note: In applications involving a catheter, the pump must be primed before implantation (more info). When cannulating the jugular vein of rats, use the Rat Jugular Catheter (0007710), sold by DURECT Corporation. This catheter fits onto an ALZET Osmotic Pump with no modification and is provided sterile. 1. Once the animal is anesthetized, shave and clean the ventral portion of the animal's neck. 2. For ease of manipulation during surgery, the animal can be placed in a sterile stockinette and the head and neck exposed for anesthesia administration and surgical access. 3. Position the animal in dorsal recumbency and secure its head and anesthetic delivery apparatus in place. 4. Place a small bolster beneath the animal's neck to expose the ventral neck more fully. 5. Use a small, sharp scalpel blade to make a single incision from the ramus of one side of the jaw to the tip of the sternum just lateral to the trachea/midline. 6. Gently dissect down through the salivary and lymphoid glands, adipose tissue, and fascia to the external jugular vein, which is superficial to most of the neck musculature. Gently elevate and clean the jugular vein for a distance of 1.5 cm. 7. Tie off the cephalic end of the vein, leaving tails 4-5 inches long. 8. Place two loose ligatures around the cardiac end of the vein. Place hemostats on the cephalic suture and one cardiac suture to provide gentle countertraction to the vessel. 9. To inhibit vasoconstriction, apply a few drops of lidocaine or other vasodilatory substance (at body temperature), and allow time for effect. 10. Use a fine gauge needle (22 - 20 gauge for rats)* bent at an approximate 90degree angle to pierce the vessel. Alternately, a small ellipsoidal piece can be cut from the ventral aspect of the vessel with fine iris or micro scissors. Do not cut so much tissue as to weaken the vessel such that it breaks when traction is applied via the rostral ligature ends while passing the cannula. 11. Once the vessel has been pierced, control hemorrhage with gentle traction on the cephalic ligature ends. 8 IACUC Approval Form Guide www.alzet.com 2008 12. The free end of the catheter can be inserted into the hole in the vein wall, and advanced gently to the level of the heart (about 2 cm in an adult rat). Tie the cardiac ligatures snugly around the catheter, being careful not to crimp the catheter. The cephalic ligature can then be tied around the catheter. Cut the ends of all three ligatures close to the knots. 13. Using a hemostat, tunnel over the neck, creating a pocket on the back of the animal in the midscapular region. Lead the pump into this pocket, allowing the catheter to reach over the neck to the external jugular vein with sufficient slack to permit free head and neck movement. 14. Pass the caudal end of the pump through this tunnel into the pocket. 15. Use a two-layer closure, with one layer of suture in the underlying fascial tissues, and one in the skin. The deep layer should be closed with 4-0 or 5-0 absorbable material in a simple continuous or interrupted stitch, but silk is acceptable for short-term survival studies of 2-4 weeks. The skin can be closed with the same material, nonabsorbable suture, or stainless steel wound clips.* *Wound clips or ligatures in the skin should be removed within 1-2 weeks if the animals are to survive longer than 2-4 weeks. Additional Recommendations for IV Cannulation in Mice See cannulation techniques for rat. When cannulating the jugular vein of mice, use one of the Mouse Jugular Catheters (0007700, 0007701, or 0007702), sold by DURECT Corporation. Any of these catheters will fit onto an ALZET Osmotic Pump with no modification and they are provided sterile. Use a 25-23-gauge needle bent at an approximate 90-degree angle to pierce the vessel. In mice, sutures are recommended for comfort. See a list of references on the use of ALZET pumps in mice. ------------------------------------------------------------------------------------------------------------------------ 4. CNS Infusion (via Brain Cannulation) in Rats Direct access to the CNS via an ALZET Brain Infusion cannula, implanted in the cranium is useful in experimental situations where the test compound has effects on the CNS, but does not cross the blood-brain barrier appreciably. Significant doses can be administered directly to the brain using this technique, which can eliminate the uncertainty of systemic pharmacokinetic variables. 1. Anesthetize the rat using either an inhalant anesthetic 1 (such as isoflurane) or injectable anesthetic (such as Xylazine® and Ketamine®, or sodium pentobarbital). Fit the rat into a stereotaxic apparatus. 2. Shave and wash the scalp. Starting slightly behind the eyes, make a midline sagittal incision about 2.5 cm long and expose the skull. With the rounded end of a spatula, lightly scrape the exposed skull area and pat it dry. Scraping should remove the periosteal connective tissue, which adheres to the skull, permitting good adhesion of the dental cement, which is later used to secure the cannula. 