University of Minnesota
Small animal procedure record (non-USDA species: rodents/frogs/birds)
Date of procedure:_____________
Surgeon:_____________
AdCre Surgery #
Protocol Number:__ 1104A98432_______
Species/Group ID:__Mice_____________
Cage Bar Code:_____________________
Description of Procedure:
Weigh mice, administer anesthetic, shave mouse, sterilize, place eye drops on eyes, make incision
on back, pull fat pad of ovary out, inject virus into between bursa and ovary, place ovary back in
body, close skin with staples, administer ketoprofen, place animal back in cage, change sterile tool
pack at least every 6 mice, put 5ml’s children’s ibuprofen in water bottle, put red BSL-2(virus)
monitor card in cage holder, put large red rubber band around cage for 3 days and monitor until
back to normal behavior.
Anesthetic Agent: Ketamine in combination with Xylazine, Acepromazine and 0.9% saline
Master mix of Anesthetic and other drugs combined for amount of mice. From this mix we take the
correlation amount by their weight. Mixture made for __ mice (___uL Ketamine, ___uL Xylazine,
___uL Acepromazine and ____uL Saline). Average mouse weight = ____g
Route of Injection: Intraperitoneal cavity on ventral side
Cage
#
Animal ID
Animal
Weight
(g)
Dose
70mg/kg
(mg)
Total
Volume
(uL)
AdCre /
GFP
(10uL)
Time
anesthesia
given
Time
surgery
start
Anesthetic depth assessed prior to procedure (toe pinch/corneal reflex)
Heating device used to maintain body temperature
Yes
Ophthalmic ointment applied
Yes
Time
surgery
end
Time
anesthesia
end
Yes
Group anesthesia start time:___________
Group surgery start time:______________
Intra-operative Monitoring Notes:
Length of Individual surgery:_________________________________________
Assessments taken:
temperature
heart rate
respiration rate
anesthetic depth
BP
Frequency of assessments conducted within individual surgery: ___________________________________
Ketoprofen
Change
sterile
pack
Additional fluids, emergency agents (if applicable, including dose/route/time) and any complications and
actions taken:
Group surgery completion time:_____________
Group anesthesia finish time:_______________
Group immediate post operative monitoring (including analgesic/antibiotic administration)
Cage
Time
Comments
Time animals are sternal and fully recovered:_____________
Notes:
Initials
University of Minnesota
Small animal post operative record (non-USDA species: rodents/frogs/birds)
Cage Bar Codes:
Parameters to be assessed post surgically: date/time of monitoring, initials of person
performing monitoring, analgesics/antibiotics given, including dosages and route, activity of the
animals, eating/drinking status, urine and feces production, incision site observations
(healing/infection/swelling/exudate/pain or dehiscence), coat texture and posture appearance
(both indicators of pain) and procedure related complications. Post-operative records should
be kept for a minimum of three days.
Day 1: Date:________________
Comments:
Time:_________________
Initials:______________
Day 2: Date:________________
Comments:
Time:__________________
Initials:______________
Day 3: Date:_________________
Comments:
Time:___________________
Initials:______________
Day 4: Date:________________
Comments:
Time:_________________
Initials:______________
Day 5: Date:________________
Comments:
Time:__________________
Initials:______________