University Animal Care Committee (UACC)
Application to Use Vertebrate Animals
for Research or Teaching
Revised: January 2011
Investigators completing this form should be familiar with the University Animal Care
Committee (UACC) Policies and Procedures. This document is available from the Office of the
Vice-President, Research and International.
No project may commence without prior approval of the University Animal Care
Committee (UACC).
Note: All work with cephalopods must also be vetted by the UACC.
APPLICATION #AE: ______________________________ (Research Office use only) date stamp
SECTION I: PROJECT
To Be Completed By All Applicants
Name of Principal Investigator or Course Director (Faculty Member Only)
Proposed Starting Date:
Finishing Date
Project Title
This Application Is:
New
Renewal
Old Application Number
Last Expiry Date
CCAC Reporting Data
Summary Description of the Project
For Canadian Council on Animal Care reporting purposes, please write a summary description of your project, in
terms understandable to a non-scientist, in 40 words or fewer. For example: “Sampling blood from fish
exposed to low levels of mercury”.
This study is (check one)
Acute
Chronic
CCAC Purpose of Animal Use
(PAU) Category (check one)
(See PAU explanation on the next
page)
1
2
3
4
5
Maximum CCAC Category of
Invasiveness (check one) (See
Categories of Invasiveness
explanation on the next page)
A
B
C
D
CCAC Purpose of Animal Use Categories
Check the PAU category box (previous page) which BEST FITS the purpose of animal use in your project:
1. Studies of a fundamental nature in sciences relating to essential structure and function
(e.g. Biology, Psychology, Biochemistry, Pharmacology, Physiology etc).
2. Studies for medical purposes, including veterinary medicine, that relate to human or animal
disease or disorders.
3. Studies for regulatory testing of products for the protection of humans, animals or the environment.
4. Studies for the development of products or appliances for human or veterinary medicine.
5. Education and training of individuals in post-secondary institutions or facilities.
Summary of CCAC Categories of Invasiveness
Category A: Experiments on Most Invertebrates or Not Involving Intact, Living Vertebrates.
For Example: In vivo experiments or invasive procedures on protists or most invertebrates. In vitro studies
involving the use of living eggs or cells, tissues and/or organs, in culture or obtained by necropsy, from a
slaughterhouse, etc. Purely observational studies of unrestrained vertebrates.
Category B: Studies or Experiments Causing Little or No Discomfort or Distress.
For Example: Short-term skillful restraint of animals for observation, physical examination, blood sampling,
or non-toxic injections (including injectable coded wire or transponder tags) by intravenous, subcutaneous,
intramuscular, intraperitoneal or oral routes (NOT intrathoracic or intracardiac). Acute, non-survival
experiments in which animals are anesthetized for entire procedure and do not regain consciousness. Standard
methods of euthanasia that induce rapid unconsciousness, such as anesthetic overdose or decapitation preceded
by sedation or light anesthesia. Live or kill trapping of wild birds, small mammals or lower vertebrates by
CCAC and/or professional society approved methods.
Category C: Studies or Experiments Involving Minor Stress or Pain of Short Duration.
For Example: Minor surgical procedures such as cannulation or catheterization of blood vessels or body
openings, biopsy or laparoscopy done under anesthesia. Periods of food and/or water deprivation within
established tolerances of the species. Behavioral experiments on conscious animals involving short-term
stressful restraint. Attachment of externally applied CCAC or professional society approved tags or radio
telemetry devices that require penetration of the skin for anchoring (e.g. Floy Tags, and jaw or opercular tags
on fish, ear tags on small mammals). None of these may cause: significant, lasting changes in an animal's
behavior, appearance, respiratory or cardiac rate, food consumption or fecal or urinary output.
Category D: Studies or Experiments Involving Moderate to Severe Distress or Discomfort.
For Example: Major surgery under general anesthesia, with subsequent recovery of the animal, using
approved surgical procedures, post-operative care, etc. Physical restraint for periods >2hrs. Behavioral stress
such as maternal deprivation, aggression, predator-prey interactions, procedures that cause severe, persistent or
irreversible disruption of sensorimotor organization or persistent anatomical and/or physiological
abnormalities with pain or distress. Exposure to noxious stimuli while under restraint. Immunization using
Freund's Complete Adjuvant by CCAC approved routes. (Consider using an alternate, less stressful adjuvant
system.) Live capture and restraint of wild ungulates or other large, wild mammals using anesthetics or
immobilizing agents administered by dart guns.
Category E: Procedures That Involve Severe Pain At or Above the Pain Tolerance Threshold of
Unanesthetized, Conscious Animals.
For Example: Not confined to surgical procedures. Inescapable noxious stimuli, agents with unknown but
possibly severe effects, induction of burns, trauma, etc., highly invasive experiments, behavioral studies
causing severe or unknown levels of stress and the use of paralytic agents or muscle relaxants without
anesthesia all belong in this category. Category E procedures are normally not acceptable.
