APPLICATION FOR PERMISSION TO USE VERTEBRATE ANIMALS IN
RESEARCH AND (OR) TEACHING
NEW MEXICO STATE UNIVERSITY
I. General Information
1. Principal Investigator/Professor:
Dept:
Campus Box:
Tel:
email:
2. Title of Research Project/Course:
3. Funding Source:
4. Duration of Project/Course:
to
(IACUC approval is for 3-years maximum)
5. Name, position, education, and years experience with this species of each person who will perform the
experimental/instructional manipulations on the animal(s) and(or) be involved in the care, use, and treatment of
the animal(s) (include technical staff, teaching/research assistants, students, etc.).
6. Which of the following categories applies to animals used in this project (see Table 1 below for more
complete description)? _____
Category B – Animals being bred or held but not yet used in research
Category C - No stress, pain, or use of pain-relieving drugs
Category D – Involve pain or distress for which appropriate anesthetics or analgesics will be used
Category E – Involve pain or distress for which appropriate drugs will adversely affect research results
II. Certification Requirements
1. Have all personnel completed the online CITI training? (A refresher course is required every
two years.)
a.
□ Yes
b.
□ No - Please explain why not.
2. Have all personnel completed the training class for the Occupational Health and Safety
Program (OHSP) for animal workers? (A refresher course is required every three years.)
a.
□ Yes
b.
□ No - Please explain why not.
3. Have all personnel completed an initial medical evaluation conducted by the Campus Health
Center or another health care provider? (A new medical evaluation is required if the proposed
work is significantly different from previous work.)
a.
□ Yes
b.
□ No - Please explain why not.
4. To the best of your knowledge, are the animals to be used in this project free of disease
associated with illnesses or other health concerns to animal workers?
a.
□ Yes
b.
□ No - Please describe safety precautions that will be used to protect personnel.
III. Proposed Use of Vertebrate Animals
1. Provide the following information about animals to be utilized in this experiment as well their proposed use.
A. Animal - Common name - , Genus and species - , Gender - , Approximate age (if known) - , Number - .
B. Animal Supplier/Source C. Study Location:
□ Animal Care Facility, □ Foster Hall (room number ___), □ Biology Annex (room number ___),
□ Knox Hall (room number ___), □ Animal Metabolism and Physiology Building,
□ Campus Livestock Facility, □ Livestock Entomology Facility, □ Chihuahuan Desert Rangeland
Research Center, □ Corona Range and Livestock Research Center, □ Clayton Livestock Research
Center, □ Jornada Experimental Range, □ Other - please specify
D. Animal Housing:
□ Cage, □ Indoor pen, □ Metabolism crate, □ Tie stall, □ Outdoor pen, □ Free range,
□ Other - please specify
E. Describe treatments to be imposed, methods of restraint, surgical procedures, sample collection, etc.
2. Describe actions taken, including literature search to seek valid alternatives and avoid unnecessary
duplication for the proposed research. Include names of databases searched, dates searches were
conducted, and key words utilized. If the proposed research repeats aspects of previous studies, please
provide a justification.
3. Provide a justification for the species and numbers of animals to be used.
4. Provide the following information concerning veterinary care to be provided for the animals:
A. Name of the attending veterinarian (required for all protocols) B. Telephone number C. email 5. Describe procedures for ensuring that pain, discomfort, and distress will be avoided or limited to that which is
unavoidable during the project. If the protocol utilizes treatments and (or) procedures that induce pain,
discomfort, or distress that are not immediately relieved by appropriate methods, a justification must be
provided. Provide specific information about use of analgesics, tranquilizers, and anesthetics to be used.
6. Describe the method of euthanasia to be used. Even if euthanasia is not planned, provide the method to be
used if it becomes necessary due to illness or injury. If the proposed method does not follow the guidelines of
the American Veterinary Medical Association, include a justification for the alternate method.