9 IACUC Approval Form Guide www.alzet.com 2008 3. Identify the bone suture junctions bregma and lambda. With these as reference points, determine and mark the location for cannula placement using the stereotaxic apparatus. Drill a hole through the skull at the marked, stereotaxically correct, location. This hole will receive the cannula. 4. Insert the L-shaped cannula, which is attached by tubing to the ALZET pump, through the skull. To facilitate precise placement of the cannula, the tab on the top of the cannula can be attached to the electrode holder of a stereotaxic apparatus. After the cannula is firmly cemented in place, the tab is easily removed with a heated scalpel. Alternatively, this tab may be removed in advance and the cannula placed by hand. After insertion, the cannula's external arm should lie parallel to the surface of the skull with the tubing extending caudally. 5. Drill† a second hole part way through the skull lateral to the cannula. This second hole will be used to receive a small stainless steel screw, which acts as an anchor to secure the cannula. 6. Insert the small anchor screw while taking care not to go entirely through the cranium. Once the screw has been started into the skull, a turn or two is sufficient to secure it. The small anchor screw should extend approximately 12 mm above the skull. 7. Completely dry the skull surface and cover the cannula, the entire implantation site, and the anchoring screw with dental cement. The powdered dental cement can be mixed with its acrylic solvent in a dish and applied. Alternatively, the powder can be placed first and the solvent carefully added to it, taking care to limit both to the implantation site. Note: Many researchers use cyanoacrylate adhesive in place of dental cement (more info). 8. After the cement has set (about 4 minutes), prepare a subcutaneous pocket in the midscapular area of the back of the rat to receive the osmotic pump. This pocket is created by opening and closing a hemostat to blunt dissect a short subcutaneous tunnel from the scalp incision to the mid-scapular area. The pocket should be large enough to accommodate the pump and permit some pump movement, but not so large as to allow the pump to slip down onto the flank of the animal. 9. Insert the osmotic pump, still attached to the catheter leading to the brain cannula, into the subcutaneous pocket. The osmotic pump should be placed with the delivery port pointing toward the cannula site. When the pump is properly placed, the catheter should have a generous amount of slack to permit free motion of the animal's head and neck. 10. Close the scalp wound with wound clips or interrupted sutures. 11. Remove the animal from the stereotaxic apparatus and place it back into its cage. The animal requires no restraint or handling during the delivery period. †Note: These steps may be optional when the brain infusion kits 2 or 3 are used. Verifying Cannula Placement Upon sacrifice, verify the placement of the cannula and its patency according to the following method. Fix the brain with a suitable fixative (e.g., 4% formaldehyde). Remove the jaw and roof of 10 IACUC Approval Form Guide www.alzet.com 2008 the mouth of the rat and expose the floor of the brain. Cut the catheter and slowly inject a dye (e.g., Evans Blue) through the catheter toward the cannula. Expose the tip of the cannula and examine the dye stains to confirm its placement. Alternatively, after the cannula is removed, the brain can be fixed, frozen, and sectioned to confirm cannula placement. ------------------------------------------------------------------------------------------------------------------------ 5. CNS Infusion in Mice Infusing agents into the mouse CNS is facilitating new research. The low flow rate and small size of the ALZET Osmotic pump used with the Brain Infusion Kit make an ideal combination for intracerebral delivery in mice. References on ICV delivery in mice. Following are tips on infusion to the mouse brain using the ALZET Brain Infusion Kits: Use the spacers provided with the Brain Infusion Kit, as this will allow proper depth placement of the cannula for the mouse brain. Do not use a stay screw or dental cement as described for a rat brain infusion procedure. The mouse skull is too thin to support a stay screw, and there is not sufficient skin to close the incision over a large amount of dental cement. Preferably, secure the cannula in place using cyanoacrylate adhesive such as Loctite 454. The upper portion of the plastic cannula, which is used for attachment to the stereotaxic arm, should be removed before closing the incision. This part would protrude too far above the mouse skull to allow closure of the scalp incision. It can be most easily removed using a heated scalpel. Proper cranial coordinates for cannula implantation are essential. A mouse brain atlas by Franklin and Paxinos is a popular choice, 4 while two older atlases have been cited with some frequency. 