SECTION II: PERSONNEL
To Be Completed By All Applicants
NOTE: All personnel working with live animals must have appropriate technical training. The CCAC also
strongly recommends training in ethical issues related to animal use. If any personnel have not attended an
ethics course or workshop within the last 5 years, they are strongly advised to do so. Contact the Research
office for information on available courses.
1. Principal Investigator or Course Director (Faculty Member Only)
Name
Department
Academic Rank
Telephone
Office Location
FAX
E-Mail
BRIEFLY summarize your training and experience with the procedures you will be using.
Have you participated in a course or workshop on the ethical use of animals in research and
teaching within the last 5 years?
If YES, please give title, date and institution where it was held.
2.3 DESIGNATED EMERGENCY CONTACT PERSON(S)
Name
Office Phone
YES
NO
After Hours Phone
NOTE: THE UNIVERSITY VETERINARIAN IS OBLIGATED TO TREAT OR EUTHANIZE ANIMALS IN
DISTRESS. IF YOU CANNOT BE CONTACTED, THE DECISION OF THE VETERINARIAN IS FINAL,
AND WILL APPLY WHETHER OR NOT THE INVESTIGATOR CAN BE CONTACTED. ENSURE
THAT ARRANGEMENTS ARE IN PLACE TO PERMIT CONSULTATION ON A 24-HOUR BASIS.
2. Associates
NOTE: Names and particulars of any new personnel who join the project during the effective period of this
protocol must be forwarded to the Program Officer for Ethics BEFORE they may participate in the project. For
each associate, technician, graduate student or instructor in this project who will have contact with live animals,
please give the information requested below. Use additional sheets if required.
1. Name
Department
Office Phone
Technical Training/Experience
Academic Rank/Position
Has this person taken a course in the ethical use of animals in research and teaching within the
last 5 years?
If YES, please give the title, date and institution where it was held.
YES
NO
2. Name
Department
Technical Training/Experience
Office Phone
Academic Rank/Position
Has this person taken a course in the ethical use of animals in research and teaching within the
last 5 years?
YES
NO
YES
NO
If YES, please give the title, date and institution where it was held.
3. Name
Department
Technical Training/Experience
Office Phone
Academic Rank/Position
Has this person taken a course in the ethical use of animals in research and teaching within the
last 5 years?
If YES, please give the title, date and institution where it was held.
Please list names and phone numbers of all personnel authorized to order animals for this project.
Name
Phone
Name
Phone
SECTION III: ANIMAL INVOLVEMENT
To Be Completed By All Applicants
Please fill in the table below for each species of animal you propose to use in this project. The table will expand
as required as you fill it in.
Species
Source
Single Use (S),
Total
Maximum
How Transported From
Multiple Use (M), or
Number
Number at
Source To
Continual Use (C)?
Requested
Any Time
Housing/Project Site
SECTION IV: LAY DESCRIPTION OF THE PROJECT
To Be Completed By All Applicants
Answer each of the following in terms understandable to a non-scientist.
1. What is the rationale for doing this study? What are its Primary Objectives and what is the expected
contribution to knowledge or to the well being of animals or humans?
2. Please write a summary of your project, including a description of the procedures to be used involving live
animals and the end points of those procedures, and how the procedures relate to the objectives of this study.
3. What criteria will be used to determine an endpoint earlier than specified should unexpected morbidity or
mortality occur?
SECTION V: JUSTIFICATION
To Be Completed By All Applicants
Please answer each of the following in terms understandable to a non-scientist.
1. Why is it necessary to use animals in this study?
2. What is the rationale for using this particular species and/or animal model?
3. Could any mathematical models, computer simulations or in vitro preparations be used in lieu of animals in
this project? If not, please explain why they would be inappropriate.
4. For each species listed in Section II, approximate the number of animals needed per year by showing (for
example) the number of treatment and control groups you will use, the number of animals per group and the
number of replicates to be conducted. Also describe the experimental design.
5. What provisions will be made to provide environmental enrichment for animals used in this study?
If none will be made, please justify not using them.
6. Researchers must take into consideration the CCAC’s "Three Rs" alternatives to animal use: REDUCTION
of the number of animals required, REFINEMENT of procedures so as to minimize the stress placed on
animals, and REPLACEMENT of animals with alternatives whenever possible. Please refer to the CCAC
Microsite located at:
http://www.ccac.ca/en/alternatives/
Please explain how you have applied the principle of the Three Rs in determining animal usage in the design
of your research.
SECTION VI: FUNDING
To Be Completed By All Applicants
Please fill in the table below for each funding source. The table will expand as required.
Agency/Source
Awarded?
or Applied For?
Date of Award
(if Awarded)
Does this source conduct
peer review?
NOTES:
(1) If this project has not been reviewed for scientific/teaching merit by the funding agency, the Scientific Merit
Peer Review Form must be completed and signed by two knowledgeable scientists who do not collaborate
with the researcher on the said project, in consultation with the Chair of the appropriate Departmental
Animal Care Committee. The Departmental Animal Care Committee is responsible for this process and may
consult with the researcher in the selection of reviewers. Note: The form is available on the Research
Office website.
