Animal Care Committee
Application to Use Animals for Teaching
Before a protocol to use animals in teaching is approved, the proposer must show that the use of
animals is justified, and that the procedures to which the animals will be submitted will be carried out
humanely. The proposal must be reviewed for pedagogical merit. Follow the CCAC guidelines in
completing this form.
All users must complete and sign off on the appropriate CCAC training prior to animal use.
A. GENERAL INFORMATION
1. Title of Course (Provide course number):
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2. Principal Supervisor’s Name (first and last): Click here to enter text.
Academic Rank: Click here to enter text.
Training & Qualifications of Principal Supervisor: Click here to enter text.
UFV Faculty/Department: Click here to enter text.
Supervisor’s Address: Click here to enter text.
Contact Information:
Office Phone: Click here to enter text. Home Phone: Click here to enter text.
Fax: Click here to enter text.
Email: Click here to enter text.
3. Title of laboratory exercise or teaching project (in course with many different
laboratories/procedures, a separate form must be submitted for each):
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4. Project Keywords (please provide a list of keywords that describe the procedures conducted on the
animals. Please use the keywords in Appendix C of the CCAC Animal Use Data Form.
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5. Canadian Council on Animal Care (CCAC) Category of Invasiveness (refer to guidelines):
A☐
B ☐
C ☐
D☐
E☐
6. Project Period *choose from drop down menu below
Start
year, after which a renewal must be requested.
7. Expected date of animals arriving: Click here to enter text.
8. Name associates directly Date: Click here to enter a date.
End Date: Click here
to enter a date.
*Approval is only given for one involved in the care and use of animals in this project:
Co-Instructors or
Department
Rank
Phone/Email
Veterinarian
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Staff and Students
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Department
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Rank
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Phone/Email
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9. Training & Qualifications of all personnel involved:
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10. What will the ratio of instructors to students be in this project:
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11. How many students are (or are likely to be) enrolled in the class and what will be the ratio of
students to animals used?
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12. Emergency Personnel:
Work Phone:
Home Phone:
(at least 2 people, available evenings and
weekends)
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13. Please detail any additional assistance that may be required to ensure that the project will be
carried out in a competent and humane manner.
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B. DECLARATIONS
I, the undersigned, assure that all animals used in this proposal will be cared for in accordance with
the principles promulgated by the Canadian Council on Animal Care and the University of the Fraser
Valley.
_____________________________
Principal Supervisor’s Name
___________________
Date
_____________________________
Principal Supervisor’s Signature
I, the undersigned, assure that these facilities meet CCAC standards and will be available for the
procedures described here.
Note: The Dean must sign when the Department Head is the Principal Investigator.
____________________________
Department Head’s Name
_____________________________
___________________
Date
Department Head’s Signature
C. PEDAGOGICAL MERIT
14. Has this course been reviewed for pedagogical merit through program, department or
institutional review?
☐ Yes
☐ No (please explain, you cannot proceed without documented evidence) Click here to enter text.
15. Describe in lay terms a summary of the pedagogical objectives for using animals in this course. If
alternatives to animals are available, indicate why they cannot be used in this instance:
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16. What benefits will be gained by the students? (Describe in lay terms the objectives and potential
value of the project):
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D. ANIMAL INFORMATION
17.
Species
Number
Housing Location
Course Location
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18. Justify the choice of species and strain:
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19. Justify the proposed numbers to be used by indicating how the numbers were determined:
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20. If wild animals are to be used, give the licence number and the agency permitting the capture,
transportation and housing as appropriate:
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E. ANIMAL WELFARE
21. Has there been consideration of the 3R’s of replacement, reduction and refinement alternatives?
Please explain your answer.
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22. Provide a description of all the refinements to be employed to protect and enhance animals
health and welfare, which may include but are not limited to: anesthesia and analgesia, other medical
treatments as appropriate, housing and husbandry methods, environmental enrichment, refinements
to the procedures to be employed on the animals, refinements to the length of time that animals will
be held/used, and/or any other possible refinements.
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F. PROCEDURES
23. Using simple language, describe in detail the procedures involving animals. Do not excerpt pages
from a laboratory manual. The information in this section should be given in detail and refer to SOPs
as much as possible. Identify the individuals who will perform each procedure and how they are
qualified to do so. Give the level of training of students/staff/faculty involved in each procedures. If
applicable, describe field study protocols in detail. If surgery is done, describe the steps from animal
preparation to recovery. Reference can be made to subsequent sections.
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24. Describe the purpose of animal use (PAU), as defined in the CCAC Interpretation Bulletin no. 1-1:
Animal Use Data Form
☐ PAU 1 – Studies of a fundamental nature in sciences relating to essential structure or function
☐ PAU 2 – Studies for medical purposes, including veterinary medicine, that relate to human or
animal diseases or disorders.
☐ PAU 3 – Studies for regulatory testing of products for the protection of humans, animals, or the
environment.