2,3 ------------------------------------------------------------------------------------------------------------------------ Post-operative Care/Analgesics (General) 1 Post-operative care should be an extension of proper anesthesia. Provided they do not interfere with the research focus, analgesics and proper post-operative care are strongly suggested when performing surgeries, including the implantation of ALZET Osmotic Pumps. See the following list of references where researchers using the ALZET Osmotic Pumps, cite their use of post operative care techniques. The following should be considered when providing post-operative care: Recovery room environment The room should be warm and quiet. Lighting should be low, but sufficient enough to allow proper examination. The temperature should be 27-30 Celsius for adult animals and 35-37 Celsius for neonates. For adults this can be reduced to 25 Celsius once the animal has recovered from the anesthetic. Caging and Bedding Animals should be allowed to recover in their normal cages, a recovery room, or an incubator. 11 IACUC Approval Form Guide www.alzet.com 2008 Do not allow small rodents or rabbits to recover from anesthesia in cages with sawdust or wood shavings for bedding (it will stick to eyes, nose, and mouth). Instead, use synthetic bedding. Due to cough and swallow reflexes being suppressed during recovery, attempt to minimize risk of airway obstruction. Respiratory Depression Anesthesia agents can produce respiratory depression and often times this depression is extended into the post-operative recovery period. In addition, this depression can increase post-operatively. Hence it is important to monitor the respiratory system in order to prevent severe hypercapnia and hypoxia. Use a monitoring device such as a pulse oximeter or a thermistor if the former is unavailable. Observe the animal regularly and record the respiratory rates. If depression is observed, it should be countered with a respiratory stimulant (e.g., doxapram and by the administration of oxygen). Since doxapram has a short duration of action (10-15 minutes), it may be needed in repeated doses or by a continuous infusion. Fluid Therapy Voluntary water intake of all animals should be recorded post-operatively. Dehydration can compromise the recovery of the animal and should be avoided by administering fluids post-operatively. Fluid requirements for most animals are 40-80 ml kg-1 every 24 hours (vomiting, diarrhea, and other abnormal losses may increase this need). If animal is conscious, the fluid is best given orally. If animal is unable/unwilling to accept the fluid, then dextrose-saline (4% dextrose, 0.18% saline) or saline (0.9%) can be given subcutaneously or intraperitoneally. See table below: Mouse (30 g) Rat (200 g) Subcutaneous (ml) 1-2 5 Intraperitoneal (ml) 2 5 Infection Prevention The ALZET Osmotic Pumps, ALZET catheters, and other ancillary products sold by DURECT Corporation are provided sterile. Care should always be taken to use aseptic surgical techniques and maintain the sterility of the products being used. Doing so may prevent the need for routine, post-operative, antibiotic administration. Since animals may soil their wounds with feces and urine, the administration of prophylactic antibiotics may be useful in minimizing the risk of infection. For a list of antibiotics and suggested doses for each species see the following: (Table 6.2)1. Pain Relief/Analgesics Proper pain assessment is integral in minimizing post-operative pain. Some key areas to observe for pain assessment are the following: activity, appearance, temperament, vocalizations, feeding behavior, and alterations in physiological variables. 12 IACUC Approval Form Guide www.alzet.com 2008 Analgesics can be divided into two groups: opioids or narcotic analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin. For a complete table of analgesic doses see the citation at the end of this document (Table 6.3) 1 Pump Specifications ALZET Pump Model 1003D, 1007D, 1002, 1004 Reservoir Volume 100 µl Complete Osmotic Pump Model Numbers 2001D, 2001, 2002, 2004, 2006 200 µl 2ML1, 2ML2, 2ML4 2 ml Length (cm) 1.5 3.0 5.1 Diameter (cm) 0.6 0.7 1.4 Weight (g) 0.4 1.1 5.1 Total Displaced Volume (ml) 0.5 1.0 6.5 Pump Body Materials Outer Membrane Drug Reservoir Cellulose Ester Blend Thermoplastic Hydrocarbon Elastomer Note: All items are supplied sterile. Pumps cannot be reused. Bibliography Flecknell P.A. Laboratory Animal Anaesthesia, second edition; A practical introduction for research workers and technicians. Braintree Scientific 1 Sidman RL, Angevine JB, Taber PE; 1971. Atlas of the mouse brain and spinal cord. Harvard University Press, Cambridge, MA. 2 Slotnick BM, Leonard CM; 1975. A stereotaxic atlas of the albino mouse forebrain. Rockville, Maryland; Alcohol, Drug Abuse, and Mental Health Administration. 3 Franklin BJK, Paxinos G; 1997. The mouse brain in stereotaxic coordinates. Academic Press, San Diego, CA. 4 The Biology and Medicine of Rabbits and Rodents. J. E. Harkness and J. E. Wagner. 1989 5 For more information regarding the ALZET Osmotic Pumps, or to request a complimentary surgical procedures video, please contact ALZET Technical Support at: 1-800-692-2990 or alzet@durect.com 13