(2) If funding for this project is obtained from a source other than the one(s) named above, that source must be
named in an amendment to this protocol.
(3) If this project is approved on scientific/teaching merit, but not funded, attach a copy of the letter from the
reviewing agency. It will constitute evidence of merit review should funding from other sources become
available.
SECTION VII: DISPOSITION OF ANIMALS
To Be Completed By All Applicants
Please describe what will be done to the animals at the conclusion of this study. For example, will they be
euthanized? (If so, will they be disposed of or will carcasses, tissues, fluids or body parts be harvested for use in
this or other projects?) Will they be returned to stock or to a herd or returned to the wild? Consult with the
University Veterinarian about the feasibility of re-assignment of your animals to another project when
your research is completed.
SECTION VIII: PROCEDURES
To Be Completed By All Applicants
Check yes or no for all items below, and complete the required schedule for each item checked
YES.
8.1
Will surgical procedures be used? If yes, complete and attach Schedule 1: Surgery
8.2
Do you anticipate distress (for example, exercise to exhaustion) illness or pain, as a result
of any procedure you will be using? (NOTE: Pain of short duration, such as catheter
placement and surgical pain do not require this schedule.) If yes, complete and attach
Schedule 2: Distress.
8.3
Will animals be restrained, other than by holding in normal housing for any procedure?
(NOTE: Normal restraint for examination, etc. does not require this schedule.) If yes,
complete and attach Schedule 3: Restraint.
8.4
Does this project involve feed/water/nutrient deprivation? (NOTE: Presurgical fasting
does not require this schedule.) If yes, complete and attach Schedule 4: Feed / Water /
Nutrient Deprivation.
8.5
Does this project involve behavioral manipulation? If yes, complete and attach
Schedule 5: Behavioral Experiments.
8.6
Does this project involve environmental manipulation that is outside the normal range of
adaptation of the species being studied? If yes, complete and attach Schedule 6:
Environmental Manipulation.
8.7
Will these animals be used for teaching? If yes, complete and attach Schedule 7:
Teaching.
8.8
Does this project involve the use of potential hazards to animals or humans (chemicals,
infectious, in vivo, radioisotopes, carcinogens, injected neoplastic cells or other hazards?)
If yes, complete and attach Schedule 8: Potential Hazards.
8.9
Is this a field study, or does it involve the capture or release of animals into the wild? If
yes, complete and attach Schedule 9: Field Study.
8.10
Does this project involve minor procedures such as injection, non-surgical catheterization
or implantation, identification, etc.? If yes, complete and attach Schedule 10: Minor
Procedures.
8.11
Does this project involve the use of transgenic, “knockout” or mutant animals? If yes,
complete and attach Schedule 11: Transgenic / “Knockout” / Mutant Animals.
8.12
Does this project involve the use of animals on non-university property? If yes, complete
and attach Schedule 12: Outside Facilities.
8.13
Does this protocol cover animals not used for teaching or research? (For example,
breeding, quality control or demonstrations, workshops, etc. for persons or groups not part
of the University.) If Yes, complete and attach Schedule 13: Animals used for
Breeding and Quality Control.
8.14
Does this project involve euthanasia of animals? If yes, complete Schedule 14:
Euthanasia.
8.15
Does this project involve observation of animals? If yes, complete Schedule 15:
Category A.
YES
NO
SECTION IX: DECLARATION
To Be Completed By All Applicants
YOUR SIGNATURE BELOW AFFIRMS THAT:
(1) All animals used in this project will be cared for in accordance with the guidelines of the Canadian Council
on Animal Care (CCAC) and The University of Winnipeg’s University Animal Care Committee (UACC)
Policies and Procedures.
(2) The techniques, facilities and equipment to be used in this project conform to all applicable regulations and
guidelines of: (a) the Canadian Council on Animal Care; and (b) federal and local government regulations in
force in Canada and/or the country in which the project is being conducted.
(3) You have considered alternative procedures that do not involve the use of living animals.
(4) You will use the minimum number of animals consistent with the objectives of this project.
(5) You have carefully selected the most appropriate species and/or model for this project.
(6) The procedures described in this protocol must be followed unless an amendment to the protocol is submitted
and approved. Substantial changes will require re-submission to the UACC.
(7) You will notify the UACC in writing of any revisions to this protocol.
(8) You will keep copies of all approved protocols, revisions and amendments in an accessible file.
All teaching and research projects not funded by agencies providing external peer reviews must be peer reviewed.
Contact the Program Officer Ethics at 786-9058 regarding the process for obtaining scientific/teaching merit
review. Approval of a project is valid for 1 year. All protocols must be renewed annually.
Principal Investigator
Date
Chair, Departmental Animal Care Committee
Date
Chair, University Animal Care Committee (UACC)
Date
Institutional Veterinarian
Date
Community Representative
Date