Animal Care and Biosafety
Committee
ANIMAL UTILIZATION FORM FOR TEACHING EXERCISE
As required by Bishop’s University Animal Care and Biosafety Committee (BUACBC), in accordance with CCAC guidelines, an Animal Utilization
Form MUST be filed with, and approved by, the ACBC prior to undertaking any project involving the use of vertebrates or cephalopods. All
applications should follow the principles of three R’s, to replace, reduce, and refine all work using animals with the goal of minimizing the use
of animals whenever possible, and ensuring that humane practices and proper animal care standards are practiced.
1.
Protocol Information
A. Protocol number (ACBC use only)
B.
Instructor information
Name:
Department:
Telephone number:
Faculty mailbox:
Email address:
C.
Course information
Title of the course:
Course number:
Title of teaching exercise:
Type of teaching
exercise:
☐ Classroom/laboratory exercise
☐ Wild animals/field work
☐ Other, please specify:
Proposed start date: Click here to enter a date.
Expected date of completion:Click here to enter a date.
2. Pedagogical Merit of the Teaching Exercise
Experiments investigating nociception, including those involving multiple invasive procedures conducted solely for educational
purposes or to demonstrate established scientific knowledge cannot be justified.
A. Source of exercise
B.
Course objectives (in point form)
C.
Justify the necessity of using animals in this project.
D. Justify the choice of species.
E.
Are there any alternatives to using animals in this project?
☐ No
☐ Yes, please stipulate the alternative:
F.
Student / animal ratio:
G. Student / teacher ratio:
H. Who will demonstrate the procedures to the students?
I.
If, on moral grounds, a student does not wish to participate in this exercise, is there an alternative available?
☐ No
☐ Yes, please stipulate the alternative:
J.
3.
Please append to the protocol a letter signed by the Chair of the Department indicating that the Department
has reviewed the pedagogical merit of the exercise using live animals.
Animal Data
A. Please justify the need to use live animals as opposed to computer simulations, videos, etc.
B.
Describe the animals to be used.
Species:
Supplier:
Strain:
Sex:
Age / weight:
Total number of animals:
C.
Justify the use of this particular species.
D. Justify the total number of animals used. If the number of animals to be captured cannot be precisely
estimated, please indicate the maximum number of animals that would be used. Based on the experimental
paradigm describe how animals will be used, e.g. control group, experimental group(s).
4. Wild Animals / Field Work (if applicable)
It is the responsibility of the instructor to obtain all necessary permits for wildlife studies. Copies of these permits should be
attached to this form.
A. Describe in detail how animals will be captured and the duration; method of restraint and duration; monitoring
frequency; potential for harm. Please note that traps must be inspected frequently.
B.
Describe all pertinent equipment that will be used.
C.
List all targeted species.
D. Describe the fate of non-targeted species.
E.
Justify the need for permanent marking of animals.
F.
Describe any potential environmental impact of this study.
G.
Provide any other relevant information.
Page 2 of 6
5.
Description of Procedures
A. Provide a detailed description of procedures, using any relevant SOPs, related to the manipulations and
techniques which will be performed, including surgical procedures, post-operative care, tissue samples,
substance administration, behavioural tests, restraint, dietary manipulation, environmental alternations, etc.
Please see the CCAC guidelines for further information: www.ccac.ca.
B.
List all drugs (pre-anaesthetic/anaesthetic/analgesic agents) that will be used to minimize pain, distress or
discomfort (agent, dosage mg/kg, volume, route, frequency).
C.
List all non-anaesthetic agents that will be administered (agent, dosage mg/kg, volume, route, frequency).
D. Justify withholding of anaesthetic and/or analgesics for any invasive procedure.
E.
Did you obtain the appropriate authorization for the use of controlled substance(s)?
F.
At what point in the experiment will sufficient data have been collected to justify concluding the experiment?
What will be the fate of the animals once the experiment is completed?
If an animal is injured during the procedure, how are you going to care for the animal?


G. State what criteria (vocalization, unexpected body weight, behavioural deterioration, etc.) are to be used to
determine if an animal will be terminated prior to the end of the experiment. (See CCAC guideline “Choosing an
appropriate end point…” www.ccac.ca.)
H. Method of euthanasia:
Please note that the use of any physical method to euthanize animals without anaesthesia must be justified.
☐ Anaesthetic overdose
☐ Exsanguination with anaesthesia (list agent, dose and route of administration)
☐ Decapitation with anaesthesia (list agent, dose and route of administration)
☐ Cervical dislocation with anaesthesia (list agent, dose and route of administration)
☐ CO2 chamber
☐ Euthanasia without anaesthesia (please justify)
☐ Other (please specify):
I.
Describe the fate of animals which will not be euthanized.
Page 3 of 6
6. Category of Invasiveness
The categories of invasiveness are adapted from the Scientists Centre for Animal Welfare, 1984. For more detailed descriptions
of each category please refer to CCAC guidelines at www.ccac.ca.
A. Please indicate the category of invasiveness. If the level of invasiveness falls between two categories, check the
more invasive degree.
For Laboratory Experiments
☐ A
☐ B
☐C
☐ D
☐ E
A (Low or Nil): Experiments involving invertebrate animal species. Invertebrate animals have a nervous system, and
respond to noxious stimuli, and must therefore be treated humanely.
B (Low or Nil): Experiments on vertebrate animal species that are expected to produce little or no discomfort.
