J. SURGERY

Will you perform surgery? (See the HCCM website for specific requirements.) Yes ☐ No ☐

If “NO,” proceed to Section L

If “YES”, answer the following:

1.  ANESTHESIA- complete table for each proposed surgery (for non-survival procedures, “duration” is the interval between induction and death).

Procedure Name / Species / Anesthetic(s) / Dose(s) & Route / Duration (Minutes/Hours) /

2.  NON-SURVIVAL SURGERY- animals that will not recover from surgery (DO NOT include description of “euthanasia only” animals):

a.  Specify non-survival surgery (e.g. perfusion, laparotomy & organ harvest, terminal embryo harvest):
b.  Location (building & room):
c.  Describe surgical site prep:
d.  Describe non-survival surgery in detail (exclude anesthesia methods):
e.  Euthanasia method for non-survival surgery:

3.  SURVIVAL SURGERY - animals that will recover from surgery

a.  Specify MAJOR SURGERY (entering body cavity, e.g. laparotomy, craniotomy or creation of permanent physiological defect):
b.  Specify MINOR SURGERY (cut-downs, needle aspirations, etc.):
c.  Identify the location of surgery. Specify building and room:
d.  Identify the location of housing after surgery. Specify building and room:
e.  Describe surgical site prep:
f.  Describe the surgical procedure in detail (include anatomic site, incision/manipulation, and closure details, exclude anesthesia methods):
g.  Explain why it is necessary for the animals to recover from surgery:
h.  State the anticipated survival interval following surgery that is required to complete experimental objectives:
i.  Describe your plan for intra-operative AND post-operative monitoring of the animals for the first 4 post-operative days. Laboratory personnel are responsible for post-operative monitoring.
j.  Describe any impairment that may result after the surgery. List potential post-operative complications or sequelae. Describe your plans to handle them:
k.  Describe how you will treat post-operative pain, and state analgesic, dose and route:
If multiple survival procedures are described above, specify the analgesic therapy for each.
Analgesic:
Dose:
Route:
Interval between administration of drugs:
Duration of analgesic therapy (Post-operative):
**You must administer analgesia for 48 hours after major procedures and for 24 hours after minor procedures (the dosing regimen will depend on the analgesic agent). Reproductive surgery is considered a major surgical procedure. **

K. MULTIPLE SURVIVAL SURGERY

1.  Will any animals undergo more than one survival surgical procedure? Yes ☐ No ☐
See the Guide, page 30:

(NOTE: if the second surgery is a non-survival surgery, answer ‘NO’ and proceed to Section L)

2.  If “YES”, complete the following

a.  List procedures in chronological order:

Surgical procedure / Major / Minor / Interval before subsequent procedure
1. 
2. 
3. 
b.  Explain why it is scientifically necessary to have the animal(s) undergo more than one SURVIVAL surgical procedure:

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