ANIMAL ETHICS APPLICATION FOR APPROVAL TO ESTABLISH AND MAINTAIN A BREEDING LINE The purpose of this form is to allow the AEC to be informed of the potential Welfare Implications of the animals you wish to introduce/breed. It also informs the AEC of the proportion of animals bred which are ultimately useful for your purposes (i.e. the wastage rate). If the animals being bred are genetically modified the attachment 'Phenotype Passport - Phenotype report for genetically modified (GM) animals' must be completed and submitted with this application Instructions After completing this form please convert to a pdf and add any required pdf attachments in the relevant sections; For the signature section, we suggest printing out the relevant page(s) and after scanning signatures, replace these pages in the pdf version of the document; Please note that printed copies will NOT be accepted, nor will Microsoft Word versions of the document; it must be a pdf version; To submit, email the final pdf to secretary.aec@sahmri.com. Bioresources is a PC2 and SOPF facility and all animals housed here will need to comply with this health status. Please contact Bioresources for further information. We can offer rederivation services to restore your colony to a specified and opportunistic pathogen free (SOPF) health status. Common Name of Line Exact Nomenclature1 Background Strain2 Nomenclature of genetic alterations (if any) 1 Number of Backcross Generations3 Contact e.g. Facility Manager, Scientist Name (include title) Applicant's Institution and Department Contact details (including After Hours) Email Phone Mobile SAHMRI AEC’s breeding form Page 1 of 8 Details of modification45 References and Websites5 Origin of strain (location and researchers)6 Genotyping Method7 Please attach a protocol; send control DNA if possible. Husbandry Recommendations 1. What diet and bedding have been used?8 2. What housing system has been used and what is most appropriate?9 3. What environmental enrichment has been used?10 4. Current breeding strategy (e.g. heterozygote x heterozygote)? SAHMRI AEC’s breeding form Page 2 of 8 5. Breeding information Average litter size: Pre-weaning mortality: Post-weaning mortality: Fecundity limit (age): 6. What containment category is appropriate for the animals (PC1-4)? 7. Detail the current environmental parameters for the animal (e.g. temperate, humidity, light cycle) 8. Breeding recommendations11 9. Other Phenotype 1. Current health status of the colony12 2. General appearance and coat colour 3. Any physical abnormalities? Yes No If yes, please detail and indicate if any remedial action is necessary 4. Are there any behavioural traits e.g, aggression, termor, abnormal movement? SAHMRI AEC’s breeding form Page 3 of 8 Yes No If yes, please detail and indicate if any remedial action is necessary 5. Has a welfare assessment been carried out on the line?13 Yes No If yes, detail over what period assessment was carried out and findings. 6. Have any specific phenotype test been carried out? 14 Yes No If yes, detail which tests and findings. Include published references if relevant? 7. What is the immune status of the line e.g. normal, deficient? 8. If a GM line, describe any issues associated with homozygosity versus heterozygosity for the mutation e.g. lethality. 9. Growth rate 10. Other phenotype observations SAHMRI AEC’s breeding form Page 4 of 8 Date Passport Last Updated SAHMRI AEC’s breeding form Page 5 of 8 Attachment: Mouse Passport Attach as pdf pages or if text by copy-paste into field below SAHMRI AEC’s breeding form Page 6 of 8 Attachment: Other Attach as pdf pages or if text by copy-paste into field below SAHMRI AEC’s breeding form Page 7 of 8 Passport Guidance Notes The mouse passport is intended to provide husbandry and welfare information for establishments receiving genetically altered mice. The passport does not replace any requirements for Home Office permission for Movement, Defra import licences or Health Certification. The passport is provided for information and guidance and the originating establishment accepts no liability arising from the use of information provided in this document. 1. Details of correct strain nomenclature for rodents can be found at http://www.informatics.jax.org/mgihome/nomen/#rag. 2. Details of the original genetic background should be given. 3. Details of any subsequent breeding should be given. 4. Please give details of the modification e.g. transgene (and, where known, copy number if generated by pronuclear microinjection or random integration) or targeting construct and ES cell details; or TALEN or Crispr-Cas mutation if appropriate. If mice are genetic mutants, give details of the nature of the mutation and whether original mice were spontaneous or induced mutants). 5. Please give details of any publications or websites that deal specifically with the strain. If substantial information is available please give the most comprehensive or recent reference 6. This should refer to the originator of the GA mice and the contact details in order to obtain permission to use the mice. Details should include where and when the mouse was generated. 7. Please give details of the genotyping procedure. Is screening by Southern Blotting, PCR, ELISA, physical appearance or phenotypic expression? Please attach a protocol for the screening method. 8. Are any dietary supplements required i.e.: Lectade rehydration therapy? Please provide a reason as to why this may be necessary. 9. What is the most appropriate housing system? For example, conventional housing, I.V.C, isolators, containment or quarantine. 10. This would include nesting material and other enrichment devices found to be useful or inappropriate. 11. Breeding recommendations. It is important to state which animals (male, female, all) carry the relevant transgene for breeding and welfare purposes. Details of system used to breed mice and any comments relating to breeding management (e.g. age for first mating, pairs or harems, inbred or outbred, etc. 12. Any known microbiological contamination? Include any information on what microorganisms were included in the screen, the length of time between each screen and the method used (e.g. sentinels or littermates). 13. Welfare assessments should be carried out for the period that adults are normally maintained for that particular line, and the limit to this should be noted. 14. Specific phenotypic tests include post mortem data, histology and any other analyses performed on the mice. Please give references if applicable. SAHMRI AEC’s breeding form Page 8 of 8