Manipulating animals for experimental purposes (e.g. injections, removal from cages); injections of non-toxic substances,
naturalistic observation, experiments on fully anaesthetized animals, and standard methods of anaesthesia fall within
this category.
C (Low to Moderate): Experiments that involve some discomfort (short lasting) to vertebrate animal species.
Implantation of cannulae, or catheters, short periods of restraint as part of the experimental protocol; food and water
deprivation for short periods of time, protocols using escape from noxious stimuli, social isolation or crowding, minor
surgical procedures under anaesthesia, among others.
D (Moderate to High): Experiments that involve significant but unavoidable distress or discomfort to vertebrate animals.
Major surgical procedures under anaesthesia with post-surgical pain or discomfort or functional deficit, application of
inescapable noxious stimuli, maternal deprivation, prolonged periods of restraint, induction of aggressive behaviour,
procedures that alter perceptual or motor functioning of an animal. Category D experiments present an explicit
responsibility on the part of the investigator to explore alternative designs to ensure that animal distress is minimized.
E (High or Severe Pain): Experiments that involve inflicting severe pain on conscious vertebrate animals. Procedures
involving severe pain or severe deprivation, burn or severe trauma infliction on anaesthetized animals that are allowed
to recover consciousness, inescapable stress; painful shock, use of muscle relaxants to induce surgical restraint without
use of anaesthesia among others. Category E experiments are considered to be highly questionable or unacceptable,
regardless of the significance of the result.
For Wildlife Studies
☐ A
☐ B
☐C
☐ D
☐ E
A (Low or Nil): Methods used on most invertebrates or on live isolates. Invertebrate animals have a nervous system, and
respond to noxious stimuli, and must therefore be treated humanely. The use of tissue culture and tissues obtained at
necropsy. The use of eggs, protozoa or other single-celled organisms. Experiments involving containment, incision or
other invasive procedures on metazoan. Studies in which the animals are observed without any disturbance to them.
B (Low or Nil): Experiments on vertebrate animal species that are expected to produce little or no discomfort or stress.
Observational studies in which there is some disturbance to the animals but not to the point that the same individuals
are repeatedly observed so as to habituate or otherwise modify their behavior.
C (Low to Moderate): Methods which cause minor stress of pain of short duration. Capture, using methods with little or
no potential to cause injury and marking animals for immediate release. Long term observational studies on free ranging
animals where the behavior of individuals may be altered by repeated contact; brief restraint for blood or tissue
sampling; short periods of restraint beyond that for simple observation or examination, but consistent with minimal
distress.
D (Moderate to High): Methods which cause moderate to severe distress or discomfort. Use of methods that have the
potential to cause injury; maintenance of wild caught animals in captivity. Translocation of wildlife to new habitats.
Major surgical procedures conducted under general anesthesia, with subsequent recovery. Prolonged periods of physical
restraint. Induction of behavioral stresses such as maternal deprivation, aggression, predator-prey interactions.
Procedures which cause severe, persistent or irreversible disruption of sensorimotor organization.
Page 4 of 6
E (High or Severe Pain): Procedures which cause severe pain near, at, or above the pain tolerance threshold of
unanesthetized, conscious animals. This category is not necessary confined to surgical procedures, but may include
exposure to noxious stimuli or agents whose effects are unknown. Exposure to drugs or chemicals at levels that (may)
markedly impair physiological systems and which cause death, severe pain, or extreme distress. Behavioral studies about
which the effects of the degree of distress are not known. Environmental deprivation that has the potential to seriously
jeopardize an animal’s well-being. Use of muscle relaxants or paralytic drugs without anesthetics. Burn or trauma
infliction on unanesthetized animals. A euthanasia not approved by CCAC. Any procedures that will result in pain which
approaches the pain tolerance threshold and cannot be relieved by analgesia. Capture methods with a high potential of
causing severe injury that could result in severe chronic pain and / or death.
7. Use of Hazardous Materials
A. The instructor must obtain all permits related to the use of hazardous materials or radiation and must attach a copy of
permits to this form.
☐ No hazardous materials or radiation will be used.
The following materials will be used:
☐ Toxic chemicals
☐ Radioisotopes
☐ Carcinogens
☐ Infectious agents
☐ Other, please specify:
Complete the following table for each agent used.
Substance name
Dose (mg/kg)
Volume/Administration
Frequency of
administration
Duration of
administration
B.
Describe any potential health hazards to humans and animals.
C.
Describe measures implemented to reduce the risk to humans, animals, and the environment by exposure to or
resulting from these biohazards.
D.
Do you foresee any risks of injury or disease transmission to animal users?
☐ Yes
☐ No, please elaborate
Page 5 of 6
Investigator’s Declaration: The information contained in this application is complete and accurate. Animal use will conform to
the practice and principles outlined in the “Guide to the Care and Use of Experimental Animals”, Volumes 1 and 2, prepared by
CCAC, BU Terms of Reference, BU Standard Operating Procedures, and other relevant guides. No modification of the protocols
described in this application will be made without the prior permission of Bishop’s University Animal Care and Biosafety
Committee. I understand that approval of this application is valid for one year, and must be renewed if experimentation
continues beyond that point.
Signature of instructor
Date
Click here to enter a date.
Guidelines for submission:
 Print and sign the completed form.
 Prepare any applicable supplementary documentation.
 Convert (i.e. scan, using a photocopier) the complete application package into one PDF file.
 Email the PDF file to Julie Frédette (julie.fredette@ubishops.ca).
Page 6 of 6