☐ PAU 4 – Studies for the development of products or appliances for human or veterinary medicine
☐ PAU 5 – Education and training of individuals in post-secondary institutions or facilities
25. Is the work or procedures acute or chronic?
☐ Acute
☐ Chronic
☐ N/A
26. Please indicate the Category of Invasiveness as defined in the CCAC policy statements on
categories of invasiveness in animals experiments (please see document for examples):
☐ Procedures on most invertebrates or on live isolates
☐ Procedures which cause little or no discomfort or stress
☐ Procedures which cause minor stress or pain of short duration
☐ Procedures which cause moderate to severe distress or discomfort
☐ Procedures which cause severe pain near, at, or above the pain tolerance threshold of
anaesthetized conscious animals.
G. CONTENTIOUS ISSUES
27a. The following types of experiments are generally considered to be of a contentious nature.
Please indicate if any of these conditions apply to this project:
a. Physical restraint (if yes, give duration below).
☐ Yes
☐ No
b. Food and/or water deprivation (if yes, give duration below).
☐ Yes
☐ No
c. Extreme variations in environment (heat, cold, light, noise, humidity, etc.) ☐ Yes
☐ No
d. Surgical procedures where appropriate anaesthetic or post-operative
☐ Yes
☐ No
analgesic is contra-indicated.
e. Use of neuromuscular blocking agents.
☐ Yes
☐ No
f. Electroshock or negative reinforcement.
☐ Yes
☐ No
g. Burns, fractures or other severe trauma.
☐ Yes
☐ No
g. Studies in which the death of the animal is a required parameter (LD50,
☐ Yes
☐ No
infection, neoplasmas, drug studies.
i. Predator/prey or fighting experiments.
☐ Yes
☐ No
j. Inescapable pain in conscious animals.
☐ Yes
☐ No
k. Stressful or invasive procedures with recovery for demonstration or
☐ Yes
☐ No
teaching.
l. Exercise to exhaustion studies.
☐ Yes
☐ No
m. Multiple surgeries.
☐ Yes
☐ No
n. Alterations of sensory systems which cause changes in the behaviour or
☐ Yes
☐ No
welfare of the animals.
o. Will involve lethal radiation
☐ Yes
☐ No
27b. If you answered “yes” to any of the above items “a” to “o”, provide:
a. Justifications for conditions imposed.
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b. Precise details regarding these conditions, e.g. duration of restraint, frequency and intensity of
electroshock, etc.
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c. An assessment of the anticipated effects on the animals and of any possible complications.
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d. The measures being taken to minimize or eliminate any pain, discomfort or stress, and the
action which will be taken if this goes beyond that predicted by the experimental design.
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e. How many animals will be subjected to the conditions indicated?
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f. Justification if anesthesia or analgesia are not used during invasive procedures.
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H. DRUGS AND CHEMICALS
28. Give details of the anaesthetic regime to be used. Indicate dosages and routes of administration
for each species. Name the person(s) who will administer and monitor the anaesthetic.
Drug
Dosage
Route
Individual
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29. Indicate care which may be required for each species. Give dosages, frequency, routes of
administration and duration. Name the person(s) who will administer the care for each category
below.
Drug
Dosage
Route
Individual
Analgesics:
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Tranquilizers:
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Antibiotics:
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Other:
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30. If nursing or special care is required, please indicate who will provide it:
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I. FATE OF ANIMALS
31. Apart from that specifically incorporated as part of the study design, some morbidity (disease) and
mortality (death) may occur from animal manipulation. Indicate the percentage of each which may
reasonably be expected as an incidental factor during this laboratory/course:
Morbidity: %
Mortality: %
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32. Describe what will be the ultimate fate of these animals. If euthanasia is to be used, describe the
method that will be used and name the person(s) who will perform the euthanasia. Physical means,
without anaesthetics, will need to be demonstrated in the presence of the UFV veterinarian:
Ultimate Fate: Click here to enter text.
Method of Euthanasia*: Click here to enter text.
Name(s): Click here to enter text.
Provide justification of euthanasia for physical methods and any methods that deviate from those
included in the CCAC Guidelines on: euthanasia of animals used in science.
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33. Define endpoints of this study and how they will be applied, referring to SOPs as much as possible.
Please refer to the CCAC guidelines on choosing an appropriate endpoint in experiments using
animals for research, teaching, and testing, 1998:
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J. DANGEROUS MATERIALS
34. Will any hazardous materials be used in the project (Chemicals, Biologicals, Radio-isotopes,
Infectious agents, Radiation/X-rays) in vivo or in vitro?
☐ Yes
☐ No
If yes, list the agents: Click here to enter text.
If yes, please provide approval information below:
Radon Certificate number: Click here to enter text.
Biosafety Certificate number: Click here to enter text.
K. FIELD STUDIES (if applicable)
35. Describe the methods by which you will capture the animals and how you will handle the animals
afterwards:
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36. Describe how the animals will be transported.
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37. Describe how the animals will be housed:
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38. If you capture any non-target species, how will they be dealt with?
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39. Indicate what will be done to reduce the number of non-target species that are captured.
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40. Describe any risks of injuries or mortalities to captured animals.
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41. Describe the method of euthanasia. If the method is unconventional, please provide justification.
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