SECTION A SURGICAL PROCEDURES Documentation of surgical procedures and post-surgical care is required and is the responsibility of the PI. Records must be available for inspection by IACUC and outside inspectors. You are required to keep these records for 3 years after the termination of the project. A1. What types of surgeries will be performed? Check all that apply. Non-Survival Minor Survival Major Survival -- Any surgical intervention that penetrates and exposes a body cavity A2. Will animals be subjected to more than one major survival surgical procedure? Yes No A2a. If yes, provide the scientific rationale for performing multiple major survival surgeries on an individual animal. A2b. If yes, list the procedures that are a part of multiple major survival surgical procedures and provide a timeline that indicates the time allowed between each procedure on the same animal. A3. Pre-operative Preparation of the Surgical Subjects A3a. Describe the pre-operative preparation of the animal – check those that apply and provide detail as needed). Food or water withholding Length of time withheld: Acclimation to a new location on campus see CAR3: Acclimation Guideline (http://animalcare.msu.edu/guides) Acclimation period: Surgical location is approved by the IACUC Location: June 2015 Page 1 A3b. Describe the aseptic techniques used to minimize microbial contamination of the surgical site. Include preparation of the animal, surgeon, and instruments. Procedures involve the use of rodents. Campus Animal Resources ‘Guideline on Rodent Surgery’ WILL be followed. See CAR1: Rodent Surgery Guidelines (http://animalcare.msu.edu/guides) Procedures do NOT involve the use of rodents OR Campus Animal Resources ‘Guideline on Rodent Surgery’ WILL NOT be followed. Describe the aseptic techniques used below: Animal skin preparation (do not use alcohol in rodents and other small animals due to hypothermic effects): Surgeon preparation (must include sterile surgical gloves): Instrument preparation: A4. A permanent record of drugs (names, dosages, routes of administration, dates [times where appropriate] of administration, and initials of the person administering the drug) must be maintained. A4a. Pre-operative and post-operative analgesia is required. Post-surgical analgesia is required for: 24 hours for minor surgical procedures such as placement of subcutaneous pumps, surgical implantation of catheters or castration; 48 hours for major surgery such as opening an abdominal cavity; 72 hours for potentially very painful procedures such as extensive orthopedic surgery, burns, thoracic surgery. If providing analgesia will adversely affect your study, or if analgesia cannot be given at all, please provide scientific justification: A4b. Please list all drugs and/or agents that will be given to animals undergoing surgery in this project. Investigators are required to use pharmaceutical-grade medications whenever they are available, even in acute procedures. See: IG005: Use of Non-Pharmaceutical Grade Compounds (http://animalcare.msu.edu/guides) √ if not pharmac eutical grade FILL IN BOTH drug name(s) (generic only) route of administration volume dosages frequency of administration duration of treatment (# of days or hours) A4c. If applicable, scientifically justify the use of non-pharmaceutical grade compounds: June 2015 Page 2 A4d. Please indicate any non-pharmacologic agents used to alleviate pain and distress. Warming Pad Fluid replacement Hiding places Nesting materials Blankets Other (please specify: A5. Anesthetic Techniques A5a. Describe the anesthesia technique that will be utilized. A5b. Describe how the appropriate depth of anesthesia will be determined and monitored. A6. Surgical Procedures: identify the title of surgery, type of surgery, species, number of animals, location where surgery will be performed followed by a full description of the surgical procedures. Copy A6a & A6b for each surgical procedure. A6a. Title of Surgery: Type of Surgery: Non-Survival Species: Number of Animals: Minor Survival Major Survival Building/Room Where Surgery will take place: A6b. Description of surgical procedure: A7. Post-operative monitoring and care A7a. How will pain and/or distress be assessed and monitored and who will make the assessment? A7b. Post-surgical monitoring should be conducted for up to 72 hours. Describe your post-surgical monitoring plan. A7c. Describe the plan for the detection and management of post-operative complications. Include working hours, after hours as well as weekends and holidays. June 2015 Page 3