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FACULTY/PROFESSIONAL STAFF ASSURANCE STATEMENT
I accept and will conform to all Federal and State Laws and guidelines and all institutional policies and
procedures concerning the care and use of vertebrate animals. I understand that I have a responsibility to notify
in writing the Institutional Animal Care and Use Committee of any substantive changes in the proposed project
or personnel, relative to this application, PRIOR to proceeding with any animal use.
Principal Investigator:
Date:
Department Head or Research Leader:
Date:
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE
APPROVED/DISAPPROVED
IACUC Chair ____________________________________
Date ____________________________________
Send the original signed form to: Shanna Ivey, IACUC Chair, Box 3I.
Also email the form as a Microsoft Word attachment to sivey@nmsu.edu
NOTE: Regardless of the planned duration of the proposed research, IACUC approval is granted for three (3) years. An
Annual Report must be submitted for each approved protocol. Any proposed change or addition to an approved protocol
requires submission of a Protocol Amendment. Contact Dr. Hallford to obtain appropriate Yearly and Amendment forms.
AFTER APPROVAL, ANY CONDITION THAT MAY AFFECT THE WELL BEING OF ANIMALS
INVOLVED IN THIS PROJECT SHOULD BE REPORTED IMMEDIATELY TO THE IACUC CHAIR,
DIRECTOR OF COMPLIANCE, OR THE UNIVERSITY VERTERINARIAN.
Revised August, 2013
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Table 1. Categories
Classification B: Animals being bred, conditioned, or held for use in teaching, testing,
experiments, research, or surgery, but not yet used for such purposes.
Examples:
· Breeding colonies of any animal species (USDA does not require listing of rats, mice, birds)
that are handled in accordance with IACUC approval, the Guide and other applicable
regulations. Breeding colony includes parents and offspring.
· Newly acquired animals that are handled in accordance with IACUC approval and
applicable regulations.
· Animals held under proper captive conditions or wild animals that are being observed.
Classification C: Animals upon which teaching, research, experiments, or tests will be
conducted involving no pain, distress, or use of pain-relieving drugs.
Examples:
· Procedures performed correctly by trained personnel such as the administration of
electrolytes/fluids, administration of oral medication, blood collection from a common
peripheral vein per standard veterinary practice [dog cephalic, cat jugular] or
catheterization of same, standard radiography, parenteral injections of non-irritating
substances.
· Manual restraint that is no longer than would be required for a simple exam; short period of
chair restraint for an adapted nonhuman primate.
Classification D: Animals upon which experiments, teaching, research, surgery, or tests will be
conducted involving accompanying pain or distress to the animals and for which appropriate
anesthetic, analgesic, or tranquilizing drugs will be used.
Examples:
· Surgical procedures conducted by trained personnel in accordance with standard veterinary
practice such as biopsies, gonadectomy, exposure of blood vessels, chronic catheter
implantation, and laparotomy or laparoscopy.
· Blood collection by more invasive routes such as intracardiac or periorbital collection from
species without a true orbital sinus [e.g., guinea pigs].
· Administration of drugs, chemicals, toxins, or organisms that would be expected to produce
pain or distress but which will be alleviated by analgesics, anesthetics, tranquilizers, or
supportive care.
Classification E: Animals upon which teaching, experiments, research, surgery, or tests will be
conducted involving accompanying pain or distress to the animals and for which the use of
appropriate anesthetic, analgesic, or tranquilizing drugs will adversely affect the procedures,
results, or interpretation of the teaching, research, experiments, surgery, or tests.
Examples:
· Procedures producing pain or distress unrelieved by analgesics such as toxicity studies,
microbial virulence testing, radiation sickness, and research on stress, shock, or pain.
· Surgical and postsurgical sequella from invasion of body cavities, orthopedic procedures,
dentistry or other hard or soft tissue damage that produces unrelieved pain or distress.
· Negative conditioning via electric shocks that would cause pain in humans.
· Chairing of nonhuman primates not conditioned to the procedure for the time period used.
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